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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Grand Rounds: Dr. Molly Fuentes, Health Inequities Among Children with Disabilities: Focus on American Indian and Alaska Native Children. Part 1
05/08/2025
Grand Rounds: Dr. Molly Fuentes, Health Inequities Among Children with Disabilities: Focus on American Indian and Alaska Native Children. Part 1
Dr. Molly Fuentes is medical director at the inpatient rehabilitation unit at the Seattle Children’s Hospital. Dr. Fuentes is an assistant professor of rehabilitation medicine at the University of Medicine. She also is a pediatric physiatrist. She completed her undergraduate degree at Stanford University and is a graduate of the School of Medicine at the University of Michigan. She completed her residency at the University of Washington and later completed a pediatric fellowship at the Seattle Children’s Hospital. She then completed a research fellowship in pediatric injury at the Harborview Injury Prevention and Research Center at the University of Washington. She is the medical director at the inpatient rehabilitation unit at the Seattle Children’s Hospital. Part 1 Dr. Fuentes described her life experiences that influenced her choice of a career in the area of pediatric disability. In this presentation, she wanted to: review the injury epidemiology literature for American Indian and Alaska Native children and teens, identify some historical traumas that impact native people, recognize the utility of the injury-equity framework, the international classification of functioning disability and health model, conceptualize rehabilitative care, and describe some barriers to rehabilitation care. A health disparity is just that difference in health status between population groups. A health disparity becomes an inequity when that disparity is due to systematic differences in social, economic, environmental, or health care resources. There is a health care inequity when there is a difference in access to health care utilization or receipt of health care services. Looking specifically at disability and functional difference among American Indian and Alaska Native children, there really is not that much published literature on the prevalence of disability in this population. Dr. Fuentes concluded Part 1 by discussing historical relationships between Native American tribes and the federal government, which have had a significant deleterious impact on individual and community health status of these individuals. For example, boarding schools or residence schools represent another kind of push in the direction of forced assimilation where traditional practices were punished.
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Dr. Shae Datta: Nutritional Recovery After Concussion, Part 2
04/23/2025
Dr. Shae Datta: Nutritional Recovery After Concussion, Part 2
Shae Datta, MD is a Sports Neurologist with special interest in post-concussion syndrome, vestibulo-ocular dysfunction and the relation of integrative medicine on brain health. Her specific training allows for a variety of treatment modalities in the identification of mild traumatic brain injury and sideline concussion diagnosis. She has written a book chapter on the gut microbiome and its relation to headache syndromes in concussion. Her primary research interests include identifying predictors of concussion recovery, examining the role of sleep during concussion recovery, and investigating the cognitive implications of concussion. Dr. Datta serves as Vice Chair of the American Academy of Neurology's Sports Neurology Section to further awareness and develop new education initiatives in the field. Part 2 We call them psychobiotics because these specific probiotics actually are helping the targeting of treatment of things we are trying to do.) Next, we are going to discuss nutritional support of these patients. She discussed the role of nutritional supplements, such as Vitamin E. The brain requires high levels of Vitamin C after a traumatic brain injury, It is a potent antioxidant. Magnesium levels drop acutely right after a concussion. It reduces stress and promotes relaxation. It helps in sleeping. She identified which magnesium supplements should be used. She furnished information about jockeys who are at a high risk for experiencing concussions. Additionally, in order to meet requirements in competition, many of them starve themselves to arrive at their goal weight. They talk openly about their eating disorders. Another topic covered in her presentation is mitochondria and fatigue. She also indicated the use of various alternative and complementary substances.
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Dr. Shae Datta: Nutritional Recovery After Concussion, Part 1
04/09/2025
Dr. Shae Datta: Nutritional Recovery After Concussion, Part 1
Shae Datta, MD is a Sports Neurologist with special interest in post-concussion syndrome, vestibulo-ocular dysfunction and the relation of integrative medicine on brain health. Her specific training allows for a variety of treatment modalities in the identification of mild traumatic brain injury and sideline concussion diagnosis. She has written a book chapter on the gut microbiome and its relation to headache syndromes in concussion. Her primary research interests include identifying predictors of concussion recovery, examining the role of sleep during concussion recovery, and investigating the cognitive implications of concussion. Dr. Datta serves as Vice Chair of the American Academy of Neurology's Sports Neurology Section to further awareness and develop new education initiatives in the field. Part 1 Today’s topic is something none of us got in medical school. What makes her successful in treating her patients is having this approach, sort of a 180-360 approach to nutritional status among the head-neck , vestibular balance, and everything else we do. When a concussion occurs, we often have disruption of the blood-brain barrier. There also is inflammation. Ultimately, there can be cell death. We have an opportunity for nutritional repair in concussions. There is an energy crisis in the brain. We need to increase the brain’s need for anti-inflammatory and antioxidant nutrients. We will discuss in this presentation how to get that into a person’s brain or diet and look at why diet matters.
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Avery Menaker and Faye Bronstein: High Intensity Training Across the Continuum.
03/26/2025
Avery Menaker and Faye Bronstein: High Intensity Training Across the Continuum.
Avery Menaker is a senior occupational therapist at NYU Rusk Rehabilitation. She is certified as both a stroke rehabilitation specialist and a brain injury specialist. She co-leads an initiative at NYU to bring high intensity practice to patients participating in occupational therapy. Faye Bronstein is the inpatient rehabilitation clinical specialist at Rusk Rehabilitation. She is board certified in neurology, geriatrics, and physical therapy, and has led initiatives to bring high intensity training practice into the NYU inpatient setting over the past three years. The following topics were among those discussed in the interview: how high intensity training differs from traditional therapy approaches and what its benefits are; kinds of patients for whom high intensity training is appropriate; research to support high intensity training; equipment needed for this intervention; what a typical high intensity treatment session looks like in physical therapy and occupational therapy; implementation challenges; whether high intensity training is done in every therapy clinic and if all therapists know about it; and contents of an NYU continuing education course on high intensity training that will be offered on May 17-18, 2025.
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Dr. Andrew Bateman: Care of Patients with Neurological Impairments, Part 3
03/12/2025
Dr. Andrew Bateman: Care of Patients with Neurological Impairments, Part 3
Dr. Andrew Bateman has worked in clinical rehabilitation and research since 1990 as a chartered physiotherapist. He was fascinated by the problem of patients with neurological conditions not doing what he expected. So, he went off to learn more about neuropsychology and did so by completing a PhD in Neuropsychology in 1997. He was at the National Health Service until 2019 when he left to take up his current academic role as a full professor of rehabilitation. He is a Past President and currently Treasurer of The Society for Research in Rehabilitation; and Chair of the charity “United Kingdom Acquired Brain Injury Forum” and was recently appointed President of the Association of Chartered Physiotherapists in Neurology. Part 3 The discussion covered the following topics: spiritual aspects of health care, use of wearable devices by patients, role of physical exercise in the care of patients, influence of dietary practices on patients’ health status, and personal research underway and expected to begin in the near term.
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Dr. Andrew Bateman: Care of Patients with Neurological Impairments, Part 2
02/26/2025
Dr. Andrew Bateman: Care of Patients with Neurological Impairments, Part 2
Dr. Andrew Bateman has worked in clinical rehabilitation and research since 1990 as a chartered physiotherapist. He was fascinated by the problem of patients with neurological conditions not doing what he expected. So, he went off to learn more about neuropsychology and did so by completing a PhD in Neuropsychology in 1997. He was at the National Health Service until 2019 when he left to take up his current academic role as a full professor of rehabilitation. He is a Past President and currently Treasurer of The Society for Research in Rehabilitation; and Chair of the charity “United Kingdom Acquired Brain Injury Forum” and was recently appointed President of the Association of Chartered Physiotherapists in Neurology. Part 2 The discussion covered the following topics: launching new program initiatives, professionals involved in holistic neuropsychological rehabilitation, addressing health care disparities, willingness of patients to cooperate in their care, role of informal caregivers, and use of telehealth as an intervention.
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Dr. Andrew Bateman: Care of Patients with Neurological Impairments, Part 1
02/12/2025
Dr. Andrew Bateman: Care of Patients with Neurological Impairments, Part 1
Dr. Andrew Bateman has worked in clinical rehabilitation and research since 1990 as a chartered physiotherapist. He was fascinated by the problem of patients with neurological conditions not doing what he expected. So, he went off to learn more about neuropsychology and did so by completing a PhD in Neuropsychology in 1997. He was at the National Health Service until 2019 when he left to take up his current academic role as a full professor of rehabilitation. He is a Past President and currently Treasurer of The Society for Research in Rehabilitation; and Chair of the charity “United Kingdom Acquired Brain Injury Forum” and was recently appointed President of the Association of Chartered Physiotherapists in Neurology. Part 1 The discussion covered the following topics: diagnosing acquired brain injuries; biomarkers for neurological impairments; Long COVID and neurological symptoms; recruitment and retention of health personnel; and composition of the health care team.
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Dr. Sara Cuccurullo and Dr. Talya Flemming: Investigating and Analyzing the Effect of a Comprehensive Stroke Recovery Program, Part 2
01/29/2025
Dr. Sara Cuccurullo and Dr. Talya Flemming: Investigating and Analyzing the Effect of a Comprehensive Stroke Recovery Program, Part 2
The 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 2 Dr. Flemming described the functional results obtained from their intervention. They specifically chose the activity measure proposed for post-acute care, abbreviated as AM-PAC. It showed improvement over time and it allowed looking at specific subsections within rehabilitation, such as basic mobility, daily activity, and cognitive scores. An AM-PAC score is a recognized tool by Medicare used in multiple post-acute care settings. Dr. Cuccurullo indicated that according to an article published in 2011 in the journal Stroke, the all-cause mortality for stroke patients in the U.S. is 31%. In one year, the all-cause mortality in their program was 1.47%. Their results were published in the American Journal of Physical Medicine and Rehabilitation. The paper received the Excellence in Research Writing Award for the most impactful article of the year. Significantly, the manuscript attracted the attention of Medicare officials who asked them to present their findings. CMS wanted to know if it can be proved that the stroke recovery program saves money, can they validate their previous improvement in mortality with more patients, and can they replicate the results at other institutions nationally. Drs. Fleming and Cuccurullo described what they did in response to these questions. A Question & Answer period followed.
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Dr. Sara Cuccurullo and Dr. Talya Flemming: Investigating and Analyzing the Effect of a Comprehensive Stroke Recovery Program, Part 1
01/15/2025
Dr. Sara Cuccurullo and Dr. Talya Flemming: Investigating and Analyzing the Effect of a Comprehensive Stroke Recovery Program, Part 1
The 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.
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Kate Parkin, Mary Reilly, Angela Stolfi, and Christina Tafurt: Clinical Practice of Occupational Therapy, Physical Therapy, and Speech-Language Pathology, Part 4
12/30/2024
Kate Parkin, Mary Reilly, Angela Stolfi, and Christina Tafurt: Clinical Practice of Occupational Therapy, Physical Therapy, and Speech-Language Pathology, Part 4
Catherine Parkin serves as Clinical Assistant Professor, , She co-authored the book, Medical aspects of disability for the rehabilitation professionals in 2017 by the Springer Publishing Company. Mary Regina Reilly has served as the Clinical Director of Speech Language Pathology at Rusk Rehabilitation, NYU Langue Health for the last ten years. Her Master’s Degree is from Columbia University and she did her fellowship at Montefiore Medical Center in the Bronx, New York. Clinical concentration has focused on pediatric dysphagia with medically complex infants with additional efforts in developing specialty programs for adults with acquired neurogenic disorders. She was instrumental in assisting in the development of the Masters of Science Program in Communication Sciences at Yeshiva University and has served as an adjunct professor at both Mercy College and NYU Steinhardt. Dr. Angela Stolfi is the Director of Physical Therapy, Director of Therapy Services at Rusk Ambulatory Satellite Locations, Site Coordinator of PT Clinical Education, and Director of PT Residency and Fellowship Programs at Rusk Rehabilitation, NYU Langone Health. Dr. Stolfi holds a faculty appointment in the Department of Rehabilitation at NYU School of Medicine and regularly lectures in the physical therapy programs at both NYU and the University of Scranton. The focus of much of her current and recent research relates to mentoring and education of student physical therapists. She is also an Associate Editor of the Journal of Clinical Education in Physical Therapy (JCEPT). Maria Cristina Tafurt is the Site Director at the Rusk Institute NYU Langone Medical Center, Hospital for Joint Diseases. She has been a licensed occupational therapist for over 30 years receiving her Bachelor’s degree from the University of Rosario in Bogata Colombia, and her Advance Master’s degree from NYU University. Her clinical experience has varied with an emphasis on brain injury rehabilitation, pain management, hand therapy, and orthopedics. She holds a faculty appointment in the Department of Rehabilitation Medicine as a Clinical Instructor and has authored or co-authored sixteen articles, abstracts and international presentations in her field. The discussion covered the following topics: influence of artificial intelligence, and research endeavors pertaining to occupational therapy, physical therapy, and speech-language pathology.
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Kate Parkin, Mary Reilly, Angela Stolfi, and Christina Tafurt: Clinical Practice of Occupational Therapy, Physical Therapy, and Speech-Language Pathology, Part 3
12/18/2024
Kate Parkin, Mary Reilly, Angela Stolfi, and Christina Tafurt: Clinical Practice of Occupational Therapy, Physical Therapy, and Speech-Language Pathology, Part 3
Catherine Parkin serves as Clinical Assistant Professor, , She co-authored the book, Medical aspects of disability for the rehabilitation professionals in 2017 by the Springer Publishing Company. Mary Regina Reilly has served as the Clinical Director of Speech Language Pathology at Rusk Rehabilitation, NYU Langue Health for the last ten years. Her Master’s Degree is from Columbia University and she did her fellowship at Montefiore Medical Center in the Bronx, New York. Clinical concentration has focused on pediatric dysphagia with medically complex infants with additional efforts in developing specialty programs for adults with acquired neurogenic disorders. She was instrumental in assisting in the development of the Masters of Science Program in Communication Sciences at Yeshiva University and has served as an adjunct professor at both Mercy College and NYU Steinhardt. Dr. Angela Stolfi is the Director of Physical Therapy, Director of Therapy Services at Rusk Ambulatory Satellite Locations, Site Coordinator of PT Clinical Education, and Director of PT Residency and Fellowship Programs at Rusk Rehabilitation, NYU Langone Health. Dr. Stolfi holds a faculty appointment in the Department of Rehabilitation at NYU School of Medicine and regularly lectures in the physical therapy programs at both NYU and the University of Scranton. The focus of much of her current and recent research relates to mentoring and education of student physical therapists. She is also an Associate Editor of the Journal of Clinical Education in Physical Therapy (JCEPT). Maria Cristina Tafurt is the Site Director at the Rusk Institute NYU Langone Medical Center, Hospital for Joint Diseases. She has been a licensed occupational therapist for over 30 years receiving her Bachelor’s degree from the University of Rosario in Bogata Colombia, and her Advance Master’s degree from NYU University. Her clinical experience has varied with an emphasis on brain injury rehabilitation, pain management, hand therapy, and orthopedics. She holds a faculty appointment in the Department of Rehabilitation Medicine as a Clinical Instructor and has authored or co-authored sixteen articles, abstracts and international presentations in her field. The discussion covered the following topics: involvement of informal caregivers in treatment, staying on top of new developments, use of assistive technology, provision of care via telehealth, and impact of Long Covid on patient care.
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Kate Parkin, Mary Reilly, Angela Stolfi, and Christina Tafurt: Clinical Practice of Occupational Therapy, Physical Therapy, and Speech-Language Pathology, Part 2
12/04/2024
Kate Parkin, Mary Reilly, Angela Stolfi, and Christina Tafurt: Clinical Practice of Occupational Therapy, Physical Therapy, and Speech-Language Pathology, Part 2
Catherine Parkin serves as Clinical Assistant Professor, , She co-authored the book, Medical aspects of disability for the rehabilitation professionals in 2017 by the Springer Publishing Company. Mary Regina Reilly has served as the Clinical Director of Speech Language Pathology at Rusk Rehabilitation, NYU Langue Health for the last ten years. Her Master’s Degree is from Columbia University and she did her fellowship at Montefiore Medical Center in the Bronx, New York. Clinical concentration has focused on pediatric dysphagia with medically complex infants with additional efforts in developing specialty programs for adults with acquired neurogenic disorders. She was instrumental in assisting in the development of the Masters of Science Program in Communication Sciences at Yeshiva University and has served as an adjunct professor at both Mercy College and NYU Steinhardt. Dr. Angela Stolfi is the Director of Physical Therapy, Director of Therapy Services at Rusk Ambulatory Satellite Locations, Site Coordinator of PT Clinical Education, and Director of PT Residency and Fellowship Programs at Rusk Rehabilitation, NYU Langone Health. Dr. Stolfi holds a faculty appointment in the Department of Rehabilitation at NYU School of Medicine and regularly lectures in the physical therapy programs at both NYU and the University of Scranton. The focus of much of her current and recent research relates to mentoring and education of student physical therapists. She is also an Associate Editor of the Journal of Clinical Education in Physical Therapy (JCEPT). Maria Cristina Tafurt is the Site Director at the Rusk Institute NYU Langone Medical Center, Hospital for Joint Diseases. She has been a licensed occupational therapist for over 30 years receiving her Bachelor’s degree from the University of Rosario in Bogata Colombia, and her Advance Master’s degree from NYU University. Her clinical experience has varied with an emphasis on brain injury rehabilitation, pain management, hand therapy, and orthopedics. She holds a faculty appointment in the Department of Rehabilitation Medicine as a Clinical Instructor and has authored or co-authored sixteen articles, abstracts and international presentations in her field. The discussion in Part Two covered the following topics: types of patients treated, impact of health care disparities, and patient cooperation in health care interventions by providers.
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Kate Parkin, Mary Reilly, Angela Stolfi, and Christina Tafurt: Clinical Practice of Occupational Therapy, Physical Therapy, and Speech-Language Pathology, Part 1
11/20/2024
Kate Parkin, Mary Reilly, Angela Stolfi, and Christina Tafurt: Clinical Practice of Occupational Therapy, Physical Therapy, and Speech-Language Pathology, Part 1
Catherine Parkin serves as Clinical Assistant Professor, , She co-authored the book, Medical aspects of disability for the rehabilitation professionals in 2017 by the Springer Publishing Company. Mary Regina Reilly has served as the Clinical Director of Speech Language Pathology at Rusk Rehabilitation, NYU Langue Health for the last ten years. Her Master’s Degree is from Columbia University and she did her fellowship at Montefiore Medical Center in the Bronx, New York. Clinical concentration has focused on pediatric dysphagia with medically complex infants with additional efforts in developing specialty programs for adults with acquired neurogenic disorders. She was instrumental in assisting in the development of the Masters of Science Program in Communication Sciences at Yeshiva University and has served as an adjunct professor at both Mercy College and NYU Steinhardt. Dr. Angela Stolfi is the Director of Physical Therapy, Director of Therapy Services at Rusk Ambulatory Satellite Locations, Site Coordinator of PT Clinical Education, and Director of PT Residency and Fellowship Programs at Rusk Rehabilitation, NYU Langone Health. Dr. Stolfi holds a faculty appointment in the Department of Rehabilitation at NYU School of Medicine and regularly lectures in the physical therapy programs at both NYU and the University of Scranton. The focus of much of her current and recent research relates to mentoring and education of student physical therapists. She is also an Associate Editor of the Journal of Clinical Education in Physical Therapy (JCEPT). Maria Cristina Tafurt is the Site Director at the Rusk Institute NYU Langone Medical Center, Hospital for Joint Diseases. She has been a licensed occupational therapist for over 30 years receiving her Bachelor’s degree from the University of Rosario in Bogata Colombia, and her Advance Master’s degree from NYU University. Her clinical experience has varied with an emphasis on brain injury rehabilitation, pain management, hand therapy, and orthopedics. She holds a faculty appointment in the Department of Rehabilitation Medicine as a Clinical Instructor and has authored or co-authored sixteen articles, abstracts and international presentations in her field. The discussion covered the following topics in Part One: a description of each of the three professions, educational requirements to become practitioners, and recruitment and retention of clinicians.
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Dr. Heidi Fusco, Alaina B. Hammond, Dr. Jessica Rivetz: Traumatic Brain Injury, Part 3
11/06/2024
Dr. Heidi Fusco, Alaina B. Hammond, Dr. Jessica Rivetz: Traumatic Brain Injury, Part 3
Dr. Heidi Fusco is an assistant professor of Rehabilitation Medicine at NYU LANGONE Health and the Rusk Rehabilitation hospital. She is the Assistant Director of the Traumatic Brain Injury Program at Rusk and the Medical Director of the Brain Injury Unit at Queens Nassau Nursing and Rehabilitation. She completed a fellowship in Brain injury Rehab in 2013 at the Rusk Institute and is board certified in Brain Injury medicine and Physical Medicine and Rehabilitation. Alaina B. Hammond is a board certified rehabilitation psychologist and currently serves as Clinical Assistant Professor and Staff Psychologist in the NYU Langone Rusk Adult Inpatient - Brain Injury Rehabilitation Program. She provides psychological and neuropsychological intervention and assessment to patients and families with acquired brain injury, stroke, spinal cord injury and other illness/injuries. In addition, she supervises psychology interns and enjoys researching family/caregiver adjustment to medical illness. Dr. Jessica Rivetz is the current Brain Injury Medicine Fellow at NYU Rusk Rehabilitation. She recently completed her residency in physical medicine and rehabilitation at NYU Rusk. She received her MD degree at Albany Medical College, and also has a Master's of Science in health care management. Extracurricular activities include serving as co-chairperson of the NYU GME House Staff Patient Safety Council. Within brain injury medicine, she has a special interest managing patients with moderate to severe traumatic brain injury and helping them and their caregivers navigate life after brain injury and achieve their functional and quality of life goals. Part 3 The discussion covered the following topics: phases of treatment when mindfulness and self-compassion can be introduced to achieve optimal effectiveness; the role of telehealth; extent to which a group-based approach is used; availability of commercialized digital resources on the Internet, such as apps; use of wearable devices by patients; and the impact of artificial intelligence on patient care.
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Dr. Heidi Fusco, Alaina B. Hammond, Dr. Jessica Rivetz: Traumatic Brain Injury, Part 2
10/23/2024
Dr. Heidi Fusco, Alaina B. Hammond, Dr. Jessica Rivetz: Traumatic Brain Injury, Part 2
Dr. Heidi Fusco is an assistant professor of Rehabilitation Medicine at NYU LANGONE Health and the Rusk Rehabilitation hospital. She is the Assistant Director of the Traumatic Brain Injury Program at Rusk and the Medical Director of the Brain Injury Unit at Queens Nassau Nursing and Rehabilitation. She completed a fellowship in Brain injury Rehab in 2013 at the Rusk Institute and is board certified in Brain Injury medicine and Physical Medicine and Rehabilitation. Alaina B. Hammond is a board certified rehabilitation psychologist and currently serves as Clinical Assistant Professor and Staff Psychologist in the NYU Langone Rusk Adult Inpatient - Brain Injury Rehabilitation Program. She provides psychological and neuropsychological intervention and assessment to patients and families with acquired brain injury, stroke, spinal cord injury and other illness/injuries. In addition, she supervises psychology interns and enjoys researching family/caregiver adjustment to medical illness. Dr. Jessica Rivetz is the current Brain Injury Medicine Fellow at NYU Rusk Rehabilitation. She recently completed her residency in physical medicine and rehabilitation at NYU Rusk. She received her MD degree at Albany Medical College, and also has a Master's of Science in health care management. Extracurricular activities include serving as co-chairperson of the NYU GME House Staff Patient Safety Council. Within brain injury medicine, she has a special interest managing patients with moderate to severe traumatic brain injury and helping them and their caregivers navigate life after brain injury and achieve their functional and quality of life goals. Part 2 The discussion covered the following topics: persistence of sleep disorders and the role of physical exercise in treating them; definition of mindfulness; kinds of interventions included under the heading of mindfulness; examples of how it aims to address the severity of various TBI-related health problems; duration of mindfulness treatment; and self-compassion as another type of non-pharmacological intervention.
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Dr. Heidi Fusco, Alaina B. Hammond, Dr. Jessica Rivetz: Traumatic Brain Injury, Part 1
10/09/2024
Dr. Heidi Fusco, Alaina B. Hammond, Dr. Jessica Rivetz: Traumatic Brain Injury, Part 1
Dr. Heidi Fusco is an assistant professor of Rehabilitation Medicine at NYU LANGONE Health and the Rusk Rehabilitation hospital. She is the Assistant Director of the Traumatic Brain Injury Program at Rusk and the Medical Director of the Brain Injury Unit at Queens Nassau Nursing and Rehabilitation. She completed a fellowship in Brain injury Rehab in 2013 at the Rusk Institute and is board certified in Brain Injury medicine and Physical Medicine and Rehabilitation. Alaina B. Hammond is a board certified rehabilitation psychologist and currently serves as Clinical Assistant Professor and Staff Psychologist in the NYU Langone Rusk Adult Inpatient - Brain Injury Rehabilitation Program. She provides psychological and neuropsychological intervention and assessment to patients and families with acquired brain injury, stroke, spinal cord injury and other illness/injuries. In addition, she supervises psychology interns and enjoys researching family/caregiver adjustment to medical illness. Dr. Jessica Rivetz is the current Brain Injury Medicine Fellow at NYU Rusk Rehabilitation. She recently completed her residency in physical medicine and rehabilitation at NYU Rusk. She received her MD degree at Albany Medical College, and also has a Master's of Science in health care management. Extracurricular activities include serving as co-chairperson of the NYU GME House Staff Patient Safety Council. Within brain injury medicine, she has a special interest managing patients with moderate to severe traumatic brain injury and helping them and their caregivers navigate life after brain injury and achieve their functional and quality of life goals. Part 1 The discussion covered the following topics: concussions and TBIs; pediatric care; use of biomarkers; common causes of a TBI; common symptoms and their length of duration; involvement of informal caregivers; and occurrence of sleep disorders.
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Dr. Steven DeKosky: CTE History, Questions and Future Directions, Part 2
09/25/2024
Dr. Steven DeKosky: CTE History, Questions and Future Directions, Part 2
Dr. Steven DeKosky is professor of Alzheimer’s research at the University of Florida College of Medicine and Deputy Director of the McKnight Brain Institute at that institution. He also is a professor of neurology and neuroscience there. Previously, he served as vice president and dean of the University of Virginia School of Medicine and was chairperson of the department of neurology at the University of Pittsburgh. Part 2 For the short-term, with mild to moderate traumatic injury you can have altered synaptic structure and function. For the longer term, chronic inflammation and chronic oxidative stress can lead to subsequent degeneration and also some chronic microglial activation, which may turn on mechanisms that you do not necessarily want, including cleaning up partially injured neurons that may recover. Especially in patients who get the disease in an older age, there is other pathology in the CTE. There are nerve fibrillary tangle and Lewy body. Amyloid beta can be elevated in both white matter and grey matter and might add to the cascade that is thought amyloid leads to, which leads to degeneration especially Alzheimer’s disease, but cannot prove it. Participants in contact sports all are at significant risk. APOE 4 increases the risk of Alzheimer’s disease and the risk of tau deposition. Currently, when patients arrive for rehabilitation, they are going to have things a lot better described than was the case previously. We can look at disruption of structures, see hemorrhage and inflammation. We know that CTE is not a new disease, but we do see the pathology in other contact sports and we do not view it in autopsy series unless the individual had a history or repetitive head injury. A Question & Answer period followed.
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Dr. Steven DeKosky: CTE History, Questions and Future Directions, Part 1
09/12/2024
Dr. Steven DeKosky: CTE History, Questions and Future Directions, Part 1
Dr. Steven DeKosky is professor of Alzheimer’s research at the University of Florida College of Medicine and Deputy Director of the McKnight Brain Institute at that institution. He also is a professor of neurology and neuroscience there. Previously, he served as vice president and dean of the University of Virginia School of Medicine and was chairperson of the department of neurology at the University of Pittsburgh. Part 1 Dr. DeKosky described how CTE has a fascinating history, There still are questions about it. Some questions are old while some are new, but they all are interesting with respect to injury to the brain and how you try to repair it. Future directions also will be covered because the data arrive quickly. Mild traumatic brain injury usually means at least being knocked unconscious. It is not clear whether there is short-term pathology that lasts. Recovery usually is good. It is not clear exactly how much of an increased risk of Alzheimer’s disease there is with a single severe TBI while more is being learned about the long-term effects. Only recently has CTE been defined clearly. Boxing is where CTE came from initially. He indicated that football helmets first were used at the U.S. Naval Academy in 1894 because one player needed protection against experiencing another head injury. He mentioned that the NCAA owes its origins to efforts to reduce brutal injuries sustained by football players. President Theodore Roosevelt led governmental efforts to prevent such injuries. Several examples were provided of developments that occurred over the decades to obtain a greater understanding of the prevention and treatment of brain damage. Apart from head injuries in sports, an uptick in interest in such uncommon disorders resulted from modern day wars in the middle east involving blast injuries from IEDs and the discovery that playing football and other sports led to many injuries viewed as being more common.
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Dr. Darryl Kaelin: Traumatic Brain Injury And Its Association With Neurodegenerative Disorders, Part 2
08/28/2024
Dr. Darryl Kaelin: Traumatic Brain Injury And Its Association With Neurodegenerative Disorders, Part 2
The introduction is done by Dr. Steven Flanagan, Chairperson of the Department of Rehabilitation at NYU Langone Health. His remarks ended at the 2 minute: 24 second mark. Dr. Darryl Kaelin is the Endowed Chair of Stroke and Brain Injury Rehabilitation at the University of Louisville. In this Grand Rounds session, he speaks about Traumatic Brain Injury and its Association with Neurodegenerative Disorders. Part 2 Repetitive mild brain injuries also can result in the same kinds of findings. So, it is not just moderate to severe, but repetitive mild injuries that increase the risk. Although there may not be a direct causal relationship, certainly having a brain injury, multiple mild brain injuries or a moderate to severe brain injury increases the risk of developing neurodegenerative processes like Alzheimer’s and Parkinson’s. He tells his patients that the likelihood of developing a neurodegenerative process may be there, but in each individual it can be different. We don’t know specifically what it might mean for you. On average the risk may go up, but it still is very small. He talked about some potential neuro-protective treatments that might exist out there or are in the process of being looked at. He stated that this patient population is heavily heterogeneous, especially in how it presents and responds to trauma. Additionally, patients in the U.S. don’t all receive exactly the same treatment after their trauma, which is a confounding variable that results in a very different outcome for each of those kinds of patients. Nutrition is a highly important factor when it comes to recovery and outcomes. Parenteral nutrition goes a long way in helping their outcomes. It also is important to keep an eye on vitamin and mineral levels. Zinc is a key supplement for many patients and magnesium can help in recovery. He closed by describing a disorders of consciousness program at his institution called the Emerge Program. A Question &Answer period followed.
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Dr. Darryl Kaelin: Traumatic Brain Injury and its Association with Neurodegenerative Disorders, Part 1
08/14/2024
Dr. Darryl Kaelin: Traumatic Brain Injury and its Association with Neurodegenerative Disorders, Part 1
The introduction is done by Dr. Steven Flanagan, Chairperson of the Department of Rehabilitation at NYU Langone Health. Dr. Darryl Kaelin is the Endowed Chair of Stroke and Brain Injury Rehabilitation at the University of Louisville. In this Grand Rounds session, he speaks about Traumatic Brain Injury and its Association with Neurodegenerative Disorders. Part 1 Dr. Kaelin described the interesting relationship between the University of Louisville Frazier Rehabilitation Institute and NYU Rusk in New York. The Institute has its origins at NYU. His presentation had a focus on cellular level and pathophysiology that contribute to complications of brain injury, Alzheimer’s type dementia, Parkinson’s Disease and some similarities that exist. He began a literature review one-year ago on this topic, which has led to today’s discussion. It is important to start by talking a little about the pathophysiology TBI and cerebral insults. It can have some correlation to stroke and other insults to the brain and central nervous system. He also talked a little bit about things that we don’t think about much as physiatrists –astrocytes and microglia and what their roles are in the brain and in brain trauma. He indicated that astrocytes are the scaffolding or the structure upon which neurons and other cells hold themselves to and create the structure and shape of the brain. Microglial cells help in brain infection and brain inflammation. In a resting, healthy brain they are highly mobile and will undergo morphological changes following a brain trauma. He indicated that synapses between neurons are significantly affected both mechanically and in becoming lost in severe brain injury. He discussed the importance of sleep for patients with a brain injury.
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Dr. Julie Silver: Strategies to Address Workforce Diversity, Equity, and Inclusion, Part 2
07/31/2024
Dr. Julie Silver: Strategies to Address Workforce Diversity, Equity, and Inclusion, Part 2
Dr. Julie Silver is an associate professor and associate chairperson in the department of physical medicine and rehabilitation at Harvard Medical School PART 2 In Part 2, Dr. Silver began by indicating that thinking about belonging and social integration are super important. There are two bodies of literature--a retention literature and a belonging literature. Very few studies have looked at them together. One investigation that did so found that women who have fewer belonging components are more likely to leave their workplace and more likely to stay if they have more of these components. What can be done right now to improve the situation? Her answer is that individuals should be told that they belong. Inclusion is not a synonym of belonging. She provided examples of constructive steps that have been implemented at other academic institutions. Mentoring is a critically important model. She described how she works with individuals in helping them to feel that they belong and indicated five strategies that leaders can implement. Let’s not assume that progress happens. Instead, let’s believe the science and follow the data. When looking at the proportion of women on specialty boards, they found in a comparison study that six boards decreased and that two stayed the same. Progress does not just happen on its own. In PM&R, there was an increase, but it still is not really at the equitable level. We must continue to focus on it. The same holds true when looking at race and ethnicity.
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Dr. Julie Silver: Strategies to Address Workforce Diversity, Equity, and Inclusion, Part 1
07/17/2024
Dr. Julie Silver: Strategies to Address Workforce Diversity, Equity, and Inclusion, Part 1
Dr. Julie Silver is an associate professor and associate chairperson in the department of physical medicine and rehabilitation at Harvard Medical School PART 1 Her presentation is a data-driven lecture for individuals who believe in science. A big theme in her work is to focus on tipping points that will drive change faster. An important large study reported in the journal Lancet in 2018 attracted widespread attention. Researchers looked at clinical practice guidelines. They found that the representation of female authors was low, but even lower for female physicians. Looking at PM&R since then shows similar findings. Problems were not being solved because while medical societies indicated that they were not at fault, their journals expressed the same opinion. It became obvious that many organizations were working together in ways that were complicit. Not many women were included in the clinical practice guidelines. Compensation is an important issue that also was studied extensively. Dr. Silver provided an example of how men were compensated more than women for performing similar procedures. She discussed medical recognition awards that also reveal a considerable amount of disparity that favors men over women. The same holds true for minoritized groups as explained using the concept of inexorable zero. A promotion problem is involved in this situation, which can be fixed. Additionally, her lecture also focused on challenges pertaining to faculty retention. Women physicians are more likely to leave academia at all career stages. A key issue is enabling individuals to feel that they belong.
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Nicole Lund: Sports and Performance Nutrition, Part 2
07/03/2024
Nicole Lund: Sports and Performance Nutrition, Part 2
Nicole Lund is a registered dietitian at NYU Langone’s Sports Performance Center. A certified health and well-being coach and certified personal trainer, as a former dancer her love of movement led her into a career as a step aerobics instructor and personal trainer. Through her work, she recognized a need for a discussion about food and its impact on everything from performance to health. She sees medical nutrition therapy patients via insurance and self-pay sports. She is a clinician with the Running Lab and works with athletes on the USA Nordic team. Her expertise is in sports and performance nutrition while her clinical interests include chronic inflammation, weight loss, migraines, and menopause. She has a master’s degree in public health nutrition from Hunter College. Part 2 The discussion covered the following topics: complementary and alternative therapies; accuracy of patients' nutrition knowledge; influence of demographic factors on the adequacy of nutritional status; provision of nutritional health care care via telehealth; prevention of health problems related to participating in vigorous physical activities; and how improved dietary practices may help to prevent health problems.
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Nicole Lund: Sports and Performance Nutrition, Part 1
06/19/2024
Nicole Lund: Sports and Performance Nutrition, Part 1
Nicole Lund is a registered dietitian at NYU Langone’s Sports Performance Center. A certified health and well-being coach and certified personal trainer, as a former dancer her love of movement led her into a career as a step aerobics instructor and personal trainer. Through her work, she recognized a need for a discussion about food and its impact on everything from performance to health. She sees medical nutrition therapy patients via insurance and self-pay sports. She is a clinician with the Running Lab and works with athletes on the USA Nordic team. Her expertise is in sports and performance nutrition while her clinical interests include chronic inflammation, weight loss, migraines, and menopause. She has a master’s degree in public health nutrition from Hunter College. Part 1 The discussion covered the following topics: how and when she began to develop an interest in performance nutrition; types of patients she treats; the role that diet plays in improving problems involving overweight and obesity; and use of dietary supplements by patients.
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Dr. David Jevotovsky: TBI Recovery from Both Patient and Provider Perspectives
06/05/2024
Dr. David Jevotovsky: TBI Recovery from Both Patient and Provider Perspectives
Dr. David Jevotovsky is in the second year of a residency program at the Rusk Rehabilitation Institute at NYU Langone Health. A former graduate of NYU Grossman School of Medicine, he is keen on pursuing a fellowship in interventional pain medicine. Having experienced a traumatic brain injury during his medical training, he possesses a unique understanding of both the patient and provider perspectives of this condition. As patients differ on the basis of age, gender, and racial/ethnic background, whether they also tend to differ in how they express what it is like to experience a TBI and live with its aftermath; the role played by social media in the residency program; whether beneficial outcomes can result from having patients with a TBI participate in physical exercise activities; why it is hard for many patients, their loved ones, and even PM&R physicians to understand how a brain could be rewired; and different perspectives that patients and physicians may have regarding agitation/delirium, cognition, return to work, and support systems.
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Special Episode:The New Metro: Sports Medicine Board Review Course 2024
05/29/2024
Special Episode:The New Metro: Sports Medicine Board Review Course 2024
This unique episode features course directors Dr. Salvador Portugal, Dr. Surein Theivakumar, Dr. Julia Iafrate, Dr. Jina Libby and Dr. Haruki Ishii for the course taking place 6/7-6/9. The following link has more information, if you or anyone you know is interested in registering:
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Dr. Jina Libby and Dr. Laurenie Louissaint: Global Health Spotlight: Rehabilitation Medicine in Namibia, Part 2
05/22/2024
Dr. Jina Libby and Dr. Laurenie Louissaint: Global Health Spotlight: Rehabilitation Medicine in Namibia, Part 2
Dr. Jina Libby completed her PM&R residency in Michigan. Her dedication to that profession and sports medicine extends beyond clinical practice as she serves on the executive committee for the International Rehab and Global Health Committee of AAPM&R. Her fervor for education is evident through her commitment to teaching physical medicine and rehabilitation, not only locally, but also by championing its integration on an international scale. Beyond her current role as a fellow physician, Dr. Laurenie Louissaint's compassionate spirit leads her on frequent global impact trips, where she provides critical medical support to underserved communities, such as Haiti and Namibia. She also is an active member of the New York City cycling community while also providing medical care for injured cyclists and developing related research. Part 1 The discussion in Part 1 included the following items: demographic aspects of Namibia, major health problems in that nation, how health care is financed, similarities with western allopathic health practices, use of traditional and alternative health care interventions, status of health professions educational institutions, and nature of the auspices sponsoring the visitation trip by U.S. clinicians to that country. Part 2 The discussion in Part 2 included the following items: types of health professionals in the group visiting Namibia, kinds of Namibian practitioners interacted with during the visit, most evident aspects of health care in that nation where improvements would appear to be beneficial, possibly reversing the flow of clinicians to enable Namibians to spend time in U.S. clinical facilities, and health professional literature produced in that country.
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Dr. Jina Libby and Dr. Laurenie Louissaint: Global Health Spotlight: Rehabilitation Medicine in Namibia, Part 1
05/08/2024
Dr. Jina Libby and Dr. Laurenie Louissaint: Global Health Spotlight: Rehabilitation Medicine in Namibia, Part 1
Dr. Jina Libby completed her PM&R residency in Michigan. Her dedication to that profession and sports medicine extends beyond clinical practice as she serves on the executive committee for the International Rehab and Global Health Committee of AAPM&R. Her fervor for education is evident through her commitment to teaching physical medicine and rehabilitation, not only locally, but also by championing its integration on an international scale. Beyond her current role as a fellow physician, Dr. Laurenie Louissaint's compassionate spirit leads her on frequent global impact trips, where she provides critical medical support to underserved communities, such as Haiti and Namibia. She also is an active member of the New York City cycling community while also providing medical care for injured cyclists and developing related research. Part 1 The discussion in Part 1 included the following items: demographic aspects of Namibia, major health problems in that nation, how health care is financed, similarities with western allopathic health practices, use of traditional and alternative health care interventions, status of health professions educational institutions, and nature of the auspices sponsoring the visitation trip by U.S. clinicians to that country. Part 2 The discussion in Part 2 included the following items: types of health professionals in the group visiting Namibia, kinds of Namibian practitioners interacted with during the visit, most evident aspects of health care in that nation where improvements would appear to be beneficial, possibly reversing the flow of clinicians to enable Namibians to spend time in U.S. clinical facilities, and health professional literature produced in that country.
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Dr. Sharon Kolasinski: Grand Round Presentation on Treatment of Patients with Osteoarthritis, Part 2
04/24/2024
Dr. Sharon Kolasinski: Grand Round Presentation on Treatment of Patients with Osteoarthritis, Part 2
Dr. Sharon Kolasinski is a professor of clinical medicine at the University of Pennsylvania and chief of the Division of Rheumatology at Penn Presbyterian Medical Center. Part 1 Her objectives in the presentation are to help listeners by learning about evidence-based treatment for patients with osteoarthritis (OA), to understand the process by which guidelines are developed that might help us figure out our evidence-based approach, to review the recommended treatments for OA, and to review some treatments that are not recommended for OA. Her basic evidence-based reference is a University of Pennsylvania guideline that was published in 2020. Numerous other guidelines are available, which she described. She discussed her work with a case involving a 55-year-old male patient. He arrived for routine follow-up care for immunosuppressive medication monitoring. He described pains that he was experiencing and was diagnosed with OA. She indicated the impacts OA has on patients. Clinicians find it a daunting challenge to provide satisfactory treatment. For example, for some clinicians, the guidelines do not appear to be clear and provide a roadmap. Also, they do not always believe in the recommendations contained in the guidelines. In this presentation, she wants to see if she can change some minds about guidelines. She provided an example based on investigations conducted at her institution. The outcome was a series of recommendations that she described. Part 2 Dr. Kolasinski began Part 2 of her presentation by continuing to focus on the importance of having patients with OA engage in physical activity. She stated that “they are worn out and the implication is that a doctor is needed to fix them.” Perhaps a perspective should be taken of a more participatory discourse where we encourage physical therapy and emphasize that physical exercise is safe when you have arthritis and focus on what the patient can do, empowering them to exercise. A starting point is to give patients a physical therapy prescription. She discussed the extent to which physical therapy is useful, along with indicating how much and how frequently exercise is beneficial (e.g., for 20 minutes, three times a week). Losing weight is an effective way of reducing symptoms. Food choices can affect OA symptoms. Diet and exercise used together can produce effective results. References were made to several studies that involve the status of steroid injections on improving patient health status. Acupuncture also was mentioned. She indicated conditional recommendations on the use of pharmacological interventions. She concluded by describing how to treat the 55-year-old patient she mentioned in Part 1 of her presentation.
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Dr. Sharon Kolasinski: Grand Round Presentation on Treatment of Patients with Osteoarthritis, Part 1
04/10/2024
Dr. Sharon Kolasinski: Grand Round Presentation on Treatment of Patients with Osteoarthritis, Part 1
Dr. Sharon Kolasinski is a professor of clinical medicine at the University of Pennsylvania and chief of the Division of Rheumatology at Penn Presbyterian Medical Center. Part 1 Her objectives in the presentation are to help listeners by learning about evidence-based treatment for patients with osteoarthritis (OA), to understand the process by which guidelines are developed that might help us figure out our evidence-based approach, to review the recommended treatments for OA, and to review some treatments that are not recommended for OA. Her basic evidence-based reference is a University of Pennsylvania guideline that was published in 2020. Numerous other guidelines are available, which she described. She discussed her work with a case involving a 55-year-old male patient. He arrived for routine follow-up care for immunosuppressive medication monitoring. He described pains that he was experiencing and was diagnosed with OA. She indicated the impacts OA has on patients. Clinicians find it a daunting challenge to provide satisfactory treatment. For example, for some clinicians, the guidelines do not appear to be clear and provide a roadmap. Also, they do not always believe in the recommendations contained in the guidelines. In this presentation, she wants to see if she can change some minds about guidelines. She provided an example based on investigations conducted at her institution. The outcome was a series of recommendations that she described. Part 2 Dr. Kolasinski began Part 2 of her presentation by continuing to focus on the importance of having patients with OA engage in physical activity. She stated that “they are worn out and the implication is that a doctor is needed to fix them.” Perhaps a perspective should be taken of a more participatory discourse where we encourage physical therapy and emphasize that physical exercise is safe when you have arthritis and focus on what the patient can do, empowering them to exercise. A starting point is to give patients a physical therapy prescription. She discussed the extent to which physical therapy is useful, along with indicating how much and how frequently exercise is beneficial (e.g., for 20 minutes, three times a week). Losing weight is an effective way of reducing symptoms. Food choices can affect OA symptoms. Diet and exercise used together can produce effective results. References were made to several studies that involve the status of steroid injections on improving patient health status. Acupuncture also was mentioned. She indicated conditional recommendations on the use of pharmacological interventions. She concluded by describing how to treat the 55-year-old patient she mentioned in Part 1 of her presentation.
/episode/index/show/ruskinsights/id/30715693