Dr. Sara Cuccurullo and Dr. Talya Flemming: Investigating and Analyzing the Effect of a Comprehensive Stroke Recovery Program, Part 1
RUSK Insights on Rehabilitation Medicine
Release Date: 01/15/2025
RUSK Insights on Rehabilitation Medicine
Dr. Steven Flanagan is Howard A. Rusk Professor of Rehabilitation Medicine and Chairperson of the Department of Rehabilitation Medicine at Rusk. He provides care for patients with physical and cognitive disabilities. He specializes in treating those who are recuperating from a stroke or brain injury. He is accompanied in this interview by Dr. Jonathan Whiteson who holds the rank of professor in both the Department of Medicine and the Department of Rehabilitation at Rusk Rehabilitation. Dr. Whiteson’s skills and expertise focus on patients recovering from coronary and lung...
info_outlineRUSK Insights on Rehabilitation Medicine
Dr. Steven Flanagan is Howard A. Rusk Professor of Rehabilitation Medicine and Chairperson of the Department of Rehabilitation Medicine at Rusk. He provides care for patients with physical and cognitive disabilities. He specializes in treating those who are recuperating from a stroke or brain injury. He is accompanied in this interview by Dr. Jonathan Whiteson who holds the rank of professor in both the Department of Medicine and the Department of Rehabilitation at Rusk Rehabilitation. Dr. Whiteson’s skills and expertise focus on patients recovering from coronary and lung...
info_outlineRUSK Insights on Rehabilitation Medicine
Dr. Steven Flanagan is Howard A. Rusk Professor of Rehabilitation Medicine and Chairperson of the Department of Rehabilitation Medicine at Rusk. He provides care for patients with physical and cognitive disabilities. He specializes in treating those who are recuperating from a stroke or brain injury. He is accompanied in this interview by Dr. Jonathan Whiteson who holds the rank of professor in both the Department of Medicine and the Department of Rehabilitation at Rusk Rehabilitation. Dr. Whiteson’s skills and expertise focus on patients recovering from coronary and lung...
info_outlineRUSK Insights on Rehabilitation Medicine
Ted Joyce is a Professor of Economics at Baruch College and the Graduate Center, the City University of New York and a Research Associate in the National Bureau of Economic Research’s program in Health Economics. He has published extensively in the area economic demography and reproductive health policy. His work on abortion policy has appeared in the Journal of Political Economy, New England Journal of Medicine, the Journal of the American Medical Association, the Journal of Human Resources and the Review of Economics and...
info_outlineRUSK Insights on Rehabilitation Medicine
Ted Joyce is a Professor of Economics at Baruch College and the Graduate Center, the City University of New York and a Research Associate in the National Bureau of Economic Research’s program in Health Economics. He has published extensively in the area economic demography and reproductive health policy. His work on abortion policy has appeared in the Journal of Political Economy, New England Journal of Medicine, the Journal of the American Medical Association, the Journal of Human Resources and the Review of Economics and...
info_outlineRUSK Insights on Rehabilitation Medicine
Both corticosteroid injection and PRP demonstrate initial efficacy where steroid appears to provide superior pain relief, as you can see here going down within the first four weeks, whereas PRP demonstrated longer lasting effect, as you can see that the VAS score is actually going down all the way up to 24 weeks, where the corticosteroid injections kind of peak at four weeks, and then slowly the pain comes back to its original level by 24 weeks, maybe around, even like a 12 weeks’ time mark. So, both steroid and PRP are considered safe and an effective treatment for the GTPS. But in more...
info_outlineRUSK Insights on Rehabilitation Medicine
Dr. Haruki Ishii discussed a review paper on the risks and benefits of corticosteroid injections versus plasma injections in patients. The aim of this review was to compare the evidence for clinical applications of these injectates as a treatment for a variety of musculoskeletal conditions in patients. Platelet-Rich Plasma (PRP) injections for clinical use as discussed here, is defined as autologous plasma, extracted from minimally processed blood, and then containing activated platelets. So PRP delivers concentrated growth factors and cytokines acting as extra cell signaling...
info_outlineRUSK Insights on Rehabilitation Medicine
Dr. Kathleen Martin Ginis is a Distinguished University Scholar and a Professor in the Department of Medicine (Division of Physical Medicine and Rehabilitation) and in the School of Health and Exercise Sciences at The University of British Columbia. She holds the Reichwald Family Chair in Preventive Medicine and is a Fellow of the Royal Society of Canada, the Canadian Academy of Health Sciences, the Canadian Society for Psychomotor Learning and Sport Psychology, and as is an International Fellow of the National Academy of Kinesiology. The focus of Dr. Martin Ginis’s research is placed on...
info_outlineRUSK Insights on Rehabilitation Medicine
Dr. Kathleen Martin Ginis is a Distinguished University Scholar and a Professor in the Department of Medicine (Division of Physical Medicine and Rehabilitation) and in the School of Health and Exercise Sciences at The University of British Columbia. She holds the Reichwald Family Chair in Preventive Medicine and is a Fellow of the Royal Society of Canada, the Canadian Academy of Health Sciences, the Canadian Society for Psychomotor Learning and Sport Psychology, and as is an International Fellow of the National Academy of Kinesiology. The focus of Dr. Martin Ginis’s research is placed on...
info_outlineRUSK Insights on Rehabilitation Medicine
With over 20 years of extensive clinical experience, Dr. Kedzierska is a Board Certified Clinical Specialist in Neurologic Physical Therapy from the American Board of Physical Therapy Specialties. She serves as a faculty member of an Accredited Physical Therapy Neurology Residency Program. She mentors department staff on assessment/treatment for related diagnosis. She has presented in local and national conferences and is a published author in the ANPT newsletter and Brain Injury Journal. She received her Master’s Degree in Physical Rehabilitation in Poland, Advanced Master’s Degree from...
info_outlineThe introduction is done by Dr. Steven Flanagan, Chairperson of the Department of Rehabilitation at NYU Langone Health.
Sara Cuccurullo MD is Professor and Chairman, Residency Program Director in the Department of Physical Medicine and Rehabilitation at Hackensack Meridian School of Medicine, Rutgers- Robert Wood Johnson Medical School; Medical Director, VP at JFK Johnson Rehabilitation Institute; and Physician in Chief of HMH Rehabilitation Care Transformation Services
Talya Flemming MD is Medical Director: Stroke Recovery Program, Post-COVID Rehabilitation Program, Aftercare Program ABMS, Brain Injury Medicine Certified JFK Johnson Rehabilitation Institute, Department of Physical Medicine and Rehabilitation Clinical Associate Professor, Rutgers Robert Wood Johnson Medical School Core Associate Professor, Hackensack Meridian School of Medicine.
Part 1
Dr. Cuccurullo began by discussing their stroke recovery program, specifically investigating and analyzing the effects of a comprehensive initiative on all-cause mortality, function, and readmissions. She listed the learning objectives for today’s grand round presentation. Strokes are the number one admission in their inpatient rehab facility. Twenty-two percent of their patients comply with going to the facility. Their patients have a finite resource for Medicare once they leave inpatient or the acute care setting. Payment caps compromise the ability to have outpatient therapies that prevent them from having a full recovery. Dr. Flemming pointed out that there is an overlap with patients who have neurologic disease after stroke as well as patients who have cardiac disease. So, they designed their program to combine both elements of neurorehabilitation and a modified cardiac rehabilitation program, which starts with an outpatient visit with a stroke physiatrist. Common challenges that need to be addressed are patients with: weakness on their one side versus the other, cognitive or attention deficits, poor safety awareness, and post-stroke fatigue. They decided that it would be important to collect medical and functional outcome data to see if the program could affect hospital readmissions, the recurrence of stroke, and overall mortality.