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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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Dec 8, 2021

Dr. Antonio Stecco is an Assistant Professor at Rusk Rehabilitation, New York University. A physiatrist, he has been President of the Fascial Manipulation Association since 2010, Assistant to the President of the International Society of Physical Medicine and Rehabilitation from 2012 to 2014, and President of the International Myopain Society since 2020. His scientific activity is devoted to the study of the human fasciae from a macroscopically, histologically and patho-physiologically point of view. He personally made over 100 cadaver dissections for research. From 2007, he organized and personally held theoretical-practical courses about the Fascial Manipulation method in all five continents. The author of more than 50 in extensor papers about the fascia, Dr. Stecco has co-authored 5 books and is co-author of different chapters of international books. His medical degree and PhD degree are from the University of Padova in Italy.

In Part 1, we discussed: what attracted him to accept a position at NYU Langone Health; whether the COVID resurgence affected his ability to do research and furnish care for patients; results of his research on a comparison between traditional rehabilitation treatment and fascial manipulation of chronic neck pain; the results of a study he conducted on the role played by fasciae in ankle injuries sustained by basketball players; differences between males and females in the kind of injuries they sustain to their ankles and other body parts playing basketball; his training of major league baseball players in using fascial manipulation to decrease injury and improve performance; how to decrease injury among soccer players; and how fascial or muscle stretching exercises are an integral part of rehabilitation and athletics.  

 

Nov 24, 2021

Part 2

Advance care planning involves talking now about the future and the setting where someone has deteriorating health and is not able to converse with clinicians about patients’ wishes, preferences, fears, expectations of what is going on, and their hopes. At this juncture, there can be a discussion about a patient’s quality of life and what he or she would like it to be. Sometimes, patient preferences can be put into advance directives (e.g., a living will or a medical power-of-attorney). Some barriers to advance care planning were described. Examples of patient barriers are procrastination, apathy, and fear of burdening the family. Some provider barriers are a lack of desire in talking about a negative future outcome and not wanting to burden patients and families by discussing this topic. Two other big considerations are time constraints on the part of providers and a general lack of knowledge about advance directives. It is important to be able to offer some sort of direction to families regarding possible health care outcomes even when there is a lot of uncertainty. End-of-life care can make some individuals nervous, which is understandable. Withholding or withdrawing interventions that are not in line with patient goals is OK. We do not want to cause any harm or do inappropriate things. As long as we are eliciting what is important to families and doing what meets their goals, generally speaking, we are doing the right thing. 

Nov 10, 2021

Part 1

Although cancer is the second lead cause of death in the U.S., the rate has been falling. It is becoming more of a chronic disease and has a treatment paradigm that is different from the past. Cancer also is the second most common cause of disability claims. Breast and prostate cancer have a heightened incidence of disabling complications, which is relevant because it is a potential interplay area of palliative care and rehabilitation. Fewer patients are dying in hospitals while the home and hospice settings are on a little upswing. He mentioned common symptoms (e.g., pain and shortness of breath) at end-of-life that differentiate patients with cancer from those who do not have it. The ultimate goal of palliative care and rehabilitation is to improve quality of life. Palliative medicine is one component of the bigger group of palliative care interventions. Regarding hospice care, someone may or may not be eligible for hospice services because of the insurance situation, but everybody is eligible for good end-of-life care and that is what can be provided regardless of insurance status. He then discussed what rehabilitation entails. One main focus is pain management. He indicated ways in which rehabilitation and palliative care can be provided together effectively in four domains, e.g., caregiver support.

Oct 27, 2021

Dr. Jonas Sokolof is Director of the Division of Oncological Rehabilitation and Clinical Associate Professor in the Department of Rehabilitation Medicine at NYU Grossman School of Medicine. He is certified by the American Board of PM&R both in Sports Medicine and in Physical Medicine & Rehabilitation. His doctor of osteopathy degree is from the New York Institute Of Technology. His Residency occurred at the Harvard Medical School and the Spaulding Rehabilitation Hospital in Boston. He also had a fellowship in sports medicine from Rutgers New Jersey Medical School. Prior to arriving at NYU Langone Health in 2018, he was at the Memorial Sloan Kettering Cancer Center in New York City.

In Part 1, we discussed the following:  if the recent COVID resurgence affected his ability to furnish care for patients with cancer; the types of cancer in which most of his patients can be found; what manual medicine entails; assessment of patients' emotional needs; supportive needs of patients of an informational, spiritual, or social nature;  whether patients are requested to produce autobiographical accounts of how they experience life as a cancer patient and the treatment they receive; and efforts to enable patients to become adept as self-managers of cancer so that they can be effective in self-monitoring, recognizing and reporting symptoms, and treating side effects. 
 
In Part 2, we discussed the following: from the perspective of osteopathic medicine, how rehabilitation can be used to deal with undesirable side effects; extent to which telemedicine is employed in the treatment of patients; current status of an exercise oncology initiative known as “Moving Through Cancer;” challenges involved in motivating patients to exercise whose lifestyle prior to the onset of cancer did not include efforts to be physically fit; and topics involving cancer rehabilitation where more research could prove to be advantageous in improving patient care, along with research that either is underway or projected to occur.
Oct 13, 2021

Dr. Jonas Sokolof is Director of the Division of Oncological Rehabilitation and Clinical Associate Professor in the Department of Rehabilitation Medicine at NYU Grossman School of Medicine. He is certified by the American Board of PM&R both in Sports Medicine and in Physical Medicine & Rehabilitation. His doctor of osteopathy degree is from the New York Institute Of Technology. His Residency occurred at the Harvard Medical School and the Spaulding Rehabilitation Hospital in Boston. He also had a fellowship in sports medicine from Rutgers New Jersey Medical School. Prior to arriving at NYU Langone Health in 2018, he was at the Memorial Sloan Kettering Cancer Center in New York City.

In Part 1, we discussed the following:  if the recent COVID resurgence affected his ability to furnish care for patients with cancer; the types of cancer in which most of his patients can be found; what manual medicine entails; assessment of patients' emotional needs; supportive needs of patients of an informational, spiritual, or social nature;  whether patients are requested to produce autobiographical accounts of how they experience life as a cancer patient and the treatment they receive; and efforts to enable patients to become adept as self-managers of cancer so that they can be effective in self-monitoring, recognizing and reporting symptoms, and treating side effects. 
 
 
 

 

Sep 29, 2021

PART TWO

In Part 1, Dr. Kim presented information about the historical and legal background for cannabis, variations in policies in the states, and the status of current research. In Part 2, she discussed cancer pain that is not neuropathic. She described the results of a study that involved opioid refractory cancer pain. Evidence currently shows that patients who have increased access to cannabis actually have higher rates of opioid overdose and deaths. She reviewed a case of one of her patients who had prostate cancer. This individual was not amenable to physical therapy and was weaned off opioids because they were not effective. Finally, they decided to try different types of cannabis for pain and sleep and he is doing quite well. He eventually used a combination of low and high THC capsules and was weaned off all other drugs. She and her colleagues also looked at how patients considered the use of cannabinoid therapy and found that overall they preferred it for their future chemo. Even though cannabis is a natural product, it is not true that it is free of side effects. There is some concern that it can have interactions on the heart, result in psychotic symptoms, affect psychomotor performance, and lead to an increase in tolerance, making it necessary to use higher and higher doses to achieve the same effect. A question-and-answer period followed her presentation. 

Sep 15, 2021

PART ONE

In Part 1 of a two-segment presentation, Dr. Kim discussed historical and legal background for medical cannabis and cannabis in general; mechanism of action; applications for pain and symptom management; the science behind cannabis for cancer care; relative safety issues; contraindications and monitoring; and some public health concerns. She defined cannabis, marijuana, hemp, and indicated various code names for recreational marijuana. Marijuana was criminalized and removed from the U.S. Pharmacopeia in 1941, Most recently, some states have legalized it both medically and recreationally. For medical purposes, there is a lot of variation in what states will allow. A concern has been about the presence of contaminants in many products. Based on current research, the science and the evidence are not where they could be ideally. She discussed marijuana and how it works, mentioning the endocannabinoid system. Different ways exist to act on that system. She described the entourage effect and how it functions.

 

D

Sep 1, 2021

Dr. Kim received his medical degree from SUNY Brooklyn and he completed a residency in both physical medicine and rehabilitation, along with a fellowship in anesthesiology and pain management at Mt. Sinai. He is board certified in both PM&R and anesthesiology.

In Part 1 of his presentation, he indicated that he would mention some specific products and companies, but he does not have a financial relationship with them. One of his objectives is to provide background information about PNS. Currently, there is an increase in this kind of technology and also in the demand for non-opioid pain management. PNS can be fitted into the specialty of neuro modulation, a field that touches upon multiple specialties, including PM&R. The basic goal in PNS is to stimulate the nerve and reduce unwanted pain. PNS has been around since the early 1960s.  Pain is the most common indicator for employing its usage. Dr. Kim has a specific interest in post-stroke shoulder pain, which is a difficult condition to treat. Post-surgical pain in general and post-amputation pain have led to the increased demand for PNS. Complications of this kind of treatment include the risk of infection and scarring around the nerve. Modern implantables show why PNS has increased in demand because technology has led to more miniaturization of these stimulators, which significantly has decreased the amount of invasiveness. Based on work performed at Rusk, he mentioned how research findings have been shared with professional organizations, such as the North American Neuromodulation Society (NANS).

In Part 2 of his presentation, he continued describing the current state of research on the use of PNS, which to some degree is lacking, but certainly it potentially is increasing. He referred to a multi-center, randomized, double-blind investigation that looked at PNS technologies in a variety of pain conditions. He then described a product that was cleared by the FDA in July 2016. It involves the use of multiple electronic leads rather than using a single one. The implant used is of a temporary nature (60 days) rather than something permanently. He pointed out that because the technology is much smaller, no incision is necessary. The micro lead is much smaller in diameter and does not have to be as close to the nerve. He showed a video about a typical implant for a shoulder, involving the 60-day version of technology being used. While it played, he narrated some of the steps shown in the video regarding the implant of the electrode. Everything becomes stabilized as the electrode moves closer to the nerve. His presentation concluded with his fielding questions asked by participants at this event, including two by Dr. Steven Flanagan, Director of the Rusk Rehabilitation Institute at NYU Langone Health.

Aug 18, 2021

Dr. Kim received his medical degree from SUNY Brooklyn and he completed a residency in both physical medicine and rehabilitation, along with a fellowship in anesthesiology and pain management at Mt. Sinai. He is board certified in both PM&R and anesthesiology.

In Part 1 of his presentation, he indicated that he would mention some specific products and companies, but he does not have a financial relationship with them. One of his objectives is to provide background information about PNS. Currently, there is an increase in this kind of technology and also in the demand for non-opioid pain management. PNS can be fitted into the specialty of neuro modulation, a field that touches upon multiple specialties, including PM&R. The basic goal in PNS is to stimulate the nerve and reduce unwanted pain. PNS has been around since the early 1960s.  Pain is the most common indicator for employing its usage. Dr. Kim has a specific interest in post-stroke shoulder pain, which is a difficult condition to treat. Post-surgical pain in general and post-amputation pain have led to the increased demand for PNS. Complications of this kind of treatment include the risk of infection and scarring around the nerve. Modern implantables show why PNS has increased in demand because technology has led to more miniaturization of these stimulators, which significantly has decreased the amount of invasiveness. Based on work performed at Rusk, he mentioned how research findings have been shared with professional organizations, such as the North American Neuromodulation Society (NANS).

Aug 4, 2021
Dr. Joshua Rozell is a hip and knee replacement surgeon at NYU Langone with practices in Brooklyn and Manhattan. He specializes in anterior approach hip replacement, computer-navigated and robotic knee replacements, and outpatient joint replacement surgery. Many of the techniques he uses allow patients to recover more quickly and improve their function and strength after surgery. He did his undergraduate training at Emory University, went to medical school at Drexel University, and had his orthopaedic surgery residency at the University of Pennsylvania, along with a hip and knee replacement fellowship at the prestigious Steadman Clinic in Vail, Colorado.
 
Dr. Manuel Wilfred is a physical therapist who provides care for joint replacement patients at NYU Langone-Brooklyn. He has worked with orthopedic patients both inpatient and outpatient throughout his 19 years in the profession. Prior to being at NYU Langone-Brooklyn, he received his bachelor's degree in physical therapy from India and then he left that country to study at University College London and work in the National Health Service's Middlesex Hospital. He has a doctor of physical therapy degree from the University of Montana and completed his PhD degree from Seton Hall University. 
 
In Part 2, we discussed: advanced surgical techniques employed for both hip and knee surgery; time after surgery when physical therapy interventions are initiated; other kinds of members of the health care team at NYU Langone Health involved both pre- and post-surgery to make possible same-day discharge; additional therapy provided once patients return home and when it is initiated; the role of telehealth in delivering home-based care; situations at home that may result in patients seeking emergency room care or requiring in-patient hospitalization; whether patients who undergo bilateral hip and knee surgery are suitable candidates for same-day discharge; and kinds of research being conducted at NYU involving same-day discharge
Jul 21, 2021
Dr. Joshua Rozell is a hip and knee replacement surgeon at NYU Langone with practices in Brooklyn and Manhattan. He specializes in anterior approach hip replacement, computer-navigated and robotic knee replacements, and outpatient joint replacement surgery. Many of the techniques he uses allow patients to recover more quickly and improve their function and strength after surgery. He did his undergraduate training at Emory University, went to medical school at Drexel University, and had his orthopaedic surgery residency at the University of Pennsylvania, along with a hip and knee replacement fellowship at the prestigious Steadman Clinic in Vail, Colorado.
 
Dr. Manuel Wilfred is a physical therapist who provides care for joint replacement patients at NYU Langone-Brooklyn. He has worked with orthopedic patients both inpatient and outpatient throughout his 19 years in the profession. Prior to being at NYU Langone-Brooklyn, he received his bachelor's degree in physical therapy from India and then he left that country to study at University College London and work in the National Health Service's Middlesex Hospital. He has a doctor of physical therapy degree from the University of Montana and completed his PhD degree from Seton Hall University. 
 
In Part 1, we discussed: the effect of the COVID pandemic on performing hip and knee replacement surgery and providing post-operative care; typical hospital length of stay experienced by patients prior to implementing same-day discharge; number of these surgical procedures performed on a weekly basis; the proportion of these operations resulting in same day-discharge; kinds of factors used to identify patients who are excellent candidates for same-day discharge following hip and knee replacement surgery; factors indicating that certain patients should be excluded from participating in same-day discharge; and contents of a "playbook" used during the preoperative consultation phase. 
Jul 7, 2021

In Part 2 of his presentation on the topic of diversity and inclusion in medicine, Dr. Lopez continued describing the use of a holistic approach to interview candidates for admission to NYU’s PM&R residency program. Factors currently being  taken into account other than board scores, include socio economic hardship, commitment to the underserved, work experience, and fluency in other languages. A task force also was formed to review every candidate individually. Interviews  presently involve taking a closer look at structured behavioral interview questions, which can be used to measure factors, such as professionalism and teamwork. Interviewers also are blinded to board scores to eliminate a higher halo effect that might exist. Dr. Lopez then reviewed the results of the latest match and identified the kinds of efforts that should be undertaken to increase the proportion of underrepresented groups, including women and members of the LGBTQ community. More diversity is welcome at NYU. Change is not going to happen overnight. Current efforts are just the starting point. A question and answer session for several minutes followed his presentation, including comments made by Dr. Steven Flanagan, Howard A. Rusk Professor of Rehabilitation Medicine and Chairperson of the Department of Rehabilitation Medicine at NYU Langone Health.

 
 
 
 
 
Jun 23, 2021

In Part I, Dr. Lopez wanted to familiarize listeners in this grand rounds presentation with a history of minorities in medicine and to describe current trends in diversity and inclusion in medicine in general and specifically in PM&R.  He identified arguments for diversity and contrasted past, present, and future recruitment efforts at NYU. He also discussed this years’ match data results. Historically, there have been many challenges for minorities to gain a foothold in medicine. He wanted to furnish objective data about this situation. These individuals had a problem right from the beginning in obtaining admission to medical schools. He described enrollment data from the Association of American Medical Colleges (AAMC) and compared it to U.S. Census Bureau data. Over the last 50 years, Dr. Lopez noted how medical schools have tried to do something about increasing the proportion of students from underrepresented minority groups. Specific information entailed showing what has occurred in PM&R, involving students and faculty. Comparisons then were made with overall U.S. population trends. Reasons are provided for increasing diversity and inclusion in medicine, e.g., minority patients seek doctors who look like them and more minority physicians are likely to take care of minority patients

Jun 9, 2021

Dr. Ryan Branski is the Howard A. Rusk Associate Professor of Rehabilitation Research and the Vice Chair for Research in Rehabilitation Medicine at the NYU Grossman School of Medicine. He also has appointments in Otolaryngology-Head and Neck Surgery in the school of medicine and Communicative Sciences and Disorders in the Steinhardt School of Culture, Education, and Human Development. 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 Fellow of the American Academy of Otolaryngology-Head and Neck Surgery, the American Speech Language Hearing Association, and the American Laryngological Association.

In Part 1 of his presentation, Dr. Branski discussed how efforts are underway to push research over the top in productivity at NYU. It is important to consider the economic implications of research. Obtaining external support is not easy and we should celebrate those accomplishments when funding is obtained. Voice disorders are the single most common communication disorder across the lifespan. He mentioned the importance of Reinke’s space and his contributions in describing the layered structure of the vocal folds. He indicated how challenging it is to deal with the problem of vocal fold necrosis. 

In Part 2 of his presentation, Dr. Branski discussed voice research, an area of investigation that not only poses the most opportunities, but also the most obstacles. He also mentioned developments in addressing tissue deficits in the airway. He closed on the theme that research needs to be opportunistic and that what is of value in this institution is to enhance communication between the thousand clinicians at NYU and the researchers. 

A Q & A period followed.

May 26, 2021

Dr. Ryan Branski is the Howard A. Rusk Associate Professor of Rehabilitation Research and the Vice Chair for Research in Rehabilitation Medicine at the NYU Grossman School of Medicine. He also has appointments in Otolaryngology-Head and Neck Surgery in the school of medicine and Communicative Sciences and Disorders in the Steinhardt School of Culture, Education, and Human Development. 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 Fellow of the American Academy of Otolaryngology-Head and Neck Surgery, the American Speech Language Hearing Association, and the American Laryngological Association.

In Part 1 of his presentation, Dr. Branski discussed how efforts are underway to push research over the top in productivity at NYU. It is important to consider the economic implications of research. Obtaining external support is not easy and we should celebrate those accomplishments when funding is obtained. Voice disorders are the single most common communication disorder across the lifespan. He mentioned the importance of Reinke’s space and his contributions in describing the layered structure of the vocal folds. He indicated how challenging it is to deal with the problem of vocal fold necrosis. 

In Part 2 of his presentation, Dr. Branski discussed voice research, an area of investigation that not only poses the most opportunities, but also the most obstacles. He also mentioned developments in addressing tissue deficits in the airway. He closed on the theme that research needs to be opportunistic and that what is of value in this institution is to enhance communication between the thousand clinicians at NYU and the researchers. 

A Q & A period followed.

May 12, 2021

This is a special two-part Grand Rounds series with Dr. Steven Flanagan, Professor and Chairman of Rehabilitation Medicine and Medical Director of Rusk Rehabilitation. 

In Part 1 of his presentation, Dr. Flanagan discusses the contributions of Dr. Howard Rusk, the father of rehabilitation medicine. He brought it to the forefront as a recognized specialty by showing that rehabilitation contributed to improving the lives of patients with disabilities. Dr. Flanagan referred to various efforts over the decades to manage health care costs through managed care and other means. Even today when it is evident that a inpatient care is necessary, barriers can offer resistance because of the costs involved. What makes the case of inpatient care more challenging is the need to have more data to justify the decision to provide care at that level. He predicts that cost containment will continue well into the future. Our aims are to improve health care outcomes and increase efficiency. He concluded Part 1 of his presentation by stating that PM&R has a critical role to play in attaining the Triple Aim.

In Part 2 of his presentation, Dr. Flanagan discusses challenges involved in justifying the need for the provision of inpatient rehabilitation care in the context of controlling expenditures and the critical role that physical medicine and rehabilitation play in attaining the Triple Aim. We know that the intensity of some of our rehabilitation therapies are associated with better outcomes, for example, aphasia therapy. Early mobilization results in better outcomes with cost savings. Nonetheless, we still need more data to show that what we do is important. Mention was made of expansions at Rusk, such as a new division on Technology and Innovation to advance rehabilitation science. Health care is changing and education must change with it.

 
Apr 28, 2021

This is a special two-part Grand Rounds series with Dr. Steven Flanagan, Professor and Chairman of Rehabilitation Medicine and Medical Director of Rusk Rehabilitation. 

In Part 1 of his presentation, Dr. Flanagan discusses the contributions of Dr. Howard Rusk, the father of rehabilitation medicine. He brought it to the forefront as a recognized specialty by showing that rehabilitation contributed to improving the lives of patients with disabilities. Dr. Flanagan referred to various efforts over the decades to manage health care costs through managed care and other means. Even today when it is evident that a inpatient care is necessary, barriers can offer resistance because of the costs involved. What makes the case of inpatient care more challenging is the need to have more data to justify the decision to provide care at that level. He predicts that cost containment will continue well into the future. Our aims are to improve health care outcomes and increase efficiency. He concluded Part 1 of his presentation by stating that PM&R has a critical role to play in attaining the Triple Aim.

In Part 2 of his presentation, Dr. Flanagan discusses challenges involved in justifying the need for the provision of inpatient rehabilitation care in the context of controlling expenditures and the critical role that physical medicine and rehabilitation play in attaining the Triple Aim. We know that the intensity of some of our rehabilitation therapies are associated with better outcomes, for example, aphasia therapy. Early mobilization results in better outcomes with cost savings. Nonetheless, we still need more data to show that what we do is important. Mention was made of expansions at Rusk, such as a new division on Technology and Innovation to advance rehabilitation science. Health care is changing and education must change with it.

Apr 14, 2021

Dr. Mahya Beheshti is a physician scientist at NYU Langone Health’s Rusk Rehabilitation Institute. She has been working at the Visuomotor Integration Laboratory with the focus on eye-hand coordination research as it relates to acquired brain injury. She also collaborates with  the Rehabilitation Engineering Alliance and Center Transforming Low Vision Laboratory where her research involves advanced wearables for sensory deprived patients. Additionally, she is a Mechanical and Aerospace Engineering PhD student at NYU-Tandon.

Dr. J.R. Rizzo also is a physician scientist at NYU Langone Health’s Rusk Rehabilitation Institute. He serves as Director of Innovation and Technology for Physical Medicine and Rehabilitation with cross-appointments in the Department of Neurology and the Departments of Biomedical & Mechanical and Aerospace Engineering at NYU-Tandon. He also is the Associate Director of Healthcare for the renowned NYU Wireless Laboratory in the Department of Electrical and Computer Engineering at NYU-Tandon. He leads both the Visuomotor Integration Laboratory and the Rehabilitation Engineering Alliance and Center Transforming Low Vision Laboratory.

This is a two-part series. In Part 1, they discuss: how the ability to conduct research has been affected by the arrival of the coronavirus pandemic; possible reluctance of patients to be involved in research that occurs in a clinical setting because of a fear of contracting COVID-19 there; the extent to which delays and postponements have occurred because of disease resurgences; how COVID-19 limitations on touch and physical contact have led to unintended yet significant challenges to spatial perception, interpretation, and behavior for individuals who are blind or visually impaired;  the effectiveness of gloves, hand sanitizers, and hand washing in reducing the risk of touching contaminated surfaces and what, if any downsides, would be associated with such practices; and how the the Visually Impaired Smart Service System for Spatial Intelligence and Onboard Navigation operates. 
 
In Part 2, they discuss: research involving advanced wearables for sensory deprived patients; the use of other kinds of suitable assistive technology devices; the role of the cerebellum and the cortex regarding critical aspects of functional movement control; the results of a study to determine if native English speakers perform differently compared to non-native English speakers on a sideline-focused rapid number naming task and to characterize objective differences in eye movement behavior between these cohorts; the role of the long white cane as a mobility tool for individuals who have visual impairments and any shortcomings this assistive instrument may have; and any other current research not discussed in this interview, along with any projected vision research at NYU. 
Mar 31, 2021

Dr. Mahya Beheshti is a physician scientist at NYU Langone Health’s Rusk Rehabilitation Institute. She has been working at the Visuomotor Integration Laboratory with the focus on eye-hand coordination research as it relates to acquired brain injury. She also collaborates with  the Rehabilitation Engineering Alliance and Center Transforming Low Vision Laboratory where her research involves advanced wearables for sensory deprived patients. Additionally, she is a Mechanical and Aerospace Engineering PhD student at NYU-Tandon.

Dr. J.R. Rizzo also is a physician scientist at NYU Langone Health’s Rusk Rehabilitation Institute. He serves as Director of Innovation and Technology for Physical Medicine and Rehabilitation with cross-appointments in the Department of Neurology and the Departments of Biomedical & Mechanical and Aerospace Engineering at NYU-Tandon. He also is the Associate Director of Healthcare for the renowned NYU Wireless Laboratory in the Department of Electrical and Computer Engineering at NYU-Tandon. He leads both the Visuomotor Integration Laboratory and the Rehabilitation Engineering Alliance and Center Transforming Low Vision Laboratory.

This is a two-part series. In Part 1, they discuss: how the ability to conduct research has been affected by the arrival of the coronavirus pandemic; possible reluctance of patients to be involved in research that occurs in a clinical setting because of a fear of contracting COVID-19 there; the extent to which delays and postponements have occurred because of disease resurgences; how COVID-19 limitations on touch and physical contact have led to unintended yet significant challenges to spatial perception, interpretation, and behavior for individuals who are blind or visually impaired;  the effectiveness of gloves, hand sanitizers, and hand washing in reducing the risk of touching contaminated surfaces and what, if any downsides, would be associated with such practices; and how the the Visually Impaired Smart Service System for Spatial Intelligence and Onboard Navigation operates. 
 
In Part 2, they discuss: research involving advanced wearables for sensory deprived patients; the use of other kinds of suitable assistive technology devices; the role of the cerebellum and the cortex regarding critical aspects of functional movement control; the results of a study to determine if native English speakers perform differently compared to non-native English speakers on a sideline-focused rapid number naming task and to characterize objective differences in eye movement behavior between these cohorts; the role of the long white cane as a mobility tool for individuals who have visual impairments and any shortcomings this assistive instrument may have; and any other current research not discussed in this interview, along with any projected vision research at NYU. 
 

 

Mar 17, 2021

Dr. Robert Gordon is the Director of Intern Training and Associate Director of Postdoctoral Fellow Training at Rusk Rehabilitation Institute and Clinical Associate Professor at New York University Grossman School of Medicine. He has been the Director of Intern Training since 1995 and has trained over 270 psychology interns. He has specialties in the areas of neuropsychological and forensic testing and psychotherapy with children and adults with physical and learning disabilities and chronic illness. He has published in the areas of existential-humanistic and relational therapeutic approaches during COVID-19 with patients with preexisting conditions, ethics, supervision, relational psychoanalysis, dream interpretation, pain management, and the use of projective testing in neuropsychology. He received his doctorate from the Ferkauf Graduate School of Psychology, Yeshiva University in Child Clinical/School Psychology in 1985 and a Certificate in Psychoanalysis and Psychotherapy from Adelphi University in 1999. 

This is a two part series. In Part 1, he discusses: his role at Rusk and the services his department provides and with what populations; the extent to which telehealth was used prior to the COVID-19 outbreak and how this usage compares to the aftermath of the appearance of this disease; what motivated him to write a recent article entitled “Existential-Humanistic and Relational Approaches During COVID with Patients with Preexisting Medical Conditions;” his description of the meaning of the term Existential-Humanistic Psychotherapy; who some major writers are in the field of Existential-Humanistic Therapy and how their ideas are relevant to dealing with COVID; some psychological challenges of dealing with COVID; and what constitutes relational psychotherapy and what major ideas there are in this approach.

In Part 2, he discusses: some major techniques in applying Existential-Humanistic and Relational approaches with patients with preexisting medical conditions; what Posttraumatic Growth is and what strategies are used in exploring it in psychotherapy; major issues that patients with preexisting issues experience; kinds of therapeutic adjustments that must be made in treating patients with communication impairments; the nature of group work with patients and determining when it is advantageous to use it; and some implications of the paper he wrote regarding clinical practice and  society in general.

Mar 3, 2021

Dr. Robert Gordon is the Director of Intern Training and Associate Director of Postdoctoral Fellow Training at Rusk Rehabilitation Institute and Clinical Associate Professor at New York University Grossman School of Medicine. He has been the Director of Intern Training since 1995 and has trained over 270 psychology interns. He has specialties in the areas of neuropsychological and forensic testing and psychotherapy with children and adults with physical and learning disabilities and chronic illness. He has published in the areas of existential-humanistic and relational therapeutic approaches during COVID-19 with patients with preexisting conditions, ethics, supervision, relational psychoanalysis, dream interpretation, pain management, and the use of projective testing in neuropsychology. He received his doctorate from the Ferkauf Graduate School of Psychology, Yeshiva University in Child Clinical/School Psychology in 1985 and a Certificate in Psychoanalysis and Psychotherapy from Adelphi University in 1999. 

This is a two part series. In Part 1, he discusses: his role at Rusk and the services his department provides and with what populations; the extent to which telehealth was used prior to the COVID-19 outbreak and how this usage compares to the aftermath of the appearance of this disease; what motivated him to write a recent article entitled “Existential-Humanistic and Relational Approaches During COVID with Patients with Preexisting Medical Conditions;” his description of the meaning of the term Existential-Humanistic Psychotherapy; who some major writers are in the field of Existential-Humanistic Therapy and how their ideas are relevant to dealing with COVID; some psychological challenges of dealing with COVID; and what constitutes relational psychotherapy and what major ideas there are in this approach.

In Part 2, he discusses: some major techniques in applying Existential-Humanistic and Relational approaches with patients with preexisting medical conditions; what Posttraumatic Growth is and what strategies are used in exploring it in psychotherapy; major issues that patients with preexisting issues experience; kinds of therapeutic adjustments that must be made in treating patients with communication impairments; the nature of group work with patients and determining when it is advantageous to use it; and some implications of the paper he wrote regarding clinical practice and  society in general.

Feb 17, 2021

Dr. Joan Gold is a clinical professor in the Department of Rehabilitation at Rusk Rehabilitation, NYU Langone Health. 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 in Pediatrics. Her area of specialization includes the pediatric disorders cerebral palsy and spina bifida.

This is a special two-part Grand Rounds series.

In Part 1 of her presentation, Dr. Gold contrasted a time 50 years ago when she made a presentation on the topic of spina bifida. Today, we have a change in attitude and a change in medical information since that earlier period and we also need to be aware of long-term care needs and the need for continuity of care of these patients, and all our patients who are aging out. She cited professional literature from 1971 that described many kinds of pediatric patients whose conditions were such that rather than try to treat them, they should be allowed to succumb. For example, comments made back then about these patients being incontinent and socially unacceptable were not true. By 1996, it was shown that most of the previous assumptions were wrong. A child in a wheelchair is worth living. Many surgical deformities that once were present can be corrected today. Incontinence is not inevitable and bowel function can be controlled. She discussed the role of folate in reducing the incidence of spina bifida. She mentioned the implications of providing care for these patients. Most of the surgical procedures undertaken today are neurosurgical. Various generalizations can be made. One is that adult spina bifida patients are likely to have fewer primary care visits than patients under the age of 18 and she explained reasons why it is so. She concluded Part 1 of her presentation by talking about the role that urinary complications may play in the death of many patients.

Listeners to Part 1 of Dr. Gold’s presentation will recall she indicated that it probably is the urinary complication that is the cause of death in most of these patients, which is critical. In Part 2, she began by asking what multilevel care elements should exist for patients with spina bifida? She mentioned that as a result of pushing wheelchairs, some patients experience rotator cuff injuries. Although therapeutic services do not have to be performed for all patients, she described some kinds of assistance that they may need. Some patients may experience functional regression. Once able to walk at ages five and 10, they no longer can do so. There is a higher incidence of neuroses. These patients need vocational, nutritional, and social work services. A problem for many patients is when they have to travel a considerable distance for hospital care, the facility they go to may lack the personnel necessary to provide appropriate kinds of spina bifida care. She indicated some surgical concerns. Most shunted patients have long term motor and cognitive behavioral deficits. She described urological issues that are most paramount and frequent. She asked what kinds of things should we do when we assess patients within a therapeutic realm? We should look at their transportation skills, perceptual motor skills to drive, be knowledgeable of their medical management and history, and try to establish some autonomy with money management, household skills, and community living skills. Also, there is a need to work on their parenting skills and on obtaining adequate health care for themselves and their children. There are issues with cardiovascular disease. Studies show that as many as 73% of spina bifida patients have chronic pain. A final portion of the presentation was on the topic of women with spina bifida giving birth.

Feb 3, 2021

Dr. Joan Gold is a clinical professor in the Department of Rehabilitation at Rusk Rehabilitation, NYU Langone Health. 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 in Pediatrics. Her area of specialization includes the pediatric disorders cerebral palsy and spina bifida.

This is a special two-part Grand Rounds series.

In Part 1 of her presentation, Dr. Gold contrasted a time 50 years ago when she made a presentation on the topic of spina bifida. Today, we have a change in attitude and a change in medical information since that earlier period and we also need to be aware of long-term care needs and the need for continuity of care of these patients, and all our patients who are aging out. She cited professional literature from 1971 that described many kinds of pediatric patients whose conditions were such that rather than try to treat them, they should be allowed to succumb. For example, comments made back then about these patients being incontinent and socially unacceptable were not true. By 1996, it was shown that most of the previous assumptions were wrong. A child in a wheelchair is worth living. Many surgical deformities that once were present can be corrected today. Incontinence is not inevitable and bowel function can be controlled. She discussed the role of folate in reducing the incidence of spina bifida. She mentioned the implications of providing care for these patients. Most of the surgical procedures undertaken today are neurosurgical. Various generalizations can be made. One is that adult spina bifida patients are likely to have fewer primary care visits than patients under the age of 18 and she explained reasons why it is so. She concluded Part 1 of her presentation by talking about the role that urinary complications may play in the death of many patients.

Listeners to Part 1 of Dr. Gold’s presentation will recall she indicated that it probably is the urinary complication that is the cause of death in most of these patients, which is critical. In Part 2, she began by asking what multilevel care elements should exist for patients with spina bifida? She mentioned that as a result of pushing wheelchairs, some patients experience rotator cuff injuries. Although therapeutic services do not have to be performed for all patients, she described some kinds of assistance that they may need. Some patients may experience functional regression. Once able to walk at ages five and 10, they no longer can do so. There is a higher incidence of neuroses. These patients need vocational, nutritional, and social work services. A problem for many patients is when they have to travel a considerable distance for hospital care, the facility they go to may lack the personnel necessary to provide appropriate kinds of spina bifida care. She indicated some surgical concerns. Most shunted patients have long term motor and cognitive behavioral deficits. She described urological issues that are most paramount and frequent. She asked what kinds of things should we do when we assess patients within a therapeutic realm? We should look at their transportation skills, perceptual motor skills to drive, be knowledgeable of their medical management and history, and try to establish some autonomy with money management, household skills, and community living skills. Also, there is a need to work on their parenting skills and on obtaining adequate health care for themselves and their children. There are issues with cardiovascular disease. Studies show that as many as 73% of spina bifida patients have chronic pain. A final portion of the presentation was on the topic of women with spina bifida giving birth.

Jan 20, 2021
Holly Cohen is the Program Manager of the Assistive Technology Service at NYU Langone Health. Along with her clinical experience, she holds certification in assistive technology from the Rehabilitation and Engineering and Assistive Technology Society of North America, has a specialty certification in environmental modifications from the American Occupational Therapy Association, and is a Certified Driving Rehabilitation Specialist from the Association for Driver Rehabilitation Specialists. She founded the Assistive Technology Service and also started the Driving Rehabilitation program, serving as program manager of both services at NYU. She is an adjunct professor in the Department of the Occupational Therapy in the Steinhardt School at New York University. Her degree in Occupational Therapy is from the State University of New York and she has taken graduate level courses within the Interactive Telecommunications department at New York University. 
 
In this interview, she discusses how the coronavirus led to changes in how she works with patients, examples of low tech/high tech assistive devices, kinds of devices she uses most frequently, health problems of patients she treats, determining which forms of assistive technology to use, working with patients whose coronavirus symptoms persist, using telehealth to enable patients to use assistive devices at home, and helping patients to avoid abandoning the use of these devices.
 

 

Jan 6, 2021

Dr. Chelsea Schoen provides psychological and neuropsychological assessment and intervention services to a wide range of adults recovering from traumatic brain injury, stroke, other complex neurologic conditions, spinal cord injury, and orthopedic/musculoskeletal conditions. Her clinical and research interests include psychological factors associated with fear of falling. She received her PhD in Clinical Psychology with a Health Emphasis and specialization in neuropsychology from the Yeshiva (Yeshiva) University.

Dr. Philip J. Uy is a Senior Psychologist at Rusk Rehabilitation and works at Cardiopulmonary/Medically Complex on the Main Campus and at the Neurorehabilitation (Langone Orthopedic Hospital) acute inpatient rehabilitation. His clinical and research interests are in neurologic disorders, cardiopulmonary conditions, and adjustment to medical disability. He also has expertise in substance use disorders. He obtained his doctorate in Clinical Psychology from Fairleigh Dickinson University. 

In Part 1, they discuss the following: kinds of patients treated involving COVID-19; possible after-effects either caused or associated with the onset of coronavirus symptoms; types of challenges treating coronavirus patients;  mental health conditions that persist long-term; and mental health services provided for clinical colleagues.
 
In Part 2, they discuss the following: work involving telehealth care of patients; Acceptance and Commitment Therapy;  sleep disturbance or disorders experienced by patients; kinds of coronavirus patients at an increased risk for emotional disorders; and topics where more research could prove to be advantageous in improving patient care.

 

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