STEP Spasticity


How the Best Minds Get Even Better


STEP Interventional Spasticity Certificate Program

Enroll now and attend the April 14-15, 2023 Interventional Spasticity Management Applications course in Rosemont, IL. Space is limited! Read program details and click 'Register Now' under Registration to enroll.

Propel Yourself and Your Practice to the Forefront of Spasticity Expertise

AAPM&R is arming members with training to help them prepare and lead in competitive landscapes. Following the success of the highly-acclaimed STEP Ultrasound Certificate Program, we are excited to announce the launch of the STEP Interventional Spasticity Certificate Program.

STEP stands for Skills, Training, Evaluation and Performance. The STEP Interventional Spasticity Certificate Program teaches and assesses interventional spasticity skills using a standardized, progressive, and competency-based curriculum with both online and live components.

When you earn the STEP Interventional Spasticity Program Certificate, you:

  • Gain confidence by representing the highest standard in the field
  • Enhance your career opportunities
  • Earn visibility and credibility in spasticity management
  • Communicate to patients and employers that you are committed to excellence
  • Earn AMA PRA Category 1 Credits™ and meet American Board of Physical Medicine and Rehabilitation (ABPMR) Maintenance of Certification® (MOC®) Part II and Part IV requirements

Participants move through a series of three STEPs. Those who complete all the required STEPs earn a Certificate of Completion.

Learning Objectives

After completion of the STEP Interventional Spasticity Program, participants should be able to:

  • Have in-depth understanding of spasticity and its impact on patients
  • Assess the advantages and disadvantages of all treatment options (i.e., pumps, oral medications, surgeries)
  • Synthesize an optimal dynamic treatment plan for spasticity interventions
  • Discuss the pharmacology of injectable agents
  • Prepare and administer injectable toxins and nerve blocks
  • Recognize and assess functional anatomy related to spasticity (i.e., motion analysis)
  • Utilize multiple localization methods (EMG, US, hands/eyes, muscles, landmarks) for chemodenervation and nerve blocks
  • Recognize appropriate candidates for targeted drug delivery
  • Perform basic pump programming (increase/decrease, bridge bolus) on the most commonly used delivery systems
  • Recognize the utility of complex pump programming
  • Handle ITB emergencies
  • Identify the resources necessary to establish, manage, and grow a spasticity practice




Spasticity management has been identified as an area of clinical interest for most physiatrists. Upon completion of this course, the participant should be able to insert interventional spasticity techniques into their clinical practice. The expertise of the faculty is elite. The opportunity for close contact with these talented clinicians has never been duplicated.” - Michael F. Saulino, MD, PhD, FAAPMR, Program Director




Physiatrists are truly the leaders in neuro-musculoskeletal care. We need to ensure our skill set in interventional spasticity is improving health and bettering patients. During this program, you will learn so much from the top experts in the field. You will leave feeling confident and comfortable with treating your spasticity patients the best way possible. “- Monica Verduzco-Gutierrez, MD, FAAPMR, Program Director

Who Should Participate

Physiatrists who received limited exposure to this clinical area during residency and general physiatrists looking to add interventional muscle over-activity management to their practice, both in private practice and academic medical centers.


STEP 1: Online Program


Assess your current interventional spasticity knowledge with a baseline pre-exam and fill in your gaps and knowledge with a robust online curriculum which includes 30+ slide lectures, demonstration videos and assessments.

  1. Baseline Pre-Exam with 25 Questions
  2. Online Curriculum = 16 CME credits


STEP 2: Live Course 


Reassess your interventional spasticity knowledge with an interval test and receive hands-on training from experts in the field at the live course.

  1. Live Step 2 Course - Interventional Spasticity Management Applications - April 14-15, 2023
    • (15.25 MOC® Part II Self-assessment Credits)
  2. Online Post-Exam with 25 Questions
  3. Case Log


STEP 3: Assessments and Certificate 


Complete and pass the final online and in-person skills assessment to receive your Certificate of Completion.

  1. Online Final Post-Exam with 50 Questions
    • 80% minimum passing score required
  2. In-Person Skills Assessment at the 2023 Annual Assembly (New Orleans, LA)
    • Passing score will be required


Pathway to the STEP Interventional Spasticity Certificate

It is expected that it can take at least a year for a participant to complete this program depending on availability of registration spots for the program's live events and participant's completion of each program component. Because this is a structured program, all steps must be completed in the order listed above (Step 1 > Step 2 > Step 3) and the entry point must start with Step 1.

CME Credit

This STEP program offers 31.25 AMA PRA Category 1 Credits™:

  • Online Curriculum offers 16 AMA PRA Category 1 Credits
  • Live Course offers 15.25 AMA PRA Category 1 Credits


Recommended prerequisites for successful completion of the program are:

  • At least three years of PM&R residency. 4th year PM&R residents may participate but should have their ACGME-required 20 toxin injections and 10 US scanning completed.
  • Some familiarity with ultrasound and EMG principles.
  • A sound working knowledge of MSK anatomy and kinesiology.

Invest in Your Future

Full STEP Interventional Spasticity Certificate Program:

AAPM&R Member: $2,500
Nonmember: $3,500


Click the button below to register for the STEP Interventional Spasticity Certificate Program. 

PLEASE NOTE BEFORE REGISTERING - By enrolling in the program now, you are also committing and registering to attend the April 14-15 STEP 2 live course in Rosemont, IL.  

Register today!

Cancellation Policy

STEP Interventional Spasticity Certificate Program cancellations must be submitted in writing via email to

Cancelling before starting the Step 1 Online Curriculum
Cancellations received before starting the Step 1 Online Curriculum will be refunded STEP Interventional Spasticity Certificate Program fees paid, minus a $200 processing fee.

Cancelling after starting the Step 1 Online Curriculum and before attending the Step 2 Live Course
Cancellations received after starting the Step 1 Online Curriculum and 60 days before the Step 2 Live Course date the participant is scheduled to attend will be refunded STEP Interventional Spasticity Certificate Program fees paid, minus a $595 fee to retain access to the Step 1 Online Curriculum.

Cancellations received less than 60 days before the scheduled Step 2 Live Course dates will receive a refund of STEP Interventional Spasticity Certificate Program fees paid, minus the Step 2 Live Course registration fee and a $595 fee to retain access to the Step 1 Online Curriculum.

Cancelling after attending the Step 2 Live Course
Cancellations after attending the Step 2 Live Course will not receive a refund.

All refund requests will be processed 7-14 days after refund approval is received.

Thank You, Volunteers!

We would like to thank the following STEP Interventional Spasticity Workgroup members for dedicating their time, knowledge, and skills to the development of this program.

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

The Academy is also grateful to our volunteers who contributed to the development of the online program development and test-item writing!

  • Roy L. Adair, MD
  • Abraham Alfaro, PhD, DO
  • Katharine E. Alter, MD
  • Keith D Baldwin, MD, MSPT, MPH
  • Gerald S. Bilsky, MD
  • Kristin E. Caldera, DO
  • Jeimylo C. de Castro, MD
  • Jennifer E. Doble, MD
  • Franklin SP Domingo, MD
  • Steve V. Escaldi, DO
  • Nicholas A. Godby, MD
  • Fatma Gul, MD
  • Shivani Gupta, DO
  • Patricia J. Hantsch, MD
  • Kimberly Heckert, MD
  • Didem Inanoglu, MD
  • Cindy B. Ivanhoe, MD
  • Mary Ann Keenan, MD
  • Nicholas C. Ketchum, MD
  • Heakyung Kim, MD
  • Linda E. Krach, MD
  • Christina Kwasnica, MD
  • John Lin, MD
  • Sheng Li, MD PhD
  • John R. McGuire, MD
  • Daniel K. Moon, MD
  • Marisa Moreta, DO
  • Patricia Nance, MD
  • Atul T. Patel, MD, MHSA
  • Natasha L. Romanoski, DO
  • Mary E. Russel, DO, MS
  • Erik T. Shaw, DO
  • Jose A. Urquidez, MD
  • Heather W. Walker, MD

Partial support of this education has been provided through educational grants from AbbVie, Ipsen Biopharmaceuticals and Merz Neurosciences in accordance with ACCME Guidelines for Integrity and Independence.

Partial support of this education has been provided through in-kind support from AbbVie, Amneal Pharmaceuticals, Ipsen Biopharmaceuticals, Medtronic, Merz Neurosciences, Pajunk, Piramal, and Terason in accordance with ACCME Guidelines for Integrity and Independence.