2016 / YEAR IN REVIEW

Rusk Rehabilitation

TOP 10 37% ADVANCING IN U.S. NEWS & INCREASE IN VALUE BASED WORLD REPORT OUTPATIENT VISITS MEDICINE

NYU LANGONE MEDICAL CENTER 550 First Avenue, New York, NY 10016

NYULANGONE.ORG Contents

1 MESSAGE FROM THE CHAIR

2 FACTS & FIGURES

4 NEW & NOTEWORTHY

8 TRANSLATIONAL CLINICAL CARE 9 Rehabilitation’s Role in Value Based Medicine 12 Novel Treatment for Post-Stroke Muscle Stiffness 14 Rehabilitation Following Groundbreaking Face Transplant 16 Neuromodulation to Treat Shoulder Pain 18 Early Mobilization in the PICU 20 Brain Injury Research 23 Complex Case: NSTEMI Patient

24 ACADEMIC ACTIVITIES

29 LOCATIONS

30 LEADERSHIP

Produced by the Office of Communications and Marketing, NYU Langone Medical Center Writer: Robert Fojut Design: Ideas On Purpose, www.ideasonpurpose.com Photography: Maria Aufmuth/TED; Karsten Moran Printing: Allied Printing Services, Inc.

On the cover: Micro image of muscle fibers Message from the Chair

Dear Colleagues and Friends:

I am pleased to share with you the 2016 “Year in Review” from Rusk Rehabilitation. Our annual report highlights some of our team’s most significant achievements this year.

In today’s world of healthcare reform, we can’t talk about any kind of achievement without asking two questions. First, did we improve patient outcomes? Second, did we control costs? These two issues define the essence of value-based care. At Rusk, we are focusing all our efforts on increasing the value of the care we provide. Our goal is to achieve better outcomes while lowering total costs. What are we doing to increase healthcare value? For one, we have helped pioneer a strategy that is delivering significant savings—early, intensive rehabilitation in critical care. Last year, our early mobilization initiative in the adult ICU reduced length of stay (LOS) and increased home discharge rates. In 2016, we expanded early mobilization to the pediatric ICU, where we look forward to achieving similar gains. We also took steps this year to ensure STEVEN R. FLANAGAN, MD that ICU patients receive a physiatry consult early in their stay. This initiative has helped ensure that patients receive appropriate rehabilitation services more quickly. As a result, Howard A. Rusk Professor of we have dramatically decreased LOS in acute rehabilitation while maintaining outcomes. Rehabilitation Medicine While we improve the way we deliver care, Rusk researchers are continuing to investigate Chair, Department of Rehabilitation Medicine new treatments. One major area of interest is stroke. In 2016, Rusk faculty demonstrated that Medical Director, Rusk Rehabilitation a long-available drug therapy can effectively reduce muscle stiffness in post-stroke patients. Their research generated a great deal of interest, and we are working to disseminate this promising therapy to other institutions. Our investigators are also very active in the area of brain injury. This year, they developed several new tools for detecting and assessing brain injury and honed new strategies for delivering the most effective rehabilitative care to TBI patients. I can’t conclude this note without mentioning a major milestone for NYU Langone Medical Center and a significant achievement for the entire rehabilitation team at Rusk. One year ago, the recipient of the most extensive face transplant to date was discharged from NYU Langone. After his surgery and in the months that followed, our physical and occupational therapists, speech language pathologists, and physiatrists worked tirelessly to help him achieve rehabilitation goals far beyond what most patients ever confront. This team’s work broke new ground in our field—and demonstrated the key role of rehabilitation in the healthcare system of the future. I am very proud of the entire faculty and staff of Rusk Rehabilitation. It’s my firm belief that healthcare reform will not be as successful as it can be without the involvement of rehabilitation medicine. And the people I work with every day here at Rusk are the ones who are creating that success. Thank you for your interest in our work. On behalf of all my colleagues, I look forward to the great things that every one of us in the field of rehabilitation medicine will achieve in the years to come.

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 1 Facts & Figures

Rusk Rehabilitation

Clinical Education and Research 261,000+ 2,100+ 23 $6.5M OUTPATIENT VISITS INPATIENT DISCHARGES PM&R CHAIRS TOTAL FUNDED RESEARCH around the U.S., both current and a 37% increase compared former, who have graduated from with last year Rusk’s residency program 89 36 30,000+ CERTIFIED SPECIALIST PHYSICAL CERTIFIED REHABILITATION DOWNLOADS OF RUSK INSIGHTS THERAPISTS REGISTERED NURSES (CRRN) podcast via iTunes and accounting for 10% of all other podcast apps certified specialists in the state including two CRRN-certified of New York nurse managers

Accolades

TOP 10 AACVPR 3-YEAR IN THE COUNTRY PROGRAM CARF for rehabilitation in CERTIFICATION ACCREDITATION U.S. News & World Report’s for Rusk’s Joan and Joel Smilow granted in 2016 CIIRP, Pediatrics, “Best Hospitals” since Cardiac Prevention and Brain Injury, Stroke, and Limb Loss; the rankings began in 1989 Rehabilitation Center Exemplary conformance in research and community outreach

Numbers represent FY16 (Sept 2015–Aug 2016) unless otherwise noted

2 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 NYU Langone Medical Center

# 10 # 11 LEADER IN THE NATION IN THE NATION IN QUALITY CARE AND BEST HOSPITALS BEST MEDICAL SCHOOLS PATIENT SAFETY FOR RESEARCH and nationally ranked in 12 specialties, and recognized for superior performance including top 10 rankings in Orthopaedics, and a leader in innovation in medical as measured by Vizient’s nationwide Geriatrics, Neurology & Neurosurgery, education, including accelerated 2016 Quality and Accountability Study Rheumatology, Rehabilitation, pathways to the MD degree Cardiology & Heart Surgery, and Urology. Nationally ranked in Cancer, Diabetes & Endocrinology, Ear, Nose & Throat, Gastroenterology & GI Surgery, and Pulmonology

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 3 New & Noteworthy

New Clinical Programs, Education Initiatives, and Platforms for Experts

Rusk on the TED Stage

Holly A. Cohen, OTR/L, ATP, SCEM, CDRS, Cohen pointed out that there is one area of Cohen described a 25-cent part that lets you assistive technology program manager, has activity that people do not often think about add hundreds of different accessibility a passion for helping people with disabilities in terms of accessibility—play. Cohen switches. What about more complex toys use technology to make their world more explained how she helps children and their like video games? Cohen and a colleague accessible. In 2016, she shared that passion families modify commercial toys using adapted a PlayStation for a teen with at the prestigious TED Conference. This DIY tools such as 3D printers, laser cutters, muscular dystrophy who can move only year’s event featured cultural leaders such and inexpensive electronics. For example, his head and one finger. The key is to focus as Al Gore and John Legend, and the to play with a remote control car, a child on abilities. “Build for what they can do,” audience included innovators like Bill Gates must be able to work the controller. But she says, “not for what they can’t do.” and Steven Spielberg. During her session, what if she can’t use her hands?

Holly Cohen, OTR/L, ATP, SCEM, CDRS

4 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 New Program Provides Intensive Speech Language Therapy for Stroke Survivors

In early 2017, Rusk is launching its Intensive therapy,” explains Dr. Galletta. “Our improvements in communication. Group Comprehensive Aphasia Program (ICAP), intensive three-week program uses a variety therapy sessions incorporate Constraint- which offers concentrated speech therapy of evidence-based treatment approaches Induced Language Therapy (CILT) for stroke survivors. The program was that directly target both the impairment principles, which strengthen speech by developed by Mary R. Reilly, MS, CCC-SLP, itself and the activity of communicating.” systematically constraining the use of director of speech language pathology, and Individual therapy sessions make use of non-verbal communication during CILT Elizabeth E. Galletta, PhD, CCC-SLP, clinical modified Verb Network Strengthening sessions. The Rusk Rehabilitation ICAP research specialist. “Research in Treatment (VNeST), an approach for also includes music group sessions, neuroplasticity has demonstrated that promoting verb and sentence production in computerized treatment, counseling, stroke survivors who have a language people with aphasia. Studies have shown and family education. impairment can benefit from intensive that VNeST leads to clinically significant

Education Keeps Pace with Rehabilitation Trends

As rehabilitation evolves, Rusk is residency focused on acute care. introducing new education programs to According to Dr. Moroz, the initiative CONTINUING EDUCATION: prepare graduates for the future. In 2016, reflects the growing importance 2017 COURSES Rusk restructured its PM&R residency of early interventions delivered in the February 4: Splinting for Stiffness: to include additional training in subacute inpatient setting. A Seminar on Mobilization Orthoses rehabilitation. Residents now have the In addition, 2016 saw the launch of option to do a rotation at NYU Lutheran Rusk’s new fellowship in pediatric February 24: 4th Annual Concussion Augustana Center, a skilled nursing facility rehabilitation medicine. This two-year Across the Spectrum of Injury: Case Studies in Brooklyn. “A large percentage of our program is accredited by the Accreditation and the Latest for Diagnosis and Management graduates will end up working in subacute Council for Graduate Medical Education. rehabilitation,” says Alex Moroz, MD, It offers physicians a unique opportunity March 11: The Rusk Complex Case associate professor of rehabilitation to obtain advanced training in pediatric Series: Rehabilitation Medicine and medicine and vice chair of education rehabilitation in the inpatient, Management of the Patient with and training. “This rotation aligns their outpatient, and specialty settings. Heart Failure training with what they will actually encounter in practice.” Also this year, March 27–April 1: 42nd Annual Rusk introduced a new physical therapy Comprehensive Review of Physical Medicine and Rehabilitation

May 20: Rusk Lumbar Spine Symposium: Translating Evidence into Clinical Practice

For more information go to med.nyu.edu/cme

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 5 New & Noteworthy

Residency Program Adopts Digital Tools

Evidence shows that receiving feedback as diagnostic ability, patient management, Also this year, Rusk began transitioning is essential to developing medical expertise. procedural skill, and professionalism. residency education materials to the However, the feedback process can be Faculty mentors then provide their Brightspace learning management system. daunting for both residents and faculty assessments. PRIMES matches the answers, “The Brightspace platform allows us to put members. A new iPad® app called PRIMES highlighting areas of agreement and all our resident education content in one is facilitating this essential learning activity disagreement. “The app structures the place,” Dr. Moroz says. “These are true for PM&R residents at Rusk Rehabilitation. feedback process and scaffolds it, education modules, with learning objectives, PRIMES was developed by the making it easier for people to do,” says materials, assessments, and the ability to NYU School of Medicine and recently Dr. Moroz. “I think this tool will completely track completion. The system has been adapted for the residency program. In the change the culture of asking for and up for just a few months, but residents are middle of each rotation, residents use giving feedback in our institution.” already heavily using it.” the app to self-assess in domains such

Alex Moroz, MD, and Angela Stolfi, PT, DPT

6 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 After Rehab, Smartphone App Keeps Patients on Track

Research shows that many heart attack newly prescribed lifestyle.” says Jonathan conversation with the patient.” patients, despite completing outpatient H. Whiteson, MD, assistant professor of The researchers are currently conducting cardiac rehabilitation and learning a new rehabilitation medicine and vice chair a clinical trial to test the smartphone app heart-healthy lifestyle, revert to their former of clinical operations. against standard discharge instructions lifestyle within one year, increasing their Data from the app is transmitted to a alone. Dr. Whiteson believes the app could risk of a second cardiac event. To help dashboard monitored by cardiopulmonary become an important element in the close this adherence gap, Rusk clinicians specialists at Rusk. “The specialists rehabilitation toolbox. “It allows us to partnered with mobile tech experts at watch for things like missed medications maintain contact with a population that is Moving Analytics to develop a smartphone or a spike in blood pressure,” explains busy and tends to fall out of compliance app that keeps track of patients following Tamara Bushnik, PhD, FACRM, associate with a heart-healthy lifestyle alone. their cardiac rehabilitation course. professor of rehabilitation medicine and “The app lets patients record everything director of inter-hospital research and they do—diet, exercise, medications, knowledge translation. “If one of these weight, and blood pressure readings— things happens, staff can send a message so we can track their adherence to the through the app and have a two-way

NYU LANGONE AFFILIATION WITH WINTHROP-UNIVERSITY HOSPITAL BRINGS EXPANDED AND ENHANCED HEALTHCARE NETWORKS TO LONG ISLAND

NYU Langone and Winthrop-University The affiliation will further expand healthcare needs of the communities we serve,” Hospital on Long Island have reached an NYU Langone’s presence on Long Island, says Robert I. Grossman, MD, the Saul J. Farber agreement to affiliate the institutions’ extensive while enhancing Winthrop’s inpatient Dean and CEO of NYU Langone. Pending healthcare networks. NYU Langone, with more and outpatient services with improved regulatory approval, the institutions are aiming than 150 ambulatory sites throughout the access to NYU Langone’s wide range of to complete their affiliation in spring 2017. region, will complement Winthrop-University medical and surgical specialties. Hospital’s main campus, multiple ambulatory sites and network of 66 faculty and community- “This agreement publicly confirms our based practices in more than 140 locations confidence that an affiliation will allow extending from eastern Long Island to both of our institutions to collaborate and Upper Manhattan. share best practices to better meet the

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 7 Translational Clinical Care

Rehab Medicine Leading a Changing Healthcare Landscape ACROSS DISCIPLINES, RUSK REHABILITATION IS ESTABLISHING A CARE MODEL WHERE PM&R FINDS A KEY ROLE IN THE CHANGING LANDSCAPE OF HEALTHCARE. OUR PHYSIATRISTS AND CLINICAL TEAM ARE TAKING ON NYU LANGONE’S MOST COMPLEX CASES, FORGING NEW TREATMENT METHODS, AND LEADING INNOVATIVE VALUE-BASED MANAGEMENT PRACTICES.

Preeti Raghavan, MD

8 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 With the Shift from Volume to Value, Rehabilitation Takes a Leading Role

The ongoing transition from fee-for-service to value-based payment has created a new imperative for caregivers to ensure that healthcare spending is linked to quality, not quantity. At Rusk Rehabilitation, leaders are using a range of strategies to enhance care while improving cost efficiency.

“Cost in healthcare is obviously driven by things like Hospital leaders began by setting an overall target service and device utilization, radiology use, and ratio of 1.1 for O/E LOS for the acute care hospital’s pharmacy spending,” says Jonathan H. Whiteson, MD, inpatient rehabilitation patients. Led by Dr. Whiteson, assistant professor of rehabilitation medicine and Kate Parkin, PT, DPT, MA, clinical assistant professor of vice chair of clinical operations. “But a big issue rehabilitation medicine and senior director of therapy is length of stay, because every day in the hospital is services, and Katherine Hochman, MD, assistant associated with significant cost.” professor of medicine, then analyzed acute rehab Over the last few years, Rusk care teams have used processes to understand what was extending patient early intervention strategies to reduce length of stay stays. They identified three issues: (LOS) in several units. In 2016, they turned their focus to inpatient rehabilitation. There, data showed that the • First, acute care clinical teams were uncertain acute care hospital’s observed-to-expected (O/E) LOS about which physiatrist to call for which patient. for rehab patients was near 1.5. “To some degree this They often turned to the physician they knew was understandable, since these patients were the best rather than the one who specialized in the sickest of the sick,” Dr. Whiteson says. “But based on particular area needed. our success with early intervention in other units, • Second, rehabilitation was often consulted very we knew there was an opportunity to improve.” late in the patient’s acute stay, frequently the day before a planned discharge, which did not always give the clinician enough time to carry out an “Rehabilitation medicine should effective care plan. consider itself central to the value- • Third, patients were frequently admitted to the based care movement.” wrong rehabilitation unit based on the preference of the referring acute care team, versus the patient’s —Jonathan Whiteson, MD diagnosis and the accepting rehab unit’s specialty. The wrong patient on the wrong rehabilitation unit, in turn, blocked beds and patient flow—and extended the acute care hospital’s LOS.

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 9 Translational Clinical Care

Once they identified the issues leading to feedback from the physiatrist for discharge planning, service inefficiencies, Dr. Whiteson and his and few consult reports contained specific details colleagues implemented several changes to address regarding the patient’s ongoing rehabilitation needs— them, including: information crucial for acute care teams to complete disposition planning and expedite care. To ensure STANDARDIZED CONSULT ORDER. “Previously, staff patients saw a physiatrist as soon as possible, Rusk could order a physiatry consult in many ways—by targeted completion of consults to a 16-hour window phone, by email, through one of several EMR functions, after the order was placed. “In addition, we specified or simply by grabbing a colleague’s elbow in the elevator,” that the consult has to be directive,” Dr. Whiteson said. Dr. Whiteson says. “We realized that we had to “The physiatrist has to state clearly whether the patient is standardize this, so we developed a diagnosis-based a candidate for inpatient rehab or can be discharged consult request within our EMR.” The system uses home with other rehabilitation recommendations.” 10 diagnostic categories, ranging from orthopaedic This clear directive now helps the acute care team rehabilitation through hemorrhagic brain injury. expeditiously plan the next step in the patient’s care. “Now, for instance, the specialist in cardiopulmonary rehabilitation checks the cardiopulmonary consult MULTIDISCIPLINARY DISCHARGE PLANNING. list, and picks up only those patients referred under that To strengthen the discharge process, the Rusk team diagnostic category.” identified ways to more deeply involve rehabilitation specialists. “We added physical therapists to the TIMELY PHYSIATRY CONSULT REQUEST. Calls for a morning huddle and to daily rounds on each acute care physiatry consult from the acute care team as the patient unit,” says Parkin. “Our standardized interdisciplinary was discharged to inpatient rehabilitation left little time rounds have helped ensure rehabilitation is involved in to coordinate admission and care at Rusk, clearly discharge decisions, and our goal as a team is to ensure contributing to prolonged length of stay. Dr. Whiteson that the right patient gets to the right bed at the right explains, “From previous research, we knew that the time.” To that end, processes were adjusted to ensure earlier our rehabilitation therapists saw patients in acute that every rehabilitation candidate is discharged to care, the shorter those patients’ LOS. Our ICU early the correct rehab unit. mobilization data indicated significant length of stay reduction with early involvement of the rehabilitation EDUCATION AND CULTURE CHANGE. To embed the team.” Changing the culture to encourage consultation newly created care and discharge processes systemically, to the physiatrist much earlier in the patient’s stay has rehabilitation leaders educated physicians and other yielded significant results. interdisciplinary providers on the role of physiatry, the phases of rehabilitation, and the value of an early 16-HOUR TARGET FOR PHYSIATRY CONSULT physiatrist consult. “We knew this was not only about COMPLETION. Prior data often showed a wide lag from changing practice to order a consult early, but actually the time a physiatry consult was called to consult’s changing the culture of our medical and surgical completion. Acute care hospital teams often waited for teams,” says Dr. Whiteson.

10 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 EARLY RESULTS: SHORTER LOS, The ultimate impact of the rehabilitation team’s HIGHER PATIENT SATISFACTION early involvement with the entire rehabilitation team These new consult processes were put in place during extends far beyond cost control. By both shortening the first two months of 2016. Between February and stays and increasing home discharge rates, these March, the average time to completed physiatry consult interventions also help increase patient satisfaction— decreased from 22.7 to 10.2 hours, with averages a key measure of quality under value-based payment. remaining under the 16-hour target in the months Dr. Whiteson believes that these results demonstrate that followed. The earlier, more directive physiatrist the key role of rehabilitation medicine in the new consults have ensured that patients receive healthcare environment. “I think everyone in rehabilitation interventions more quickly—which, rehabilitation medicine should recognize how much in turn, has had a significant impact on patient stays. we have to contribute in terms of coordinating care, As a result, between September 2015 and July 2016, leading care teams, and having the vision to O/E LOS in acute rehab declined from 1.47 to 1.15. identify new opportunities to enhance quality while In addition, efforts to ensure the practice of “the right minimizing costs,” he says. “Rehabilitation medicine patient on the right unit at the right time” has not only should consider itself central to the value-based eliminated rehabilitation patients being treated on care movement.” the wrong specialty Rusk unit, but has also enhanced bed availability at Rusk as well as patient flow and timely discharge of acute care patients.

Jonathan Whiteson, MD, and Kate Parkin, PT, DPT, MA, with Fritz Francois, MD, Chief Medical Officer of NYU Langone

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 11 Translational Clinical Care

Novel Treatment Strategy Reduces Post-Stroke Muscle Stiffness

Muscle stiffness is a common aftereffect of stroke and other neurologic injuries. But is it caused directly by neuronal hyperactivity? A group of Rusk investigators recently proposed an alternative hypothesis—and a new treatment strategy—for muscle stiffness related to cerebral injury.

“For a long time, people have thought that something CASE SERIES SHOWS DRAMATIC IMPROVEMENT besides neuronal damage contributed to muscle Dr. Raghavan and colleagues tested the hypothesis by stiffness, but we didn’t know what it was,” says Preeti injecting recombinant hyaluronidase into a series of Raghavan, MD, assistant professor of rehabilitation 20 patients with moderately severe upper-limb muscle medicine and vice chair of research. “What was hotly stiffness. The results were published in the July 2016 debated is whether a contracture begins to occur issue of EBioMedicine. “For most patients, resistance very early after the injury, or whether it results to passive movement decreased within a week, and from later changes that take place in the muscles those results were maintained at both one month and themselves and surrounding soft tissue.” three months,” she says. Modified Ashworth Scale About three years ago, Dr. Raghavan began scores were reduced significantly across the patient discussing the problem with Antonio Stecco, MD, PhD, cohort. In addition, active range of motion improved clinical instructor of rehabilitation medicine and an at one and three months. “It’s typically thought that expert in fascial manipulation. “This type of friction you are not likely to see much change in active motion massage is incredibly effective at restoring movement in stroke patients after two or three years. So to get for people with musculoskeletal pain,” Dr. Raghavan these changes in active motion and see them increase says. “We started to talk about what substances this over time has been very exciting.” massage could be releasing, and looked at the possibility Hyaluronidase is a potential treatment not only for that it was mechanically breaking up hyaluronic acid.” stroke patients, but also for individuals with neurologic Hyaluronic acid is a non-sulfated, high-molecular- conditions, such as cerebral palsy and traumatic brain weight glycosaminoglycan that is abundant in the injury. According to Dr. Raghavan, it can be used in connective tissues surrounding muscle fibers. “It acts conjunction with other treatments like intrathecal as a lubricant that allows muscle fibers to slide against baclofen. However, hyaluronidase offers significant each other during movement,” Dr. Raghavan says. benefits over central nervous system depressants since “But when hyaluronan is left to sit still and accumulate, it does not cause weakness, drowsiness, or cognitive it binds to itself and becomes extremely viscous. So impairment. Another benefit is that it can facilitate instead of acting as a lubricant, it acts like a glue that physical therapy. “Many times stroke patients have a binds muscles together and gives the perception of hard time in therapy because their muscles are so stiff,” stiffness and increased resistance to movement.” The Dr. Raghavan says. “What we have found is that by researchers hypothesized that post-stroke muscle reducing the stiffness, therapy efforts are much more stiffness was caused by the accumulation of hyaluronic likely to yield benefits for patients.” acid due to immobility. If so, then muscle stiffness could potentially be resolved by breaking up the hyaluronan chemically with the enzyme hyaluronidase.

12 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 Leveraging Technology to Aid Stroke Rehab Rusk investigators are developing several technologies for pinpointing post-stroke deficits and targeting therapeutic interventions.

MIRRORED MOTION BIMANUAL ARM TRAINER (BAT) LOCATING THE BROKEN LINK BETWEEN EYE AND HAND MOVEMENT IN STROKE PATIENTS The Mirrored Motion BAT combines a rowing simulation device with a videogame interface to help stroke victims John-Ross (J.R.) Rizzo, MD, assistant professor of regain arm function through “mirrored motion” therapy. rehabilitation medicine and neurology, is using advanced In 2016, Preeti Raghavan, MD, and her colleagues launched technology to study eye-hand coordination in stroke three separate clinical trials focused on the use of patients. “Research has shown that when the eye and the Mirrored Motion BAT in acute rehabilitation, outpatient hand work together, the eye informs the hand. But recent rehabilitation, and pediatric home-based rehabilitation. studies have also suggested that the hand actually informs the eye as well,” he says. “So there is a bidirectional flow of information between these systems.” In the Visuomotor WIRELESS FEEDBACK WEARABLES Integration Laboratory at Rusk, Dr. Rizzo and colleagues use advanced motion capture systems to capture precise, Dr. Raghavan has also collaborated with researchers at the simultaneous measurements of ocular motor and manual NYU Tandon School of Engineering to develop a motor functions. Their data shows that in many stroke mechatronic jacket and gloves for stroke rehabilitation patients, the link between those two systems breaks down. therapy. The wearable devices record patient movements “The technology is allowing us to objectively highlight and transmit them wirelessly to a computer. A videogame where some of those breakdowns are,” he says. “Our hope interface provides the patient with highly personalized is to characterize these deficits in fine detail, and create feedback during movement exercises. The goal is to enable precise, patient-tailored therapeutic targets to help restore patients to receive precision therapy at home. “Ultimately, this link, all through novel biofeedback strategies.” the therapist will be able to teach movement strategies to patients in the clinic and then monitor them remotely with a smartphone,” Dr. Raghavan says. “Most importantly, the wearables allow patients to work on their rehabilitation remotely on their own time.”

CLINIC OPENED, CLINICAL TRIAL PLANNED “Our results so far show us that the immobilization that occurs as a consequence of a neurological injury In fall 2016, Rusk opened a hyaluronidase injection is a major contributor to muscle stiffness,” says clinic, treating adult patients from across the United Dr. Raghavan. “The most exciting thing is that we now States. Dr. Raghavan and colleagues are currently have a direct way to actually bring relief to patients.” planning a randomized, controlled clinical trial to demonstrate the efficacy of hyaluronidase for treating muscle stiffness due to neurologic injury.

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 13 Translational Clinical Care

After Groundbreaking Face Transplant, Rusk Practitioners Forge New Rehabilitation Frontiers

For firefighter Patrick Hardison of Mississippi, a 2001 accident—in which he became trapped under a collapsed roof and suffered disfiguring burns over most of his head—led to 70 grueling reconstructive procedures in the years that followed.

In 2015, his long cycle of surgeries was disrupted by a and motivating Patrick to perform even very slight landmark, 26-hour transplant procedure led by Eduardo movements of different facial muscles.” His face D. Rodriguez, MD, DDS, the Helen L. Kimmel Professor transplant was the first to include the muscles that of Reconstructive Plastic Surgery, at NYU Langone control blinking, so eyelid movement presented Medical Center. Performing the most extensive face additional unfamiliar territory. “We began by trying transplant ever, surgeons replaced Hardison’s entire face to get Patrick to open his eyelids as much as possible,” and scalp, including his lips, ears, and eyelids. Dr. Balou says. Three days after surgery, Hardison For rehabilitation providers at Rusk, the face finally blinked—for the first time in 14 years. transplant catalyzed the creation of a long and complex treatment plan that has challenged every conventional approach to post-transplant rehabilitation medicine. “We were involved in the planning with the face transplant team from the outset, and we were ready to address Patrick’s recovery as we would for patients 26 Hours following other extremely complicated procedures,” says Jeffrey M. Cohen, MD, clinical professor of rehabilitation face transplant total procedure time medicine and director of medically complex rehabilitation. “However, his case was obviously incredibly unique and brought distinct challenges.” 100+ physicians, nurses, and support AN EARLY PRIORITY: REANIMATING MUSCLES AND NERVES staff involved in the surgery

During the procedure, surgeons attached a donor’s cranial and facial nerves to Hardison’s facial substructure. The complexity of transplanting entirely new facial nerves—the nerves needed to be adapted and While the Rusk team addressed facial movement, trained to work for Hardison—necessitated muscle they also focused on swallowing therapy as an early rehabilitation approaches above and beyond those priority. “After surgery, Patrick’s pharyngeal muscles employed for typical facial nerve trauma. were very weak, so we spent a lot of time on swallowing “We initially started with face reanimation, training maneuvers to help him clear his pharynx,” Dr. Balou his facial muscles to move and form expressions,” says. She began by placing a drop of water at the says Matina Balou, PhD, speech-language pathologist. very back of his throat, eliciting a swallow reflex and “That involved stretching and massage exercises stimulating the pharyngeal muscles. “It was a very slow

14 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 Preoperative: August 2014 Postoperative: November 11, 2015 Postoperative: August 3, 2016

process, but with a lot of work Patrick was able to ADDRESSING UNEXPECTED CHALLENGES swallow and transition from a feeding tube to a regular Other milestones came more slowly than expected. diet without restrictions within three months, which “I thought that because Patrick did not have any speech was much faster than we anticipated.” impairment before the transplant, he would have a very smooth transition to speaking afterward,” Dr. Balou KEY ROLE FOR PHYSICAL AND says. In reality, major deconditioning after more than OCCUPATIONAL THERAPY a day of surgery left him with severe speech impairments Meanwhile, Patrick progressed quickly through physical at multiple levels. and occupational therapy. “What was really interesting “In terms of speech-language pathology, Patrick about this case is that we didn’t have a benchmark was different in many unexpected ways,” Dr. Balou says. timeline for rehabilitation,” said Megan Evangelist, One challenge was that his tongue weakness was MS, OTR/L, occupational therapy clinical specialist. asymmetrical, and the weakness shifted from left to Five days after his transplant, Hardison was measuring right after a few weeks. To address this, Dr. Balou about half the hand grip strength of someone his age focused on strengthening Hardison’s tongue with a and gender. PT and OT staff worked with him six days series of exercises that utilized a feedback device to a week. One month later, he was scoring within measure the amount of force he exerted. “His tongue normal limits for hand grip strength and performing eventually became much stronger and with that basic daily activities independently. According to strength, his speech was much more fluent.” Evangelist, personal determination was a deciding The procedure has been transformative in ways factor. “Patrick was highly motivated to participate beyond its physical effects. “Patrick has realized so many in therapy,” she says. “It was pretty amazing to see milestones that we can see through his eyes,” Dr. Balou how quickly he progressed.” notes. “You can see how happy he is that no one notices his injuries anymore because he’s just a normal guy in the crowd.”

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 15 Translational Clinical Care

New Device Brings Neuromodulation Technology to Post-Stroke Shoulder Pain

For the many people who develop moderate-to-severe shoulder pain after suffering a stroke, treatment options have traditionally been limited.

“I’ve seen many of these patients over the years, and they’re quite challenging to treat,” says Charles Kim, FOR PAIN PATIENTS, INTEGRATIVE CARE MD, assistant professor of rehabilitation medicine and PROVIDES OPTIONS anesthesiology. “Frequently, the only recourse is pain Rusk clinicians are committed to providing chronic medication, with its concurrent side effects like pain sufferers the most effective treatments available. sleepiness, constipation, and addiction—so it’s a real For many, that may be physical therapy or a high-tech trade-off.” implant like the StimRouter. For others, the best In 2016, Dr. Kim became one of the first physicians treatment plan may include alternative therapies in the country to treat post-stroke hemiplegic shoulder such as acupuncture. pain with an implanted device called StimRouter, “We often see patients who have tried everything but which was recently cleared by the FDA. “It’s based on nothing worked,” says Alex Moroz, MD, associate neuromodulation technologies that have been around professor of rehabilitation medicine and vice chair for for decades,” he says. “The big difference with this device education at Rusk. “Sometimes acupuncture will help is that the technology has been miniaturized and is these patients. I look at it as one of the tools in our tool much less invasive.” belt for chronic pain.”

Dr. Kim agrees. “There is a lot of interest in acupuncture SIGNIFICANT IMPROVEMENT IN PAIN MEASURES and, especially with its use during the recent Olympics, in The implant is a thin, flexible electrode that resembles cupping,” he notes. “I use both with some patients, a short strand of spaghetti. During an outpatient because they offer effective pain relief.” procedure, a surgeon uses real-time image guidance to Given their effectiveness, these alternative approaches position the electrode near the axillary nerve. “It’s a very also have a role in research, education, and training. elegant procedure,” Dr. Kim says. “We use two small Research led by Barbara Siminovich-Blok, ND, MS, LAc, incisions that are maybe half to one centimeter each.” NCCAOM Dpl, includes a study that looks to determine The patient controls the stimulator with an external the effects of acupuncture on improving cognitive transmitter worn on an armband. When activated, an performance in individuals who have experienced electrical current modulates the nerve signals involved a left-sided cerebrovascular accident and to clarify the in pain perception. “One of the great things about this mechanism of improvement via functional brain imaging. device is that there is no implanted internal battery,” For residents, Rusk collaborates with the Tri-State Dr. Kim explains. “The patient can stimulate the area College of Acupuncture to offer a unique acupuncture training track that can lead to credits toward licensure for 30 to 60 minutes, and the pain relief will often last in acupuncture. for several hours.”

16 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 Early results are encouraging. “One longtime patient POTENTIAL FOR WIDE APPLICATION has endured constant shoulder pain since his stroke The initial indication for the neuromodulation device 10 years ago, because he preferred to deal with it over the is post-stroke shoulder pain, but according to Dr. Kim, side effects of pain medications,” says Dr. Kim. Shortly the device offers many possibilities. “The design is a after receiving the StimRouter, the patient reported a real breakthrough, so the uses will undoubtedly expand pain improvement of about 70 percent. “Another patient to include other chronic pain conditions,” he says. suffered from intractable pain for years in spite of her “It could potentially relieve pain anywhere there’s a pain medications,” he says. “After we implanted the nerve, so the number of indications is almost infinite.” device, she experienced about 90 percent improvement.”

Charles Kim, MD

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 17 Translational Clinical Care

Expanding Early Mobilization to Complex Pediatric Patients

NYU Langone is one of a handful of hospitals pioneering early mobilization initiatives for pediatric critical care patients. After a 2014 Rusk pilot program in the adult ICU reduced overall length of stay by 30 percent and more than doubled the home discharge rate, early mobilization protocols were introduced into the pediatric ICU (PICU).

In 2016, Rusk doubled down on this approach: A quality with complex inherited muscle disorders. “Even patients improvement team launched an effort to increase with severe neuromuscular disorders can benefit the percentage of PICU patients who are mobilized from timely and early interventions during their PICU within recommended time frames—18 hours post-ICU stay,” he says. “We aim to provide these patients with a admission for non-ventilated patients, and 48 hours high-quality, goal-oriented, and family-centered for patients on mechanical ventilation. structured rehabilitation continuum of care from “This was a multipronged initiative,” says Jodi PICU onward.” Herbsman, PT, DPT, program manager of acute care rehabilitation therapy services. “We updated the EARLY REHABILITATION ENABLES RECOVERY PICU admission order set to include activity orders, IN COMPLEX CASE implemented an algorithm to identify children eligible for early mobility, educated patients and families In one example, early mobilization proved effective on the benefits of early mobilization, and trained staff in a recent case involving a four-year-old girl with a on how to safely mobilize critically ill patients.” neuromuscular disease of unknown etiology, loosely defined as neuromyotonia. In 2015, the patient was hospitalized with severe pneumonia. She developed severe respiratory compromise and was ventilator- “We found that early mobilization in the dependent for an extended period. In addition, she PICU is feasible, safe, and ultimately was diagnosed with tracheal stenosis requiring and most importantly, an opportunity laryngotracheal reconstruction. The patient spent about six weeks in the PICU as for us to enhance patient care.” a result of her primary condition, and she declined —Jodi Herbsman, PT, DPT significantly in functional abilities. Early rehabilitation interventions began while she was still intubated. Bedside, physical, and occupational therapy interventions included sitting and standing while Between fall 2015 and summer 2016, the percentage of mechanically ventilated. Early speech therapy PICU patients mobilized within the recommended time focused on communication, and she was able to use frame increased from 60 percent to 85 percent. At the specialized devices to allow her to communicate same time, the average time to mobilization decreased with family, visitors, and the medical team. from 20 hours to 10 hours, and there were no safety In March 2016, the patient was admitted to pediatric incidents associated with mobilizing these patients. inpatient rehabilitation. The multidimensional nature Renat Sukhov, MD, medical director of pediatric of her condition and functional inabilities stemming rehabilitation, believes that early mobilization is from both her primary neuromuscular conditions important for all PICU patients, including children and the negative effects of her prolonged hospitalization

18 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 Renat Sukhov, MD

and surgeries required a coordinated approach led by a pediatric physiatrist. As a result, the four-year-old patient made significant progress medically, physically, 24% to 89% functionally, and psychologically, and managed to increase in patients with activity orders in the PICU walk out of the rehab unit at discharge and be during the implementation of the program reintegrated to her home and preschool environment. “The challenge of a severe neuromuscular disorder and the necessity for rehabilitative teamwork were critical,” Dr. Sukhov says. “Timely goal-oriented, disease-specific early rehabilitation interventions allow seamless transition home and add quality to their lives, providing necessary structure for the patient and hope for their families at a time of severe distress.”

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 19 Translational Clinical Care

New Strategies to Detect, Track, and Treat Brain Injury

Patients with moderate to severe traumatic brain injury (TBI) can face life-altering disabilities. But even people who suffer mild TBI/concussion may experience chronic problems in physical and cognitive function. At Rusk, researchers are collaborating across disciplines to develop innovative strategies for diagnosing, tracking, and treating TBI.

NEW REFERENCE DATA HONES MMPI TO and colleagues recently conducted research focused ASSESS MILD TBI on the autonomic nervous system. In the study, patients Rehabilitation psychologists use the Minnesota with chronic TBI and healthy control subjects were Multiphasic Personality Inventory (MMPI) to assess shown clips of emotion-provoking movie scenes; for the psychopathology of patients with concussion. Yet example, to elicit fear, subjects viewed a scene from many of the physical and cognitive sequelae of mild The Silence of the Lambs. During the test, the research TBI produce MMPI scale elevations that can lead to team recorded heart-rate variability to measure activity misinterpretation. Corrective factors have been suggested, but the real solution is to obtain reference group data specific to this patient population. At Rusk, researchers administered MMPI tests to 200 outpatients One of 16 with uncomplicated mild TBI. The data establishes a centers in the United States to be designated as comparison sample that can help define the typical Traumatic Brain Injury Model Systems (TBIMS) of care MMPI-2 profile for concussion patients. “By getting normative data for this population, we hope to help rehabilitation psychologists better identify individuals with unexpected scale elevations,” says Amanda Childs, of the sympathetic nervous system, and respiratory PhD, psychology postdoctoral fellow. “That will activity to generate measures of sympathetic and help us identify patients who could benefit from parasympathetic nervous system activity. The results additional interventions.” showed that TBI patients had a markedly decreased sympathetic nervous system activity in response to amusing stimuli and a markedly increased sympathetic POST-TBI EMOTIONS: FROM SUBJECTIVE MEASURES nervous system activity to sad stimuli. “Our study shows TO PHYSIOLOGICAL MARKERS that TBI patients process emotions differently from a Many people with TBI experience emotional physiological standpoint and in ways that do not impairments, such as mood swings, anxiety, irritability, correspond with their subjective experience of emotion,” and depression. “Emotional problems in TBI are Dr. Amorapanth says. “If we could use physiological suboptimally diagnosed in many clinical settings,” markers to characterize these emotional changes says Prin Amorapanth, MD, PhD, instructor of objectively, we could better diagnose these changes rehabilitation medicine. “The problem is that current and identify more effective treatments.” clinical measures rely heavily on subjective complaints.” To uncover more objective physiologic markers of post-TBI emotional impairment, Dr. Amorapanth

20 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 Tamara Bushnik, PhD, and the TBI Model Systems team

EDUCATION EFFORT SEEKS TO OVERCOME CULTURAL follow-up care. The study is underway at Bellevue DISPARITIES IN TBI CARE Hospital, which serves one of New York City’s most Rusk Rehabilitation is one of 16 centers nationwide ethnically diverse populations. “The patients at Bellevue designated as Traumatic Brain Injury Model Systems often lack social support, which we know is so crucial for (TBIMS) of care. As part of this government-funded good outcomes after TBI,” Dr. Bushnik says. “Our program, investigators at Rusk are midway through a research here could really shed light on ways inpatient multiyear project to design inpatient education rehabilitation could change in many hospitals in the materials for TBI patients from culturally diverse years ahead.” backgrounds. In the project’s first phase, researchers contacted patients six months after discharge to assess THERAPEUTIC IMPROVEMENTS OBSERVED YEARS their barriers to receiving follow-up care. “In many AFTER TBI cases, we found that patients faced personal barriers Although most people with moderate to severe TBI directly related to their TBI,” says Tamara Bushnik, PhD, recover through cognitive rest, about 20 percent FACRM, associate professor of rehabilitation medicine experience persistent symptoms, such as dizziness, and director of inter-hospital research and knowledge headache, insomnia, and difficulty concentrating. These translation. In the current phase of the project, patients patients often face a discouraging Catch-22. “First they view two educational videos, available in English or are told to take a leave from work and refrain from Spanish, in the days before discharge: one video that physical activities,” says Joseph Adams, PT, DPT, NCS, provides basic information about brain injury, and the senior physical therapist. “Then, after four or five months other with information on discharge, medications, and of persistent symptoms, they are told that they’re outside

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 21 Translational Clinical Care

the initial window of recovery.” Adams and colleagues rapid number-naming test used to detect concussion. asked whether these patients could benefit from They found that chronic concussion patients take an rehabilitation even months or years after their initial average of 10 seconds longer than healthy individuals injury. In their study, patients at an average of 12 months to complete the test. To determine whether concussion post-injury took part in vestibular rehabilitation. Before patients also exhibit slower eye movements, the research therapy, only 50 percent of patients were able to work at group applied their testing methodology to patients least part-time; after therapy, that rate increased to 92 with post-concussion syndrome. Using advanced percent. In addition, the full-time work rate went from 15 high-resolution video technology, they measured the percent to 50 percent. Adams theorizes that late sequence of quick eye movements (saccades) and rehabilitation helps patients counteract avoidance intermittent pauses or rests (intersaccadic intervals) that behaviors. “By giving patients a graded approach to start typically characterize eye control associated with moving their head and participating in light aerobic reading. “When we looked at kinematics—eye exercise again, they are empowered to return to life movement velocity and acceleration—we did not see a activities they thought they were unable to do.” significant difference between concussion patients and healthy patients,” says John-Ross (J.R.) Rizzo, MD, assistant professor of rehabilitation medicine and EYE MOVEMENT STUDY YIELDS NEW CONCUSSION BIOMARKERS neurology. Instead, the group made three novel discoveries. “First, we found that the pauses between eye Rusk Rehabilitation specialists recently partnered movements—the intersaccadic intervals—are longer for with colleagues in the Department of Neurology to concussion patients,” he continues. “Second, we found create a digitized version of the King-Devick test, a that their eye movements are dysmetric, meaning a little off target. And third, concussion patients tend to make more eye movements when they’re completing the task.” Dr. Rizzo believes these findings provide a new tool for measuring mild TBI and tracking recovery. “We now have the ability to quantitatively analyze specific metrics that are, in essence, behavioral biomarkers.”

3,300+ PATIENTS have received care at NYU Langone’s multidisciplinary Concussion Center since it launched in 2013

Janet Rucker, MD, and J.R. Rizzo, MD, using eye-tracking technology to study concussion

22 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 Complex Case: NSTEMI Patient

With Early Interdisciplinary Rehabilitation, a NSTEMI Patient Navigates His Complex Recovery

Rehabilitation medicine plays a key role in achieving good outcomes for medically complex patients—not only in supporting their recovery, but also in identifying complications before they become further problems.

PRESENTATION care was key to identifying a common, yet often undetected, problem—delirium. “Our rehabilitation team is trained to In one recent case, the patient, a 72-year-old man from the evaluate for confusional states, cognitive deficiencies, and Bronx, New York, presented to Tisch Hospital with accelerating delirium, because these problems will have a big impact on exertional angina. He was diagnosed with non-ST segment physical function and overall daily life,” Dr. Whiteson says. elevation myocardial infarction (NSTEMI) and after cardiac catheterization underwent a quadruple coronary To address the problem of delirium in critical care, Rusk artery bypass graft. physicians reintroduce sleep-wake cycles for the patient and work with the intensive care team to limit medications The patient’s postoperative course was prolonged and very that may cause confusion. Says Dr. Whiteson, “part of this complicated, according to his physician, Jonathan H. Whiteson, involves limiting sedation, so we encourage the intensive MD, assistant professor of rehabilitation medicine and vice care team to give the patient a ‘sedation vacation.’ That chair of clinical operations. Problems included acute blood means the patient is kept awake during the day to take loss anemia, gastrointestinal bleeding, hypervolemia, and part in physical therapy.” hypotensive episodes as part of cardiogenic shock, and rapid atrial fibrillation, all contributing to his critical state. Due to persistent respiratory failure and dysphagia, the RESULTS AND POST-DISCHARGE PLAN patient received a tracheostomy and a PEG tube. After seven weeks in critical care, the patient transitioned Over the course of several weeks in the ICU, the patient to inpatient rehabilitation. There, he received comprehensive developed symptoms of critical illness myopathy and displayed cardiopulmonary rehabilitation services, including physical significant functional deficits. “This level of critical care and occupational therapy and speech-language pathology. medicine understandably focuses on survival by all means, The Rusk team addressed his profound critical illness; but that often means missing troubling warning signs— myopathy-related weakness; balance, transfer, and gait issues; notably progressive physical weakness—that can lead to speech and swallowing function; personal care; and significant functional challenges during recovery,” says psychological barriers to recovery. Rusk Rehabilitation Dr. Whiteson. nurses were essential in the monitoring and management of his variable cardiovascular and respiratory parameters, and in supporting and reinforcing his functional gains DIAGNOSIS AND TREATMENT: EARLY MOBILIZATION during the arduous rehabilitative process. AND DETECTING DELIRIUM Following 17 days in acute rehab, the patient was discharged While still on mechanical ventilation in the ICU, the patient home without a tracheostomy, walking without an assistive underwent early mobilization protocols with a high frequency device, and performing ADLs with supervision. For this of therapy services that Rusk developed as part of a successful patient, the early involvement of the rehabilitation team pilot last year. “We based our interventions on some early helped avoid the potentially devastating consequences of literature showing that when patients are mobilized sooner a prolonged postoperative recovery. in the intensive care setting, they experience fewer complications,” Dr. Whiteson explains. “We are trying to move critical care from a ‘survival culture’ to a ‘thriving culture’ that helps patients get through the hospital While working with the patient, rehabilitation staff noted his episode faster and with fewer issues,” says Dr. Whiteson. fluctuating mental state. The Rusk team’s presence in critical

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 23 Academic Activities

Publications

Birkemeier J, Hudson T, Rizzo JR, Dai W, Failla MD, Myrga JM, Ricker JH, Eixon CE, Conley YP, Hasanaj L, Webb N, Birkemeier J, Serrano L, Nolan R, Selesnick I, Hasanaj L, Balcer L, Galetta S, Rucker J. Wagner, AK. Posttraumatic brain injury cognitive Raynowska J, Souza-Filho L, Hudson T, Rizzo JR, Dai W, The ocular motor underpinnings of rapid number-naming performance is moderated by variation within ANKK1 Rucker J, Galetta S, Balcer L. Rapid number naming as a sideline performance measure for concussion. and DRD2 genes. Journal of Head Trauma Rehabilitation. and quantitative eye movements may reflect contact Neurology. 2016; 86(16). 2015; 30: E54–66. sport exposure in a collegiate ice hockey cohort. Neurology. 2016; 86(16). Busato M, Quagliati C, Magri L, Filippi A, Sanna A, Ferizi U, Rossi I, Teplensky J, Lee Y, Lendhey M, Kirsch T, Branchini M, Marchand AM, Stecco A. Fascial Kennedy O, Bencardino J, Raya J. DTI can monitor changes He S, Limi S, McGreal RS, Xie Q, Brennan LA, Kantorow Manipulation Associated With Standard Care in articular cartilage after a mechanically induced injury. WL, Kokavec J, Majumdar R, Hou H Jr, Edelmann W, Liu W, Compared to Only Standard Postsurgical Care for Osteoarthritis & Cartilage. 2016; 24: S368–S369. Ashery-Padan R, Zavadil J, Kantorow M, Skoultchi AI, Total Hip Arthroplasty: A Randomized Controlled Stopka T, Cvekl A. Chromatin remodeling enzyme Snf2h Trial. PM&R. 2016. Gaugler JE, Reese M, Mittelman MS. Effects of the regulates embryonic lens differentiation and denucleation. Minnesota Adaptation of the NYU Caregiver Intervention Development. 2016; 143(11): 1937–1947. Bushnik T, Smith M, Im B. Role of acculturation in on Primary Subjective Stress of Adult Child Caregivers of rehabilitation outcomes. Brain Injury. 2016; 30(5-6): 690. Persons With Dementia. Gerontologist. 2016; 56(3): 461–474. Hilz MJ, Liu M, Koehn J, Wang R, Ammon F, Flanagan SR, Hosl KM. Valsalva maneuver unveils central baroreflex Cho YS, Sohlberg M, Rath J, Diller L. Exploring Gromisch ES, Zemon V, Holtzer R, Chiaravalloti ND, dysfunction with altered blood pressure control in persons the Psychosocial Impact of Ekso Bionics Technology. DeLuca J, Beier M, Farrell E, Snyder S, Schairer LC, with a history of mild traumatic brain injury. BMC Archives of Physical Medicine & Rehabilitation. Glukhovsky L, Botvinick J, Sloan J, Picone MA, Kim S, Foley Neurology. 2016; 16(1): 61. 2016; 97(10): e57. FW. Assessing the criterion validity of four highly abbreviated measures from the Minimal Assessment Hincapie O, Elkins J, Vasquez-Welsh L. Proprioception Cobbs L, Hasanaj L, Amorapanth P, Rizzo JR, of Cognitive Function in Multiple Sclerosis (MACFIMS). retraining for a patient with chronic wrist pain Nolan R, Serrano L, Raynowska J, Rucker JC, Jordan BD, Clinical Neuropsychologist. 2016; 30(7): 1032–1049. secondary to ligament injury with no structural instability. Galetta SL, Balcer LJ. Mobile Universal Lexicon J Hand Therapy. 2016; 29: 183–190. Evaluation System (MULES) test: A new measure Gu W, Reddy HB, Green D, Belfi B, Einzig S. Inconsistent of rapid picture naming for concussion. responding in a criminal forensic setting: An evaluation Hudson TE, Landy MS. Sinusoidal error perturbation Journal of the Neurological Sciences. 2016. of the VRIN-r and TRIN-r scales of the MMPI–2–RF. reveals multiple coordinate systems for sensorymotor Journal of Personality Assessment. 2016; 4: 1–11. adaptation. Vision Research. 2016; 119: 82–98. Corcoran JR, Herbsman JM, Bushnik T, Vanlew S, Stolfi A, Parkin K, McKenzie A, Hall GW, Joseph W, Whiteson J, Gurin L, Blum S. Delusional nihilism after ‘mild’ traumatic Kesinger MR, Juengst SB, Bertisch H, Niemeier JP, Flanagan SR. Early Rehabilitation in the Medical and brain injury: A case report and review of the literature on Krellman J, Pugh MJ, Kumar RG, Sperry J, Arenth PM, Surgical Intensive Care Units for Patients With and Without Cotard syndrome and the neuropsychiatry of time Fann J, Wagner AK. Acute trauma factor associations Mechanical Ventilation: An Interprofessional Performance perception. Brain Injury. 2016; 30(5-6): 786–787. with suicidality across the first 5 years after traumatic Improvement Project. PM&R. 2016. brain injury. Archives of Physical Medicine and Hada E, Juszczak M, Long C, Smith M, Shagalow S, Bushnik Rehabilitation. 2016; 97(8): 1301–1308. Dempsey K, Birkemeier J, Hudson T, Dai W, Selesnick I, T. A demographic analysis of the barriers and supporters of Hasanaj L, Balcer L, Galetta S, Rucker J, Rizzo JR. enrollment for traumatic brain injury model systems Kim S, Foley FW, Cavallo M, Howard J, Rath J, Dadon K, Visual performance of non-native versus native (TBIMS) research. Archives of Physical Medicine & Rimler Z, Kalin JT. Growth and benefit finding post- English speakers on a sideline concussion screen: Rehabilitation. 2016; Conference (93rd): e11–e12. trauma: A qualitative study of partners of individuals An objective look at eye movement recordings. with multiple sclerosis. Archives of Physical Medicine & Neurology. 2016; 86(16). Hada E, Long C, Smith M, Bushnik T. The influence of Rehabilitation. 2016; 97(10): e28. country of origin and attitudes towards healthcare, Diab M, Poulos PJ, Grant EC, Mirchandani M, Maikos J. language preference and health outcomes in individuals Kim S, Rath JF, Zemon V, Picone MA, Portnoy JG, Foley FW. Gait analysis after bilateral quadriceps tendon rupture with TBI. Brain Injury. 2016; 30(5-6): 688–689. Cognitive status and employment in persons with multiple in a patient who elected to be conservatively managed: sclerosis: The effects of problem orientation. Archives of A case report. PM&R. 2016; Conference. Hada E, Smith M, Bushnik T. Beyond the bars: Traumatic Physical Medicine & Rehabilitation. 2016; 97(10): e85. brain injury (TBI) and incarceration. Brain Injury. 2016; Dijkers M, Gordon W, Bogner J, Cicerone K, Flanagan S, 30(5-6): 715. Kim S, Zemon V, Rath JF, Picone M, Gromisch ES, Glubo H, Dams-O’Connor K, Kolakowsky-Hayner S. Guidelines for Smith-Wexler L, Foley FW. Screening instruments for the the rehabilitation and disease management of adults with Hainline C, Rizzo JR, Hudson T, Dai W, Joel B, Nolan R, early detection of cognitive impairment in patients with moderate-to-severe traumatic brain injury: Methodology Hasanaj L, Balcer L, Galetta S, Kister I, Rucker J. multiple sclerosis. International Journal of MS Care. 2016; and PICOT questions. Brain Injury. 2016; 30(5-6): 512. Capturing the efferent side of vision in multiple sclerosis: epub ahead of print. New data from a digitized rapid number naming task. Ellois V, Long C, Childs A, Smith J, Amorapanth PX, Neurology. 2016; 86(16). Kurella Tamura M, Pajewski NM, Bryan RN, Weiner DE, Bertisch H, Lui Y, Rath JF. Relationships among Diamond M, Van Buren P, Taylor A, Beddhu S, Rosendorff slowed processing speed, emotional reactivity, and Hanson C, Lolis AM, Beric A. SEP Montage Variability C, Jahanian H, Zaharchuk G. Chronic kidney disease, postconcussive symptoms in adults with mild Comparison during Intraoperative Neurophysiologic cerebral blood flow, and white matter volume in traumatic brain injury. Archives of Physical Medicine & Monitoring. Frontiers in Neurology. 2016; 7: 105–105. hypertensive adults. Neurology. 2016; 86(13): 1208–1216. Rehabilitation. 2016; Conference (93rd). Hart T, Novack TA, Temkin N, Barber J, Dikmen Sureyya S, Li X, Black M, Xia S, Zhan C, Bertisch HC, Branch CA, Elwood D, Hall G, Feliz J. Spreading the word: Using Diaz-Arrastia R, Ricker J, Hesdorffer DC, Jallo J, Hsu NH, DeLisi LE. Subcortical structure alterations impact podcasting to advance scientific knowledge across Zafonte R. Duration of Posttraumatic Amnesia Predicts language processing in individuals with schizophrenia the spectrum of PM&R. PM&R. 2016; Conference. Neuropsychological and Global Outcome in Complicated and those at high genetic risk. Schizophrenia Research. Mild Traumatic Brain Injury. Journal of Head Trauma 2015; 169: 76–82. Erkut Kucukboyaci N, Leyden K, Lee D, Girard H, Puckett Rehabilitation. 2016; 31(6): E1–E9. O, Tecoma E, Iragui-Madoz V, McDonald C. Post-Surgical Lin Q, Lu J, Chen Z, Yan J, Wang H, Ouyang H, Mou Z, Uncinate Fasciculus Diffusivity In TLE and Its Relationship Hasan S, McGee A, Weinberg M, Bansal A, Hamula M, Huang D, O’Young B. A Survey of Speech-Language- to Changes in Executive Function After ATL. Abstract 1.168. Wolfson T, Zuckerman J, Jazrawi L. Change in Driving Hearing Therapists’ Career Situation and Challenges 2015 American Epilepsy Society Annual Meeting. Performance Following Arthroscopic Shoulder Surgery. in Mainland China. Folia Phoniatrica & Logopaedica. 2016; International Journal of Sports Medicine. 2016; 37(9): 68(1): 10–15. Evangelist M, Gartenberg A. Toolkit for developing 748–753. an occupational therapy program in the ICU. SIS Quarterly Practice Connections. 2016; 1(1): 20–22.

24 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 Lu W, Cantor JB, Aurora RN, Gordon WA, Krellman JW, Rizzo JR, Hudson TE, Dai W, Birkemeier J, Pasculli RM, Nguyen M, Ashman TA, Spielman L, Ambrose AF. The Selesnick I, Balcer LJ, Galetta SL, Rucker JC. Rapid number Posters relationship between self-reported sleep disturbance and naming in chronic concussion: eye movements in the polysomnography in individuals with traumatic brain King-Devick test. Annals of Clinical & Translational injury. Brain Injury. 2015; 29: 1242–1350. Neurology. 2016; 3: 801–811. AMERICAN ACADEMY OF PHYSICAL MEDICINE AND REHABILITATION ANNUAL ASSEMBLY 2015 Lu W, Krellman JW, Dijkers M. Can cognitive behavioral Rizzo JR, Hudson TE, Dai W, Desai N, Yousefi A, Palsana D, therapy for insomnia also treat fatigue, pain, and Selesnick I, Balcer LJ, Galetta SL, Rucker JC. Objectifying Amorapanth PX, Raghavan P, Aluru V, Aronson M, Im B, mood symptoms in individuals with traumatic brain eye movements during rapid number naming: Rath JF, Bilaloglu S. Physiologic mechanisms of emotional injury? — A multiple case report. NeuroRehabilitation. Methodology for assessment of normative data for the impairment in traumatic brain injury 2016; 38: 59–69. King-Devick test. Journal of the Neurological Sciences. 2016; 362: 232–239. AMERICAN ACADEMY OF PHYSICAL MEDICINE AND Luchsinger JA, Burgio L, Mittelman M, Dunner I, Levine JA, REHABILITATION ANNUAL ASSEMBLY 2016 Kong J, Silver S, Ramirez M, Teresi JA. Northern Manhattan Rubin JP, Gurtner GC, Liu W, March KL, Seppanen- Alomar W. Unusual cause of myelopathy related to Hispanic Caregiver Intervention Effectiveness Study: Kaijansinkko R, Yaszemski MJ, Yoo JJ. Surgical Therapies neurofibromatosis type 1: a case report protocol of a pragmatic randomised trial comparing the and Tissue Engineering: At the Intersection Between effectiveness of two established interventions for informal Innovation and Regulation. Tissue Engineering Part A. Bonte B, Freeman J, Fang G, Sauthoff H. Ultrasound caregivers of persons with dementia. BMJ Open. 2016; 22(5-6): 397–400. guided diaphragmatic EMG in patient with respiratory 2016; 6(11): e014082. decline and pre-existing contralateral diaphragm atrophy: Sabari J, Capasso N, Feld-Glazman R. Optimizing motor a case report Markos SM, Failla MD, Ritter AC, Dixon CE, Conley YP, planning and performance for clients with neurological Ricker JH, Arenth PM, Juengst SB, Wagner AK. Genetic disorders. In Radomski M and Trombly-Latham C. Franzese K. 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Smith M, Long C, Bushnik T. Supporting factors for transplantation, a case report follow-up care in TBI patients post-inpatient discharge. Moroz A, Bang H. Predicting Performance on the American Archives of Physical Medicine & Rehabilitation. Ho D, McKay T, Kao D. Teetering on the edge: rehabilitation Board of Physical Medicine and Rehabilitation Written 2016; Conference (93rd). in a medically complex patient with familial dysautonomia Examination Using Resident Self-Assessment Examination (hereditary sensory autonomic neuropathy type III), Scores. Journal of Graduate Medical Education. Stewart C, Riedel K. Managing Speech and a case report 2016; 8(1): 50–56. Language Deficits after Stroke. In Gillen G (Ed.) Stroke Rehabilitation: A Function-Based Approach. Kao DJ, Franzese K, Seo YI, Mandalaywala NV, Oak K, Myrga JM, Failla MD, Ricker JH, Dixon CE, Conley YP, St. Louis, Missouri: Elsevier. 2016. Moroz A, Espiritu T, Ho DJ. Evaluating burnout in physical Arenth PM, Wagner AK. A Dopamine Pathway Gene Risk medicine and rehabilitation residents Strober LB, Binder A, Nikelshpur OM, Chiaravalloti N, Score for Cognitive Recovery Following Traumatic Brain Kaul A, Franzese K. Ataxia and dysarthria secondary to Injury: Methodological Considerations, Preliminary DeLuca J. The Perceived Deficits Questionnaire (PDQ): Perception, Deficit, or Distress? International Journal Kufor-Rakeb syndrome in two siblings and their Findings, and Interactions With Sex. Journal of Head progression in outpatient rehabilitation: a case report Trauma Rehabilitation. 2016; 31(5): E15–E29. of MS Care. 2015; epub ahead of print. Mandalaywala NV, Seo YI, Fusco N. Management of acute Phongtankuel V, Amorapanth PX, Siegler EL. Pain in Sumowski JF, Inglese M, Petracca M, Erlanger DM. BICAMS underestimates verbal memory impairment in MS patients: baclofen withdrawal in the setting of intrathecal pump the Geriatric Patient with Advanced Chronic Disease. infection: a case report Clinics in Geriatric Medicine. 2016; 32(4): 651–661. We propose a simple solution. Multiple Sclerosis. 2016; Conference: (32nd). Oak K, Kumar A. A novel presentation of acute motor Raghavan P, Geller D, Guerrero N, Aluru V, Eimicke JP, axonal neuropathy: a case report Teresi JA, Ogedegbe G, Palumbo A, Turry A. Tulsky DS, Kisala PA, Victorson D, Carlozzi N, Bushnik T, Music Upper Limb Therapy-Integrated: An Enriched Sherer M, Choi SW, Heinemann AW, Chiaravalloti N, Pruski A, Shin R. Better functional outcome with acute Collaborative Approach for Stroke Rehabilitation. Sander AM, Englander J, Hanks R, Kolakowsky-Hayner S, inpatient rehabilitation—a case report of Frontiers in Human Neuroscience. 2016; 10: 498. Roth E, Gershon R, Rosenthal M, Cella D. TBI-QOL: neurocysticercosis with devastating acute hospital course Development and Calibration of Item Banks to after initial presentation of hydrocephalus Raghavan P, Lu Y, Mirchandani M, Stecco A. Human Measure Patient Reported Outcomes Following Traumatic Recombinant Hyaluronidase Injections For Upper Limb Brain Injury. Journal of Head Trauma Rehabilitation. Shalwala M. Bilateral symptomatic snapping knee from Muscle Stiffness in Individuals With Cerebral Injury: 2016; 31(1): 40–51. biceps femoris tendon subluxation—an atypical cause of A Case Series. EBioMedicine. 2016; 9: 306–313. bilateral knee pain: a case report Vanlew S, Geller D, Feld-Glazman R, Capasso N, Dicembri Ritter AC, Wagner AK, Fabio A, Pugh MJ, Walker WC, A, Pinto Zipp G. Development and Preliminary Reliability Shalwala M. Gait analysis after bilateral quadriceps tendon Szaflarski JP, Zafonte RD, Brown AW, Hammond FM, of the Functional Upper Extremity Levels (FUEL). rupture in a patient who elected to be conservatively Bushnik T, Johnson-Greene D, Shea T, Krellman JW, The American Journal of Occupational Therapy. managed: a case report Rosenthal JA, Dreer LE. Incidence and risk factors of 2015; 69(6): 69063350010. Shalwala M. Myopathy, neuropathy, or both? A case report posttraumatic seizures following traumatic brain injury: A Traumatic Brain Injury Model Systems Study. Wang B, Prastawa M, Irimia A, Saha A, Liu W, Goh SYM, Epilepsia. 2016. Vespa PM, Van Horn JD, Gerig G. Modeling 4D Pathological AMERICAN BOARD OF REHABILITATION Changes by Leveraging Normative Models. PSYCHOLOGY AND AMERICAN PSYCHOLOGICAL Ritter AC, Wagner AK, Szaflarski JP, Brooks MM, Zafonte Computer Vision & Image Understanding. 2016; 151: 3–13. ASSOCIATION DIVISION OF REHABILITATION RD, Pugh MJV, Fabio A, Hammond FM, Dreer LE, Bushnik PSYCHOLOGY ANNUAL CONFERENCE T, Walker WC, Brown AW, Johnson-Greene D, Shea T, Childs A, Long C, Ellois V, Smith J, Bertisch H, Lui Y, Rath Krellman JW, Rosenthal JA. Prognostic models for JF. Postconcussive symptoms in the context of above- predicting posttraumatic seizures during acute average neuropsychological test performance: no evidence hospitalization, and at 1 and 2 years following traumatic for exaggerated complaints or suboptimal effort brain injury. Epilepsia. 2016; 57(9): 1503–1514.

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 25 Academic Activities

Posters (cont.)

Childs A, Rath JF, Barr W, Ricker JH. MMPI profiles Ellois V, Long C, Childs A, Smith J, Bertisch H, Amorapanth Evangelist M, Brown E, Fisher M. Delirium: prevention, of outpatients with mild traumatic brain injury: P, Lui Y, Rath JF. Relationships among slowed processing identification, and interventions by rehabilitation what’s the norm? speed, emotional reactivity, and postconcussive symptoms therapists in the acute care setting in adults with mTBI Ellois V, Long C, Childs A, Smith J, Bertisch H, Lui Y, Finley B. Current concepts in evaluation and treatment Rath JF. TBI model systems defined problematic Fraser F, Matsuzawa Y, Lee C, Childs A, Barr W, MacAllister of non-operative orthopedic shoulder pathology substance use in healthy controls: essential context for W, Ricker J. Gender differences in self-reported post- understanding substance use rates in mild TBI samples concussion symptoms Geller D, Vanlew S. Mirror therapy Grunwald I, Gershon S. Psychological characteristics Juszczak M, Beattie A, Smith M, Nelson L, Maikos J, Kearney O’Neill A, Kloczko E, Martori E, Vanlew S, of outpatients with voice disorders: implications Bushnik T. A descriptive analysis of pain and Waskiewicz M. Full-time clinicians to adjunct professors: for rehabilitation psychosocial characteristics of civilian and veteran lower the mutual benefit from the classroom to the clinic extremity amputees Kim S, Foley FW, Cavallo MM, Howard J, Rath JF, Dadon K, Magsombol C, Estrada I, Sheikovitz L. Diabetes Kalina JT. A qualitative study of posttraumatic growth in Juszczak M, Beattie A, Smith M, Nelson L, Maikos J, management program in inpatient rehabilitation partners of individuals with multiple sclerosis Bushnik T. The influence of social support on functional Marino C. Occupational therapy interventions with outcomes and quality of life in lower limb amputees Lindsey HM, Mercuri G, Lazar M, Rath JF, Bushnik T, Wallenberg Syndrome: a case study Flanagan S, Voelbel GT. Changes in white matter integrity Juszczak M, Bushnik T. Examining the effect of a McClelland K, Capasso N, Flumara E. Use my arm following neurorehabilitation: a diffusion tensor imaging powered exoskeleton on quality of life in people with study of adults with chronic traumatic brain injury spinal cord injury Mouldovan T. Implementing an assistive technology program on an inpatient unit Long C, Gordon RM, Childs A, Ellois V, Bertisch H, Rath JF. Kim S, Foley FW, Cavallo MM, Howard J, Rath JF, Dadon K, Outcomes of the first APA-accredited predoctoral Rimler Z, Kalina JT. Growth and benefit finding post Mouldovan T. Self-care success: OT improves function internship focusing on rehabilitation psychology trauma: a qualitative study of partners of individuals with for lower limb amputee patients multiple sclerosis Mouldovan T. Viewing the world through a telescope: AMERICAN CONGRESS OF REHABILITATION Kim S, Rath JF, Zemon V, Picone M, Portnoy JG, Foley FW. strategies for treatment of Balint’s Syndrome MEDICINE ANNUAL CONFERENCE 2015 Cognitive status and employment in persons with multiple Rosenblum J, Finley B. Technology in hand therapy: Childs A, Long C, Smith M, Ellois V, Smith-Wexler L, sclerosis: the effects of problem orientation current concepts in the use of applications for clinicians Bertisch H, Rath JF, Busknik T. Body mass index following and clients traumatic brain injury: demographic and psychosocial Langhammer B, Fugl-Meyer K, Sallstrom S, Sunnerhagen variables at injury and one-year follow-up SK, Bushnik T, Stanghelle KJ. Activities of daily living and life satisfaction—what influence and predict outcomes? AMERICAN PHYSICAL THERAPY ASSOCIATION Elliott CS, Kajankova M, Murray N, Lu W, Kaplan E, Dijkers Sunnaas International Network (SIN) stroke study (APTA) COMBINED SECTIONS ANNUAL MEETING M. Empirically-supported programs for caregivers of adults Coppola N, Dack C. PT intervention for patient s/p with traumatic brain injury: a systematic review Long C, Childs A, Ellois V, Smith J, Bertisch H, Lui Y, Rath JF. Gender differences in neuropsychological functioning antibiotic hip spacer with ICU acquired delirium Glubo H, Fraser F, Creighton J, Lee CYS, Marks B, following mild traumatic brain injury: implications for Finnen K, Weber K. Increasing physical therapist Matsuzawa Y, Trubetckaia O, Langenbahn D, Kingsley K. assessment and rehabilitation awareness of cardiovascular disease risk among people Group treatment for individuals with post-concussion of South Asian descent syndrome: a pilot study of feasibility and initial efficacy Siminovich-blok B, Portugal L. Is Reiki an effective addition to standard of care in an acute adult rehabilitation setting? Finnen E, Weber K. Utility of the 5 meter walk test post Hada E, Long C, Jenkins N, Childs A, Smith M, Bushnik T. transcatheter aortic valve replacement First year follow-up of traumatic brain injury: effect Smith M, Long C, Bushnik T. Supporting factors for of social integration on life satisfaction, depression, follow-up care in TBI patients post-inpatient discharge Fischer M, Evangelist M, Brown E, Josef K, Herbsman J, and anxiety Smith M, Reimann G, Long C, Siminovich-blok B, Bushnik Laverty P, Harb J. Prevention, identification and treatment of delirium: the role of the rehabilitation therapist Jenkins N, Long C, Hada E, Childs A, Smith M, Bushnik T. T. A center-specific demographic analysis of barriers First year follow-up of traumatic brain injury: effect of to retention in traumatic brain injury model systems Frey C, Klein D. From Struggle to Success: Addressing employment on life satisfaction, depression, and anxiety (TBIMS) research cognitive and behavioral aspects of patient care in the physical therapy treatment of a young boy with acute Kim S, Rath JF, Zemon V, Cavallo MM, McCraty R, Sostre A, AMERICAN EPILEPSY SOCIETY ANNUAL disseminated encephalomyelitis Foley FW. HRV biofeedback, TBI, and problem solving: the CONFERENCE moderating effect of positive affect Frey C, Klein D. Optimizing participation and functional Kucukboyaci NE, Leyden KM, Lee D, Girard H, Puckett O, progress with physical therapy treatment for the acute care Langenbahn D, Colantonio A, Constantinidou F. Survey of Tecoma E, Iragui VJ, Bartsch H, McDonald CR. Post- patient during a long term stay: a case study international interest in research collaboration among surgical uncinate fasciculus diffusivity in TLE and its ACRM members relationship to changes in executive function after ATL Hincapie O, Elkins J, Vasquez-Welsh L. Proprioception retraining for a patient with chronic wrist pain secondary Matsuzawa Y, Lee CYS, Creighton J, Fraser F, Glubo H, AMERICAN NURSES ASSOCIATION CONFERENCE to ligament injury with no structural instability Marks B, Trubetckaia O, Kingsley K, Langenbahn DM. Feasibility of psychoeducation and strategies group De Claro L. Enhancing patient satisfaction through Josef K, Fischer M. Development of a functional fall risk program for patients with concussion discharge follow-up phone calls on a neurological assessment tool for the acute care setting: a pilot study rehabilitation unit Khalil N, Knopf L, Lam M. Assessment and management of AMERICAN CONGRESS OF REHABILITATION a pediatric patient with conversion disorder: a case report MEDICINE ANNUAL CONFERENCE 2016 AMERICAN OCCUPATIONAL THERAPY ASSOCIATION ANNUAL MEETING Amorapanth P, Aluru V, Yousefi A, Tang A, Stone J, Cox S, Khalil A, Shah K. Early mobilization of patients at high risk Aronson M, Bilaloglu S, Lu Y, Rath JF, Im B, Raghavan P. Burns S, DelCorro-Cao J. Occupational therapy of vasospasm in the neurological intensive care unit: Altered physiologic, but not subjective, responses to consideration for treating the neuro-oncology population a case report on an adult inpatient rehab unit emotional stimuli Laverty P, Keeler A, Rankel E. It’s only temporary: the Cho YS, Sohlberg MM, Rath JF, Diller L. Exploring the Estrada I. Occupational performance based assessments benefits of early intensive physical therapy in a patient with psychosocial impact of Ekso Bionics Technology SMA Syndrome

26 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 Matejovsky I. Stroke-related ataxia: the effect of NATIONAL REHABILITATION ASSOCIATION ANNUAL WORLD CONGRESS OF NEUROREHABILITATION coordination and balance training on a patient with acute TRAINING CONFERENCE Aluru V, Ali SZ, Jin X, Dalsania R, Agrawal S, Raghavan P. cerebellar stroke Kvaternik K, Laster B, Lindsey R, Tran A. A case study Personalized robotic training for stroke rehabilitation of on the job interventions to maintain employment Newkirk M, Ramirez J. The effect of prolonged bed rest in Raghavan P, Shalwala M, Lu Y, Stecco A. acute care on a healthy 28 y/o female with multiple traumas Human recombinant hyaluronidase injections for due to a motor vehicle accident NEW YORK ACADEMY OF SCIENCES SYMPOSIUM upper limb spasticity ON SURGERY AND COGNITION: DELIRIUM, APTA NEXT CONFERENCE & EXPOSITION COGNITIVE DECLINE, AND OPPORTUNITIES TO PROTECT THE BRAIN Fischer M, Evangelist M, Brown E, Josef K, Harb J. Prevention, identification and treatment of delirium: the Langer KG, Jimenez AC. Unexpected cognitive difficulty role of the rehabilitation therapist is an important problem in the rehabilitation of the post-surgical patient Presentations AMERICAN PSYCHOLOGICAL ASSOCIATION ANNUAL CONVENTION NEW YORK STATE SPEECH HEARING LANGUAGE ASSOCIATION Avitia M, DeBiase E, Pagirsky M, Cross K, Knupp T. 22ND ANNUAL INTERDISCIPLINARY STROKE COURSE Differences in errors between students with language and Dobranski, N. Aphasia in an English second language reading disabilities learner Raghavan P. Selecting the right treatment at the right time for the right person for restoration of arm and hand Wolfson J, Shreck E, Cercy S. Association between cognitive Kane A, Schieber A. Feeding tube weaning for children function post stroke functioning and treatment adherence in primary care with congenital cardiac anomalies Tan T, Danziger K, Kane A. Progression of speaking valve AMERICAN ACADEMY OF PHYSICAL MEDICINE & AMERICAN SPEECH HEARING ASSOCIATION ANNUAL tolerance in a child with craniofacial disorder REHABILITATION MEETING Alter K, Fusco H, Ketchum N, Levine J, Lin J, McGuire J, Dobranski N. Stroke rehabilitation for English-language THE OBESITY SOCIETY ANNUAL MEETING Pacheco M. Improving assessment and maximizing learners Childs A, Cervoni C, Loizos M, Swencionis C, Wylie-Rosett intervention options for patients with spasticity, dystonia, and related motor disorders Durkin A. The impact of visual impairments on orientation J. Frequency of use and perceived helpfulness of cognitive & memory following brain injury and behavioral coping strategies in a weight-loss Balou M, Bartels M, Cohen J, O’Young B, Young M. intervention study Rehabilitation following organ transplantation: what Haddad A. Insomnia & aphasia recovery in a severe TBI EVERY physiatrist must know SOCIETY FOR ACUPUNCTURE RESEARCH Houck K, D’sa I. Feel your food: an intensive sensory- Bansal A, Cohen J, Edelstein J, Moroz A. Pathological gait: motor feeding program Siminovich-blok. B. Treating connective tissue disorders an interactive workshop with acupuncture: the case for Ehlers-Danlos Syndrome Schmidt J, Rabinowitz L. Age & language recovery Bernard K, Kim C, Portugal S, Sackheim K. Spine center during acute inpatient rehabilitation stay SOCIETY FOR NEUROSCIENCE surprises: unusual diagnoses presenting as typical spine syndromes Schmidt J, Rabinowitz L. Gender & language recovery Bilaloglu S, Chakrabarty S, Lu Y, Yousefi A, Raghavan P. during acute inpatient rehabilitation stay Plasticity in cortical control signals to muscles in Caballes E, Stokes W. Knee and shoulder surgery: Schmidt J, Rabinowitz L. Type of stroke & language pianists with overuse injury with peripheral behavioral why or why not refer? intervention recovery during acute inpatient rehabilitation stay Fusco H, Levine J. Neuropharmacology in TBI: what we Singleton-Coyne M, Burns S. Role of speech-language Raghavan P, Lu Y, Bayona C, Bilaloglu S, Yousefi A, Tang A, know and what we don’t Aluru V, Rangan A. Determination of treatment algorithms pathologists in developing models of education for Khan S, Parkin K, Whiteson J. Physical medicine and neuro-oncology patients for patient subgroups for post-stroke hand function rehabilitation rehabilitation as a driving force of value based medicine ASSOCIATION OF REHABILITATION NURSES Yousefi A, Bilaloglu S, Rizzo JR, Lu Y, Raghavan P. Gaze Sweeney G, Whiteson J. Cardiac rehabilitation exemplifies CONFERENCE pattern differences inform hand posture to object shape the role of PM&R in value-based medicine: growth opportunities for medically-complex cardiac rehabilitation De Claro L. Improving discharge planning from an during reach-to-grasp programs acute neuroscience rehabilitation unit using a structured teaching approach SOCIETY OF BEHAVIORAL MEDICINE ANNUAL MEETING AMERICAN BOARD OF REHABILITATION PSYCHOLOGY AND AMERICAN PSYCHOLOGICAL INTERNATIONAL CONGRESS OF PARKINSON’S Chiusano C, Anastasides N, Chelenza M, Friedlander M, ASSOCIATION DIVISION OF REHABILITATION DISEASE AND MOVEMENT DISORDERS ANNUAL Greenberg L, Helmer D, Litke D, Lu S, Petrakis BA, Pigeon PSYCHOLOGY ANNUAL CONFERENCE MEETING W, Quigley K, Rath JF, Ray K, Santos S, McAndrew L. Bertisch H. Problem orientation, mood, and related McCabe DL, Bono AD, Stafford RS, Dumer A, Scorpio KA, Protocol for randomized controlled trial of problem- constructs in cognitive rehabilitation Spielman J, Bind R, Ramig LO, Borod JC. Facial expressivity solving therapy for Gulf War Illness in Parkinson’s disease (PD) via an examination of smiling Childs A, Rath JF, Barr WB, Ricker JH. MMPI profiles behavior: preliminary findings WORLD CONFERENCE OF THE INTERNATIONAL of outpatients with mild traumatic brain injury: BRAIN INJURY ASSOCIATION what’s the norm? INTERNATIONAL NEUROPSYCHOLOGICAL SOCIETY Hada E, Long C, Smith M, Im B, Bushnik T. Beyond the Cho YS. Way finding when lost in the community: ANNUAL MEETING bars: traumatic brain injury and incarceration in America a help-seeking approach Lee YSC, Matsuzawa Y, Creighton J, Fraser F, Glubo H, Hada E, Long C, Smith M, Im B, Bushnik T, Flanagan S. Kim S, Zemon V, Cavallo MM, Rath JF, McCraty R, Kingsley K, Marks B, Trubetchkaia O, Langenbahn DM. The role of acculturation in rehabilitation outcomes Does psychoeducation promote recovery for patients Ellois V, Foley FW. Heart rate variability biofeedback, with persistent concussion symptoms? Rabinowitz L, Chung M, Laporte A. Transdisciplinary self-regulation, and severe brain injury: a individualized patient protocols—a pilot study in inpatient psychophysiological approach McCabe DL, Merker BM. Perceived value and feasibility neurorehabilitation of centralized scoring and research databases in the field Litke DR, McAndrew LM, Rath JF. Gulf War illness of neuropsychology clinical trial: adapting problem solving and emotional self-regulation interventions for veterans with complex medical illness

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 27 Academic Activities

Presentations (cont.)

Rath JF. Problem solving and emotional self-regulation AMERICAN OCCUPATIONAL THERAPY ASSOCIATION INTERNATIONAL LYME AND ASSOCIATED DISEASE approaches in outpatient cognitive rehabilitation: NATIONAL CONFERENCE SOCIETY ANNUAL EUROPEAN CONFERENCE the evidence base, impact and extensions Castle K, Flaherty R. Topographical orientation skills: the Shea L. Plenary session moderator path to community return AMERICAN CONGRESS OF REHABILITATION INTERNATIONAL LYME AND ASSOCIATED DISEASE Cohen H. Addressing the needs of a progressive neurologic MEDICINE ANNUAL CONFERENCE 2015 SOCIETY ANNUAL SCIENTIFIC SESSION diagnosis through technology use Heinemann AW, Herrold AA, Kim S, Heyn PC, Ciro C. Shea L. Pediatric neuropsychiatric Lyme/tick-borne Progress and report of the ACRM Measurement Geller D, Capasso N, Dicembri A, Feld-Glazman R, Vanlew diseases (session moderator) Networking Group Applied Cognition Task Force S. Functional upper extremity levels (FUEL): a hierarchical (MNG ACTF) classification tool for the neurological upper extremity INTERNATIONAL STROKE CONFERENCE Kingsley K, Hayner-Kolokowsky S, Vakil E, Constantinidou Waskiewicz M, Martori E, Sproul M. Interdisciplinary Raghavan P. Young stroke: changing the way we view stroke F. Cognitive reserve in healthy aging and long-term collaboration: OTs role in effectively treating concussion care in America—personalized rehabilitation for outcomes for individuals with brain injury patients post-stroke relearning Kingsley K, O’Connell B, Vakil E, Armstrong J. Community integration for individuals with brain injury: AMERICAN PHYSICAL THERAPY ASSOCIATION MASSACHUSETTS GENERAL HOSPITAL—SPAULDING a cross-cultural review of service delivery models (APTA) COMBINED SECTIONS MEETING REHABILITATION HOSPITAL Corcoran J. Taught leadership 201: advanced leadership Shea L. Neuropsychology and Lyme Disease (grand Smith-Wexler L. Disordered eating, weight, and development rounds) physical activity concerns in rehabilitation outpatients with acquired brain injury APTA NEXT CONFERENCE & EXPOSITION MUSICARES HEALTHY ESSENTIALS PRESENTS VOCAL HEALTH AMERICAN CONGRESS OF REHABILITATION Brown E, Evangelist M, Fischer M, Joseph K, Harb J. MEDICINE ANNUAL CONFERENCE 2016 Deviating from the path: a roadmap for navigating Grunwald I, Gherson S, Kim D, Redler B. This is your voice delirium on anxiety in New York Adams J, Denham T, Flanagan S, Fraser F, Kothare S, Langenbahn D, Matsuzawa Y, Minen M, Pagnotta G, AMERICAN PSYCHOLOGICAL ASSOCIATION ANNUAL Palazzo M, Rizzo JR, Schneider E, Sproul M, Waskiewicz M. NATIONAL REHABILITATION ASSOCIATION ANNUAL CONVENTION Concussion and the road to recovery: navigating obstacles, TRAINING CONFERENCE overcoming challenges, and striving for tailored Avitia M, Pagirsky M. Patterns of errors made by children Donroe L, Kvaternik K. Say goodbye to online job search: multi-disciplinary care with SLD versus ADHD new strategies for 2016 Blum S, Voss J. Neuroplasticity of cognitive recovery after AMERICAN SOCIETY OF NEURORADIOLOGY ANNUAL NEURO- AND MIND SCIENCES CONFERENCE acquired brain injury MEETING Starshinina A, Kucukboyaci NE. Brains and bodies: Childs A. MMPI profiles of adults with mild traumatic brain Chung S, Fieremans E, Rath JF, Smith J, Flanagan S, Babb reading bodily movements as signs of brain pathology injury: what’s the norm? JS, Lui YW. Performance of complex tasks of working memory related to brain tissue microstructure: a diffusion Cicerone K, Dawson D, Langenbahn D, Yi A. Cognitive NEW YORK STATE SPEECH HEARING LANGUAGE kurtosis imaging study rehabilitation training ASSOCIATION Brown E, Fischer M, Evangelist M. DELIRIUM prevention, Hada E, Juszczak M, Long C, Smith M, Shagalow S, Bushnik AMERICAN SPEECH HEARING ASSOCIATION ANNUAL identification & intervention by rehab therapists T. A demographic analysis of the barriers and supporters of MEETING enrollment for traumatic brain injury model systems Brown E, Fischer M, Evangelist M. DELIRIUM: prevention, (TBIMS) research NORTH AMERICAN BRAIN INJURY SOCIETY ANNUAL identification, and intervention by rehab therapists CONFERENCE Kim S, Hyn P, Takahaski Hoffecker L, Hu X, Mortera MH, Kazachkov M, Tan T, Ashbaugh A. Pulmonary Lee YSC. Feasibility of group intervention for concussed Heinemann AW. Progress and report of the ACRM complications of aspiration and diagnostic techniques patients in the early stage of recovery Measurement Networking Group Applied Cognition Task Force (MNG ACTF) ASIAN-AMERICAN PSYCHOLOGICAL ASSOCIATION REHABILITATION MEDICINE DEPARTMENT, Mollayeva T, Bushnik T, Colantonio A. Fatigue, impaired CONVENTION GOTHENBURG UNIVERSITY, SWEDEN alertness and daytime sleepiness in traumatic brain injury Lee YSC. Amplifying leadership and building community: Langenbahn D. Evidence-based treatment of hemispatial Pape T, Monti M, Blum S. Leveraging neural mechanisms AAPA Leadership Fellows share their stories neglect and social communication to promote plasticity during neurorehabilitation of patients in states of disorders of consciousness after severe brain ASOCIACION HISPANOAMERICANA DE ACUPUNTURA TECHNOLOGY FOR SUSTAINABLE MANAGEMENT OF injury Siminovich-blok B. Acupuncture for acute traumatic brain DISABILITY injury Raghavan P. Imagining the possible: digital innovation, Pape T, Wasserman E, Sisto S, Janicak P, Cherney L, community, health and rehabilitation medicine Madhavan S, Peters H, Ng K, Raghavan P, Page S. Neuroplasticity: leveraging principles of plasticity to BRAIN INJURY ASSOCIATION OF DELAWARE ANNUAL optimize rehabilitation CONFERENCE WORLD STROKE CONGRESS Connor FB, Stewart T. Welcome home, now what? Raghavan P: Creating an enriched rehabilitation Raghavan P. Leveraging Principles of Plasticity to Optimize environment in a low-resource setting Neurorehabilitation. Upper limb motor recovery CANCER AND CAREERS NATIONAL CONFERENCE ON post-stroke: is there a way forward? WORK & CANCER AMERICAN CONGRESS OF REHABILITATION Blacker D. Vocational rehab: improving your work ability MEDICINE MID-YEAR MEETING APRIL 2016 CRITICAL CARE REHAB CONFERENCE Kingsley KTP. Cognitive rehabilitation of hemispatial neglect Evangelist M, Gartenberg A. A toolkit for developing an occupational therapy program in the ICU Kingsley KTP. Cognitive rehabilitation of impairments of memory

28 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 Locations

1 6 additional Ambulatory Care Center locations in CT 240 East 38th Street, New York, NY Westchester

2 NYU Langone Medical Center Main Campus 550 First Avenue, New York, NY

3 Hospital for Joint Diseases 301 East 17th Street, New York, NY

4 ESTCESTER NYU Langone Levit Medical (two locations)

4a 1300 Avenue P, Brooklyn, NY

4b 1902 86th Street, Brookly n, NY N

5 Columbus Medical 97-85 Queens Boulevard, Queens, NY 2 additional BRN 6 locations in New Jersey Center for Musculoskeletal Care 333 East 38th Street, New York, NY MANATTAN

7 8 Preston Robert Tisch Center for Men’s Health 7 555 Madison Avenue, New York, NY 1 6 2 3 UEENS 8 5 Joan H. Tisch Center for Women’s Health 207 East 84th Street, New York, NY

9 8 additional NYU Lutheran Medical Center BRKLYN locations in 150 55th Street, Brooklyn, NY Long Island 9 11 10 10c 10a NYU Lutheran Rehabilitation (four locations) 10d STATEN 10b 10a ISLAND 4a 4b 5008 7th Avenue, Brooklyn, NY Lorem ipsum 10b 1 additional 9000 Shore Road, East Building, Lower Level location in Brooklyn, NY Staten Island

10c 5610 Second Avenue, Brooklyn, NY X

10d 230 60th Street, Brooklyn, NY Rusk Rehabilitation For more information about our locations, 11 visit, nyulangone.org/locations NYU Langone Medical Center NYU Lutheran Augustana Center for Extended Care and Rehabilitation 5434 2nd Avenue, Brooklyn, NY

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 29 Leadership

Senior Leadership Physician Leadership Nursing Leadership

Steven R. Flanagan, MD Jung Hwan Ahn, MD Kimberly S. Glassman, PhD, RN, NEA-BC Howard A. Rusk Professor Professor of Rehabilitation Medicine Senior Vice President, Patient Care Services of Rehabilitation Medicine Medical Director of Inpatient Chief Nursing Officer Professor of Pathology Rehabilitation Medicine Nancy Rodenhausen, RN Chair of the Department of Rehabilitation Medicine Jeffrey M. Cohen, MD Vice President, Nursing & Patient Care Services Medical Director, Rusk Rehabilitation Professor of Rehabilitation Medicine [email protected] Director, Medically Complex Rehabilitation Ann Vanderberg, RN Vice President, Nursing, David A. Dibner, MPH, FACHE Joan T. Gold, MD Hospital for Joint Diseases Senior Vice President for Professor of Rehabilitation Medicine HJD Hospital Operations and Director, Pediatric Rehabilitation Program Mary Ann Loftus, RN Musculoskeletal Strategic Area Brian Sung-Hoon Im, MD Clinical Director of Nursing Rehabilitation Alex Moroz, MD Assistant Professor Associate Professor of Rehabilitation Medicine of Rehabilitation Medicine Director, Brain Injury Vice Chair for Clinical Affairs Rusk Physicians Ira G. Rashbaum, MD Kate Parkin, PT, DPT, MA Professor of Rehabilitation Medicine Prin Amorapanth, MD, PhD Clinical Assistant Professor Medical Director, Tension Myoneural of Rehabilitation Medicine Syndrome (TMS) and Mind-Body Medicine Craig Antell, DO and Physical Therapy Amit Bansal, DO Senior Director, Therapy Services Wayne Stokes, MD Associate Professor Louis Dizon, MD Jonathan H. Whiteson, MD of Rehabilitation Medicine Jason Fritzhand, MD Assistant Professor Director, Sports Medicine Rehabilitation of Rehabilitation Medicine Jason Freeman, DO Renat Sukhov, MD Vice Chair of Clinical Operations Heidi Fusco, MD Associate Professor of Rehabilitation Medicine Parul Jajoo, DO Associate Medical Director, Pediatric Arthur Jimenez, MD Rehabilitation Service Robert Kaylakov, MD Charles Kim, MD Dallas Kingsbury, MD Gavriil Ilizarov, DO

30 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 Valery Lanyi, MD Mary R. Reilly, MS, CCC-SLP Wei Angela Liu, MD Clinical and Site Leadership Clinical Director, Speech Language Pathology Vladimir Onefater, MD Vincent Cavallaro, PT Rhonda Reininger, MA, OTR Nanwai A. Pak, MD Vice President of Neurology and Director, Rehabilitation Compliance Rehabilitation, NYU Lutheran Salvador E. Portugal, DO Joseph Ricker, PhD, ABPP John R. Corcoran, DPT Sofiya Prilik, MD Professor of Rehabilitation Clinical Assistant Professor Medicine and Psychiatry Kimberly Ann Sackheim, DO of Rehabilitation Medicine Director, Rusk Psychology Naheed A. Van de Walle, MD Site Director, Tisch Hospital Nicole Sasson, MD Ora Ezrachi, PhD Clinical Associate Professor Clinical Assistant Professor of Rehabilitation Medicine of Rehabilitation Medicine Director of Rehabilitation Medicine, Research Leadership Director, Outcomes Management Veteran Affairs-New York Tamara Bushnik, PhD, FACRM Safia Khan, MS, MPA Harbor Healthcare System Associate Professor Divisional Administrator Angela M. Stolfi, DPT of Rehabilitation Medicine Owen Kieran, MD Clinical Instructor Director, Inter-Hospital Research Clinical Director, Physical Therapy and Knowledge Translation Clinical Professor of Rehabilitation Medicine Site Director for Ambulatory Services Preeti Raghavan, MD Director of Rehabilitation Medicine, Maria Cristina Tafurt, MA, OTR/L, ABD Bellevue Hospital Center Assistant Professor Clinical Assistant Professor of Rehabilitation Medicine Robert J. Lindsey, MA, CRC, LMHC of Rehabilitation Medicine Vice Chair of Research Director, Vocational Rehabilitation Site Director, Hospital for Joint Diseases John-Ross Rizzo, MD Debbie Newman, MA, ORT/L Monica Tietsworth Assistant Professor Department Administrator of Rehabilitation Medicine Site Administrator, Center for Musculoskeletal Care Director, Visuomotor Integration Steve F. Vanlew, MS, OTR/L Laboratory (VMIL) Dina L. Pagnotta, MPT, MPH Clinical Director, Director, Technology Translation Director of Strategic Initiatives Occupational Therapy in Medicine Laboratory (TTML)

RUSK REHABILITATION 2016 / NYU LANGONE MEDICAL CENTER 31 Leadership

New York University

William R. Berkley Andrew Hamilton, PhD Robert Berne, MBA, PhD Chair, Board of Trustees President Executive Vice President for Health

NYU Langone Medical Center

Kenneth G. Langone Michael T. Burke Joseph Lhota Chair, Board of Trustees Senior Vice President and Senior Vice President and Vice Dean, Corporate Chief Financial Officer Vice Dean, Chief of Staff Robert I. Grossman, MD Saul J. Farber Dean and Richard Donoghue Vicki Match Suna, AIA Chief Executive Officer Senior Vice President Senior Vice President and Vice Dean for Strategy, Planning, for Real Estate Development and Facilities Steven B. Abramson, MD and Business Development Senior Vice President and Nader Mherabi Vice Dean for Education, Faculty, Annette Johnson, JD, PhD Senior Vice President and Vice Dean, and Academic Affairs Senior Vice President and Vice Dean, Chief Information Officer General Counsel Dafna Bar-Sagi, PhD Robert A. Press, MD, PhD Senior Vice President and Grace Y. Ko Senior Vice President and Vice Dean, Vice Dean for Science, Chief Scientific Officer Senior Vice President for Chief of Hospital Operations Development and Alumni Affairs Andrew W. Brotman, MD Nancy Sanchez Senior Vice President and Kathy Lewis Senior Vice President and Vice Dean Vice Dean for Clinical Affairs and Strategy, Senior Vice President for for Human Resources and Organizational Chief Clinical Officer Communications and Marketing Development and Learning

NYU Langone By the Numbers*

1,519 100 145,907 68,602 3,850,000 9,649 Beds Operating Emergency Patient Outpatient Births Rooms Room Visits Discharges Faculty Practice Visits

3,584 4,899 574 80 233 397 1,472 Physicians Nurses MD Candidates MD/PhD PhD Candidates Postdoctoral Residents and Candidates Fellows Fellows

4,381 550,500 $334M $328M Original Square Feet of NIH Funding Total Grant Research Research Space Revenue Papers** *Numbers represent FY16 (Sept 2015–Aug 2016) and include NYU Lutheran **Calendar year 2015

32 NYU LANGONE MEDICAL CENTER / RUSK REHABILITATION 2016 Contents

1 MESSAGE FROM THE CHAIR

2 FACTS & FIGURES

4 NEW & NOTEWORTHY

8 TRANSLATIONAL CLINICAL CARE 9 Rehabilitation’s Role in Value Based Medicine 12 Novel Treatment for Post-Stroke Muscle Stiffness 14 Rehabilitation Following Groundbreaking Face Transplant 16 Neuromodulation to Treat Shoulder Pain 18 Early Mobilization in the PICU 20 Brain Injury Research 23 Complex Case: NSTEMI Patient

24 ACADEMIC ACTIVITIES

29 LOCATIONS

30 LEADERSHIP

Produced by the Office of Communications and Marketing, NYU Langone Medical Center Writer: Robert Fojut Design: Ideas On Purpose, www.ideasonpurpose.com Photography: Maria Aufmuth/TED; Karsten Moran Printing: Allied Printing Services, Inc.

On the cover: Micro image of muscle fibers 2016 / YEAR IN REVIEW

Rusk Rehabilitation

TOP 10 37% ADVANCING IN U.S. NEWS & INCREASE IN VALUE BASED WORLD REPORT OUTPATIENT VISITS MEDICINE

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