NISE-Stim® Level 1
Non-Invasive Spinal Electrical Stimulation Certification Course (2 Days – 16 Hours)

Discover how NISE-Stim® is reshaping therapy for children with neurological and motor impairments. This foundational course introduces a non-invasive spinal stimulation approach that enhances motor control, posture, sensation, and autonomic function through improved neuromuscular communication.

Who is eligible to take NISE-Stim® courses?: Physical therapists, occupational therapists, and rehabilitation professionals eager to integrate spinal stimulation safely and effectively into their practice.

💡 You’ll Learn
• Non-Invasive Spinal Electrical Stimulation techniques
• Muscle–nerve testing and individualized protocol design
• Functional Electrical Stimulation (FES) for trunk and extremity control
• Hands-on labs with clinical case videos
• Optional: Introduction to Turtle Bracing for customizable pediatric orthotics

💰 Level 1 Course Fee
In-person courses (fee per person, per course) 
$660 Early Bird (register at least one month before the course)
$690 Regular (register within one month of the course)

Live online course
$370 per person

Recorded course
$370 per person

Course Description

This specialized course is designed for physical therapists and clinicians seeking the most advanced applications of Non-Invasive Spinal Electrical Stimulation (NISE-Stim) to enhance clinical outcomes in children with:

  • Cerebral palsy (CP)
  • Hypotonia
  • Spina bifida
  • Spinal muscular atrophy (SMA)
  • Spinal cord injuries
  • Brachial plexus paralysis
  • Other neuromotor impairments


Course Highlights

  • Muscle Activation & Neuromodulation – Learn how NISE-Stim can be used to activate muscles and, with different parameters, dampen spasticity and dystonia.
  • Functional Electrical Stimulation (FES) – Discover effective treatment strategies for improving trunk, upper, and lower extremity control.
  • Muscle & Nerve Testing – Gain expertise in assessing muscle-nerve function and optimizing stimulation parameters.
  • Hands-On Training & Clinical Videos – Participate in practical sessions and review real case studies to enhance your skills.

This course will provide step-by-step guidance on selecting optimal stimulation settings, refining treatment plans, and advancing therapy techniques for better patient outcomes.

Course Objectives

  1. Define the required stimulation parameters, protocols, and procedures used in pediatrics for electrical stimulation. (Knowledge)
  2. Analyze the advantages, limitations, contraindications, and indications for electrical stimulation in managing pediatric patients. (Analysis)
  3. Explain the mechanisms by which functional electrical stimulation (FES) and NISE-Stim impact the peripheral neuromuscular, vascular, skeletal, and central nervous systems. (Comprehension)
  4. Demonstrate nerve conduction testing procedures and the application of lower spinal stimulation protocols effectively. (Application)
  5. Develop functional electrical stimulation protocols for gait training and illustrate electrode placement for upper spinal stimulation in plexus paralysis. (Synthesis)
  6. Evaluate patient suitability for NISE-Stim for neuromotor impairments such as spina bifida and implement treatment effectively. (Evaluation)
  7. Train caregivers on how to properly use electrical stimulation at home to optimize outcomes. (Application)
  8. Explain the advantages, limitations, contra-indications, and indications for the use of Turtle Bracing for pediatric patients.
  9. Fabricate a Turtle Brace and assess the Turtle Brace for good alignment and fit.

In-Person Class Schedule (subject to change)

Day 1 (9 hours)

7:30 AM: Registration

8:00–9:00 AM: Electrical stimulation technology (electrical parameters, electrodes). What we must know about the stimulation systems

9:00–10:30 AM: Hands–on laboratory I: Sensory vs. muscle activation, twitch vs. tetanic contraction, symmetrical vs asymmetrical current

10:30–11:00 AM: Research

11:00–11:15 AM: Break

11:15 AM–12:00 PM: Electrical excitability testing for peripheral nerve damage, upper and lower extremity, and trunk

12:00–1:00 PM: Introducing surface non-invasive spinal cord stimulation

1:00–1:30 PM: Lunch

1:30–2:30 PM: Demo patient: nerve conduction testing and spinal stimulation treatment

2:30–3:00 PM: Discussion of the evaluation findings and treatment approach

3:00–3:30 PM: Spinal Stimulation for club foot, nerve pain, CP, scoliosis, plexus paralysis, bowel, and bladder

3:30–3:45 PM: Break

3:45–6:00 PM: Hands–on laboratory II: Various placements and settings for NISE-Stim for lower extremity

Day 2 Schedule (7 hours)

7:30–8:00 AM: Review of key points

8:00–9:00 AM: Hands-on Laboratory III: NISE-Stim for upper extremity and trunk for various impairments, spinal stimulation on the sensory level  Hands-On Laboratory: NISE-Stim for various impairments

9:00–10:00 AM: Functional Electrical Stimulation

10:00–10:15 AM: Break

10:15–11:15 AM: Hands-On Laboratory: FES for sit-to-stand transitions, bilateral reaching, gait, transitions, crawling, and unilateral reaching

11:15 AM–12:15 PM: Demonstration patient: assessment and treatment. Discussion of findings and treatment approach

12:15–12:45 PM: Lunch

12:45–1:45 PM: Five demonstration patients for class treatment

1:45–2:00 PM: Break

2:00–2:30 PM: Feedback on treatment

2:30–3:30 PM: Review key points and Q&A

Research:
Motavalli, Gerti, Jan J. McElroy, and Gad Alon. “An exploratory electrical stimulation protocol in the management of an infant with spina bifida: a case report.” Child Neurology Open 6 (2019): 2329048X19835656.

Goutam Singh, PT, PhD; Anastasia Keller, PhD; et al.
Safety and Feasibility of Cervical and Thoracic Transcutaneous Spinal Cord Stimulation to Improve Hand Motor Function in Children With Chronic Spinal Cord Injury. Neuromodulation 4/2023, https://doi.org/10.1016/j.neurom.2023.04.475

Kristin Girshin 1,2, Rahul Sachdeva, et al. Spinal Cord Neuromodulation to treat Cerebral Palsy in Pediatrics: POUNCE Multiside Randomized Clinical Trial 6/2023 Frontiers in Neuroscience, 10.3389/fnins.2023.1221809

James J. Laskin, Zeina Waheed,et al. Spinal Cord Stimulation Research in the Restoration of Motor, Sensory, and Autonomic Function for Individuals Living With Spinal Cord Injuries: A Scoping Review, Archives of Physical Medicine and Rehabilitation 2022;103: 1387-97, http://www.archives-pmr.org/

Parag N. Gad, Evgeniy Kreydin, Non-invasive Neuromodulation of Spinal Cord Restores Lower Urinary Tract Function After Paralysis, Frontiers in Neuroscience, doi: 10.3389/fnins.2018.00432

Samejima, S. Caskey, C. D. Inanici, F. Multisite Transcutaneous Spinal Stimulation for Walking and        Autonomic Recovery in Motor-Incomplete Tetraplegia: A Single-Subject Design. Phys Ther 2022;102: DOI10.1093/ptj/pzab228.

Anastasia Keller1,2, Goutam Singh 1,2, et al. Noninvasive spinal stimulation safely enables upright posture in children with spinal cord injury NATURE COMMUNICATIONS https://doi.org/10.1038/s41467-021-26026-z

Solopova IA, Sukhotina IA, Zhvansky DS, et al. Effects of spinal cord stimulation on motor functions in children with cerebral palsy. Neurosci Lett. 2017;639:192-198.

Krucoff MO, Rahimpour S, Slutzky MW, Edgerton VR, Turner DA. Enhancing Nervous System Recovery through Neurobiologics, Neural Interface Training, and Neurorehabilitation. Front Neurosci. 2016;10:584.

Gerasimenko Y, Gad P, Sayenko D, et al. Integration of sensory, spinal, and volitional descending inputs in regulation of human locomotion. J Neurophysiol. 2016;116(1):98-105.

Lee NG, Andrews E, Rosoklija I, et al. The effect of spinal cord level on sexual function in the spina bifida population. J Pediatr Urol. 2015;11(3):142 e141-146.

Sayenko DG, Atkinson DA, Floyd TC, et al. Effects of paired transcutaneous electrical stimulation delivered at single and dual sites over lumbosacral spinal cord. Neurosci Lett.2015;609:229-234.

Shideler, B.L., et al., Toward a hybrid exoskeleton for crouch gait in children with cerebral palsy: neuromuscular electrical stimulation for improved knee extension. J Neuroeng Rehabil, 2020.