Rusk Insights On Rehabilitation Medicine

A special two-part Grand Rounds presentation by Dr. Carlo Pardo, who is a clinical neurologist/pathologist and professor of neurology and pathology at the Johns Hopkins School of Medicine. Part One He began by stating that the main objective of this presentation is understanding the concept of myelopathies versus myelitis. He wants to present a diagnostic approach for the evaluation of a patient with an acute case of myelopathy and vascular myelopathy, and review the current concepts of vascular myelopathies, something that probably will be encountered very often in rehabilitation clinical practice. It is truly important that after this lecture to stop using the term myelitis and instead use a more precise etiological diagnosis of myelopathy. He disclosed where his research funding comes from. He presented a historical concept of myelitis and myelopathies. In the past several years, the major revolution in neurology has been the discovery of many biomarkers that are identified myelopathies. Etiological diagno

A special two-part Grand Rounds presentation by Dr. Carlo Pardo, who is a clinical neurologist/pathologist and professor of neurology and pathology at the Johns Hopkins School of Medicine. Part One He began by stating that the main objective of this presentation is understanding the concept of myelopathies versus myelitis. He wants to present a diagnostic approach for the evaluation of a patient with an acute case of myelopathy and vascular myelopathy, and review the current concepts of vascular myelopathies, something that probably will be encountered very often in rehabilitation clinical practice. It is truly important that after this lecture to stop using the term myelitis and instead use a more precise etiological diagnosis of myelopathy. He disclosed where his research funding comes from. He presented a historical concept of myelitis and myelopathies. In the past several years, the major revolution in neurology has been the discovery of many biomarkers that are identified myelopathies. Etiological diagno

In this episode, the two discuss how and when they began to develop an interest in performing arts medicine; health screening of performers prior to participation in these activities; failure to admit the existence of a health problem because of a fear of being replaced by a healthier performer; types of clinicians involved in treating performing artists; and approaches to preventing health problems in performing artists. Dr. Tracy McKay is a Clinical Assistant Professor in the Department of Rehabilitation Medicine at NYU Grossman School of Medicine.  She specializes in Integrative Sports and Spine Medicine with a special interest in Performing Arts Medicine. Dr. McKay is Chairperson of the Performing Arts Medicine Community of the American Academy of Physical Medicine and Rehabilitation and served as consulting medical director for the Broadway show, Here Lies Love. She is a staff physician at the Harkness Center for Dance Injuries and provides care to professional dance companies that include Complexions, A

We should begin with every patient by validating that their pain is real. He discussed the role played by cognitive behavioral therapy (CBT). It is referenced most often because it has the best evidence, but we do not really know how to break that down for patients. He described three basic stages. It is important to recognize that CBT is not the best and only treatment. Exercise is important in a lot of musculoskeletal conditions, but it should be tailored to benefit that window between benefit and symptom aggravation. Next, is the question of what must be done with all the information he has provided in this presentation thus far. There seems to be evidence of some advantage to participating in athletics or being fit. Also, not everyone who is fit is having a good time and not everyone with a chronic condition can jump into fitness in the right way. So, we need to figure out how to meld that. Patients come to us because they are suffering. We need a team approach to close the performance gap they experience

PART 1 Dr. Vasudevan began by discussing how pain is experienced by athletes and non-athletes, how to identify components of multidisciplinary care for both those groups, and incorporate some reasonable strategies that might help with exercise prescriptions and lifestyle modifications for those with chronic pain. He provided some definitions for various terms, such as pain medicine, sports medicine, and pain. The latter is in the brain, which is the summation of all inputs. As physiatrists, we look at what the pain is keeping you from doing what you want to perform. He addressed the question of whether there are gender differences in the perception of pain. The short answer is no. Strength and endurance matter more. Endurance athletes can tolerate pain better. He discussed some consequences of the overtraining syndrome. If an athlete cannot perform at a desired level, there is a higher mental risk. Insufficient sleep is a risk factor. A pertinent concern is how to improve mental health in athletes. He indicat

Holly Cohen is the program manager of assistive technology and the driving rehabilitation program at NYU Langone Health. She is an Occupational Therapist with over 25 years of experience. She also is an adjunct professor at New York University where she teaches occupational therapy and engineering students on the importance of accessibility and adaptability in everyday technology.  Additionally, she has lectured both nationally and internationally on the importance of assistive technology to improve function and quality of life for users. The following items were discussed in Part 1: Determining the ability of patients to use various forms of assistive technology; examples of the kinds of assistive technology employed in providing care to patients; kinds of patients treated; treatment offered in the clinical setting and by telehealth; if patients ever abandon using assistive devices; whether patients influence the kinds of assistive technology used; use of a patient group-based treatment approach; emerging te

This is an exciting year for RUSK, celebrating our 75th anniversary! As part of our celebration, we are hosting a number of events including our Research Symposium, podcasts, and interviews. Our content continues to cover a wide range of topics within PM&R, and this particular segment includes special Rusk 75th Anniversary episodes featuring Rusk leadership, faculty, and residents. This is the third of three special episodes... Dr. Lindsey Gurin specializes in Dementia & Alzheimer's, Neuropsychiatry and is Assistant Professor, Department of Neurology at NYU Grossman School of Medicine, an Assistant Professor, Department of Psychiatry at NYU Grossman School of Medicine ,and an Assistant Professor, Department of Rehabilitation Medicine at NYU Grossman School of Medicine She is also Director of both the  Neurology/Psychiatry Residency Program and Behavioral Neurology, NYU Langone Orthopedics Hospital. Dr. Prin Amorapanth is an Assistant Professor, Department of Rehabilitation Medicine at NYU Grossman Sch

This is an exciting year for RUSK, celebrating our 75th anniversary! As part of our celebration, we are hosting a number of events including our Research Symposium, podcasts, and interviews. Our content continues to cover a wide range of topics within PM&R, and this particular segment includes special Rusk 75th Anniversary episodes featuring Rusk leadership, faculty, and residents. This is the second of three special episodes... Dr. Jonathan Whiteson is Assistant Professor, Department of Rehabilitation Medicine; Assistant Professor, Department of Medicine; Medical Director of Rusk Outreach and Growth; and Medical Director of Cardiac Rehabilitation. His research interests include: cardiac and pulmonary rehabilitation coping strategies during cardiac rehabilitation following cardiac surgery, pulmonary rehabilitation of individuals exposed to world trade center dust, and recognizing encephalopathy and delirium in the cardiopulmonary rehabilitation setting. He is also part of the Senior Leadership team of Rus

This is an exciting year for RUSK, celebrating our 75th anniversary! As part of our celebration, we are hosting a number of events including our Research Symposium, podcasts, and interviews. Our content continues to cover a wide range of topics within PM&R, and this particular segment includes special Rusk 75th Anniversary episodes featuring Rusk leadership, faculty, and residents. This is the first of three special episodes... Steven Flanagan, MD is professor and chairman of the Department of Rehabilitation Medicine, New York University School of Medicine, and the medical director of the Rusk Institute of Rehabilitation Medicine, New York University Langone Medical Center. Dr. Flanagan has served on medical advisory boards of many national and international committees and has presented at scientific meetings both nationally and internationally, most notably on topics pertaining to brain injury rehabilitation. He has authored numerous chapters and publications and has participated in both federally and in

Dr. Weiss is Professor of Rehabilitation Medicine at the NYU Long Island School of Medicine. She previously was the Chairman and Director of Residency Training for the Department of Physical Medicine and Rehabilitation at Nassau University Medical Center. She also was the Director of Electrodiagnostic Medicine and Chair of the Ethics committee. She is Board Certified in both Physical Medicine and Rehabilitation and Electrodiagnostic Medicine and in November 2018 was among the first group of professionals to become Healthcare Ethics Consultant-Certified. Dr. Weiss has published numerous articles, book chapters, and authored 10 books. She is active in professional organizations on a national level. Her professional interests include electrodiagnostic medicine, ethics, and women in medicine. The following items were discussed in Part 2:  Differences between monopolar and concentric needles; possible role of contaminants leading to diagnostic misinterpretation; training or certification required to become eligibl

Dr. Weiss is Professor of Rehabilitation Medicine at the NYU Long Island School of Medicine. She previously was the Chairman and Director of Residency Training for the Department of Physical Medicine and Rehabilitation at Nassau University Medical Center. She also was the Director of Electrodiagnostic Medicine and Chair of the Ethics committee. She is Board Certified in both Physical Medicine and Rehabilitation and Electrodiagnostic Medicine and in November 2018 was among the first group of professionals to become Healthcare Ethics Consultant-Certified. Dr. Weiss has published numerous articles, book chapters, and authored 10 books. She is active in professional organizations on a national level. Her professional interests include electrodiagnostic medicine, ethics, and women in medicine. The following items were discussed in Part 1:  Reason for deciding to practice in PM&R; some indications for electrodiagnostic testing; difference between nerve conduction studies and EMG; most common health problems that go

Dr. Tan participated in a Dual Residency Program in Physical Medicine and Rehabilitation/Pediatrics at Long Island Jewish Medical Center in New Hyde Park, New York. She has received Fellowship Grants and Support from the Christopher Reeve Foundation, the  Medtronics/Allergan: Spasticity Management Workshop, and the Starlight Children’s Foundation. She served as Founder of the Philippine Chinese-American Medical Association and became President of that organization in 2014. Dr. Tan obtained her medical degree from the Faculty of Medicine and Surgery at the University of Santo Tomas in Manila, Philippines. The following items were discussed in Part 2: role played by family in providing care; outcomes produced when treating with botox; implementation of alcohol blocks in treatment; what serial casting in treatment entails; use of oral medications; role played by complementary and alternative modalities; whether symptoms change with age; the transition from pediatric to adult care; potential of big data,

Dr. Tan participated in a Dual Residency Program in Physical Medicine and Rehabilitation/Pediatrics at Long Island Jewish Medical Center in New Hyde Park, New York. She has received Fellowship Grants and Support from the Christopher Reeve Foundation, the  Medtronics/Allergan: Spasticity Management Workshop, and the Starlight Children’s Foundation. She served as Founder of the Philippine Chinese-American Medical Association and became President of that organization in 2014. Dr. Tan obtained her medical degree from the Faculty of Medicine and Surgery at the University of Santo Tomas in Manila, Philippines. The following items were discussed in Part 1: how she decided to become a pediatrician specializing in cerebral palsy; what causes cerebral palsy; if heredity plays a role; likelihood of any demographic factors involved in the onset of this condition; tools and practices used in early diagnosis; types of cerebral palsy; whether it can be acquired after birth; preventability; incidence of cerebral pal

Dr. Morris currently works full-time as a researcher. She is founder and director of the Disability Equity Collaborative where her work focuses on provider and health care organization-level factors that negatively impact the quality of care delivered to patients with disabilities. Her work has been funded by the NIH and other key sources of support. She has published in major medical periodicals, including the New England Journal of Medicine and the journal Health Affairs. Dr. Morris has a Masters of Science degree in Speech-Language Pathology, a Masters of Public Health degree, and a PhD in Rehabilitation Sciences from the University of Washington. She completed post-doctoral fellowships at Northwestern University and the Mayo Clinic in health services research. She has served as a faculty member at the Mayo Clinic, Harvard Medical School, and the University of Colorado Medical School. The following items were discussed in Part 2: how ableism, including structural ableism appear in the healthcar

Dr. Morris currently works full-time as a researcher. She is founder and director of the Disability Equity Collaborative where her work focuses on provider and health care organization-level factors that negatively impact the quality of care delivered to patients with disabilities. Her work has been funded by the NIH and other key sources of support. She has published in major medical periodicals, including the New England Journal of Medicine and the journal Health Affairs. Dr. Morris has a Masters of Science degree in Speech-Language Pathology, a Masters of Public Health degree, and a PhD in Rehabilitation Sciences from the University of Washington. She completed post-doctoral fellowships at Northwestern University and the Mayo Clinic in health services research. She has served as a faculty member at the Mayo Clinic, Harvard Medical School, and the University of Colorado Medical School. The following items were discussed in Part 1: her definition of the term ableism; meaning of the term structural ableism an

Akhila Veerubhotla is an Assistant Professor in the Department of Rehabilitation Medicine at NYU-Grossman School of Medicine. She completed her post-doctoral fellowship jointly at the Center for Mobility and Rehabilitation Engineering at the Kessler Foundation and in the Department of Physical Medicine and Rehabilitation at Rutgers – New Jersey Medical School. She has a PhD in Rehabilitation Science from the University of Pittsburgh and a Masters degree in Biomedical Engineering from Carnegie Mellon University. Her research focuses on using technology to help improve mobility, balance, and physical activity in individuals with neurological impairments. Her work primarily is focused toward individuals with stroke, traumatic brain injury and spinal cord injury.  The following items were discussed in Part 2: a Novel Core Strengthening Intervention for Improving Trunk Function, Balance and Mobility after a Stroke; variability in interventions may occur when therapists also provide assistance; risk of fal

Akhila Veerubhotla is an Assistant Professor in the Department of Rehabilitation Medicine at NYU-Grossman School of Medicine. She completed her post-doctoral fellowship jointly at the Center for Mobility and Rehabilitation Engineering at the Kessler Foundation and in the Department of Physical Medicine and Rehabilitation at Rutgers – New Jersey Medical School. She has a PhD in Rehabilitation Science from the University of Pittsburgh and a Masters degree in Biomedical Engineering from Carnegie Mellon University. Her research focuses on using technology to help improve mobility, balance, and physical activity in individuals with neurological impairments. Her work primarily is focused toward individuals with stroke, traumatic brain injury and spinal cord injury.  The following items were discussed in Part 1: whether devices used in her studies also are available commercially for patients to use at home; a systematic review study involving wearable devices for tracking physical activity in the community aft

Dr. Kathleen Isaac is a licensed Clinical Psychologist and Clinical Assistant Professor at NYU Langone Health. As a Haitian-American, cis-gender female, she directs the Medical Student and House Staff Mental Health program, which provides individual, couples, and group psychotherapy to medical students, residents, and fellows. She also has a part-time private practice focused on serving BIPOC and LGBTQ+ clients with integrative treatment approaches, where she specializes in trauma, health psychology, and cultural issues. Dr. Isaac also is an adjunct lecturer in the City College of New York’s doctoral program in clinical psychology where she teaches an advanced practicum on intersectional therapy and a Group Psychotherapy course. She has been featured on multiple media platforms, including NBC and the New York Times. Recently, she has published in the journal Psychiatry Annals and in a book chapter dealing with Her Clients’ Racial Identity Development During the Pandemic and the Black Lives Matter Moveme

Dr. Kathleen Isaac is a licensed Clinical Psychologist and Clinical Assistant Professor at NYU Langone Health. As a Haitian-American, cis-gender female, she directs the Medical Student and House Staff Mental Health program, which provides individual, couples, and group psychotherapy to medical students, residents, and fellows. She also has a part-time private practice focused on serving BIPOC and LGBTQ+ clients with integrative treatment approaches, where she specializes in trauma, health psychology, and cultural issues. Dr. Isaac also is an adjunct lecturer in the City College of New York’s doctoral program in clinical psychology where she teaches an advanced practicum on intersectional therapy and a Group Psychotherapy course. She has been featured on multiple media platforms, including NBC and the New York Times. Recently, she has published in the journal Psychiatry Annals and in a book chapter dealing with Her Clients’ Racial Identity Development During the Pandemic and the Black Lives Matter Moveme

Dr. Salvador Portugal is an Assistant Professor in the Dapartment of Rehabilitation Medicine at NYU Grossman School of Medicine. He is also Director of the Sports Fellowship program and Medical Director, Sports Medicine Rehabilitation. Dr. Portugal completed his residency at NYU Grossman and his fellowship at UMDNJ. He also received an MBA from Brandies in 2020.  In this segment, Dr. Portugal indicated that in 2014, a systematic review was done, which found that a combination of PT and mobilization was strongly recommended, especially in patients in stages two and three. Cortisone injections were found to be most effective early, and acupuncture plus therapeutic exercises improved pain, range of motion and function. Therapeutic sonograph treatment was not recommended. PT is recommended after phase one or after the painful phase. A Cochrane study concluded that PT should be provided in combination with other treatments. Patients that were compliant with home exercises are shown to be equally effective compared