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.
info_outline
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.
/episode/index/show/ruskinsights/id/30715698
info_outline
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
info_outline
Dr. Natalie Azar: Long-COVID As It Relates To Rheumatology, Part 2
03/27/2024
Dr. Natalie Azar: Long-COVID As It Relates To Rheumatology, Part 2
Dr. Natalie Azar is an Associate Clinical Professor of Medicine & Rheumatology at NYU Langone Health. Certified by the American Board of Internal Medicine, she is a designated long Covid provider in rheumatology. Her practice locations are at the Langone orthopedic center and Washington Square, and she has been in private practice since 2001. A graduate of Wellesley College, Dr. Azar’s medical degree is from Cornell University Medical College. She completed her internship, residency, and fellowship at New York University. Her fellowship in rheumatology was at the Hospital For Joint Diseases. She has been a medical contributor to NBC News since 2014. Part 1 The discussion in Part 1 included the following items: clinical definition of Long-COVID; predictability of developing Long-COVID; whether patients with existing rheumatic disease are more susceptible to developing Long-COVID; whether COVID-19 could trigger rheumatic disease; differences and similarities between Long-COVID and rheumatic disease; whether Long-COVID can occur following mild acute illness; risk factors associated with developing Long-COVID; presence of fatigue as a risk factor for developing Long-COVID; and major symptoms of Long-COVID. Part 2 The discussion in Part 2 included the following items: organ systems and tissues most affected by Long-COVID; variations in symptoms and disease severity among patients; diagnostic and prognostic biomarkers for Long-COVID; protective effects of vaccine; episodic aspects of Long-COVID; use of medications and non-pharmaceutical treatment interventions; and personal and NYU involvement in conducting Long-COVID studies.
/episode/index/show/ruskinsights/id/30347343
info_outline
Dr. Natalie Azar: Long-COVID As It Relates To Rheumatology, Part 1
03/13/2024
Dr. Natalie Azar: Long-COVID As It Relates To Rheumatology, Part 1
Dr. Natalie Azar is an Associate Clinical Professor of Medicine & Rheumatology at NYU Langone Health. Certified by the American Board of Internal Medicine, she is a designated long Covid provider in rheumatology. Her practice locations are at the Langone orthopedic center and Washington Square, and she has been in private practice since 2001. A graduate of Wellesley College, Dr. Azar’s medical degree is from Cornell University Medical College. She completed her internship, residency, and fellowship at New York University. Her fellowship in rheumatology was at the Hospital For Joint Diseases. She has been a medical contributor to NBC News since 2014. Part 1 The discussion in Part 1 included the following items: clinical definition of Long-COVID; predictability of developing Long-COVID; whether patients with existing rheumatic disease are more susceptible to developing Long-COVID; whether COVID-19 could trigger rheumatic disease; differences and similarities between Long-COVID and rheumatic disease; whether Long-COVID can occur following mild acute illness; risk factors associated with developing Long-COVID; presence of fatigue as a risk factor for developing Long-COVID; and major symptoms of Long-COVID. Part 2 The discussion in Part 2 included the following items: organ systems and tissues most affected by Long-COVID; variations in symptoms and disease severity among patients; diagnostic and prognostic biomarkers for Long-COVID; protective effects of vaccine; episodic aspects of Long-COVID; use of medications and non-pharmaceutical treatment interventions; and personal and NYU involvement in conducting Long-COVID studies.
/episode/index/show/ruskinsights/id/30347323
info_outline
Dr. Jacques Hacquebord: Hand Surgery in Patient Treatment, Part 2
02/28/2024
Dr. Jacques Hacquebord: Hand Surgery in Patient Treatment, Part 2
Dr. Jacques Hacquebord is Chief of Hand and Upper Extremity Surgery at NYU Langone Health. He also serves as the co-chief of the Hand Surgery service at Bellevue Hospital (a Level 1 trauma and regional replant center) and co-chief of the Center for Amputation Reconstruction. He did his surgical residency in orthopedic surgery at the University of Washington and the world-renowned trauma center Harborview Medical Center and did his fellowship in Hand/Microsurgery at the University of California at Irvine with Dr Neil Jones. He then completed two traveling fellowships in reconstructive microsurgery and brachial plexus surgery with the first in China and then the second at Ganga Hospital in India. His principal clinical interest and passion within hand and orthoplastic surgery is the primary management and secondary reconstruction of the traumatized upper extremity. This includes replantation surgery, reconstruction of bone and soft tissues deficits in the upper extremity, and complex nerve reconstruction surgery. The discussion in Part 2 included the following items: other types of clinicians who provide treatment for patients who need hand surgery; influence of artificial intelligence (AI) on hand surgery; complications that could arise during hand surgery and how to mitigate them; management of post-operative pain; dealing with pre-operative anxiety experienced by patients; quality of patient information on the Internet about hand health problems; advice on how to prevent health problems regarding the hands; personal lessons learned that have implications for improving patient care; and research involvement at NYU Langone Health.
/episode/index/show/ruskinsights/id/29933833
info_outline
Dr. Jacques Hacquebord: Hand Surgery in Patient Treatment, Part 1
02/14/2024
Dr. Jacques Hacquebord: Hand Surgery in Patient Treatment, Part 1
Dr. Jacques Hacquebord is Chief of Hand and Upper Extremity Surgery at NYU Langone Health. He also serves as the co-chief of the Hand Surgery service at Bellevue Hospital (a Level 1 trauma and regional replant center) and co-chief of the Center for Amputation Reconstruction. He did his surgical residency in orthopedic surgery at the University of Washington and the world-renowned trauma center Harborview Medical Center and did his fellowship in Hand/Microsurgery at the University of California at Irvine with Dr Neil Jones. He then completed two traveling fellowships in reconstructive microsurgery and brachial plexus surgery with the first in China and then the second at Ganga Hospital in India. His principal clinical interest and passion within hand and orthoplastic surgery is the primary management and secondary reconstruction of the traumatized upper extremity. This includes replantation surgery, reconstruction of bone and soft tissues deficits in the upper extremity, and complex nerve reconstruction surgery. The discussion in Part 1 included the following items: reason for deciding to practice in hand surgery; common health problems that result in patients undergoing hand surgery, influence of gender on the onset of health problems, kinds of health problems children experience, patient expectations of what will result from hand surgery, use of wide-awake local anesthesia no tourniquet surgery (WALANT), and patients’ level of cooperation in achieving positive surgical outcomes.
/episode/index/show/ruskinsights/id/29933798
info_outline
Dr Carlo Pardo Grand Rounds: Myelitis and Myelopathies, Part 2
01/31/2024
Dr Carlo Pardo Grand Rounds: Myelitis and Myelopathies, Part 2
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 diagnosis should dominate the evaluation of patients with acute myelopathies because once we identify the etiological factor, we are able to help those patients in a better way. A lack of proper characterization may lead to mistreatment. A major difficulty in assessment of non-inflammatory myelopathy is at this moment, we do not have clear criteria to diagnose some of them. So keep in mind that the temporal assessment of the lesion by MRI is also important and you need to think about the timing of the MRI when you are preparing to give an interpretation to decide what is a potential etiological diagnosis. Part Two Getting the clinical information, the temporal profile of the patient, along with MRI findings and spinal fluid analysis is important during the analysis of patients presenting with myelopathic syndromes. MRI is one important tool and a very good way to establish the magnitude and localization of spinal cord lesions. One thing he likes to emphasize also is that the presence of myelopathies are not following the classical territories that we know. One thing that is important is that in addition to the blood supply is the blood drainage. The blood drainage of the spinal cord once again is very complex and there is a good and complex pattern of drainage at every segment of the spinal cord. He emphasized for individuals working in rehabilitation that there are other areas of the blood supply that may be affected. Some examples were provided of what he meant. He discussed experiences in their analysis of some cases at his institution where they analyzed 125 patients, attempting to classify the topographic distribution of the lesion.
/episode/index/show/ruskinsights/id/29522273
info_outline
Dr Carlo Pardo Grand Rounds: Myelitis and Myelopathies, Part 1
01/17/2024
Dr Carlo Pardo Grand Rounds: Myelitis and Myelopathies, Part 1
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 diagnosis should dominate the evaluation of patients with acute myelopathies because once we identify the etiological factor, we are able to help those patients in a better way. A lack of proper characterization may lead to mistreatment. A major difficulty in assessment of non-inflammatory myelopathy is at this moment, we do not have clear criteria to diagnose some of them. So keep in mind that the temporal assessment of the lesion by MRI is also important and you need to think about the timing of the MRI when you are preparing to give an interpretation to decide what is a potential etiological diagnosis. Part Two Getting the clinical information, the temporal profile of the patient, along with MRI findings and spinal fluid analysis is important during the analysis of patients presenting with myelopathic syndromes. MRI is one important tool and a very good way to establish the magnitude and localization of spinal cord lesions. One thing he likes to emphasize also is that the presence of myelopathies are not following the classical territories that we know. One thing that is important is that in addition to the blood supply is the blood drainage. The blood drainage of the spinal cord once again is very complex and there is a good and complex pattern of drainage at every segment of the spinal cord. He emphasized for individuals working in rehabilitation that there are other areas of the blood supply that may be affected. Some examples were provided of what he meant. He discussed experiences in their analysis of some cases at his institution where they analyzed 125 patients, attempting to classify the topographic distribution of the lesion.
/episode/index/show/ruskinsights/id/29522263
info_outline
Dr. Tracy McKay & Dr. Rosa Pasculli: Performing Arts Medicine
01/03/2024
Dr. Tracy McKay & Dr. Rosa Pasculli: Performing Arts Medicine
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, Alvin Ailey, Ballet Hispanico, and AIM. Dr. Rosa Pasculli is a non-operative Sports Medicine physician at Emory Orthopedics at Grady Health System in Atlanta. Her primary clinical area of interest is performing arts medicine. She serves as a consulting physician for the Atlanta Ballet, the Georgia Ballet, and she is a faculty member of the Female Athlete Program. She also serves as a team physician for Emory University, the College Park Skyhawks, and several Atlanta high schools. Dr. Pasculli completed medical school at New York University School of Medicine and her residency was in Physical Medicine and Rehabilitation at NYU. She also had a fellowship in Primary Care Sports Medicine at Emory University.
/episode/index/show/ruskinsights/id/29279808
info_outline
Grand Rounds: Dr. John Vasudevan - Where Sports Medicine Meets Pain Medicine, Why Fitness Helps Everyone Win, Part 2
12/20/2023
Grand Rounds: Dr. John Vasudevan - Where Sports Medicine Meets Pain Medicine, Why Fitness Helps Everyone Win, Part 2
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. A psychological battle must be dealt with at the same time as physical problems. He described strategies he would use. Find out what exercise they do now and for how many minutes, and their amount of sleep. Determine what they enjoyed doing in the past. It is important to focus on one of their problems and aim to achieve success in treating it. He described some available resources that are useful. A Question & Answer period followed.
/episode/index/show/ruskinsights/id/28948603
info_outline
Grand Rounds Dr. John Vasudevan: Where Sports Medicine Meets Pain Medicine, Why Fitness Helps Everyone Win, Part 1
12/06/2023
Grand Rounds Dr. John Vasudevan: Where Sports Medicine Meets Pain Medicine, Why Fitness Helps Everyone Win, Part 1
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 indicated what they do at Penn to address this matter. Non-pharmacological interventions are preferred for treating injuries, e.g., massage modalities. The use of topical medications can be effective from a systemic perspective. The discussion then switched to chronic pain.
/episode/index/show/ruskinsights/id/28948568
info_outline
Holly Cohen: Role Of Assistive Technology In Patient Care
11/27/2023
Holly Cohen: Role Of Assistive Technology In Patient Care
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 technology; and key lessons learned in improving patient care.
/episode/index/show/ruskinsights/id/28707208
info_outline
Special Edition RUSK 75th Anniversary: Dr. Lindsey Gurin, Dr. Prin Amorapanth, and Dr. Jessica Rivetz
11/08/2023
Special Edition RUSK 75th Anniversary: Dr. Lindsey Gurin, Dr. Prin Amorapanth, and Dr. Jessica Rivetz
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, , an Assistant Professor, ,and an Assistant Professor, 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, . He completed his residency at the Rehabilitation Institute of Chicago, Rehab Medicine and his fellowship at NYU Langone Medical Center, Brain Injury Medicine. Dr. Jessica Rivetz is currently a resident physician in Physical Medicine and Rehabiitation at NYU Grossman School of Medicine and will be applying for her fellowship in brain injury medicine.
/episode/index/show/ruskinsights/id/28530971
info_outline
Special Edition RUSK 75th Anniversary: Dr. Jonathan Whiteson
10/24/2023
Special Edition RUSK 75th Anniversary: Dr. Jonathan Whiteson
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 Rusk Institute and Medical Director of the Rusk Institute Outpatient program.
/episode/index/show/ruskinsights/id/28407908
info_outline
Special Edition RUSK 75th Anniversary: Dr. Steven Flanagan including interview by Dr. Jonathan Whiteson
10/11/2023
Special Edition RUSK 75th Anniversary: Dr. Steven Flanagan including interview by Dr. Jonathan Whiteson
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 industry sponsored research, funded by such organization as the National Institute on Aging. 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 Rusk Institute and Medical Director of the Rusk Institute Outpatient program.
/episode/index/show/ruskinsights/id/28291751
info_outline
Dr. Lyn Weiss: EMGs in the Field of PM&R, Part 2
09/27/2023
Dr. Lyn Weiss: EMGs in the Field of PM&R, Part 2
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 eligible to engage in EMG testing; kinds of clinical personnel who conduct EMG tests; size of the workforce engaged in EMG testing; the role of EMG wearables by patients; future studies of EMG testing; and personal current research involvement.
/episode/index/show/ruskinsights/id/27998052
info_outline
Dr. Lyn Weiss: EMGs in the Field of PM&R, Part 1
09/13/2023
Dr. Lyn Weiss: EMGs in the Field of PM&R, Part 1
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 govern EMG testing; kinds of musculature tested; how electrodiagnostic testing differs from MRIs and x-rays; if patient age affects EMG tests; diagnostic information furnished by needle insertion and placement of electrodes over the skin surface; and patient characteristics to take into account when inserting needles.
/episode/index/show/ruskinsights/id/27998013
info_outline
Dr. Patricia Tan: New Pediatric Rehab Programs--Cerebral Palsy, Part 2
08/30/2023
Dr. Patricia Tan: New Pediatric Rehab Programs--Cerebral Palsy, Part 2
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, machine learning, and artificial intelligence in treating patients with cerebral palsy; and her research interests in cerebral palsy and plans to be involved in any upcoming investigations.
/episode/index/show/ruskinsights/id/27620355
info_outline
Dr. Patricia Tan: New Pediatric Rehab Programs--Cerebral Palsy, Part 1
08/16/2023
Dr. Patricia Tan: New Pediatric Rehab Programs--Cerebral Palsy, Part 1
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 palsy in the U.S.; conditions other than neurological and gross motor disorders that affect these patients; and the kinds of team members engaged in furnishing treatment.
/episode/index/show/ruskinsights/id/27620334
info_outline
Dr. Megan Morris: Ableism and Health Care, Part 2
08/02/2023
Dr. Megan Morris: Ableism and Health Care, Part 2
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 healthcare setting; how medicine, including the field of rehabilitation, contributed to ableism in society; the importance of having health care organizations systematically collect and record patients’ disability status within the electronic health record; challenges in achieving effective documentation in the record and how to overcome them; how to determine patients’ needed disability accommodations and implementing them into routine clinical and hospital care; and any ongoing studies in which she is involved and anticipates undertaking in the near term.
/episode/index/show/ruskinsights/id/27479466
info_outline
Dr. Megan Morris: Ableism and Health Care
07/19/2023
Dr. Megan Morris: Ableism and Health Care
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 and how it is manifested in society; whether there can be a tendency for ableism to occur in conjunction with another kind of ism, such as racism; and how she developed an interest in focusing on the topic of ableism.
/episode/index/show/ruskinsights/id/27479457
info_outline
Dr. Akhila Veerubhotla: Application of Technology to Rehabilitation, Part 2
07/05/2023
Dr. Akhila Veerubhotla: Application of Technology to Rehabilitation, Part 2
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 falls in individuals with traumatic brain injury; effectiveness of treadmills in conducting research that produces accurate measurements regarding falls; inclusion in studies of patients who have a communication disability as a result of a stroke; funding sources for studies involving technological devices in rehabilitation; role of artificial intelligence in rehabilitation research; and current studies underway or planned for the near future.
/episode/index/show/ruskinsights/id/27137646
info_outline
Dr. Akhila Veerubhotla: Application of Technology to Rehabilitation, Part 1
06/21/2023
Dr. Akhila Veerubhotla: Application of Technology to Rehabilitation, Part 1
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 after an acquired brain injury; why the transition of wearable devices from the laboratory to the community has gained momentum slowly in recent years; and the value of having a wider representation of participants from different population subgroups in clinical studies.
/episode/index/show/ruskinsights/id/27137622
info_outline
Dr. Kathleen Isaac: Mental Health and Medical Residents, Part 2
06/07/2023
Dr. Kathleen Isaac: Mental Health and Medical Residents, Part 2
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 Movement. The following items were discussed in Part 2: whether NYU offers any standardized screening to identify residents who may be struggling with mental health and burnout concerns; if NYU has a mentorship program for residents; kinds of differences that may occur in the types of pressures and challenges that may arise depending on the medical specialty; cultivating resilience to increase an ability to cope with various everyday pressures; and enhancing self-management skills in self-monitoring, recognizing, and reporting symptoms of any mental health problems.
/episode/index/show/ruskinsights/id/26937825
info_outline
Dr. Kathleen Isaac: Mental Health and Medical Residents, Part 1
05/24/2023
Dr. Kathleen Isaac: Mental Health and Medical Residents, Part 1
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 Movement. The following items were discussed in Part 1: regarding how she developed an interest in working with medical residents; how diversity is defined at NYU; why it is essential for the health workforce to be diverse from the perspective of both the clinicians and the patients whom they treat; kinds of structural barriers of an institutional nature within the learning environment that have the capability to hinder workforce diversity; and preparing residents at the beginning of their residency to deal with the kinds of hardship that are likely to develop during the early months of training.
/episode/index/show/ruskinsights/id/26937795
info_outline
Dr. Salvador Portugal: Adhesive Capsulitis of the Shoulder: Current Concepts and Treatment, Part 2
05/10/2023
Dr. Salvador Portugal: Adhesive Capsulitis of the Shoulder: Current Concepts and Treatment, Part 2
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 to supervised stretching exercises. He also discussed cortical steroid injections compared to other interventions. Similarly, platelet-rich plasma (PRP) was described in comparison to other forms of treatment, such as physical therapy. A related area of interest is the use of shock wave therapy in comparison to oral steroids. Many patients do well with non-surgical forms of treatment, but surgery may be an option for those who do not do so well with non-surgical treatment.
/episode/index/show/ruskinsights/id/26659881
info_outline
Dr. Salvador Portugal: Adhesive Capsulitis of the Shoulder: Current Concepts and Treatment, Part 1
04/26/2023
Dr. Salvador Portugal: Adhesive Capsulitis of the Shoulder: Current Concepts and Treatment, Part 1
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. For this portion, he discussed several topics, such as clinical presentation, risk factors, pathophysiology, diagnostic testing, and non-surgical treatment options. He provided a review from the standpoint of what we should be doing in current practice. Shoulder injury usually is characterized as a marked decrease in range of motion. Patients often have difficulty reaching overhead or behind the back that causes a sensation of pain and stiffness. Prevalence in the general population is 2-5% and women are more affected than men. Pathophysiology is not often understood. Adhesive Capsulitis of the Shoulder after surgery potentially may be a risk. Prevalence is around 11% and women are affected more than men. He addressed the issue of which kind of imaging is important, such as X-rays and MRIs. He then moved on to additional diagnostic testing. Patients with a thyroid condition or diabetes are at increased risk of developing adhesive capsulitis. So, when should we begin considering testing or evaluating these conditions? Approximately one-third of patients with adhesive capsulitis are likely to have diabetes. Next, he focused on non-surgical forms of treatment and management.
/episode/index/show/ruskinsights/id/26659842
info_outline
Dr. Alex Moroz & Dr. Brian Sunwoo: Acupuncture Panel Interview, Part 2
04/12/2023
Dr. Alex Moroz & Dr. Brian Sunwoo: Acupuncture Panel Interview, Part 2
Dr. Moroz attended the NYU School of Medicine and remained at NYU-Rusk Rehabilitation for residency training, and subsequently, his first and only job. He rose through the faculty ranks and currently is Director of Residency Training and Vice Chair for Education. Dr. Moroz sought out additional training and became a New York State certified acupuncturist, and is directing the Integrative Sports Medicine program, which includes an 18-month track for PM&R residents leading them to becoming certified physician acupuncturists. Dr. Brian Sunwoo is a current administrative chief resident in the Physical Medicine and Rehabilitation residency program at NYU Langone Health. He attended Rowan School of Osteopathic Medicine, where he received the Dean's Recognition Award and will begin a fellowship in Interventional Spine after completing residency. As an NYU resident, he has served on the Rusk Health Equity, GME Diversity and Inclusion, and House Staff Leadership Committees. Dr. Sunwoo currently is completing his clinical acupuncture certification through the NYU PM&R residency program with plans to incorporate its use in his future practice. The following items were discussed in Part 2: effectiveness of acupuncture treatment either pre- or post-operative in dealing with nausea and vomiting in the post-surgical period; use of acupuncture in treating mental health conditions; extent to which sham acupuncture is being used in research; whether expectancy data are collected beforehand to measure how strongly patients anticipate a positive acupuncture treatment outcome; health problems where research indicates a high-certainty level of evidence for acupuncture; use of artificial intelligence in acupuncture research and treatment; and current or planned research endeavors at NYU that involve acupuncture.
/episode/index/show/ruskinsights/id/26412882
info_outline
Dr. Alex Moroz & Dr. Brian Sunwoo: Acupuncture Panel Interview, Part 1
03/29/2023
Dr. Alex Moroz & Dr. Brian Sunwoo: Acupuncture Panel Interview, Part 1
Dr. Moroz attended the NYU School of Medicine and remained at NYU-Rusk Rehabilitation for residency training, and subsequently, his first and only job. He rose through the faculty ranks and currently is Director of Residency Training and Vice Chair for Education. Dr. Moroz sought out additional training and became a New York State certified acupuncturist, and is directing the Integrative Sports Medicine program, which includes an 18-month track for PM&R residents leading them to becoming certified physician acupuncturists. Dr. Brian Sunwoo is a current administrative chief resident in the Physical Medicine and Rehabilitation residency program at NYU Langone Health. He attended Rowan School of Osteopathic Medicine, where he received the Dean's Recognition Award and will begin a fellowship in Interventional Spine after completing residency. As an NYU resident, he has served on the Rusk Health Equity, GME Diversity and Inclusion, and House Staff Leadership Committees. Dr. Sunwoo currently is completing his clinical acupuncture certification through the NYU PM&R residency program with plans to incorporate its use in his future practice. The following items were discussed in Part 1: number of participants in the residency program at NYU using acupuncture with patients; professional qualifications deemed necessary to use acupuncture in treating patients; insurance company coverage of acupuncture treatment; role of patients’ age in achieving desired clinical outcomes involving acupuncture; different kinds of instruments used by acupuncture practitioners; acupuncture as a lone intervention and also as an adjunct to western medicine; contributions that acupuncture can make in dealing with problems, such as stroke; and possible differences among clinicians in different health professions regarding the effectiveness of acupuncture treatments?
/episode/index/show/ruskinsights/id/26339028
info_outline
Dr. Byron Schneider: Grand Rounds Part 2
03/15/2023
Dr. Byron Schneider: Grand Rounds Part 2
Dr. Byron Schneider is currently an associate professor with the Department of Physical Medicine and Rehabilitation at Vanderbilt University Medical Center and serves as the Director of the Interventional Spine and Musculoskeletal Medicine Fellowship. Previously, he completed his residency and interventional spine fellowship at Stanford University. He has nearly 100 publications, with a research focus on the safety and outcomes of interventional spine procedures. He has given over 100 lectures at national and international meetings. He currently is on the Spine Intervention Society Board of Directors as the Chair of Research, and within the North American Spine Society is Chair of the Interventional Spine and Musculoskeletal Section as well as Co-Chair for the Coverage Committee. In Part 2 of his presentation, he indicated that the study by Wolf and his group was observational and retrospective, so there are some missing data. They enrolled patients based on provocation discography, which you hope would result in better outcomes. He stated that this number, 50 percent of people saying that they are 50 percent better is very common in pain literature. He wouldn’t say it is favorable. Over and over, these are the numbers we see that turn out to be dead ends. These are non-compelling data unless we are able to show they are non-placebo. You need RCTs to do that. He is a huge proponent of observational studies. They can give you very meaningful clinical information, but unfortunately for a new technology like this, we need at least some evidence that these things are doing something beyond placebo. Next, he indicated the discussion in his presentation would shift to discussing some RCTs that have been published more recently. As of right now, however, the totality of evidence because of the negative RCTs in the research done today, stem cells do not work as a treatment for disc-related low back pain. He then described four new RCTs that came out in the last two years that will shed some new light. The first study involved a comparison with saline treatment. Unwanted side effects, such as infections and other complications have occurred as a result of the treatments in the four studies. Safety continues to be a concern in developing effective treatments using stem cell and PRP approaches.
/episode/index/show/ruskinsights/id/26088903