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Professional Resources & Education

Spasticity Assessment - It’s More Than Just an MAS Score!

Gerard Francisco, MD
Cori Ponter, PT, MPT, NCS

Course Date: Saturday, August 12, 2017

Time: Registration – 7:30 am, Class 8:00 am – 5:00 pm


TIRR Memorial Hermann Hospital
1333 Moursund, Houston, TX 77030
Research Building 2nd floor Conference Room

Target Audience

TIRR MHHS Occupational Therapy Professionals & Physical Therapy Professionals.


The course will focus on the different types of muscle over activity that are often grouped together as “spasticity,” and will teach various scales available to perform a detailed, meaningful assessment of the patient with spasticity.

Electronic Handouts will be available the week prior to the course.

Learning Objectives/Outcomes:

  1. Identify and differentiate types of muscle over activity and their clinical presentations
  2. Discuss the pathophysiology and origins of spastic muscle over activity
  3. Identify and differentiate various assessment tools used in assessing spasticity
  4. Perform an impairment-based assessment of a patient with spasticity, correctly utilizing the Modified Ashworth Scale, the Modified Tardieu scale, and active range of motion measurements
  5. Identify and discuss at least three different activity-based or participation-based outcome measures to utilize in the functional assessment of subjects with various levels of spasticity
  6. Discuss the findings of the patient evaluation and determine the possible functional implications of that assessment

Speaker Information

Dr Francisco WeRob

Gerard Francisco, MD

Chief Medical Officer, TIRR Memorial Hermann
Chair, Department of Physical Medicine and Rehabilitation, The University of Texas Medical School at Houston

Dr. Francisco is one of the nation's leading physicians in the field of brain injury and stroke rehabilitation and spasticity management. A frequent lecturer nationally and internationally, he is currently conducting research on the use of botulinum toxin and intrathecal baclofen for the treatment of spasticity, along with the use of robots to facilitate recovery after a stroke or spinal cord injury. Dr. Francisco is a Principal investigator in an R01 grant from the National Institutes of Health.

Dr. Francisco is chairman and clinical professor in the Department of Physical Medicine and Rehabilitation (PM&R) at The University of Texas Medical School at Houston and adjunct professor at Baylor College of Medicine. He received his medical degree from the University of the Philippines and completed his internship at Michael Reese Hospital in Chicago. His residency in PM&R was at the University of Medicine and Dentistry-New Jersey Medical School, where he was chief resident. Dr. Francisco completed a postdoctoral fellowship in Brain Injury Rehabilitation at Baylor College of Medicine. Before joining the Brain Injury Program at TIRR Memorial Hermann in 1997, he served as director of the Brain Injury Program at Kessler Institute for Rehabilitation and assistant professor in the department of Physical Medicine and Rehabilitation at New Jersey Medical School.

Dr. Francisco was named Distinguished Educator Professor by University of Texas Medical School at Houston "Academy of Master Educators" in 2012 and inducted as a member of the University of Texas Academy of Health Science Education (2013). Dr. Francisco was elected to "Best Doctors in America" for 2007-2008 by his peers. From 2001-2012, he has been listed in "Best Doctors in America" by U.S. World & News Report. In 2013, he was nominated by his peers to Houstonia Magazine's list of Top Doctors.

Conflicts of Interest/Disclosures:

  • Financial: Research grants from: Parker Hannifin, Rexbioics, Rewalk (pending), Ekso (pending)
  • Non-financial: TIRR Memorial Hermann CMO
Cori Ponter

Cori Ponter, PT, MPT, NCS, CBIS

Corina Ponter, PT, MPT, NCS, CBIS is a 2002 graduate of Emory University in Atlanta, Georgia. She worked at The Institute for Rehabilitation and Research (TIRR) in the Houston Medical Center on the Brain Injury and Stroke Team from 2004 until 2014, where she held many leadership roles, one being physical therapy clinical coordinator for the BI Team. Currently, Cori is the Therapy Services Manager for TIRR Memorial Hermann Greater Heights. In 2008, she received her Neuro-Integrative Functional Rehabilitation and Habilitation (Neuro-IFRAH) certification for treatment of adults with hemiplegia from a stroke or brain injury, and received her Neurological Certified Specialization (NCS) in 2011. She has participated in outpatient spasticity clinic, spasticity-related research studies, does ongoing program development, teaches continuing education for spasticity assessment and treatment, and mentors therapy staff members.

Conflicts of Interest/Disclosures:

  • Financial: Received payment from NeuroRecovery Training Institute in Louisville, KY for teaching a class for their residency/dPT class, and for teaching 4-hour spasticity lecture for their residency and DPT class.
  • Non-financial: Ipsen study assessor; MERZ study assessor

Saturday, August 12, 2017

TimeTopic & Activity


8:00 – 8:15 Introduction: Corina Ponter, PT
8:15 – 10:15

Scales utilized in the assessment of spasticity and appropriate documentation – Corina Ponter, PT

10:15 - 10:30Break
10:30 – 12:15


12:15 – 1:00 Lunch
1:00 – 3:00

Labs Different types of muscle over-activity, including clinical presentations and pathophysiology - Gerard Francisco, MD

3:00 – 3:15 Break
3:15 – 4:15

Treatment Options

4:15 – 4:30 Q&A
4:30 – 4:45

Feedback, sign out & certificates

Instructional Methods Used: Lecture and Lab

Assessment of Learning Objectives: Attendance, class participation, lab participation, completion of course evaluation form.



Course participants must complete any & all formal assessments, procedures, and criteria required for credit or certification. As per Memorial Hermann policy, participants must attend the entire course in order to receive CEUs and course certificate, no partial credits will be given.

Instructional Level: Advanced

OT: Memorial Hermann Health System is an AOTA Approved Provider of continuing education- provider # 8105. This course is offered for 0.7 AOTA CEU’s. The assignment of AOTA CEU’s does not imply endorsement of specific course content, products, or clinical procedures from AOTA. OT Classification Code: Occupational Therapy Process- Evaluation and Intervention

PT: Memorial Hermann Health System is TPTA Approved Provider of continuing education. This activity meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas for 7.25 CCUs.

OT Approved CE
TPTA 2017

Clothing: Please wear clothing appropriate to participate in lab portion of class. Bring a sweater if you get cold easily.

Food: Lunch with a drink will be provided.


This course is designed for MHHS Rehab Service Line Employees only and free to MHHS Rehab Service Line Employees with a required $25.00 refundable, reservation fee.
Complete registration form and reservation fee are due to reserve your place in the course. Registration fee will be returned to you after the end of the course with your completed course certificate, or returned from your Manager / Director. If you do not attend, do not cancel within the cancellation time frame, or do not fulfill the requirements of the course, your reservation fee will not be returned. Registration fee includes: Course materials and lunch.

Cancellation policy: All cancellations must be in writing 14 calendar days prior to the course start date to Refunds will not be granted past this date. Cancellation of the event by TIRR Memorial Hermann will result in a full refund of monies received. TIRR Memorial Hermann is not responsible for the refund of travel or hotel expenses under any circumstances. TIRR Memorial Hermann reserves the right to cancel or change any programs for due cause.

Conflicts of Interest: Policy & Procedures exist whereby all speakers must disclose any relationships which may cause a conflict of interest. Any relevant financial and non-financial relationships will be disclosed via speaker agreement, written notification after agreement, and prior to presentation.

Complaints: Complaints of faculty and participants are handled with dignity and respect by the course coordinator and/or Director of Rehabilitation with resolution of the complaint communicated to all involved parties. All participants in Memorial Hermann Continuing Education Courses are entitled to an accessible, accommodating, and supportive teaching and learning environment.

Parking: Please refer to for information on parking. The closest parking is available in Garage 6 and is next to TIRR Memorial Hermann. We ask that you please reserve the surface lot directly in front of TIRR for patients and their visitors.

Registration for this course is now closed