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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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Feb 1, 2023

Dr. Baumhauer is a tenured Professor and serves as the Senior Associate Dean of Academic Affairs for the University of Rochester School of Medicine and Dentistry. She also is the Associate Chair of Academic Affairs within the Department of Orthopaedics at the University of Rochester. In addition to providing clinical care and performing surgery, she holds the position as the Director of the Clinical Health Informatics Core for the UR Healthcare System and is a board of director of Accountable Health Partners, ACO for the Rochester Region. She received her Doctorate of Medicine from the University of Vermont College of Medicine. She completed orthopaedic residency at the Medical Center Hospital of Vermont and a Fellowship in Foot and Ankle Surgery at the Medical College of Wisconsin. She also completed a Masters in Public Health degree from the University of Rochester. Dr. Baumhauer is the past president of the American Board of Orthopaedic Surgery, American Orthopaedic Foot and Ankle Society (AOFAS), and Eastern Orthopaedic Association. She currently is the President of the Patient-Reported Outcomes Measurement Information System (PROMIS) Health Organization and has published over two hundred peer reviewed papers and book chapters.

Part 1:  Data are needed to help understand how a patient is feeling and functioning to implement preventive health strategies, maximize healthy behaviors, assess their treatment response, and understand how health care resources are being allocated. Dr. Baumhauer defined a patient reported outcome as information directly reported by the patient who experiences it and is not interpreted as when we usually obtain some health history and tell it in our terms and report it into the patient’s note. She provided examples of the disconnect between what is important to the patient and what the clinician believes is important for the patient. A validated number can be placed on how the patient is feeling and functioning. It is important that a validated instrument be used that is quick and does not hold up the clinician. At the University of Rochester, they landed on the use of PROMIS (Patient-Reported Outcomes Measurement Information System) on a custom platform called UR VOICE (Validated Outcomes in Clinical Experience). They collect the same information for each patient. They try to ask the right questions when the information is needed most. The aim is to be domain specific, such as symptom-based, using the core package of pain, physical function, and depression rather than focusing on various diseases. Depending on the medical specialty, the symptoms emphasized can be different. Compared to SF-36, PROMIS is a better measure since it is more responsive to change.

Jan 18, 2023
Dr. Kendall is a second-year resident physician at Rusk. She completed her undergraduate education in Nutrition Science with honors from Purdue University. Subsequently, she was awarded Master’s Student of the Year in 2017 by the Purdue University College of Health and Human Sciences for her graduate work in Cancer Epigenetics and Nutriepigenomics. Since discovering the field of physiatry as a medical student, she has adamantly pursued neurorehabilitation, spinal cord injury, and pain medicine research. She serves on the American Osteopathic College of Physical Medicine and Rehabilitation (AOCPMR) Resident Council, regularly provides mentorship to aspiring physiatrists, and serves on the Rusk Rehabilitation residency wellness committee. Her current rehabilitation interests include interventional spine medicine and movement disorders.
 
The following items were discussed in this one-part interview: incidence and prevalence data for amyotrophic lateral sclerosis (ALS) in the U.S.; the role of heredity; demographic groups more likely to experience the onset of this disease; preventability of ALS;, tools for making a clear diagnosis; ability to acquire wheelchairs in a timely fashion; when to initiate a custom power wheelchair order; training patients to use power wheelchairs; prevention of decubitus ulcers from sitting in an unchanged posture; and seeking to have an impact on legislation regarding this disease.

 

Jan 4, 2023

Originally from Brooklyn, Dr. Klyachman is the son of two Russian speaking immigrants and among the first in his family to pursue a career in medicine. He attended the University at Buffalo for his undergraduate education and continued his medical education at Touro College of Osteopathic Medicine in Harlem. After graduating, he went to Florida to complete an internship and currently is in the fourth year of a rehabilitation residency at NYU Rusk. He recently matched into a fellowship at NYU where he plans to continue specialty training that starts in July 2023. 

The following items were discussed in this one-part interview: a typical day in the life of a medical resident at Rusk; involvement in research at Rusk; area of specialization upon completion of the residency; types of components that should be included for residents in a skilled nursing facility level rehabilitation program, such as prediction tools for identifying and stratifying patients being discharged to a skilled nursing facility; social media developed for residents at Rusk; ways in which social media have played a constructive role in contributing to the mental and physical wellbeing of these clinicians; how social media can serve as a key adjunct to traditional residency learning in classrooms and on the wards; use of social media from the perspective of interacting with residency peers, instructors, and patients;  role for physiatrists to play in enhancing social media skill development in patients; and empowering patients by providing them with the necessary knowledge and skills to promote constructive behavior change. 
 
Many patients have as a rehabilitation goal a successful reintegration into the society by returning to previous employment and renewing their social networks. Self-management programs may contribute to realizing the attainment of this goal. What role do you see being played by physiatrists, if any, in empowering patients by providing them with the necessary knowledge and skills to promote constructive behavior changes through self-management.
Dec 21, 2022

Dr. Lindsey Gurin is a clinical assistant professor of neurology, psychiatry, and rehabilitation medicine at NYU Langone Health. She is dual board-certified in neurology and psychiatry and currently serves as Director of Behavioral Neurology at NYU Langone Orthopedics Hospital, where she provides neuropsychiatric consultation to the Rusk acute inpatient brain injury rehabilitation service. She also is Director of the NYU Combined Psychiatry/Neurology Residency Training Program. Dr. Gurin has published on neuropsychiatric manifestations of brain injury and her current research interests include psychosis after brain injury; disorders of consciousness; and catatonia in patients with neurologic disorders.

Dr. Brian Im is heavily involved in program development and academic medicine. He has an active role in brain injury rehabilitation research at NYU. After completing medical school at SUNY Upstate Medical University, a rehabilitation residency at NYU School of Medicine/Rusk Rehabilitation, and a fellowship in brain injury medicine at UMDNJ/Johnson Rehabilitation Institute, his subsequent tenure at Bellevue Hospital focused upon an interest in improving brain injury rehabilitation for underserved populations.  He remains involved in this research at Bellevue Hospital while at his current role as the director for brain injury rehabilitation medicine at NYU/Rusk Rehabilitation. 

In Part One, the discussion included the following: a description of the care provided at NYU for patients who experience a brain injury from the perspective of the overall number and kinds of personnel involved and the clinical facilities in which they work; early neurorehabilitation and recovery from disorders of consciousness after severe COVID-19; and the kinds of challenges involved, such as arriving at a correct diagnosis of disorders of consciousness that could prove difficult because of a combination of patient and health system factors.

In Part Two, the discussion included the following: long COVID with brain fog and treatments that are being tried; a definition of the terms catatonia and hypoxia-ischemia and a description of their causes; challenges involved in diagnosing and treating catatonia effectively in a timely manner; possible outcome of ineffective treatment occurring if catatonia is under-recognized diagnostically, and current and future research endeavors at NYU pertaining to brain injury.

Dec 8, 2022

Dr. Lindsey Gurin is a clinical assistant professor of neurology, psychiatry, and rehabilitation medicine at NYU Langone Health. She is dual board-certified in neurology and psychiatry and currently serves as Director of Behavioral Neurology at NYU Langone Orthopedics Hospital, where she provides neuropsychiatric consultation to the Rusk acute inpatient brain injury rehabilitation service. She also is Director of the NYU Combined Psychiatry/Neurology Residency Training Program. Dr. Gurin has published on neuropsychiatric manifestations of brain injury and her current research interests include psychosis after brain injury; disorders of consciousness; and catatonia in patients with neurologic disorders.

Dr. Brian Im is heavily involved in program development and academic medicine. He has an active role in brain injury rehabilitation research at NYU. After completing medical school at SUNY Upstate Medical University, a rehabilitation residency at NYU School of Medicine/Rusk Rehabilitation, and a fellowship in brain injury medicine at UMDNJ/Johnson Rehabilitation Institute, his subsequent tenure at Bellevue Hospital focused upon an interest in improving brain injury rehabilitation for underserved populations.  He remains involved in this research at Bellevue Hospital while at his current role as the director for brain injury rehabilitation medicine at NYU/Rusk Rehabilitation. 

In Part One, the discussion included the following: a description of the care provided at NYU for patients who experience a brain injury from the perspective of the overall number and kinds of personnel involved and the clinical facilities in which they work; early neurorehabilitation and recovery from disorders of consciousness after severe COVID-19; and the kinds of challenges involved, such as arriving at a correct diagnosis of disorders of consciousness that could prove difficult because of a combination of patient and health system factors.

In Part Two, the discussion included the following: long COVID with brain fog and treatments that are being tried; a definition of the terms catatonia and hypoxia-ischemia and a description of their causes; challenges involved in diagnosing and treating catatonia effectively in a timely manner; possible outcome of ineffective treatment occurring if catatonia is under-recognized diagnostically, and current and future research endeavors at NYU pertaining to brain injury.

 

Nov 23, 2022

Part Two included a discussion of the barriers that students still face despite the ADA. They did not seek supportive accommodations because of stigma or fear. Dr. Rizzo wanted to draw attention to definitions of disability. He also emphasized that people with disabilities can help with accessibility and for coming up with empathetic dialogue that is critical in moving forward as a medical community. These agendas must be pushed here at NYU to ensure that we are doing enough to increase disability inclusion and also to ensure that patients are receiving the preventive medicine that they actually need. Dr. Wu indicated that in his research conducted 30 years ago, deans not only were asked how many medical school students have disabilities, but also “how did they do?” Did you do the right thing for society by producing good physicians at the end or did you pass along somebody who shouldn’t be there? The result was those students did as well and better than their able-bodied counterparts.

Nov 9, 2022

Part One of this grand round presentation delves into the struggle faced by individuals with disabilities and future directions to take to include them in the rehabilitation field. Both Drs. Rizzo and Wu have important stories to tell about living with a disability. An aim in this session is to understand the epidemiology of disability, the American with Disabilities Act (ADA), and be familiar with the barriers that individuals with disabilities face. According to new CDC data, the prevalence of disability in the non-institutionalized portion of the U.S. population is 26%. The data may understate the true prevalence. Data also were provided on the prevalence of disability among medical students, residents, and practicing physicians. These numbers also may under represent the true extent of disability among members of the medical community. A definition of disability in the American with Disabilities Act Amendments and its implications were discussed.

Oct 26, 2022

Veronica Alfaro is a senior Design Technologist on the NYU Population Health Research team. Her work occurs in the intersection between accessibility and health care through the fields of human-centered design, user experience, user interface design, and information visualization. Her most recent focus is on reimagining health care and the use of technology and design to improve the relationship between patients and health care providers in the FuturePractice| HiBRID lab. Additionally, she focuses on the design of frameworks for developing customizable assistive technologies for individuals with disabilities, which she developed as part of her residency in the NYU Ability Project. She has an MPS degree from NYU’s Interactive Telecommunications Program.

In Part 2, the following items were discussed: collaboration with entities within and outside of NYU; how design thinking and innovative strategies are influenced by members of specific clinical groups; taking into account during the design process that patients who experience diminishing capacities may have to abandon digital health technologies; possible unintended negative consequences relating to novel digital technologies; challenges involved in the adoption of new technologies; and launching new research endeavors.

 

 

Oct 13, 2022

Veronica Alfaro is a senior Design Technologist on the NYU Population Health Research team. Her work occurs in the intersection between accessibility and health care through the fields of human-centered design, user experience, user interface design, and information visualization. Her most recent focus is on reimagining health care and the use of technology and design to improve the relationship between patients and health care providers in the FuturePractice| HiBRID lab. Additionally, she focuses on the design of frameworks for developing customizable assistive technologies for individuals with disabilities, which she developed as part of her residency in the NYU Ability Project. She has an MPS degree from NYU’s Interactive Telecommunications Program.

In Part 1, the following items were discussed: how she became interested in designing assistive technologies; use of 3D printing in producing custom educational materials and medical devices; her role in the the FuturePractice/HiBRID team;  and how the digital health component is integrated into the various FuturePractice/HiBRID activities.

Sep 28, 2022

Professor Arthur Matthews is chief operating officer of Matthews & Matthews Consulting, a boutique firm specializing in customized and divergent aspects of human resources, labor, and the workforce. His clients primarily are corporations, government agencies, unions, and 501(C)(3) organizations that include Johns Hopkins University, Con Edison, the Centers for Disease Control and Prevention, and New York City Health and Hospitals. Additionally, he is a Teaching Professor of Labor and Employment Relations at Penn State University and a Visiting Lecturer at the University of Arkansas. He began his teaching career in 1987 first at the Medgar Evers College/City University of New York and the Van Arsdale School of Labor Studies. Since 1989 he also has served on the faculty at NYU and Cornell University School of Industrial and Labor Relations. His law degree with a Concentration in Human Rights, Civil Rights, and Public Policy is from Howard University. 

In this interview, he discusses the following: principles of leadership, going from a leader to becoming an ambassador, interchangeable skills for different situations, dealing with conflict, adding leadership training to the curricula at health professions schools, and the notion of shared leadership.

Sep 14, 2022

Dr. Linda Carozza is a clinical professor in the Department of Physical Medicine and Rehabilitation at NYU Langone Health. She has written extensively on the broad topic of communication and aging with a focus on creative approaches to improving the quality of life. Her publications include the topic of counselling in chronic aphasia: integrating theory with professional roles in clinical practice and also on the topic of non-pharmacological approaches to dementia. She has a Certificate of Clinical Competence from the American Speech-Language-Hearing Association. In 2021, she was selected a National Academy of Practice Speech Pathology Fellow. She has a doctorate in speech and hearing sciences from the Graduate Center at the City University of New York. Her baccalaureate and master’s degree in speech and hearing are from the City College of New York. 

Topics discussed in Part 2  included the following: common symptoms that will be experienced by an individual who is beginning to reveal signs of dementia or Alzheimer’s disease; primary progressive aphasia (PPA); effective tools and resources used since 2019 when the World Health Organization published its first evidence-based guidelines on dementia risk reduction; roles played by informal and family caregivers and preparing them to do so; use of telehealth in treating patients; non-pharmacological approaches in assessment and treatment of dementia; and future research projects envisioned.

 
 
 
Sep 1, 2022

Dr. Linda Carozza is a clinical professor in the Department of Physical Medicine and Rehabilitation at NYU Langone Health. She has written extensively on the broad topic of communication and aging with a focus on creative approaches to improving the quality of life. Her publications include the topic of counselling in chronic aphasia: integrating theory with professional roles in clinical practice and also on the topic of non-pharmacological approaches to dementia. She has a Certificate of Clinical Competence from the American Speech-Language-Hearing Association. In 2021, she was selected a National Academy of Practice Speech Pathology Fellow. She has a doctorate in speech and hearing sciences from the Graduate Center at the City University of New York. Her baccalaureate and master’s degree in speech and hearing are from the City College of New York. 

Part 1 included a discussion of the following: how she become interested in the area of adult neurogenic communication disorders; conditions encompassed by the term adult neurogenic communication disorders; professional qualifications for students or other individuals who wish to pursue this line of practice; some defining characteristics of dementia-communication changes and how they differ from stroke-treated communication changes; incidence and prevalence of dementia and Alzheimer’s disease in the US; whether the terms dementia and Alzheimer’s disease basically are the same, and if not,  important distinctions between them; and some major causes of dementia.

Aug 17, 2022

Dr. Koto Ishida is an Associate Professor in the Department of Neurology at NYU Grossman School of Medicine. She also serves as Medical Director of the Stroke Program at NYU Langone Health and Director of Clinical Affairs at the Center for Stroke and Neurovascular Diseases. She is Board-certified both in vascular neurology and neurology by the American Board of Psychiatry & Neurology. Her medical degree is from the University of Rochester. She completed her residency in neurology at the Hospital of the University of Pennsylvania where she had a fellowship in vascular neurology. Dr. Ishida has her name on 70 publications in the professional literature.    

The following topics were discussed in Part 3: Patient-Reported Outcome Measures employed in vascular technology at NYU and their utility; the extent to which patients who  experienced a stroke are suitable candidates for becoming competent self-managers so that they can be effective in self-monitoring, recognizing and reporting symptoms, and treating side effects, and efforts undertaken at NYU to foster self-management by patients; if patients are treated at a presenting hospital, whether teleneurology is involved in providing care; and assessing the value of self-wearable devices for diagnostic purposes and their future prospects for achieving better health care outcomes?

 

Aug 3, 2022

Dr. Koto Ishida is an Associate Professor in the Department of Neurology at NYU Grossman School of Medicine. She also serves as Medical Director of the Stroke Program at NYU Langone Health and Director of Clinical Affairs at the Center for Stroke and Neurovascular Diseases. She is Board-certified both in vascular neurology and neurology by the American Board of Psychiatry & Neurology. Her medical degree is from the University of Rochester. She completed her residency in neurology at the Hospital of the University of Pennsylvania where she had a fellowship in vascular neurology. Dr. Ishida has her name on 70 publications in the professional literature.    

The following topics were discussed in Part 2: once patients arrive at NYU Langone Health emergency rooms and a stroke is confirmed, the steps in treatment that will follow; after stroke treatments are provided, how prognostication is affected by the interplay between demographic factors, such as age, sex, and ethnicity, the kind of stroke, stroke causation, and clinical severity; the role, if any, that blood biomarkers play in improving the prognostic assessment; how a patient’s cognition is affected by having a stroke, the degree to which factors such as pre- and post-stroke physical fitness, smoking, and body weight play a role; and the kind of impact that related mental states, such as depression and anxiety can have on cognition.

Jul 20, 2022

Dr. Koto Ishida is an Associate Professor in the Department of Neurology at NYU Grossman School of Medicine. She also serves as Medical Director of the Stroke Program at NYU Langone Health and Director of Clinical Affairs at the Center for Stroke and Neurovascular Diseases. She is Board-certified both in vascular neurology and neurology by the American Board of Psychiatry & Neurology. Her medical degree is from the University of Rochester. She completed her residency in neurology at the Hospital of the University of Pennsylvania where she had a fellowship in vascular neurology. Dr. Ishida has her name on 70 publications in the professional literature.    

This is a special three-part series.

The following topics were discussed in Part 1:  how common strokes are; distinguishing features of ischemic and hemorrhagic stroke; some major causes of a stroke and if genetics and family history are among them; from the standpoint of sex and gender, if there are any differences in specific risk factors, differences in presentation, response to treatment, and stroke outcomes between what commonly are referred to as male and female; how the acronym FAST is applicable and the importance of going to a hospital as soon as possible upon experiencing stroke symptoms; and the likelihood that a patient may have a non-cerebrovascular disease that mimics a stroke, and if so, how to distinguish between stroke and non-stroke symptoms.
Jul 6, 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 second part of a two-part series. In this one, he points out that:

We find that when we are looking at over time the changes of profiles, it means they are appearing and disappearing. How does that look like compared to the appearance of those proteins in the blood?  We are finding an interesting correlation that is kind of a combination between how open the blood brain barrier is and how much axon pathology is. It has become possible to diagnose the 20 percent of patients who will have persistent symptoms at the time they come to the ED and then we can direct them to you in rehabilitation. The next step is to have a clinical trial. He asked how all this links with neurodegeneration? Within hours of an injury, it can begin to look like an Alzheimer’s disease brain. Something is going on that is crazy. An axon injury is one that can keep on taking. Tau is what gets all the big news. It may be too simplistic a view. It is not just tau. It actually is a whole bunch of things happening to the brain. Many other different types of neuropathologies occur in the brain that are initiated by injury. A subset of patients will develop these changes. If males dominate concussions, which they do, in theory you would think that they possibly would dominate dementia or mild cognitive impairment later in life, but that is not true. Women have a higher rate. There is a lot of work to be done. A lot of people who have concussions are going to be fine and we need to find a way to avoid having people worry and cause stress. A Question and Answer period followed  the presentation.

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.  

 

May 26, 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 1 covers various topics, including: an average day’s caseload size of patients who are being treated for an acquired brain injury or ABI; creation of a tool called the Preparedness for Caregiving Scale; kinds of skills being developed by caregivers; members of the rehabilitation team participating in caregiver training;  Care Partner Carryover Day activities; and program limitations. 

 

May 11, 2022

Dr. Jonas Sokolof graduated from the New York College of Osteopathic Medicine. He completed his PM&R residency at Harvard Medical School and his fellowship at the Kessler Institute. He joined NYU Langone Health and the Rusk Rehabilitation Institute in 2018 where he has served as director of oncological rehabilitation. His research interests include the role of lifestyle intervention in the rehabilitation of cancer patients. 

Dr. Sokolof noted in Part 2 of his presentation that many patients may be reluctant to take medications. They don’t want injections and the last thing they look forward to is taking another drug or having something else done to them. Trismus is condition we often see in this population, developing from radiation. We tend to see it more as actual fibrosis of the muscles of mastication. Neuropathy also is quite common in this population. We often see it from the radiation itself. Post-radiation functional status and quality of life have a strong correlation with overall long-term survival in the head and neck cancer population. As physiatrists, not only do we have a role to play in restoring functioning, we are involved in altering the disease course itself. The fibrosis syndrome stemming from radiation is problematic and progressive. There is nothing out there so far that can cure it. An exciting emerging treatment in a study he is involved in at NYU is looking at photo biomodulation therapy or low-level laser light therapy. It is a technology used a lot in sports medicine to treat musculoskeletal pain and sports-related injuries. It basically is light therapy rather than heat therapy and works at the level of the mitochondria. The primary objective is to determine if this is a feasible treatment for head and neck cancer patients. He concluded by indicating that the earlier we can become involved in the whole cancer continuum as physiatrists the better, especially in radiation fibrosis. A question-and-answer question followed his presentation.

Apr 27, 2022

Dr. Jonas Sokolof graduated from the New York College of Osteopathic Medicine. He completed his PM&R residency at Harvard Medical School and his fellowship at the Kessler Institute. He joined NYU Langone Health and the Rusk Rehabilitation Institute in 2018 where he has served as director of oncological rehabilitation. His research interests include the role of lifestyle intervention in the rehabilitation of cancer patients. 

In Part 1 of his presentation, he indicated that head and neck cancer is a unique pathology where a huge impact is made by physiatry. This kind of cancer is more commonly associated with older males, alcohol and tobacco use, genetics, and other factors. Head and neck cancer is on the rise in younger males. He mentioned different cancer subtypes, such as oral cavity and lip. Induction chemotherapy and chemoradiation tend to be the main forms of treatment presently rather than surgery alone. Radiation affects the surrounding tissue, which is where we as physiatrists come into play. The more common conditions encountered include pain, dysphagia, inability to open the mouth, and limited head and neck mobility. As physiatrists, there are conditions that we ourselves proactively can treat as opposed to speech and swallowing dysfunctions that we refer to other clinicians. Fibrosis can extend throughout the entire radiation field, affecting all the skin, nerves, muscles, and blood vessels. Radiation tends to disrupt the normal phases of healing. He described various effects that are irreversible. Patients usually are referred to physiatrists at the first sign of lymphedema. He stated that a high suicide rate is associated with this kind of cancer. Physiatry care should be involved in every stage of treatment. He carries over a sports medicine approach to oncological rehabilitation with the first step in the process being pain control followed by range of motion and strength and endurance. He also described some interventions for treating lymphedema.

Apr 13, 2022
Welcome back to this special two-part series.

Part 1 covered various topics, including:  pulmonary conditions that could lead to the need for a transplant; if the recent resurgence of the coronavirus and its continued display of new emerging variants has affected the ability to furnish care for patients; kinds of contributions physiatry, physical therapy, occupational therapy, and speech-language pathology clinicians can make in preparing patients for transplantation and in optimizing function; whether rehabilitation settings differ based on the kinds of health problems that patients have; and prevention of the occurrence of hospital readmissions. 

Part 2 covers many new areas, including: how patients requiring rehabilitation services may differ according to personal characteristics, such as age and how such differences are taken into account when providing treatment; kinds of physiological changes patients can experience post-transplantation; prevention of the risk of infection; steps taken to deal with the issue of nonadherence of recommended treatment protocols; use of rehabilitation notebooks and peer support groups; comparison of telehealth and face-to-face interactions with patients; and kinds of key rehabilitation questions to address.

Megan Carroll is a Board Certified Clinical Specialist in Geriatric physical therapy. She has been an intensive care unit physical therapist working at NYU Langone Health since 2015.

Camille Magsombol works on developing occupational therapy programs to support patients' successful health management of their chronic diseases, including medication management.

Christina Moriarty's work focuses on speech/swallow assessment and treatment with head and neck cancer as well patients in the surgical intensive care unit, including those with heart and lung transplants. 

Sofia Prilik is a physiatrist who serves as clinical director of inpatient cardiac and pulmonary rehabilitation, with a focus on inpatient rehabilitation of lung and heart transplant patients.

Mar 30, 2022
Welcome to this special two-part series with a panel of speakers. 
Part 1 covers various topics, including:  pulmonary conditions that could lead to the need for a transplant; if the recent resurgence of the coronavirus and its continued display of new emerging variants has affected the ability to furnish care for patients; kinds of contributions physiatry, physical therapy, occupational therapy, and speech-language pathology clinicians can make in preparing patients for transplantation and in optimizing function; whether rehabilitation settings differ based on the kinds of health problems that patients have; and prevention of the occurrence of hospital readmissions. 

Megan Carroll is a Board Certified Clinical Specialist in Geriatric physical therapy. She has been an intensive care unit physical therapist working at NYU Langone Health since 2015.

Camille Magsombol works on developing occupational therapy programs to support patients' successful health management of their chronic diseases, including medication management.

Christina Moriarty's work focuses on speech/swallow assessment and treatment with head and neck cancer as well patients in the surgical intensive care unit, including those with heart and lung transplants. 

Sofia Prilik is a physiatrist who serves as clinical director of inpatient cardiac and pulmonary rehabilitation, with a focus on inpatient rehabilitation of lung and heart transplant patients.

Mar 16, 2022

In Part 1, we discussed the incidence and prevalence of MS in the United States; whether MS is on the rise, holding steady, or in decline; kinds of symptoms that occur either singly or in combination and their impact on patients from the perspective of psychology; roles that stress and mood disturbances play in influencing various MS symptoms; how perception of illness perception by patients has an impact on psychological distress; other kinds of therapeutic interventions to treat symptoms; cultivation of resilience among patients; and helping patients to become adept as self-managers of MS.

In Part 2, we discussed the use of cannabis for medicinal purposes among patients with MS; non-adherence to prescribed treatment plans; the extent to which lockdown policies have disrupted normal lifestyle and the ability to access health services; use of telemedicine with patients and how it compares in effectiveness with face-to-face interactions; and key insights observed as a result of working with  patients. 

Felicia Connor is the Director of Internship and Training for an APA approved internship program at NYU Langone Health, Rusk Rehabilitation. She is Board Certified in Rehabilitation Psychology and is a licensed clinical psychologist in Delaware and New York. For the last decade, she has specialized in rehabilitation of individuals with medical and neurological conditions with Traumatic Brain Injury, concussion, stroke and multiple sclerosis. She administers neuropsychological assessment and provides cognitive remediation and individual and group psychotherapy for individuals who are adjusting to their medical conditions. 

Barbara Cicero is the Program Manager of the Adult Outpatient Psychology Service at NYU Langone Health, Rusk Rehabilitation. She received her Ph.D. from the Graduate Center of CUNY and completed a post-doctoral fellowship in Rehabilitation
Psychology at Mount Sinai Medical Center. In addition to her administrative responsibilities, she conducts neuropsychological evaluations and provides individual and group treatment to individuals with a variety of medical and neurological conditions. Her clinical interests include the assessment and treatment of individuals with traumatic brain injury and multiple sclerosis. 

Mar 2, 2022

In Part 1, we discussed the incidence and prevalence of MS in the United States; whether MS is on the rise, holding steady, or in decline; kinds of symptoms that occur either singly or in combination and their impact on patients from the perspective of psychology; roles that stress and mood disturbances play in influencing various MS symptoms; how perception of illness perception by patients has an impact on psychological distress; other kinds of therapeutic interventions to treat symptoms; cultivation of resilience among patients; and helping patients to become adept as self-managers of MS.

Felicia Connor is the Director of Internship and Training for an APA approved internship program at NYU Langone Health, Rusk Rehabilitation. She is Board Certified in Rehabilitation Psychology and is a licensed clinical psychologist in Delaware and New York. For the last decade, she has specialized in rehabilitation of individuals with medical and neurological conditions with Traumatic Brain Injury, concussion, stroke and multiple sclerosis. She administers neuropsychological assessment and provides cognitive remediation and individual and group psychotherapy for individuals who are adjusting to their medical conditions.

Barbara Cicero is the Program Manager of the Adult Outpatient Psychology Service at NYU Langone Health, Rusk Rehabilitation. She received her Ph.D. from the Graduate Center of CUNY and completed a post-doctoral fellowship in Rehabilitation
Psychology at Mount Sinai Medical Center. In addition to her administrative responsibilities, she conducts neuropsychological evaluations and provides individual and group treatment to individuals with a variety of medical and neurological conditions. Her clinical interests include the assessment and treatment of individuals with traumatic brain injury and multiple sclerosis. 

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