Interventional Spasticity Management Applications

STEP Interventional Spasticity

Interventional Spasticity Management Applications

April 14-15, 2023
Rosemont, IL

This two-day course is an intensive, hands-on program that will elevate the attendee’s knowledge and skills in the evaluation and management of spasticity and other forms of muscle overactivity. Strategies to differentiate and identify patterns of presentation and different focal and regional interventions that include neurolytic agents, neurotoxins and intrathecal medications will be discussed. World class faculty will guide small groups during hands-on training sessions. Upon completion of this course, attendees should be capable of planning and executing these procedures with a higher degree of confidence and efficiency.

Directors and Faculty



Alberto Esquenazi, MD, FAAPMR and Michael F. Saulino, MD, PhD, FAAPMR


Kristin E. Caldera, DO
Reza Farid, MD
Shivani Gupta, DO
Ryan C. Hafner, MD
Kimberly Heckert, MD
Daniel Moon, MD, MS
Marilyn S. Pacheco, MD
Mary E. Russell, DO, MS
Monica Verduzco-Gutierrez, MD

Learning Objectives

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

  • Identify and apply interventional techniques for management of upper and lower extremity spasticity patterns
  • Utilize ultrasound, EMG and electrical stimulation guidance to perform focal chemodenervation techniques
  • Identify and apply interventional techniques for management of spasticity with intrathecal baclofen therapy
  • Describe various imaging techniques to troubleshoot intrathecal delivery systems

AAPM&R COVID-19 Code of Conduct for In-Person Meetings and Events

The American Academy of Physical Medicine and Rehabilitation (AAPM&R) is committed to safeguarding the health and well-being of its community, and strongly encourages staying up-to-date with COVID vaccinations and supports in-door masking.   

As a community of medical professionals, the Academy expects attendees at all Academy-hosted in-person meetings, gatherings and events to be considerate and respectful of each other’s health and well-being.  

Specifically, attendees are asked to comply with the following:

  1. If you have tested positive for COVID in the past 10 days or have any symptoms that could be caused by COVID, please stay home*
  2. If you have been exposed to COVID-10 in the past 10 days, even if you are not experiencing any symptoms, please take a PCR and/or rapid test(s) to confirm a negative result before attending the event. While at the event, please wear a mask for the period of 10 days since exposure and re-test on day six (6) after exposure. If positive on the re-test on day six (6), even if asymptomatic, please do not attend the event.

*If you have had symptoms for three (3) or more days and have two negative COVID tests at least 48 hours apart after symptom onset, you may attend but should mask while symptomatic. Please re-test on day six (6) of symptom onset. If positive on the re-test on day six (6), even if asymptomatic, please do not attend the event.

AAPM&R reserves the right to implement additional masking or testing protocols at any time based on ongoing monitoring of the environment and federal and/or local recommendations. Any such modifications will be effective immediately upon public posting and proactively communicated to attendees.




Friday, April 14

7:00am – 8:00am                   Registration / Breakfast Available

8:00am – 8:15am                   Welcome and Introduction
                                                  Alberto Esquenazi, MD and Michael F. Saulino, MD, PhD  

8:15am – 8:45am                   Incidence and Presentation Based on Diagnosis
                                                  Thomas K. Watanabe, MD 

8:45am – 9:15am                   Focal Interventional Treatment Considerations 
                                                   Kimberly Heckert, MD                                                  

9:15am – 9:45am                 Case-based Discussion: Diplegic Cerebral Palsy Leading to Lower
                                                  Extremity Neurolysis
                                                  Reza Farid, MD  

9:45am – 10:15am               Case-based Discussion: Hemiplegic Stroke Leading to Upper Extremity
                                                  Marilyn S. Pacheco, MD                                   

10:15am – 10:30am               Break

10:30am – 11:00am               Case-based Discussion: Paraplegic Spinal Cord Injury Leading to
                                                  Intrathecal Baclofen Therapy 
                                                  Andrea P. Toomer, MD  

11:00am – 11:45pm               Case-based Discussion: Quadriparetic Multiple Sclerosis Leading to
                                                  Intrathecal Baclofen Disruption
                                                  Michael F. Saulino, MD, PhD    

11:45am – 12:00pm                 Review of Morning
                                                  Alberto Esquenazi, MD

12:00pm – 1:00pm                 Lunch

1:00pm – 2:00pm                   Hands-On Skills Training: Session 1

2:00pm – 3:00pm                   Hands-On Skills Training: Session 2 

3:00pm – 3:15pm                   Break

3:15pm – 4:15pm                   Hands-On Skills Training: Session 3

4:15pm – 5:15pm                   Hands-On Skills Training: Session 4

Saturday, April 15

7:15am – 8:00am                   Breakfast Available

8:00am – 9:00am                   Hands-On Skills Training: Session 5

9:00am – 10:00am                 Hands-On Skills Training: Session 6

10:00am – 10:15am               Break

10:15am – 11:15am               Hands-On Skills Training: Session 7

11:15am – 12:15pm               Hands-On Skills Training: Session 8

12:15pm – 1:00pm                 Lunch

1:00pm – 3:00pm                   Focused Skills Training Sessions

3:00pm – 3:15pm                   Break

3:15pm – 5:15pm                   Focused Skills Training Sessions

5:15pm                                  Adjourn

Hands-on Skills Training Sessions

Friday afternoon and Saturday morning will focus on:

  • Pump refill with visual / palpation techniques as well as drug preparation
  • Pump basic and advanced programming
  • Catheter port access with visual / palpation techniques
  • Lumbar puncture on a simulation model 
  • Ultrasound guidance for reservoir and catheter access port
  • Radiographic review of pump troubleshooting techniques
  • Upper and lower limb muscle identification focusing on commonly encountered patterns with simulated injections on simulation models
  • Ultrasound guidance for upper and lower limb muscle and nerve localization
  • Upper and lower limb nerve localization with electrical stimulation

Focused Skills Training

Saturday afternoon will feature a focused training sessions covering unusual chemodenervation and neurolytic techniques when severe deformities are present (toxin dilution and volume adjustment to optimize effect, motor point vs nerve block, individual finger flexor fascicles, and importance of toe flexors on gait improvement) and cervical dystonia treatment with ultrasound guided muscle identification and simulated injections.

Agenda Breakdown

  • Up to 15.25 AMA PRA Category 1 Credits™ — MOC approved! 
  • 6 dynamic lectures and case-based discussions
  • 11 hours of hands-on, diagnostic and interventional procedures


The American Academy of Physical Medicine and 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 and Rehabilitation (AAPM&R) designates this live activity for a maximum of 15.25 AMA PRA Category 1 Credits™.  Physicians should only claim credit commensurate with the extent of their participation in the activity. 

This course has been approved by the American Board of Physical Medicine and Rehabilitation (ABPMR) for a maximum of 15.50 Maintenance of Certification® (MOC®) Part II Self-Assessment credits. Attendees must actively participate and complete a self-evaluation at the conclusion of the course to earn MOC Part II credit.

Hotel Information

Hilton Rosemont/Chicago O'Hare
5550 N River Rd, Rosemont, IL 60018

Book before Monday, March 27, 2023, to receive a discounted rate of $172 per night (plus tax). You can book by clicking the "Reserve a Room" link below. To book by phone please call 888-452-6943 and reference “the AAPM&R April Spasticity Course, group code AAP

Reserve a Room

Air Travel

As an option, air travel reservations may be made by calling TruTravel Solutions, the official travel partner for AAPM&R.

Jennifer Schaller
Direct line: 312-224-7048

Saira Flores
Direct line: 312-224-8365

TruTravel Solutions hours are Monday – Friday. 8:30 am-5 pm (Central Time). TruTravel Solutions charges a $25 per ticket transaction fee.

Course Check-In

Course check-in will be April 14 from 7-8 am where course badges will be provided. 


Breakfast items and lunch will be served on both days of the course.


Attendees are encouraged to dress comfortably. Scrubs are not required.

Cancellation and Change Policy

All cancellations for the Interventional Spasticity Management Applications must be submitted in writing via email to or via mail postmarked by March 3, 2023 to: 

American Academy of Physical Medicine and Rehabilitation
Attention: Education Department
9700 W. Bryn Mawr Avenue, Suite 200
Rosemont, IL 60018

We look forward to your participation! Please contact with any questions.


This course is Step 2 of the STEP Interventional Spasticity Certificate Program. To attend the course you must register for the full STEP program. A la carte registration for this course is not available. Click here to view program details and to register for the STEP program.