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RUSK Insights on Rehabilitation Medicine

RUSK Insights on Rehabilitation Medicine is a top podcast featuring interviews with faculty and staff of RUSK Rehabilitation as well as leaders from other rehabilitation programs around the country. These podcasts are being offered by RUSK, one of the top rehabilitation centers in the world. Your host for these interviews is Dr. Tom Elwood. He will take you behind the scenes to look at what is transpiring in the exciting world of rehabilitation research and clinical services through the eyes of those involved in making dynamic breakthroughs in health care.
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Nov 27, 2019

Dr. Ryan Branski is an Associate Professor of Otolaryngology-Head and Neck Surgery and Pathology in the School of Medicine at NYU. He also has an affiliate appointment in Communicative Sciences and Disorders in the Steinhardt School of Culture, Education, and Human Development. He is a licensed speech pathologist and serves as the Associate Director of the Voice Center at NYU Langone Health. In addition to maintaining a clinical practice, Dr. Branski runs a productive research enterprise encompassing both clinical and laboratory initiatives. His NIH-funded laboratory primarily focuses on wound healing and regenerative approaches to optimized healing in the upper aerodigestive track. Dr. Branski is one of only a few investigators to be named a Fellow of the American Academy of Otolaryngology-Head and Neck Surgery, the American Speech Language Hearing Association, and the American Laryngological Association.

This is the first of a two-part interview with Dr Ryan Branski. 

In Part One, Dr. Branski points out that voice loss is the most common communication disorder while the Institute for Deafness and Other Communication Disorders allocates only 6% of research dollars for voice disorders and 70% for hearing loss research. The impacts of voice disorders are broad and hard to characterize. Psychosocial implications also are profound. 

PART 2

 

Dr. Branski indicated that we do a ton of in-office procedures. We can put just about any therapeutic into a larynx. In our lab, we have spent a lot of time looking at steroids. We also do a fair amount of gene therapy. Unlike cholesterol studies, looking at vocal fold function in humans is not the same as looking at it in other animals, such as rabbits. We do a lot of tissue engineering. An area we are most interested in using a regenerative medicine approach to vocal fold injury. He indicated that in research, they are starting with new pre-clinical trials. They have new custom carriages and do not have to use connect. One problem is that pre-clinically, we did not know what to look at. So, we have become interested in biomechanical testing. 

Nov 13, 2019

Dr. Julie Silver has been an integral part of developing the new Spaulding Research Institute from conception to launch. Her research and clinical work have focused on improving gaps in the delivery of healthcare services, particularly cancer rehabilitation. She has published many scientific reports and is well-known for her ground-breaking work on “impairment-driven cancer rehabilitation.” She is the co-founder and co-director of the Cancer Rehabilitation Group for the American Congress of Rehabilitation Medicine, a research-focused interdisciplinary professional society. As a healthcare leader, Dr. Silver also is committed to supporting the healthcare workforce, and she is a researcher and nationally recognized expert on inclusion, diversity and equity. She has published multiple reports on bibliometrics—educating researchers about both conventional and alternative metrics—aimed at supporting both research dissemination and faculty promotion. Her work has been featured in several major print and broadcast media throughout the United States.

In Part 2 of this presentation on the topic of “How to Lead High Impact Strategic Initiatives in Health Care,” Dr. Silver specifies that you need to tell a compelling story and every story needs a story board. She tells faculty members, here is your story and here are the parts that are missing. She recognized that medical societies had to do more to equitably support our faculties so that we could be promoted and compensated better. She was able to show that women are under-represented in recognition awards. She also looked at elections. For example, one of her studies demonstrated that for 10 medical societies, they had zero leadership positions for women in the past decade. It also is useful to look at micro inequities. Women are not showing up in medical society newsletters, which means that it is not possible to hear about their work. Progress is underway because medical societies all around the U.S. are beginning to pass gender equity resolutions.

Oct 30, 2019

Dr. Julie Silver has been an integral part of developing the new Spaulding Research Institute from conception to launch. Her research and clinical work have focused on improving gaps in the delivery of healthcare services, particularly cancer rehabilitation. She has published many scientific reports and is well-known for her ground-breaking work on “impairment-driven cancer rehabilitation.” She is the co-founder and co-director of the Cancer Rehabilitation Group for the American Congress of Rehabilitation Medicine, a research-focused interdisciplinary professional society. As a healthcare leader, Dr. Silver also is committed to supporting the healthcare workforce, and she is a researcher and nationally recognized expert on inclusion, diversity and equity. She has published multiple reports on bibliometrics—educating researchers about both conventional and alternative metrics—aimed at supporting both research dissemination and faculty promotion. Her work has been featured in several major print and broadcast media throughout the United States.

In Part 1 of this presentation, Dr. Silver addresses the topic of “How to Lead High Impact Strategic Initiatives in Health Care” from the perspective of the traditional three hats worn in academic medicine: medical education, clinician, and researcher. When dealing with patients who had polio, she came to the realization that someone had to record their stories regarding what happened to them, which led to her creating an oral history project. When it comes to innovation, it is not enough to have a great idea, but to have a strategy around it, which means the necessity of developing an innovation engine that takes a great idea to enable others to understand it.Tipping points really matter and are the hardest part by being able to define what really makes a difference. Another key essential is to leverage your network. When you want to have divergent change, it helps to have a bridging network and to be able to leverage different groups to bring about big change.

Oct 16, 2019

Kathryn Schmitz is a Professor of Public Health Sciences at the Pennsylvania State University’s College of Medicine. She has led many exercise trials and her work has been translated into clinical practice. Dr. Schmitz has published more than 230 peer-reviewed scientific papers and has had $25 million dollars in funding for her research since 2001. She was the lead author of the first American College of Sports Medicine Roundtable on Exercise for Cancer Survivors, which published guidance for exercise testing and prescription for cancer survivors in July 2010. In June 2017, she became president-elect of that organization, assumed its presidency in June 2018, and became Immediate Past President in June 2019. While serving as chairperson in March 2018 of an International Multidisciplinary ACSM Roundtable on Exercise and Cancer Prevention and Control, participants agreed it is time for exercise oncology to go prime time. The question is how. Her professional mission is to answer that question. Her doctorate is from the University of Minnesota-Twin Cities.

She began Part Two of her presentation by indicating that as a result of the intervention described in Part 1, arm swelling among lymphedema patients was reduced by 70% among women with five or more nodes removed. A big question that arose was who was going to do all the things necessary that were part of a research study? Problems with sustainability and dissemination occurred. There also were safety concerns and costs that could not be met. She then described another initiative that was undertaken. Following a referral by an oncologist, physical therapy evaluation and education in a group setting occurred. Participation could occur in a YMCA setting or at home, but a challenge was to figure out how to pay for equipment in the home after the program ended. Subsequently, the program was renamed Strength After Breast Cancer, which is paid for by insurance. She described a series of lessons learned involving transportation, competing demands affecting patients with jobs, location, keeping up with training requirements, and cost. A need also exists for provider education on matters, such as progression of the weights used by patients. She concluded by noting that her mission and the Rusk mission are a shared mission.

Oct 2, 2019

Dr. Kathryn Schmitz is a Professor of Public Health Sciences at the Pennsylvania State University’s College of Medicine. She has led many exercise trials and her work has been translated into clinical practice. Dr. Schmitz has published more than 230 peer-reviewed scientific papers and has had $25 million dollars in funding for her research since 2001. She was the lead author of the first American College of Sports Medicine Roundtable on Exercise for Cancer Survivors, which published guidance for exercise testing and prescription for cancer survivors in July 2010. In June 2017, she became president-elect of that organization, assumed its presidency in June 2018, and became Immediate Past President in June 2019. While serving as chairperson in March 2018 of an International Multidisciplinary ACSM Roundtable on Exercise and Cancer Prevention and Control, participants agreed it is time for exercise oncology to go prime time. The question is how. Her professional mission is to answer that question. Her doctorate is from the University of Minnesota-Twin Cities.

She began Part One of her presentation by indicating that only a miniscule proportion of patients who begin cardiac rehabilitation complete the entire number of sessions, even though it is clear that such rehabilitation works effectively. Patients are not being referred, they are not coming and they are not staying once referred. The first thing to do to fix the problem is to ask if there is evidence and the answer is yes. From there it is necessary to look at the referral base to see if there are clinicians who will make the referrals, whether 3rd party coverage is available for your program, and if there are acceptable co-pays. Flexibility is necessary regarding when patients can obtain services and a lot of training is required, not only for the clinicians, but also for the rehab providers. Research should be conducted on what is necessary to fix problems and the results disseminated so that more than just a single rehab facility is implementing correct procedures. Based on her research, she described an example involving breast cancer care. She discussed the risks of lymphedema for women undergoing treatment. Unfortunately, the advice patients receive places them at even greater risk of a condition they want to avoid. She described a weight training intervention.

 

 
 
 

 

Sep 18, 2019

Liz Donroe is a Senior Placement and Rehabilitation Counselor in Rusk’s Vocational Rehabilitation Department at NYU Langone Health. With over 17 years’ experience in the field of rehabilitation, she has expertise in counseling individuals with complex medical conditions including traumatic brain injury, spinal cord injury, and amputation in returning to work. Her focus is on career counseling, work readiness, job placement and employment retention. Liz served on NYU Langone Medical Center’s Accessibility Committee and is an active member of the New York City Placement Consortium Network. She has presented at multiple national rehabilitation association annual conferences reporting on evidence based return to work methodologies. She currently is employed as a contractor for the U.S. Department of Labor, Office of Workers Compensation, assisting with return to work goals for injured workers. She holds a Master of Science in Rehabilitation Counseling from Hofstra University and is a Certified Rehabilitation Counselor (CRC).

In this interview, Liz discusses: how old age is being defined when referring to older workers with disabilities who are trying to obtain jobs; kinds of personal factors of a positive nature associated with enabling rehabilitation patients to be active in the workforce and any possible deterrent factors; impact of the overall state of the economy on the prospects of finding suitable jobs; barriers and facilitators viewed by potential employers that may distinguish various health conditions from one another; the role of family support; possible stigma by employers that could play a role in producing a wariness or unwillingness to hire individuals with various kinds of health problems; challenges involved in providing vocational rehabilitation services for individuals with physical or mental impairments; workplace accommodations made by employers; proportion of patients who want to return to an existing job and the proportion who may end up being employed in something different; and ways in which the field of vocational rehabilitation could benefit from additional research.
Sep 4, 2019

This special panel presentation features three leaders in the space: 

Tara Denham, supervisor of vestibular physical therapy, is a leading expert in the field of vestibular therapy and founder of the Vestibular Physical Therapy Center at Rusk. As an American Physical Therapy Association certified vestibular clinician, she lectures extensively to a wide range of audiences. 
 
Eva Mihovich has served as a Senior Psychologist at Rusk Rehabilitation, NYU Langone Health Centers for over 20 years, and is a clinical instructor at the NYU School of Medicine. She currently coordinates Psychological Services at the Vestibular Rehabilitation Department at Rusk Rehabilitation. Her Ph.D. is from New York University. 
 
Dr. Jennifer Fay is a board-certified clinical specialist in Neurologic Physical Therapy through the American Board of Physical Therapy Specialties and is a clinical instructor in the Department of Physical Medicine and Rehabilitation in the NYU School of Medicine. 
 
Artmis Youssefnia is Senior Level II in the vestibular therapy department at Rusk Institute: NYU Langone Health System. She has over 20 years of experience working with patients with pulmonary disease and vestibular dysfunction and does extensive community outreach/education. She also is adjunct professor for Cardiovascular Pulmonary Examination at NYU Physical Therapy school.
 
This is the second of a two-part series. In this episode, the panel covers: whether any patients report out-of-body experiences associated with 3PD, evaluation techniques used in developing treatment plans for patients; dominant treatment approaches; roles played by gait training and gaze stabilization; status of clinical practice guidelines and evidence-based treatments; research gaps where more studies may be necessary; factors that may characterize patients, such as fear of the future or threats to self-image that possibly could detract from the success of rehabilitation kinds of interventions; major components of a cognitive-behavioral approach to treating 3PD; whether plateaus ever occur where further treatment is not associated with additional improvements; and current research and proposed studies on the drawing board aimed at shedding additional light on 3PD.
Aug 21, 2019

This special panel presentation features three leaders in the space: 

Tara Denham, supervisor of vestibular physical therapy, is a leading expert in the field of vestibular therapy and founder of the Vestibular Physical Therapy Center at Rusk. As an American Physical Therapy Association certified vestibular clinician, she lectures extensively to a wide range of audiences. 
 
Eva Mihovich has served as a Senior Psychologist at Rusk Rehabilitation, NYU Langone Health Centers for over 20 years, and is a clinical instructor at the NYU School of Medicine. She currently coordinates Psychological Services at the Vestibular Rehabilitation Department at Rusk Rehabilitation. Her Ph.D. is from New York University. 
 
Dr. Jennifer Fay is a board-certified clinical specialist in Neurologic Physical Therapy through the American Board of Physical Therapy Specialties and is a clinical instructor in the Department of Physical Medicine and Rehabilitation in the NYU School of Medicine. 
 
Artmis Youssefnia is Senior Level II in the vestibular therapy department at Rusk Institute: NYU Langone Health System. She has over 20 years of experience working with patients with pulmonary disease and vestibular dysfunction and does extensive community outreach/education. She also is adjunct professor for Cardiovascular Pulmonary Examination at NYU Physical Therapy school.
 
This is the first of a two-part series. In this episode, the panel covers: 
why terms previously used were abandoned and how the classification 3PD represents an improvement over them; core symptoms of 3PD; kinds of health professionals involved in making an accurate differential diagnosis; specific clinical tests to detect the presence of 3PD; how well patients perform in describing their symptoms in constructive ways that aid in arriving at a correct diagnosis; what is known about the exact etiology of 3PD from the standpoint of any common initial events that might precede its development; whether 3PD can co-exist with other kinds of dizziness problems; if onset of 3PD associated in any way with certain demographic factors; and episodes that can trigger the onset of 3PD, such as a panic attack or generalized anxiety disorders
Aug 7, 2019

Dr. Barr is an Associate Professor of Neurology and Psychiatry at the NYU School of Medicine. He has over 30 years of experience in clinical practice, training, and research in the field of clinical neuropsychology. He has been on the editorial boards of multiple professional journals and has served as an officer and board member of a number of professional societies, including a term as President of the Society for Clinical Neuropsychology (Division 40) of the American Psychological Association (APA) in 2011.  He has an active clinical practice in neuropsychological assessment with ongoing research programs on cognitive and behavioral aspects of epilepsy in addition to other programs in mild traumatic brain injury and forensic neuropsychology. He also maintains an active social media presence on topics related to sports concussion and chronic traumatic encephalopathy (CTE). His doctorate in clinical psychology is from New School University.

This is the second of a two-part series of a live Grand Rounds presentation given at RUSK. 

In Part 1 of his presentation, Dr. Barr discussed how he takes a translational approach by applying findings from sports studies to clinical practice. Athletics provide a natural laboratory for studying concussion. Unlike other kinds of concussion injury, the motivation for patients is to return to the field of athletics rather than not to do so. Currently, no obvious concussion test exists. Neuropsychological assessment represents one means of documenting symptoms. A focus in this presentation is on subjective symptoms. Some athletes either fail to report their concussion symptoms or hide them in order to remain on the field while some patients may misreport symptoms that pertain to conditions, such as anxiety and depression rather than concussion. Perhaps not as much attention should be paid to cognitive symptoms (e.g., attention and memory), which may be short-lived, as to emotional symptoms that can persist over longer periods of time. He described how the Sports Laboratory Assessment Model (SLAM) is used. A transition then occurred in the battery of neuro psychological tests from paper and pencil to computer applications.

Part 2 involves a discussion of what has occurred in neuropsychological testing since 2001 and how the SLAM model was used to replicate other studies conducted in the early part of the 21st century. Batteries of different tests were administered to large numbers of college athletes to show natural recovery curves. The results show that sideline battery testing does a good enough job while neuropsychological testing added little to the results. Questions then arose regarding how various computerized tests work and which ones should be used. In addition to studies of athletes, research also was done as part of the translational process that involved emergency room patients. Poor test-retest reliability was found for all the different measures. The test lacked reliability to identify changes.  By 2012, it became apparent that baseline neuropsychological testing of athletes was not as important as originally envisioned. Some patients experience symptoms that last beyond one month and these are the individuals who end up in the offices of psychologists. He also discussed post-concussion persistent symptoms.

Jul 24, 2019

Dr. Barr is an Associate Professor of Neurology and Psychiatry at the NYU School of Medicine. He has over 30 years of experience in clinical practice, training, and research in the field of clinical neuropsychology. He has been on the editorial boards of multiple professional journals and has served as an officer and board member of a number of professional societies, including a term as President of the Society for Clinical Neuropsychology (Division 40) of the American Psychological Association (APA) in 2011.  He has an active clinical practice in neuropsychological assessment with ongoing research programs on cognitive and behavioral aspects of epilepsy in addition to other programs in mild traumatic brain injury and forensic neuropsychology. He also maintains an active social media presence on topics related to sports concussion and chronic traumatic encephalopathy (CTE). His doctorate in clinical psychology is from New School University.

This is the first of a two-part series of a live Grand Rounds presentation given at RUSK. 

In Part 1 of his presentation, Dr. Barr discussed how he takes a translational approach by applying findings from sports studies to clinical practice. Athletics provide a natural laboratory for studying concussion. Unlike other kinds of concussion injury, the motivation for patients is to return to the field of athletics rather than not to do so. Currently, no obvious concussion test exists. Neuropsychological assessment represents one means of documenting symptoms. A focus in this presentation is on subjective symptoms. Some athletes either fail to report their concussion symptoms or hide them in order to remain on the field while some patients may misreport symptoms that pertain to conditions, such as anxiety and depression rather than concussion. Perhaps not as much attention should be paid to cognitive symptoms (e.g., attention and memory), which may be short-lived, as to emotional symptoms that can persist over longer periods of time. He described how the Sports Laboratory Assessment Model (SLAM) is used. A transition then occurred in the battery of neuro psychological tests from paper and pencil to computer applications.

Part 2 involves a discussion of what has occurred in neuropsychological testing since 2001 and how the SLAM model was used to replicate other studies conducted in the early part of the 21st century. Batteries of different tests were administered to large numbers of college athletes to show natural recovery curves. The results show that sideline battery testing does a good enough job while neuropsychological testing added little to the results. Questions then arose regarding how various computerized tests work and which ones should be used. In addition to studies of athletes, research also was done as part of the translational process that involved emergency room patients. Poor test-retest reliability was found for all the different measures. The test lacked reliability to identify changes.  By 2012, it became apparent that baseline neuropsychological testing of athletes was not as important as originally envisioned. Some patients experience symptoms that last beyond one month and these are the individuals who end up in the offices of psychologists. He also discussed post-concussion persistent symptoms.

Jul 10, 2019

Dr. Olesya Yevdayev is a Senior Physical Therapist in the Outpatient Physical Therapy Department at Rusk Rehabilitation, NYU Langone Health. She has a Bachelor of Science degree from Touro College and a Bachelor of Arts degree from Hunter College. She earned her Doctor of Physical Therapy degree from Touro College where she received an Outstanding Clinical Achievement award. She has 7.5 years of professional experience in orthopedics/ sports rehabilitation utilizing the Mulligan Method, McKenzie Method, and manual therapy with a concentration on pelvic floor, pregnancy, osteoporosis, oncology, and lymphedema rehabilitation. She also is involved in community services, patient education, and has presented lectures at NYU in Brooklyn and the 26thCancer Conference.

Dr. Kimberly Sackheim is an Assistant Professor in the Department of Physical Medicine & Rehabilitation at New York University Langone Health and private owner and founder of an office for pain management that will open in August 2019. She has a focus on interventions for spinal issues, joints/tendons, headache and also pelvic pain.  She is board certified by the American Board of Physical Medicine & Rehabilitation with sub-specialties in both pain management and brain injury medicine. She completed her residency in physical medicine and rehabilitation at Mount Sinai Medical Center, New York, NY.  Her fellowship training took place at the Beth Israel Medical Center.  She treats all types of pelvic pain disorders, including pelvic floor dysfunction, rectal pain, headache, jaw pain, along with spine and joint pain.

This is the second of a two-part series. In Part 1, the guests discuss: the kinds of pelvic floor disorders that women can experience; symptoms that patients can present with; whether only women experience pelvic floor problems;  causes of painful symptoms at the pelvic, rectal, or vaginal area and injections available to treat these kinds of pain; extent to which delivering children and growing older influence the occurrence of pelvic floor disorders; if the type of child delivery method, such as vaginal delivery, increases the probability a woman will develop a pelvic floor disorder later in life; how modalities other than surgery, such as physical therapy can contribute to positive outcomes; and the kinds of procedures involved in the administration of pelvic floor physical therapy and the basis on which  various approaches either singly or in combination are best suited for a particular patient?

 

In Part 2, they discuss: Periods of time, such as weeks or months when most rehabilitation interventions take place and whether it ever occurs that further treatment is not associated with additional improvements; if there are instances, such as the presence of a patient’s advanced old age or co-morbidities where watchful waiting may represent the best choice instead of any other kind of intervention; steps that can be taken to lower the percentages of women who experienced urinary incontinence, yet had not talked to a doctor about this problem;  pelvic floor muscle training to treat overactive bladder and who provides it; the role of botulinum toxin as a form of treatment for pelvic floor dysfunctions among elderly patients; extent to which patient education is involved in efforts to improve knowledge of, attitude towards, and practice of pelvic floor muscle exercise; frequency of urinary incontinence symptoms and other pelvic floor disorders among adolescent females; and pelvic floor muscle training as a means of primary prevention of urinary incontinence in asymptomatic women and secondary prevention for women with small muscle strength who are considered dysfunctional, but asymptomatic.

 

Jun 26, 2019

Dr. Olesya Yevdayev is a Senior Physical Therapist in the Outpatient Physical Therapy Department at Rusk Rehabilitation, NYU Langone Health. She has a Bachelor of Science degree from Touro College and a Bachelor of Arts degree from Hunter College. She earned her Doctor of Physical Therapy degree from Touro College where she received an Outstanding Clinical Achievement award. She has 7.5 years of professional experience in orthopedics/ sports rehabilitation utilizing the Mulligan Method, McKenzie Method, and manual therapy with a concentration on pelvic floor, pregnancy, osteoporosis, oncology, and lymphedema rehabilitation. She also is involved in community services, patient education, and has presented lectures at NYU in Brooklyn and the 26thCancer Conference.

Dr. Kimberly Sackheim is an Assistant Professor in the Department of Physical Medicine & Rehabilitation at New York University Langone Health and private owner and founder of an office for pain management that will open in August 2019. She has a focus on interventions for spinal issues, joints/tendons, headache and also pelvic pain.  She is board certified by the American Board of Physical Medicine & Rehabilitation with sub-specialties in both pain management and brain injury medicine. She completed her residency in physical medicine and rehabilitation at Mount Sinai Medical Center, New York, NY.  Her fellowship training took place at the Beth Israel Medical Center.  She treats all types of pelvic pain disorders, including pelvic floor dysfunction, rectal pain, headache, jaw pain, along with spine and joint pain.

 

This is the first of a two-part series. In Part 1, the guests discuss: the kinds of pelvic floor disorders that women can experience; symptoms that patients can present with; whether only women experience pelvic floor problems;  causes of painful symptoms at the pelvic, rectal, or vaginal area and injections available to treat these kinds of pain; extent to which delivering children and growing older influence the occurrence of pelvic floor disorders; if the type of child delivery method, such as vaginal delivery, increases the probability a woman will develop a pelvic floor disorder later in life; how modalities other than surgery, such as physical therapy can contribute to positive outcomes; and the kinds of procedures involved in the administration of pelvic floor physical therapy and the basis on which  various approaches either singly or in combination are best suited for a particular patient?

 

In Part 2, they discuss: Periods of time, such as weeks or months when most rehabilitation interventions take place and whether it ever occurs that further treatment is not associated with additional improvements; if there are instances, such as the presence of a patient’s advanced old age or co-morbidities where watchful waiting may represent the best choice instead of any other kind of intervention; steps that can be taken to lower the percentages of women who experienced urinary incontinence, yet had not talked to a doctor about this problem;  pelvic floor muscle training to treat overactive bladder and who provides it; the role of botulinum toxin as a form of treatment for pelvic floor dysfunctions among elderly patients; extent to which patient education is involved in efforts to improve knowledge of, attitude towards, and practice of pelvic floor muscle exercise; frequency of urinary incontinence symptoms and other pelvic floor disorders among adolescent females; and pelvic floor muscle training as a means of primary prevention of urinary incontinence in asymptomatic women and secondary prevention for women with small muscle strength who are considered dysfunctional, but asymptomatic.

 

Jun 12, 2019

Joan Gold is a clinical professor in the Department of Rehabilitation at Rusk Rehabilitation, NYU Langone Health. Her areas of specialization include the pediatric disorders cerebral palsy, and spina bifida. In her own words, she stated that she has had the pleasure of watching her patients and learning from their strengths for 45+ years. Her medical degree is from the State University of New York Downstate Medical Center. She completed her residency in physical medicine and rehabilitation at the NYU Medical Center and her residency in pediatrics at Beth Israel Medical Center. She is board-certified in the following three areas: Pediatric Rehabilitation Medicine, Physical Medicine & Rehabilitation, and also Pediatrics. 

This is the second of a two-part series. In this Part 2, she discusses: pregnancy among patients with cerebral palsy, effect of pregnancy on balance and coordination if a motor functional impairment exists; challenges and resources available for patients who become parents; identification of the felt needs of patients; improvements needed in diagnosis and treatment; time period for adoption of rehabilitation treatment innovations; and key topics in rehabilitation research.

In Part 1, Dr. Gold discussed: number of adults in the U.S. with cerebral palsy; their life expectancy; challenges involved in the transition from pediatric to adult care for these patients; kinds of health problems adult patients experience; treatment for dystonia; the impact of additional physical deterioration on quality of life and mental health; and the ability to participate in physical activities, work, family, and recreational activities.

 

May 29, 2019

Joan Gold is a clinical professor in the Department of Rehabilitation at Rusk Rehabilitation, NYU Langone Health. Her areas of specialization include the pediatric disorders cerebral palsy, and spina bifida. In her own words, she stated that she has had the pleasure of watching her patients and learning from their strengths for 45+ years. Her medical degree is from the State University of New York Downstate Medical Center. She completed her residency in physical medicine and rehabilitation at the NYU Medical Center and her residency in pediatrics at Beth Israel Medical Center. She is board-certified in the following three areas: Pediatric Rehabilitation Medicine, Physical Medicine & Rehabilitation, and also Pediatrics. 

This is the first of a two-part series. In Part 1, Dr. Gold discusses: number of adults in the U.S. with cerebral palsy; their life expectancy; challenges involved in the transition from pediatric to adult care for these patients; kinds of health problems adult patients experience; treatment for dystonia; the impact of additional physical deterioration on quality of life and mental health; and the ability to participate in physical activities, work, family, and recreational activities.

In Part 2, she discusses: pregnancy among patients with cerebral palsy, effect of pregnancy on balance and coordination if a motor functional impairment exists; challenges and resources available for patients who become parents; identification of the felt needs of patients; improvements needed in diagnosis and treatment; time period for adoption of rehabilitation treatment innovations; and key topics in rehabilitation research.

 

 

 
 
 

 

May 15, 2019

Dr. Joel Stein is Physiatrist-in-Chief at New York-Presbyterian Hospital, as well as Professor and Chairman of the Department of Rehabilitation Medicine at the Columbia University College of Physicians and Surgeons, and Professor and Chairman of the Department of Rehabilitation Medicine at Weill Cornell Medical College. His clinical and research interests are in the area of stroke rehabilitation. He has had a particular focus on the use of exercise as a treatment, and on the use of robotic and other technologies to facilitate recovery of motor function after stroke. He has authored or co-authored two books on stroke recovery and rehabilitation for stroke survivors and their families, and edited a multi-authored medical textbook on this subject entitled “Stroke Recovery and Rehabilitation.” His undergraduate degree is from Columbia University and his medical degree is from the Albert Einstein College of Medicine. He completed a residency in Internal Medicine at Montefiore Hospital in the Bronx, followed by a residency in Physical Medicine and Rehabilitation at New York-Presbyterian Hospital. He is board certified in both internal medicine and physical medicine & rehabilitation.

This is part 2 of a 2-part series. In this episode, Dr. Stein discusses: measures to predict neurological recovery and stages when they are applied most effectively; periods of time when most rehabilitations interventions take place; success of efforts to achieve the translation of clinical findings and evidence-based research to the bedside in a timely manner; and many other exciting topics.  

 
 
 
 
 

 

May 1, 2019

Dr. Joel Stein is Physiatrist-in-Chief at New York-Presbyterian Hospital, as well as Professor and Chairman of the Department of Rehabilitation Medicine at the Columbia University College of Physicians and Surgeons, and Professor and Chairman of the Department of Rehabilitation Medicine at Weill Cornell Medical College. His clinical and research interests are in the area of stroke rehabilitation. He has had a particular focus on the use of exercise as a treatment, and on the use of robotic and other technologies to facilitate recovery of motor function after stroke. He has authored or co-authored two books on stroke recovery and rehabilitation for stroke survivors and their families, and edited a multi-authored medical textbook on this subject entitled “Stroke Recovery and Rehabilitation.” His undergraduate degree is from Columbia University and his medical degree is from the Albert Einstein College of Medicine. He completed a residency in Internal Medicine at Montefiore Hospital in the Bronx, followed by a residency in Physical Medicine and Rehabilitation at New York-Presbyterian Hospital. He is board certified in both internal medicine and physical medicine & rehabilitation.

This is part 1 of a 2-part series. In this part of the discussion, Dr. Stein discusses: estimates of stroke incidence and prevalence in the U.S.; stroke occurrence among young individuals; impairments commonly resulting from a stroke; factors such as age that can affect the degree and speed of recovery; sleep apnea as a possible risk factor for stroke; relationship between sleep disorders and stroke recovery and possible contributions to cognitive decline post-stroke; whether screening for post-stroke depression and cognitive impairment can predict long-term patient outcomes; and whether persistent symptoms of anxiety can develop after a stroke.

 

Apr 17, 2019

Dr. Susan Maltser is Director of Cancer Rehabilitation and oversees the comprehensive Cancer Rehabilitation program for Northwell health. She is a practicing physiatrist and an assistant professor of Physical Medicine and Rehabilitation at Zucker School of Medicine. She also serves as Chief, Physical Medicine and Rehabilitation at Long Island Jewish Hospital. A graduate of the New York College of Osteopathic medicine, her residency in Physical Medicine and Rehabilitation was completed at the Rusk Institute at NYU Langone Medical Center. She is a fellow of the American Board of Physical Medicine and Rehabilitation, and holds membership in both the American Academy of Physical Medicine and Rehabilitation and the National Cancer Rehabilitation Physician Consortium.

This interview is a two-part series. In Part 2, Dr. Maltser discusses: the extent of post-surgical care aimed at social and emotional functions; from the perspective of patient-reported outcomes, steps taken to identify the felt needs of patients in conjunction with the needs identified by the health care team; whether demographic factors, such as age influence whether a woman wants to remain in the labor force and what can be done to assist women in this aspect of their lives; the degree to which sexual function affected by breast cancer treatment is discussed with patients; whether older women who undergo treatment for breast cancer are vulnerable to experiencing a balance problem that increases the risk of falling; if technological approaches, such as the development of wearable sensors and cloud-based apps are being used after patients leave the clinical setting to enable them to provide daily feedback on their condition and successes they are experiencing in self-care; and areas where improvements in diagnostic measures and rehabilitation treatment would be warranted.

Apr 3, 2019

Dr. Susan Maltser is Director of Cancer Rehabilitation and oversees the comprehensive Cancer Rehabilitation program for Northwell health. She is a practicing physiatrist and an assistant professor of Physical Medicine and Rehabilitation at Zucker School of Medicine. She also serves as Chief, Physical Medicine and Rehabilitation at Long Island Jewish Hospital. A graduate of the New York College of Osteopathic medicine, her residency in Physical Medicine and Rehabilitation was completed at the Rusk Institute at NYU Langone Medical Center. She is a fellow of the American Board of Physical Medicine and Rehabilitation, and holds membership in both the American Academy of Physical Medicine and Rehabilitation and the National Cancer Rehabilitation Physician Consortium.

This interview is a two-part series. In Part 1, Dr. Maltser discusses:  what cancer rehabilitation is and some conditions that commonly are treated in breast cancer patients; measures employed to assess patients who have undergone breast surgery regarding the scope of rehabilitation interventions to pursue; the adverse effect of reconstructive surgery for breast cancer on shoulder function and the kinds of rehabilitation that prove effective in dealing with this problem; debilitating side effects, such as difficulty sleeping and fatigue, associated with breast cancer surgery; the risk of developing lymphedema after undergoing surgery for breast cancer; the role of self-care in treating lymphedema; and the role that physical exercise might play and when it should occur pre- and post-surgery.

Mar 20, 2019

Dr. Mitchell Elkind is a Professor of neurology at Columbia University College of Physicians and Surgeons as well as an attending neurologist in the stroke service at New York Presbyterian Hospital. His areas of expertise are cerebrovascular disease and stroke. He completed his medical school training at Harvard Medical School. His internship was at Brigham and Women’s Hospital in Boston, MA and was followed by a residency in neurology at the Massachusetts General Hospital where he served as chief resident. Dr. Elkind subsequently obtained a master’s degree in epidemiology at the Columbia University School of Public Health and also completed fellowship training in cerebrovascular diseases. 

In the second of a two-part Grand Rounds, Dr. Elkind reviews occult atrial fibrillation, monitoring devices, and other relevant areas after which there is a Q&A. 

Mar 6, 2019

Dr. Mitchell Elkind is a Professor of neurology at Columbia University College of Physicians and Surgeons as well as an attending neurologist in the stroke service at New York Presbyterian Hospital. His areas of expertise are cerebrovascular disease and stroke. He completed his medical school training at Harvard Medical School. His internship was at Brigham and Women’s Hospital in Boston, MA and was followed by a residency in neurology at the Massachusetts General Hospital where he served as chief resident. Dr. Elkind subsequently obtained a master’s degree in epidemiology at the Columbia University School of Public Health and also completed fellowship training in cerebrovascular diseases.  

In Part 1, Dr. Elkind focuses on unexplained stroke and potentially how to prevent it, especially based on some new developments; cryptogenic stroke and embolic stroke of undetermined source; various cardiac sources of stroke and PFO (patent foramen ovale) closure; and how RoPE (Risk of Paradoxical Embolism) scores are used.

Feb 20, 2019

Dr. J.R. Rizzo is a physician scientist at NYU Langone Medical Center’s Rusk Rehabilitation Institute, where he is an Assistant Professor of Physical Medicine and Rehabilitation with a cross-appointment in the Department of Neurology. He leads the Visuomotor Integration Laboratory where his team focuses on eye-hand coordination as it relates to acquired brain injury and the Technology Translation in Medicine Laboratory, where the focus is on assistive technology for the visually impaired and benefits from his own personal experiences with vision loss.  He recently completed an R03 grant through the National Institute of Aging, as a GEMSSTAR Scholar, focusing his research goals on eye-hand coordination in elderly stroke, and is completing a K12 award, as an RMSTP Fellow, focusing on visuomotor integration in brain injury. He has funding at the federal, state, municipal and foundational levels. He has numerous peer-reviewed publications and book chapters, in addition to domestic and international patents filed for his rehabilitation tools. An honors graduate in neuroscience at NYU, hcompleted medical school on scholarship at New York Medical College and was elected to the Alpha Omega Alpha Honor’s Society Iota Chapter. He completed his residency, including a chief year, at NYU’s Physical Medicine & Rehabilitation Program where he subsequently was awarded funding to complete a clinical research fellowship at Rusk.

In the second part of this Grand Rounds presentation Dr. Rizzo continues his description of a pilot research project involving chronic stroke patients who were recruited from outpatient clinics. The investigation included eye tracking while simultaneously recording motion capture of patients’ limbs. He indicates how eye errors correlate with limb errors in this study and mentioned some cognitive implications derived from the project. A question and answer period followed his presentation.

Feb 6, 2019

Dr. J.R. Rizzo is a physician scientist at NYU Langone Medical Center’s Rusk Rehabilitation Institute, where he is an Assistant Professor of Physical Medicine and Rehabilitation with a cross-appointment in the Department of Neurology. He leads the Visuomotor Integration Laboratory where his team focuses on eye-hand coordination as it relates to acquired brain injury and the Technology Translation in Medicine Laboratory, where the focus is on assistive technology for the visually impaired and benefits from his own personal experiences with vision loss.  He recently completed an R03 grant through the National Institute of Aging, as a GEMSSTAR Scholar, focusing his research goals on eye-hand coordination in elderly stroke, and is completing a K12 award, as an RMSTP Fellow, focusing on visuomotor integration in brain injury. He has funding at the federal, state, municipal and foundational levels. He has numerous peer-reviewed publications and book chapters, in addition to domestic and international patents filed for his rehabilitation tools. An honors graduate in neuroscience at NYU, hcompleted medical school on scholarship at New York Medical College and was elected to the Alpha Omega Alpha Honor’s Society Iota Chapter. He completed his residency, including a chief year, at NYU’s Physical Medicine & Rehabilitation Program where he subsequently was awarded funding to complete a clinical research fellowship at Rusk.

In the first part of a grand rounds presentation, Dr. Rizzo discussses eye-hand coordination or what is known as the eye-hand mystique. He describes perception, the ocular motor system, perception to action, and eye-hand control deficits as they relate to visual motor integration. He discusses visual crowding as it pertains to peripheral vision and the importance of material categorization. He also describes research involving chronic stroke patients recruited from outpatient clinics using eye tracking and simultaneously recording motion capture of their actual limbs. The session includes questions from attendees at the presentation and his responses.

In the second part of a grand rounds presentation by Dr. John Ross Rizzo on December 12, 2018 at the Rusk Institute of Rehabilitation at NYU Langone Health, he continued his description of a pilot research project involving chronic stroke patients who were recruited from outpatient clinics. The investigation included eye tracking while simultaneously recording motion capture of patients’ limbs. He indicated how eye errors correlated with limb errors in this study and mentioned some cognitive implications derived from the project. For example, in reaching for a cup of tea there could be an eye movement that has some computational load, meaning what is the cerebral load to complete that task and what is involved if the reaching is done using peripheral vision? In this context, it is worth considering what is occurring in the presence of an impaired brain, such as after a stroke. A central idea is that stroke interferes with cognitive resource sharing between eye and hand movement during eye-hand coordination. A question and answer period followed his presentation.

 
 
 
 
 

 

Jan 23, 2019

Rondel King is a certified strength and conditioning specialist and corrective exercise specialist. His programming aims to bring out the best in a person’s health and performance. He has a strong interest in postural asymmetries and the nervous system as it relates to biomechanics, human performance, and general health. Mr.King leads group fitness classes at NYU Langone Orthopedic Center and is a clinician with the Running Lab and the Golf Lab.

In his interview, Rondel discusses: the relationship between gaining muscle mass versus strength and stability and the topic of weight loss; kinds of patients who can benefit from losing weight; extent of eating disorders; influence of demographic factors on the attainment of successful outcomes; role of diet in weight loss reduction; kinds of lifestyle interventions that prove to be effective in achieving weight loss; role that wearable devices play in contributing to weight loss; whether poor nutrition can be out-trained; if crunches can produce flat abs; whether more sweat burns more calories; effect of running and squats on the knees; if more gym time always is better than less; the notion of No Pain, No Gain; whether yoga can help with back pain; if lifting heavy weights can make women “bulky;" and whether machines are better than free weights.

Jan 9, 2019

Heather Milton leads group fitness classes at NYU Langone Orthopedic Center and is a clinician with the Running Laboratory and Golf Laboratory. She is a board-certified exercise physiologist and strength and conditioning specialist. She is certified in Functional Movement Systems® and by the Titleist Performance Institute. She develops specialized programs to help athletes reach their maximum potential and ability. Ms. Milton creates unique and motivational programs to inspire health and fitness clients and designs injury prevention programs for at-risk athletes and youth sports teams. She also identifies limitations that may affect sport performance, including gait faults in running, swing faults in golf, and swing, kick, and throw patterns in rotational sports. Her undergraduate degree in cardiopulmonary science and her master’s degree in clinical exercise physiology are from Northeastern University.

In this interview, she discusses: kinds of patients who can benefit from building stability, strength, and muscle; measures to assess current physical abilities of patients; conditions where building stability, strength, and muscle can produce a preventive effect; impact of strength training on other abilities, such as improved balance and mobility; influence of demographic factors on the attainment of successful outcomes; the difference between stability and strength; progression of building stability, strength and muscle; difference between strength and mass; key components of a program to build stability, strength, and hypertrophy/muscle mass; common mistakes individuals make in their training programs; whether individuals naturally bulk up; gaining strength and avoidance of adding muscle mass; what to say when efforts to gain muscle for years fail; and who benefits from each type of training.

Dec 26, 2018
David Biderman is a Clinical Assistant Professor in the Department of Rehabilitation Medicine at NYU Langone Health and serves as supervisor of the Brain Injury Day Treatment Program. He joined Rusk Rehabilitation, NYU Langone Health in 1996 as a research assistant and started working at the Brain Injury Day Treatment Program in 1999, becoming the supervisor in 2010. A New York City native, he earned his Doctoral Degree in Health Psychology from the Albert Einstein College of Medicine.  Prior to coming to Rusk, he worked in research at other major medical centers in New York. Most recently he has presented and published on the role of significant others in the rehabilitation of individuals with a brain injury. He currently is working on cognitive retraining software to improve attention functions and continues his efforts to educate Brain Injury fellows, Psychology Doctoral Interns, and other professionals interested in learning about the comprehensive neuropsychological rehabilitation of individuals with an acquired brain injury.
 
This discussion includes: assessments performed to determine if cognitive remediation is an appropriate intervention for patients who experienced a traumatic brain injury; aims pursued when engaging in cognitive remediation; the effect of TBI level of severity on kind of treatment and anticipated outcomes; the influence of demographic factors such as age, gender, and race/ethnicity on the attainment of successful outcomes; the role music can play in cognitive remediation; ways in which cognitive remediation could be enhanced through the use of existing and emerging kinds of social media platforms, along with other modalities, such as apps, wearable devices, and virtual reality technology; self- or family caregiver-treatment plans outside the clinical setting;  and current research and proposed studies at NYU aimed at producing a greater understanding of the effectiveness of cognitive remediation kinds of intervention.
 
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