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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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Now displaying: June, 2022
Jun 22, 2022

Douglas H. Smith, MD, is the Robert A. Groff Endowed Professor Neurosurgery and Director of the Center for Brain Injury and Repair at the University of Pennsylvania. He is the Scientific Director of the Big 10/Ivy League Collaboration on Concussion and also serves as a member on the Scientific Advisory Boards of the US National Football League (NFL), the National Collegiate Athletic Association (NCAA)-DoD consortium on concussion, and the International Concussion Society. 

This is the first of a two-part series. In this one, he points out that: 

An objective is to look at the biomechanics of concussion and how that selectively induces injuries to axons, and how to detect it non-invasively. Also, how does that time zero, when the injury occurs, cause neurodegeneration later on? It is weird that the definition of a concussion does not include what is going on in the brain, which is an actual true definition of a diagnosis. He showed different pathologies in concussion. White matter in the brain in particular seems vulnerable to the forces of a concussion. He discussed the role of axons in a brain injury, noting that Tau is our selective marker for axons. He talked about how multiple swelling occurs along the axon. Think of the brain being a kind of eavesdropping system, a shadow network.  He indicated that in a sports injury in soccer, there is a higher rate of concussion and a worse outcome for women. Male axons are bigger and have a more complex microtubular array. On average, smaller axons are more vulnerable and subject to greater dysfunction and loss of synchrony, so normal functions of networks are impaired in females compared to males. Another change that does a lot in a concussion is disruption of the blood brain barrier. Think of a blood brain barrier disruption map as where we see the distribution of axonal pathology. 

 

Jun 8, 2022
Dr. Karsten has more than five years of clinical experience across diverse healthcare settings and currently works full-time on an acute inpatient neurorehabilitation unit, evaluating and treating adults with acquired brain injury and other neurological & complex orthopedic conditions. She also serves as a mentor to other staff members and acts as a supporting faculty member of the Neurologic Residency Program in acute inpatient rehabilitation at NYU Langone Orthopedic Hospital. Dr. Karsten has presented posters at American Physical Therapy Association meetings and also at the 5th International Gait and Balance Symposium in Multiple Sclerosis. Her Doctor of Physical Therapy degree is from Hunter College and she has achieved Board Certification in Neurologic Physical Therapy.

Part 2 covers related topics, including: some challenges that may characterize treating different kinds of patients based on age; possible impairments associated with an ABI involving  communication, loss of mobility, increased fatigue, sleep difficulties, and vision deficits; patients’ level of self-awareness; negative health behaviors exhibited prior to sustaining a brain injury; and challenges faced by caregivers.  

 

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