Dr. Susan Maltser is Director of Cancer Rehabilitation and oversees the comprehensive Cancer Rehabilitation program for Northwell health. She is a practicing physiatrist and an assistant professor of Physical Medicine and Rehabilitation at Zucker School of Medicine. She also serves as Chief, Physical Medicine and Rehabilitation at Long Island Jewish Hospital. A graduate of the New York College of Osteopathic medicine, her residency in Physical Medicine and Rehabilitation was completed at the Rusk Institute at NYU Langone Medical Center. She is a fellow of the American Board of Physical Medicine and Rehabilitation, and holds membership in both the American Academy of Physical Medicine and Rehabilitation and the National Cancer Rehabilitation Physician Consortium.
This interview is a two-part series. In Part 2, Dr. Maltser discusses: the extent of post-surgical care aimed at social and emotional functions; from the perspective of patient-reported outcomes, steps taken to identify the felt needs of patients in conjunction with the needs identified by the health care team; whether demographic factors, such as age influence whether a woman wants to remain in the labor force and what can be done to assist women in this aspect of their lives; the degree to which sexual function affected by breast cancer treatment is discussed with patients; whether older women who undergo treatment for breast cancer are vulnerable to experiencing a balance problem that increases the risk of falling; if technological approaches, such as the development of wearable sensors and cloud-based apps are being used after patients leave the clinical setting to enable them to provide daily feedback on their condition and successes they are experiencing in self-care; and areas where improvements in diagnostic measures and rehabilitation treatment would be warranted.
Dr. Susan Maltser is Director of Cancer Rehabilitation and oversees the comprehensive Cancer Rehabilitation program for Northwell health. She is a practicing physiatrist and an assistant professor of Physical Medicine and Rehabilitation at Zucker School of Medicine. She also serves as Chief, Physical Medicine and Rehabilitation at Long Island Jewish Hospital. A graduate of the New York College of Osteopathic medicine, her residency in Physical Medicine and Rehabilitation was completed at the Rusk Institute at NYU Langone Medical Center. She is a fellow of the American Board of Physical Medicine and Rehabilitation, and holds membership in both the American Academy of Physical Medicine and Rehabilitation and the National Cancer Rehabilitation Physician Consortium.
This interview is a two-part series. In Part 1, Dr. Maltser discusses: what cancer rehabilitation is and some conditions that commonly are treated in breast cancer patients; measures employed to assess patients who have undergone breast surgery regarding the scope of rehabilitation interventions to pursue; the adverse effect of reconstructive surgery for breast cancer on shoulder function and the kinds of rehabilitation that prove effective in dealing with this problem; debilitating side effects, such as difficulty sleeping and fatigue, associated with breast cancer surgery; the risk of developing lymphedema after undergoing surgery for breast cancer; the role of self-care in treating lymphedema; and the role that physical exercise might play and when it should occur pre- and post-surgery.
Dr. Mitchell Elkind is a Professor of neurology at Columbia University College of Physicians and Surgeons as well as an attending neurologist in the stroke service at New York Presbyterian Hospital. His areas of expertise are cerebrovascular disease and stroke. He completed his medical school training at Harvard Medical School. His internship was at Brigham and Women’s Hospital in Boston, MA and was followed by a residency in neurology at the Massachusetts General Hospital where he served as chief resident. Dr. Elkind subsequently obtained a master’s degree in epidemiology at the Columbia University School of Public Health and also completed fellowship training in cerebrovascular diseases.
In the second of a two-part Grand Rounds, Dr. Elkind reviews occult atrial fibrillation, monitoring devices, and other relevant areas after which there is a Q&A.
Dr. J.R. Rizzo is a physician scientist at NYU Langone Medical Center’s Rusk Rehabilitation Institute, where he is an Assistant Professor of Physical Medicine and Rehabilitation with a cross-appointment in the Department of Neurology. He leads the Visuomotor Integration Laboratory where his team focuses on eye-hand coordination as it relates to acquired brain injury and the Technology Translation in Medicine Laboratory, where the focus is on assistive technology for the visually impaired and benefits from his own personal experiences with vision loss. He recently completed an R03 grant through the National Institute of Aging, as a GEMSSTAR Scholar, focusing his research goals on eye-hand coordination in elderly stroke, and is completing a K12 award, as an RMSTP Fellow, focusing on visuomotor integration in brain injury. He has funding at the federal, state, municipal and foundational levels. He has numerous peer-reviewed publications and book chapters, in addition to domestic and international patents filed for his rehabilitation tools. An honors graduate in neuroscience at NYU, he completed medical school on scholarship at New York Medical College and was elected to the Alpha Omega Alpha Honor’s Society Iota Chapter. He completed his residency, including a chief year, at NYU’s Physical Medicine & Rehabilitation Program where he subsequently was awarded funding to complete a clinical research fellowship at Rusk.
In the second part of this Grand Rounds presentation Dr. Rizzo continues his description of a pilot research project involving chronic stroke patients who were recruited from outpatient clinics. The investigation included eye tracking while simultaneously recording motion capture of patients’ limbs. He indicates how eye errors correlate with limb errors in this study and mentioned some cognitive implications derived from the project. A question and answer period followed his presentation.
Dr. J.R. Rizzo is a physician scientist at NYU Langone Medical Center’s Rusk Rehabilitation Institute, where he is an Assistant Professor of Physical Medicine and Rehabilitation with a cross-appointment in the Department of Neurology. He leads the Visuomotor Integration Laboratory where his team focuses on eye-hand coordination as it relates to acquired brain injury and the Technology Translation in Medicine Laboratory, where the focus is on assistive technology for the visually impaired and benefits from his own personal experiences with vision loss. He recently completed an R03 grant through the National Institute of Aging, as a GEMSSTAR Scholar, focusing his research goals on eye-hand coordination in elderly stroke, and is completing a K12 award, as an RMSTP Fellow, focusing on visuomotor integration in brain injury. He has funding at the federal, state, municipal and foundational levels. He has numerous peer-reviewed publications and book chapters, in addition to domestic and international patents filed for his rehabilitation tools. An honors graduate in neuroscience at NYU, he completed medical school on scholarship at New York Medical College and was elected to the Alpha Omega Alpha Honor’s Society Iota Chapter. He completed his residency, including a chief year, at NYU’s Physical Medicine & Rehabilitation Program where he subsequently was awarded funding to complete a clinical research fellowship at Rusk.
In the first part of a grand rounds presentation, Dr. Rizzo discussses eye-hand coordination or what is known as the eye-hand mystique. He describes perception, the ocular motor system, perception to action, and eye-hand control deficits as they relate to visual motor integration. He discusses visual crowding as it pertains to peripheral vision and the importance of material categorization. He also describes research involving chronic stroke patients recruited from outpatient clinics using eye tracking and simultaneously recording motion capture of their actual limbs. The session includes questions from attendees at the presentation and his responses.
In the second part of a grand rounds presentation by Dr. John Ross Rizzo on December 12, 2018 at the Rusk Institute of Rehabilitation at NYU Langone Health, he continued his description of a pilot research project involving chronic stroke patients who were recruited from outpatient clinics. The investigation included eye tracking while simultaneously recording motion capture of patients’ limbs. He indicated how eye errors correlated with limb errors in this study and mentioned some cognitive implications derived from the project. For example, in reaching for a cup of tea there could be an eye movement that has some computational load, meaning what is the cerebral load to complete that task and what is involved if the reaching is done using peripheral vision? In this context, it is worth considering what is occurring in the presence of an impaired brain, such as after a stroke. A central idea is that stroke interferes with cognitive resource sharing between eye and hand movement during eye-hand coordination. A question and answer period followed his presentation.
Rondel King is a certified strength and conditioning specialist and corrective exercise specialist. His programming aims to bring out the best in a person’s health and performance. He has a strong interest in postural asymmetries and the nervous system as it relates to biomechanics, human performance, and general health. Mr.King leads group fitness classes at NYU Langone Orthopedic Center and is a clinician with the Running Lab and the Golf Lab.
In his interview, Rondel discusses: the relationship between gaining muscle mass versus strength and stability and the topic of weight loss; kinds of patients who can benefit from losing weight; extent of eating disorders; influence of demographic factors on the attainment of successful outcomes; role of diet in weight loss reduction; kinds of lifestyle interventions that prove to be effective in achieving weight loss; role that wearable devices play in contributing to weight loss; whether poor nutrition can be out-trained; if crunches can produce flat abs; whether more sweat burns more calories; effect of running and squats on the knees; if more gym time always is better than less; the notion of No Pain, No Gain; whether yoga can help with back pain; if lifting heavy weights can make women “bulky;" and whether machines are better than free weights.
Heather Milton leads group fitness classes at NYU Langone Orthopedic Center and is a clinician with the Running Laboratory and Golf Laboratory. She is a board-certified exercise physiologist and strength and conditioning specialist. She is certified in Functional Movement Systems® and by the Titleist Performance Institute. She develops specialized programs to help athletes reach their maximum potential and ability. Ms. Milton creates unique and motivational programs to inspire health and fitness clients and designs injury prevention programs for at-risk athletes and youth sports teams. She also identifies limitations that may affect sport performance, including gait faults in running, swing faults in golf, and swing, kick, and throw patterns in rotational sports. Her undergraduate degree in cardiopulmonary science and her master’s degree in clinical exercise physiology are from Northeastern University.
In this interview, she discusses: kinds of patients who can benefit from building stability, strength, and muscle; measures to assess current physical abilities of patients; conditions where building stability, strength, and muscle can produce a preventive effect; impact of strength training on other abilities, such as improved balance and mobility; influence of demographic factors on the attainment of successful outcomes; the difference between stability and strength; progression of building stability, strength and muscle; difference between strength and mass; key components of a program to build stability, strength, and hypertrophy/muscle mass; common mistakes individuals make in their training programs; whether individuals naturally bulk up; gaining strength and avoidance of adding muscle mass; what to say when efforts to gain muscle for years fail; and who benefits from each type of training.
Dr. Steven Flanagan is the Chair, Department of Rehabilitation Medicine and Howard A. Rusk Professor of Rehabilitation Medicine at Rusk Rehabilitation. He is highly recognized, nationally and internationally, as one of the leading experts in the area of brain injury rehabilitation. He serves on numerous medical advisory boards, including the Brain Trauma Foundation and is a peer reviewer for several scientific journals. He currently is chairperson of the Medical Education Committee and sits on the Board of Governors of the American Academy of Physical Medicine and Rehabilitation Medicine. The author of numerous chapters and peer-reviewed publications, he has received awards from several organizations and been continually listed as one of America’s Top Doctors by Castle Connolly.
Dr. Armando Fuentes recently completed his ARRT fellowship at NYU Rusk Rehabilitation. While doing so, he focused on racial and cultural health disparities in traumatic brain injury. In October 2018, he began working as a clinician at the World Trade Center Survivors Clinic in Elmhurst Hospital, where he hopes to build a culturally informed mental health and clinical training program. He graduated with his PhD in clinical psychology from Fordham University where his research focused on culture, health beliefs, and neurocognition among Latinx patients living with HIV.
In this interview, Dr. Fuentes discusses: his presentation at a Rusk course on October 20 and 21, 2018 to highlight some of the latest evidence in complex TBI rehabilitation; clinical practice guidelines in general and for TBI patients from racial and ethnic groups in particular; outcomes in overall functioning by members of minority groups compared to whites; and lower retention rates in TBI research by Hispanics one to two years post-injury.
Dr. Estelle Gallo is a Clinical Specialist at the Rusk Rehabilitation NYU Langone Ambulatory Care Center. She is a certified clinical specialist in Neurology from the American Board of Physical Therapy Specialties who specializes in adult neurological rehabilitation. She serves as a faculty member of the accredited physical therapy neurology residency program and holds a faculty position as a Research Assistant Professor in the Physical Medicine and Rehabilitation Department at NYU School of Medicine. She has received internal funding for her research. Dr. Gallo has published her work in several peer-reviewed journals as well as presented at both national and international conferences. Currently, she is conducting a feasibility and safety study on high level mobility training in patients with non-progressive acquired central neurological injuries. She also serves as a member of the Locomotor Training Clinical Practice Guidelines Knowledge Translation Task Force for the Academy of Neurologic Physical Therapy. She received her doctorate degree from New York University.
In this interview, Dr. Gallo discusses: the ability to run a short distance in the rehabilitation of patients with acquired brain injury; existing evidence to make recommendations about the examination and intervention for high level mobility and to facilitate a return to running; examination techniques and outcome measures that are used; objective criteria used to guide initiation of high-level mobility training; recent developments in clinical practice guidelines on outcome measures for the neurologic population; upcoming recommendations about locomotor training, research being done in the physical therapy department to test the feasibility and safety of high-level mobility training; and some key rehabilitation research topics in physical therapy and some emerging areas.
Liat Rabinowitz is the Program Manager of Speech Language Pathology at Rusk. Her experience has been in evaluation and treatment of adults with acquired brain injury with a specific area of interest in cognitive communication impairments and working with patients in disorder of consciousness. Most of her current work involves managing the Speech Language Pathology department, along with supervising and training staff. A native of South Africa, she trained as a therapist at the University of Cape Town. Her master’s degree in speech-language pathology is from Columbia University. She currently teaches as an adjunct faculty member at NYU-Steinhardt school on language disorders in adults and has taught cognitive disorders at Columbia University.
In this interview, she discusses: meaning of the term post-confusional state and kinds of available treatment for it; interventions to treat acquired stuttering; language, cognitive communication, or swallowing disorders associated with the occurrence of a TBI and what can be done from the perspective of speech-language pathology; impairment of conversational ability following a brain injury; key topics within the realm of rehabilitation research in speech-language therapy; and the most common kinds of symptoms involved in post-traumatic amnesia.
Until this interview, this podcast series has focused on healthcare professionals and researchers and the myriad activities in which they all engage. We are very excited that, for this interview, listeners have an opportunity to hear the views of an individual who was on the other side. Mr. Pierre Lucien is an individual who had both legs amputated above the knee. In 2008, while on a training run with the Atlanta, Georgia Police Department, he fell to the ground unconscious when he experienced massive organ failure. In an effort to save his life, doctors had to amputate both of his legs above the knees. He later was transferred to the Rusk Rehabilitation Institute at NYU Langone where he underwent additional surgery and began rehabilitation. Today, he is married and the father of two children and earns a living while employed at a police department in Marietta, Georgia. The interview with him consists of three parts.
In Part 3 we discussed: experience of phantom pain in missing limbs and how to treat it; a sensation of feeling the presence of missing limbs; what he does to stay physically active; his family life and what he does for a living; providing assistance to new patients who undergo an amputation; additional activities in which he is engaged to inspire other individuals to cope with life’s challenges successfully; and thoughts or recommendations important to convey to health professionals.
Until today, this podcast series has focused on healthcare professionals and researchers and the myriad activities in which they all engage. We are very excited that, for this interview, listeners have an opportunity to hear the views of an individual who was on the other side. Mr. Pierre Lucien is an individual who had both legs amputated above the knee. In 2008, while on a training run with the Atlanta, Georgia Police Department, he fell to the ground unconscious when he experienced massive organ failure. In an effort to save his life, doctors had to amputate both of his legs above the knees. He later was transferred to the Rusk Rehabilitation Institute at NYU Langone where he underwent additional surgery and began rehabilitation. Today, he is married and the father of two children and earns a living while employed at a police department in Marietta, Georgia. The interview with him consists of three parts.
In Part 2 Pierre discusses: from the perspective of an amputee what is considered both a good day and a bad day; amount of time elapsed from time of surgery before prostheses were prescribed and use of them began; length of time to accommodate to having prosthetic limbs; kinds of problems that can develop when a prosthetic device exerts pressure on a limb’s soft tissue and how to deal with them; once prosthetics are fitted and used how much maintenance of them is involved; and adjustments in prostheses necessary to carry anything heavy or in trying to navigate uneven ground or a flight of stairs and the kinds of challenges involved, such as feeling a loss of balance.
Until today, this podcast series has focused on healthcare professionals and researchers and the myriad activities in which they all engage. We are very excited that, for this interview, listeners have an opportunity to hear the views of an individual who was on the other side. Mr. Pierre Lucien is an individual who had both legs amputated above the knee. In 2008, while on a training run with the Atlanta, Georgia Police Department, he fell to the ground unconscious when he experienced massive organ failure. In an effort to save his life, doctors had to amputate both of his legs above the knees. He later was transferred to the Rusk Rehabilitation Institute at NYU Langone where he underwent additional surgery and began rehabilitation. Today, he is married and the father of two children and earns a living while employed at a police department in Marietta, Georgia. The interview with him consists of three parts.
In Part 1 we discussed: if there had been any signs or symptoms prior to his collapse and loss of consciousness; where he obtained treatment; his age when his legs were amputated; length of time as both an inpatient and an outpatient; time elapsed from time of surgery to rehabilitation; kinds of health and other kinds of professionals who provided care; amputation as a life changing event; adjustments that had to be made in various aspects of daily living and functioning; and for a single person who experienced amputation, how dating was affected.
Dr. Douglas Elwood is a board-certified physician with over 15 years experience in health and wellness who has led innovation efforts for a number of companies and has dedicated his career to improving education, communication, and outcomes for patients, caregivers, and healthcare providers. As a thought-leader in the space, he has consulted to companies throughout the industry, presented at conferences worldwide, and has multiple publications including a featured chapter in the esteemed annual HIMSS publication on mHealth. He is on part-time faculty at NYU Langone Medical Center at Rusk Rehabilitation and led one of the country's first and largest clinical studies on the use of technology in clinical care at Rusk and how social media, digital, mobile, and connected health influence communications, patient behavior, and physician workflow. Along with his part-time work at Rusk, Dr. Elwood is the Chief Medical Officer for PWNHealth where he leads over 150 physicians and genetic counselors, creates clinical protocols, oversees all clinical quality issues, and provides virtual care to large numbers of patients on a daily basis. A graduate of Amherst College and Jefferson Medical College, he is the holder of both MD and MBA degrees.
In Part 2 of this two-part series. Dr. Elwood reviews: how his health career journey after medical school and residency training brought him to where he works today and how he arrived there; promising uses of virtual care technology with patients; and the importance of forecasting key trends and identifying potential new opportunities in the emerging American health care scene.
Dr. Douglas Elwood is a board-certified physician with over 15 years experience in health and wellness who has led innovation efforts for a number of companies and has dedicated his career to improving education, communication, and outcomes for patients, caregivers, and healthcare providers. As a thought-leader in the space, he has consulted to companies throughout the industry, presented at conferences worldwide, and has multiple publications including a featured chapter in the esteemed annual HIMSS publication on mHealth. He is on part-time faculty at NYU Langone Medical Center at Rusk Rehabilitation and led one of the country's first and largest clinical studies on the use of technology in clinical care at Rusk and how social media, digital, mobile, and connected health influence communications, patient behavior, and physician workflow. Along with his part-time work at Rusk, Dr. Elwood is the Chief Medical Officer for PWNHealth where he leads over 150 physicians and genetic counselors, creates clinical protocols, oversees all clinical quality issues, and provides virtual care to large numbers of patients on a daily basis. A graduate of Amherst College and Jefferson Medical College, he is the holder of both MD and MBA degrees.
In Part 1 of this two-part series, Dr. Elwood addresses: his involvement in a number of research activities exploring the use of technology to enhance patient care while serving as a resident/chief resident at Rusk and then later as a part-time clinical instructor; how technology has enhanced patient engagement in improving health care; value-based care as an emerging/blossoming approach to contain costs while enhancing care; shifts that may be occurring away from traditional providers, such as physician offices, clinics, and hospitals to a more technology-driven way of doing business; and how developments in the commercial sphere, such as the creation of apps and virtual technology parallel and augment what is unfolding in the clinical care and biomedical research domains.