Central South Regional Stroke Network Education Calendar

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Managing the High Tone UE – an NDT Workshop – November 23, 2023

November 23 @ 8:30 am - 4:00 pm

Workshop Description:

High tone is a common clinical presentation following a stroke or brain injury.  Hypertonicity can have a negative impact on recovery of the upper extremity. This one-day workshop will present the principles of the NDTA Contemporary Practice Model, and research related to the hypertonic upper extremity.  A variety of intervention strategies will be presented to address common impairments and incorporate the upper extremity in active support for participation in functional activities. The overall objective of this workshop is to provide clinicians with knowledge and skills to maximize recovery in an individual who has a high tone upper extremity. The workshop will contain didactic information, problem solving and lab sessions.

Workshop Objectives:

  1. Apply the principles of the NDTA Contemporary Practice Model in the management of the high tone upper extremity following a stroke or brain injury.
  2. Identify the significant impairments that interfere with developing upper extremity function in an individual who has high tone or hypertonicity.
  3. Develop treatment strategies that address impairments and incorporate the hypertonic upper extremity in active support during functional activities.
  4. Compare research and clinical practice related to use of various adjuncts (Botox, splints, slings, supports) in the management of the high tone upper extremity.


Instructor: Karen Guha, PT, CIDN, C/NDT, NDTA™ Coordinator Instructor

Karen Guha is a registered physical therapist who graduated from the University of Toronto in 1996 with a BSc PT. Karen worked in the United States for 3 ½ years treating individuals with neurological diagnoses in both the inpatient and outpatient settings. She returned to Canada in 2000 and began working at Grand River Hospital (GRH), Kitchener, Ontario. Karen worked in a variety of inpatient settings but primarily works in the outpatient Neuro Rehabilitation Clinic at GRH treating individuals who suffer from stroke, acquired brain injury, spinal cord injury and other neurological diagnoses. In addition, she works with individuals privately at Back Works Physiotherapy in Waterloo, Ontario. Karen has over 25 years experience working with individuals with neurological impairments.

Karen began her NDT training in 1998 by completing her Certificate Course (for adults with hemiplegia), and later took several advance level courses. In 2002 Karen became an Instructor Candidate and began assisting on various NDT courses. Karen became a NDTA PT instructor in 2007 and a NDTA Coordinator Instructor in 2011. Karen is also qualified to teach NDTA Advanced courses. She has taught NDT courses in Canada, the United States and internationally. Karen became certified in Integrated Dry Needling in 2017.

Workshop Agenda: 

8:30 – 8:45       Introduction

8:45 – 10:15     Lecture: Managing the High Tone UE

10:15 -10:30    Break

10:30 -11:30   Lab: Facilitation of the scapula

11:30 -12:30    Lab: Stretches into scapular depression and scapular adduction/G-H ER

12:30-1:00       Lunch

1:00 -1:45        Lab: Opening the high tone hand

1:45-3:00         Lab: Connecting the UE for active support

3:00 -3:30        Discussion: Splints, slings and supports

3:30-3:45         Wrap up


Participants must be a registered Physical Therapist, Occupational Therapist, Therapy Assistant or Registered Kinesiologist who work with individuals who have suffered from stroke, brain injury or other neuromotor disorders. Participants must provide stroke care within the Central South Region of Ontario.

Please indicate your interest in this course by emailing Tina Vallentin, Regional Stroke Education and Data Coordinator, at vallent@hhsc.ca by October 13, 2023.

**Please note that this workshop will take place at St. Peter’s Hospital, in Hamilton, Ontario and is only open to stroke care providers in the Central South Region. 

In your response, include the following information:

  • Work Email
  • Profession
  • Place of work  
  • Role in the stroke continuum (i.e., acute, inpatient rehab, community, etc.)

Participants will be notified by October 13th. Seats will be distributed with consideration for representation of stroke care providers across the Central South region and across the continuum of care.


November 23
8:30 am - 4:00 pm
Event Category:


Central South Regional Stroke Network


St. Peter’s Hospital
88 Maplewood Avenue
Hamilton, Ontario L8M 1W9 Canada
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