Take the Next STEP in Your Spasticity Education
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

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

Participants move through a series of 3 STEPs. Those who complete all the required STEPs earn a Certificate of Completion.

CME and MOC 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™

Prerequisites
Recommended prerequisites for successful completion of the program are:

• At least 3 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.

Accreditation
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
STEP 1 - Online Program 
The American Academy of Physical Medicine and Rehabilitation (AAPM&R) designates this enduring material for a maximum of 16 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

STEP 2 - Live Course 
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 claim only the credit commensurate with the extent of their participation in the activity.

The live course has also been approved by the American Board of Physical Medicine and Rehabilitation (ABPMR) for a maximum of 15.25 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.

STEP 3 - Assessment and Certificate
Completion of the entire program, which includes passing the assessment and submitting your case log, will count towards your American Board of Physcial Medicine and Rehabilitation MOC Part IV requirements.  

Financial Disclosures
AAPM&R requires all individuals who are in a position to affect the strategic direction of AAPM&R and/or the content of an educational activity to disclose any financial relationships with an ineligible company within the last 24 months. The ACCME defines an Ineligible Company as “those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients”. The ACCME does not consider providers of clinical service directly to patients to be an ineligible company. Disclosures are made in written form prior to the start of the educational activity and any potential conflicts of interest that exist are resolved prior to the start of the activity through AAPM&R’s Conflict of Interest Disclosure and Resolution Policy Process. Individuals in a position to control content and their disclosed financial relationships are listed below.

STEP Spasticity Workgroup 
Roy L. Adair, MD: Disclosed no relevant financial relationships 
Abraham Alfaro, PhD, DO: Disclosed no relevant financial relationships 
Katharine E. Alter, MD: Disclosed no relevant financial relationships 
Keith D Baldwin, MD, MSPT, MPH: Pfizer: Stock Options
Gerald S. Bilsky, MD: Medtronic and Saol Pharmaceuticals: Speakers' Bureau
Kristin E. Caldera, DO: Medtronic: Speakers' Bureau
Jeimylo C. de Castro, MD: Disclosed no relevant financial relationships 
Jennifer E. Doble, MD: Disclosed no relevant financial relationships 
Franklin SP Domingo, MD: Disclosed no relevant financial relationships 
Steve V. Escaldi, DO: Saol Pharmaceuticals: Consultant 
Alberto Esquenazi, MD: Disclosed no relevant financial relationships 
Reza Farid, MD: Disclosed no relevant financial relationships 
Nicholas A. Godby, MD: Disclosed no relevant financial relationships 
Fatma Gul, MD: Disclosed no relevant financial relationships 
Shivani Gupta, DO: Disclosed no relevant financial relationships 
Ryan C. Hafner, MD: Disclosed no relevant financial relationships 
Patricia J. Hantsch, MD: Disclosed no relevant financial relationships 
Kimberly Heckert, MD: Merz Therapeutics, Piramal, and Saol Pharmaceuticals: Spasticity fellowship program received educational grants
Didem Inanoglu, MD: Ipsen: Trainer/Faculty and Consultant; Allergan: Consultant, Advisory Board
Cindy B. Ivanhoe, MD: Disclosed no relevant financial relationships 
Mary Ann Keenan, MD: Disclosed no relevant financial relationships 
Nicholas C. Ketchum, MD: Medtronic: Speakers' Bureau and Consulting; Saol Pharmaceuticals: Consulting
Heakyung Kim, MD: Disclosed no relevant financial relationships 
Linda E. Krach, MD: Disclosed no relevant financial relationships 
Christina Kwasnica, MD: Ipsen Pharmaceuticals Speakers’ Bureau
John Lin, MD: Disclosed no relevant financial relationships 
Sheng Li, MD PhD: Disclosed no relevant financial relationships 
Amy A. Mathews, MD: Disclosed no relevant financial relationships 
John R. McGuire, MD: Disclosed no relevant financial relationships 
Daniel K. Moon, MD: Disclosed no relevant financial relationships 
Marisa Moreta, DO: Disclosed no relevant financial relationships 
Michael C. Munin, MD: Disclosed no relevant financial relationships 
Patricia Nance, MD: Disclosed no relevant financial relationships 
Marilyn S. Pacheco, MD: Disclosed no relevant financial relationships 
Atul T. Patel, MD, MHSA: Allergan and Ipsen Research: Grants and Speakers' Bureau
Natasha L. Romanoski, DO: Disclosed no relevant financial relationships 
Michael F. Saulino, MD PhD: Disclosed no relevant financial relationships 
Mary E. Russel, DO, MS: Merz Therapeutics and Allergan Speakers' Bureau
Erik T. Shaw, DO: TerSera Therapeutics, Boston Scientific, and SPR Therapeutics: Consultant; BDSI: Speakers' Bureau
Andrea P. Toomer, MD: Flowonix and Ipsen Biopharmaceuticals: Research/Speakers Bureau; Medtronic and Piramal: Speakers Bureau
Jose A. Urquidez, MD: Disclosed no relevant financial relationships 
Monica Verduzco-Gutierrez, MD: AbbVie and Merz Therapeutics: Consultant/Speakers' Bureau; Ipsen Biopharmaceuticals: Consultant/Research Grant/Speakers' Bureau
Heather W. Walker, MD: Disclosed no relevant financial relationships 
Thomas K. Watanabe, MD  : Disclosed no relevant financial relationships 

Medical Education Committee
John C. Cianca, MD: Musculoskeletal Ultrasound Consultants, LLC: Ownership
Karen P. Barr, MD: Disclosed no relevant financial relationships 
Rachel A. Brakke Holman, MD: Disclosed no relevant financial relationships 
Joseph E. Burris, MD: Allergan: Speakers Bureau and Research Grant 
David S. Cheng, MD: Disclosed no relevant financial relationships 
Theresa A. Gillis, MD: Disclosed no relevant financial relationships 
Kevin N. Hakimi, MD: Disclosed no relevant financial relationships 
Matthew T. Haas, MD: Disclosed no relevant financial relationships 
Sam Mayer, MD: Demos Medical Publishing: Royalties
Ameet S. Nagpal, MD MS MEd: Disclosed no relevant financial relationships 
Sunil Sabharwal, MD: Demos Publishing: Royalities; American Board of Physical Medicine and Rehabilitation: Board Member
Sarah M. Smith, MD: Disclosed no relevant financial relationships 
Stephanie Tow, MD: Disclosed no relevant financial relationships 
Kevin R. Vincent, MD: Disclosed no relevant financial relationships 

Continuing Medical Edcuation Committee  
Karen P. Barr, MD: Disclosed no relevant financial relationships 
Cherry C. Junn, MD: Disclosed no relevant financial relationships 
Sheryl R. Levin, MD: Disclosed no relevant financial relationships 
Kentaro Onishi, DO: Disclosed no relevant financial relationships 
Evan R. Peck, MD: Disclosed no relevant financial relationships 
Cynthia G. Pineda, MD: Disclosed no relevant financial relationships 
Patricia T. Tan, MD: Disclosed no relevant financial relationships 
Brionn K. Tonkin, MD: Disclosed no relevant financial relationships 
Kristin A. Wong, MD: Disclosed no relevant financial relationships 

No other planners, faculty or individuals in control of content disclosed any financial relationships. Through the planning process, all relevant financial relationships have been mitigated. 

Support 
Partial support for AAPM&R’s Interventional Spasticity Management Applications has been provided through educational grants from AbbVie, Ipsen Biopharmaceuticals and Merz Therapeutics in accordance with ACCME Guidelines for Integrity and Independence.