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Advancing Clinical Skills in Spasticity Management


Annual Assembly

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In this valuable virtual session, attendees learned how to enhance their clinical skills in managing patients with spasticity and related conditions. Attendees learned via updated journal club round-tables, were presented with case-based scenarios, heard interactive lectures on treatment plans and observe hands-on skills that are relevant to that case scenario. At the end of this session, attendees walk away with new/refreshed and updated evidence-based skills in focal chemodenervation (botulinum toxin, nerve, and motor point blocks) and intrathecal baclofen delivery.


Course Directors and Faculty


  • Michael F. Saulino, MD, PhD, FAAPMR
  • Monica Verduzco-Gutierrez, MD, FAAPMR


  • Ashlee Bolger, MD, FAAPMR
  • Alberto Esquenazi, MD, FAAPMR
  • Reza Farid, MD, FAAPMR
  • Michael C. Munin, MD, FAAPMR
  • Marilyn S. Pacheco, MD, FAAPMR
  • Andrea P. Toomer, MD, FAAPMR
  • Thomas K. Watanabe, MD, FAAPMR

Learning Objectives

At the completion of this session, participants will be able to:

  • Formulate a plan to address deficits related to the upper motor neuron syndrome for a given case scenarios
  • Analyze gait abnormalities related to patients with spasticity
  • Engage virtually in ultrasound, EMG and electrical stimulation guidance to perform focal chemodenervation techniques
  • Understand complexities and troubleshooting of targeted-drug delivery systems.

Who Should Attend?

Physicians who want to learn how to enhance and assess their clinical skills in managing patients with spasticity and related conditions. It is recommended attendees having some experience with:

  • Evaluating and managing patients with upper motor neuron syndrome
  • Reasonable foundation in functional neuroanatomy of the upper and lower limbs



6 pm – 6:10 pm                    Welcome and Faculty Introductions
                                                    Michael F. Saulino, MD PhD and
                                                    Monica Verduzco-Gutierrez, MD

6:10 pm – 6:30 pm               Spasticity Journal Club – Recent Literature Updates 
                                                    Michael C. Munin, MD and
                                                    Monica Verduzco-Gutierrez, MD

6:30 pm – 6:50 pm                Peripheral Neurolysis and Chemodenervation
                                                    Michael C. Munin, MD and Thomas K. Watanabe, MD 

6:50 pm – 7:10 pm                Intrathecal Baclofen (ITB) Targeted Drug Delivery 
                                                    Michael F. Saulino, MD PhD and Andrea P. Toomer, MD 

7:10 pm – 7:20 pm                Break

7:20 pm – 7:40 pm                Case-Based Discussion: ITB Pump Pediatric Candidate with
                                                     Hydrocephalus Treated with Toxin and Phenol Injections
                                                     Ashlee Bolger, MD and Reza Farid, MD                                   

7:40 pm – 8 pm                    Case-Based Discussion: Baclofen Therapy Troubleshooting –
                                                     How to Handle a Negative Side Port Aspiration 
                                                     Marilyn S. Pacheco, MD and Michael F. Saulino, MD PhD

8 pm – 8:10 pm                     Break
8:10 pm – 8:30 pm                Case-Based Discussion: Targeted Drug Delivery –
                                                      Approaches After an Unsuccessful Initial Trial 
                                                      Michael C. Munin, MD and Andrea P. Toomer, MD

8:30 pm – 8:50 pm                Case-based Discussion: Gait Dysfunction After Upper Motor Neuron Injury:
                                                      Highlighting the Potential Complexity of the Problem
                                                      Alberto Esquenazi, MD and Thomas K. Watanabe, MD

8:50 pm – 9 pm                     Debriefing with Q&A


The American Academy of Physical Medicine & Rehabilitation is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation of Credit

The American Academy of Physical Medicine & Rehabilitation (AAPM&R) designates this live activity for a maximum of 2.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. 


Thank You to Our Virtual Exhibitors!

AAPM&R Thanks the Exhibitors at the Advancing Clinical Skills in Spasticity Management pre-assembly session!


Partial support for the Advancing Clinical Skills in Spasticity Management pre-Assembly session has been provided through educational grants from Allergan, an Abbvie company, Ipsen Biopharmaceuticals, Merz North America, and Saol Therapeutics in compliance with ACCME Guidelines.