Spring 2012 Vol. 3, No. 1

Groundbreaking Arm Amputation Research >>Page 6

ALSO INSIDE:

Preventing Second Stroke >>Page 3

New Interventional Spine Center >>Page 4

An innovative collaboration is connecting basic, clinical and translational research to accelerate

the exploration of neuroplasticity—and increase our ability to harness the brain’s amazing

capacity to heal itself.

MedStar NRH and GUMC Join Forces to Unlock the Mystery of Neuroplasticity

The new Center for the Study of Brain Plasticity and Recovery is a partnership between MedStar National Rehabilitation Hospital (MedStar NRH) and Georgetown University Medical Center (GUMC). It brings together GUMC’s highly regarded basic neuroscience research initiatives and MedStar NRH’s strong clinical and translational stroke rehabilitation research in a continuum of investigative activity.

“We believe the center will spark collegial relationships between scientists and a more integrated approach to research,” says Edward Healton, MD, director of MedStar NRH Research Center and chair of MedStar Georgetown University Hospital’s departments of Neurology and Rehabilitation Medicine. “We are creating a platform for research that has the potential to help us make a huge leap in our understanding of brain recovery.”

Neuroplasticity and Brain Development

What basic researchers are learning in the laboratory and in animal studies about the developing brain can inform rehabilitation practice for stroke and other types of brain injury. And what clinical researchers are learning about how a damaged brain recovers function can open doors to understanding the cellular mechanisms of neuroplasticity.

“We’ve known for some time that the brain isn’t hardwired,” says Alexander Dromerick, MD, co-director of the new center, and director of MedStar NRH’s Neuroscience Research Center. “The brain is plastic and

malleable. It has some ability to create new pathways for neural communication and rearrange existing ones throughout life, adapting through experience.

“We have also learned that the biologic activity in recovery is much like the neurobiology that exists in the developing brain. As we grow older, the mechanism becomes vestigial and lies dormant. We need to determine how to turn it back on later in life because we think it can help the brain heal after damage,” he adds.

Focusing on Stroke

Elissa L. Newport, PhD, who joined the GUMC faculty in June, serves as co-director of the Center for the Study of Brain Plasticity and Recovery. She previously served as the George Eastman Professor for Brain & Cognitive Sciences and Linguistics at the University of Rochester. “Dr. Newport’s groundbreaking research in speech development and MedStar NRH’s motor recovery research are perfect compliments to one another,” says Dr. Healton.

The center will focus its research agenda on stroke. But Dr. Dromerick says, “What we learn about neuro-recovery in stroke is applicable to patients with any type of brain injury.”

Continued on page 2.

2 MedStar National Rehabilitation Network

The MedStar NRH clinical stroke program is among the nation’s largest, treating more than 600 patients each year. “However, in essence, MedStar NRH is a giant neurologic hospital, with clinical programs for all aspects of neurological injury from stroke and spinal cord injury to traumatic brain injury and cerebral palsy,” he adds.

While other centers in the country have collaborative neuroscience programs, this partnership is unique, Dr. Dromerick notes. “We already have strong ties to Georgetown; attending physicians at MedStar NRH are members of the Georgetown Department of Rehabilitation Medicine. Both Dr. Healton and I are faculty members and divide our time between the two institutions. We have the strengths of two well established and nationally respected research programs, and the

strong support of the MedStar Health system. Through MedStar Health, we have access to the resources of its nine acute care hospitals, and that is a real boon to our clinical research aspirations. I think the stars are aligned to make all of this happen now.”

Crossing Arbitrary Lines in Research

The center will be fertile ground for important “cross talk” between scientists, Dr. Dromerick adds. “There have been

barriers to communication between basic, clinical and translational researchers. We speak in different terms, and have different perspectives. But when we establish communication as a priority, the gap between the laboratory and the patient experience can be bridged.”

The center has already established this critical cross communication. “Dr. Peter Turkeltaub, who is an Assistant Professor of Neurology at Georgetown, is spending time at MedStar NRH to study aphasia. He is both a PhD in neurosciences and a physician whose lab is devoted to developing new treatments for language disorders,” Dr. Dromerick says.

Dr. Ted Supalla will also be working in collaboration with MedStar NRH researchers. His groundbreaking work on the development of sign language is helping to increase our understanding of how language forms, and this knowledge may one day be used to improve methods to recover speech after stroke.

The center is also recruiting additional research staff with “a keen interest in the model we’re promoting,” says Dr. Healton.

Building on a Solid Research Foundation

Studies underway at MedStar NRH are already bearing fruit. “We are participating in a large multi-center study called ICARE— Interdisciplinary Comprehensive Arm Rehabilitation Evaluation,” says Dr. Dromerick. This clinical trial is testing the Accelerated Skill Acquisition Program (ASAP)—an intensive therapy that may prove to be a more effective than traditional therapy for stroke patients suffering weakness in one arm.

“In this study we are looking at anatomic imaging to determine which patients—and what lesions—respond to each therapeutic technique. Drilling down further, we may be able to better understand the underlying mechanisms of recovery.”

In 2010, MedStar NRH opened a Transcranial Magnetic Stimulation lab (TMS) to study the use of neuro-navigation and magnetic stimulation to enhance stroke recovery. A computer tool, called BrainSight, can identify the precise

locations of the brain involved in recovering arm movement after a debilitating stroke.

“Dr. Michelle Harris-Love is trying to determine whether mild stimulation to that area of the brain could help enhance recovery. This research is helping us identify changes in the brain that occur during motor recovery. It may help us zero in on those techniques that result in the most productive change.”

Next Generation of Stroke Recovery

“Today stroke rehabilitation may include constraint induced movement therapy,” Dr. Healton explains. “We’re forcing the affected limb to perform a task through repetitive use. We have seen that the other parts of the brain take over the role of the damaged area that once controlled that movement, which demonstrates the plasticity of the brain. We hope the new collaboration will help us identify more sophisticated strategies to boost this neuroplasticity.”

“I think it’s plausible that we will employ multiple strategies, such as combining a biologic intervention with intensive training for maximum recovery,” Dr. Dromerick adds. But that will require connecting the dots between cell cultures, animal studies and clinical research, and will depend on creating an environment that nurtures idea sharing and collaboration.

Research of this kind takes funding and GUMC and MedStar NRH are working together to raise the dollars needed to support the center. “It’s the first time this type of collaborative fund-raising effort has been launched,” Dr. Healton explains. “We want to be able to have visiting professorships and a lecture series and to build a strong staff of researchers, as well.

“Our vision is to create a fertile environment for research with the potential to improve recovery for patients who have suffered stroke. But we know what we do will have an impact on future treatment of other brain diseases, such as Alzheimer’s and Parkinson’s disease,” he adds. “The potential is enormous.”

Continued from page 1

MedStar NRH and GUMC Join Forces to Unlock the Mystery of Neuroplasticity

“What we learn about neuro-recovery in stroke is applicable to patients with any type of brain injury.” — Alexander Dromerick, MD

Edward Healton, MD, director of MedStar NRH Research Center and chair of MedStar Georgetown University Hospital’s depart-ments of Neurology and Rehabilitation Medicine

Alexander Dromerick, MD, co-director of the Center for the Study of Brain Plasticity and Recovery, and director of MedStar NRH’s Neurosci-ence Research Center

the high risk behaviors that contributed to their initial stroke. Their limited English language skills make access to resources more difficult. Cognitive deficits and the financial loss of an illness is stressful for everyone as well,” says Oliff.

In January, an Advisory Task Force of MedStar NRH Team Members, board members and former MedStar patients, as well as representatives from the DC Department of Health, took up the charge and developed an action plan.

“The plan’s priority was the development of a pilot monthly Spanish-language psycho-educational support group, which launched in April,” says Carol Bartlett, manager of care coordination.

“We’ve gathered together a team of Spanish speakers from among MedStar NRH Team Members to provide stroke education for the group—everything from stroke prevention to exercise and stress reduction. We’ve also provided accessible transportation to the hospital for those who need it,” says Oliff.

The program includes measurement of participant learning to evaluate the process. In addition, a Spanish-language web page is under development, and stroke educational materials are being translated into Spanish, including the popular NRH Press book, Managing Stroke: A Guide to Living Well with Stroke.

MedStar NRH is also seeking partner organizations within Wards 1 and 4 of the District of Columbia, which are home to a large proportion of the city’s Hispanic population. “Ultimately, we hope to establish a neighborhood-based, psycho-educational support group, as well,” Bartlett adds.

Preventing Secondary StrokeAn estimated 25 percent of people who suffer a first stroke will have a recurrent

stroke. Two MedStar National Rehabilitation Network initiatives are aimed at

decreasing that statistic—and reducing disparities in care among African Americans

and Hispanics.

New Dimensions • Spring 2012 3

Testing Patient Navigation

In 2008, MedStar NRH began a unique project that for the first time in the U.S. examines the value of patient navigation in stroke recovery. The study, Protect DC, is a collaborative effort between MedStar NRH, MedStar Georgetown University Hospital, Howard University Hospital, Providence Hospital and MedStar Washington Hospital Center.

Protect DC— Preventing Recurrence of Thromboembolic Events through Coordinated Treatment in the District of Columbia—is a randomized-control study comparing the standard of care following a stroke with more intensive intervention by navigators who help patients adopt healthy habits once they return home.

Now four years out, Protect DC has completed patient recruitment, enrolling 230 participants from among the high-risk population of urban African Americans and Hispanics in the District of Columbia.

“We know that risk of a second vascular incident increases dramatically in people who lack access to prevention programs, have limited awareness of stroke risk factors and warning signs, and don’t utilize secondary prevention therapies,” explains Principal Investigator Alexander Dromerick, MD, director of MedStar NRH’s Neuroscience Research Center.

“While the concept of patient navigation as a preventive measure against second stroke makes sense, there is no proof that stands up in an evidence-based health care system. This is the first clinical trial to test the model with stroke patients,” he adds.

Protect DC has adopted a traditional navigator model that features culturally sensitive lay workers who receive intense stroke prevention education. “We have recruited navigators who are themselves a part of the target community. For a year post discharge, navigators provide patient education through home visits

and regular phone calls to discuss patients’ compliance to medications, diet and exercise. They also provide help finding community resources when patients require it,” says Deeonna Farr, MPH, CHES, project coordinator.

Both the control group and the navigator group receive complete outcome assessments at three months and one year. The assessments include a physical exam and an evaluation of cognitive function, ability to perform activities of daily living and evaluation of behaviors such as not smoking, exercising and eating a healthy diet.

Researchers are now evaluating outcome data and will release results in December 2012. They will also present the results at the February 2013 stroke conference of the National Institute of Neurological Disorders and Stroke (NINDS).

“With an aging population and an anticipated dramatic increase in stroke incidence in the next decade, results will help us structure health care delivery to reduce mortality and morbidity among this high risk population,” Farr adds.

Targeting Hispanic Patients, Families

In April, MedStar NRH began a first-ever Spanish-language stroke support group for patients, their families and caregivers—targeting a population who often has limited access to vital information about prevention of secondary stroke.

The community-based health education initiative was jump-started by MedStar NRH Speech Language Pathologist Ilana F. Oliff, MA, CCC-SLP, who observed that her Spanish-speaking stroke patients were struggling to find resources and support after discharge from the hospital.

“I heard time and time again the frustration of patients who were feeling isolated following a stroke. They were living with family who hadn’t been prepared to be caregivers and continuing

The newly developed MedStar NRH

Network Interventional Spine Center

is now providing comprehensive

evaluation, precision diagnostics, and

non-surgical management for patients

with chronic neck and back pain.

MedStar NRH Network Interventional Spine Center Focused on Non-Surgical Treatment for Chronic Pain

4 MedStar National Rehabilitation Network

The center takes a holistic approach to diagnosis and treatment, understanding that more often than not, chronic pain is the result of multiple issues. “While it’s true that a third of all adults will suffer some disc degeneration by 30, aging discs are only one source of chronic pain,” explains Arthur Jason De Luigi, DO, director of the Spine Center. “We know that back and neck pain can be the result of everything from arthritis and sports injury—to poor posture. In most patients, a combination of problems lead to chronic and unremitting pain that affects the quality of their lives,” he adds.

“That’s why we focus on understanding all aspects of our patients’ day-to-day lives, as well as their medical histories. Every patient receives a thorough evaluation so that we can pinpoint the causes of pain. We know that the more specific our diagnosis, the more effective the treatment.”

Dr. De Luigi is board certified in Physical Medicine and Rehabilitation, with specialization in sports medicine, musculoskeletal disorders and the biomechanics of spine injury. He leads the Spine Center’s multidisciplinary care

team that includes occupational and physical therapists, who have special training and experience working with patients who have spinal disorders.

The team utilizes the most current diagnostic and therapeutic modalities, and focuses on restoring patients’ physical, functional and emotional well-being.

“We perform dynamic ultrasound to capture images while patients are in motion to help visualize muscle, tendon, or nerve inflammation. And we employ electromyography to record electrical activity in muscles, as well as nerve conduction studies to determine if a nerve is functioning normally,” says Dr. De Luigi. “These tools and patients’ medical and social histories help us develop the most effective individualized care plan.

“As rehabilitation medical specialists, our focus is on improving patients’ daily functioning,” he explains. “We use a variety of both complementary and

traditional medical interventions alone or in combination. Our approach is to utilize the least aggressive intervention that will provide patients the most relief.”

MedStar NRH Network Interventional Spine Center In Brief

Conditions Treated

• Back and neck pain• Spinal cord spasticity • Cervical dystonia• Spinal stenosis• Disc herniation sciatica • Neuropathy• Osteoarthritis and rheumatoid arthritis• Sports injury-related spinal pain

Treatment Options

• Ultrasound-guided needle injections of anesthetics and anti-inflammatory drugs

• Cervical and lumbar epidural injections of anti-inflammatory drugs

• Nerve blocks —X-ray imaging-guided injection of anesthetic or anti-inflammatory drugs targeting nerves

• Platelet-Rich Plasma (PRP) treatments for soft tissue injuries

• Cervical, thoracic and lumbar joint injections for pain that radiates

• Botox toxin injections to relax muscle spasms

• Pain medications (NSAIDs, muscle relaxants, nerve pain drugs)

• Osteopathic manipulation• Exercise prescriptions• Physical and occupational therapy

For information, or to refer a patient, call 202-877-1621.

The ultrasound (above) shows joint cysts, known as Tarlov cysts, arising from the spine that correspond to cysts seen on the MRI scan (right). With the use of dynamic ultrasound images, physicians can safely drain the cysts.

Arthur Jason De Luigi, DO, Director, Sports Medicine,MedStar NRH Network• Fellowship in Interventional Spine and Sports Medicine,

University of Utah• Residency in PM&R at Walter Reed Army Medical Center • Specializes in sports medicine, musculoskeletal ultrasound,

and fluoroscopic guided interventional spine and pain procedures

Leadership

New Dimensions • Spring 2012 5

Seven physicians

from MedStar

National

Rehabilitation

Network

appeared in the

recent listing of

Washingtonian

magazine’s Top

Doctors. *

MedStar NRH “Top Docs” Recognized• Pamela Ballard, MD, Medical Director of the

MedStar NRH Inpatient Spinal Cord Program and chair, Credentials and Professional Standards Committee at MedStar NRH; specializing in spasticity management

• Robert Bunning, MD, MedStar NRH Network’s associate medical director for inpatient physiatry, and director of the Arthritis Prtogram

• Sally Evans, MD, first director of the National Center for Children’s Rehabilitation (NCCR) at MedStar NRH, and chief of division of PM&R at Children’s National Medical Center

• Kathleen Fink, MD, board certified in PM&R and pain management; practicing in the MedStar NRH Outpatient Network

• David Gross, MD, medical director of theSleep Center at MedStar National Rehabilitation Hospital, specializing in pulmonology

• John Toerge, DO, past medical director of MedStar NRH, specializing in spinal cord injury and sports injuries; practicing in the MedStar NRH Outpatient Network

• Curtis Whitehair, MD, MedStar NRH Network’s associate medical director for regional physiatry program, director of the MedStar NRH/MedStar Georgetown University Hospital residency program, director of Cancer Rehabilitation

* The “Top Doc” on the magazine cover is Alexandros Powers, MD, who is joining MedStar Georgetown University Hospital as a staff neurosurgeon, and who will also be working at MedStar Montgomery Medical Center.

Technical Training Exchange with Chinese Rehab Hospital: MedStar NRH will provide rehabilitation medicine training for physicians and therapists from the Anshan Rehabilitation Hospital in Lianoning, China. MedStar NRH will provide clinical training in brain injury and stroke rehabilitation over the course of several months.

A member of the MedStar NRH medical staff will then travel to China to provide instruction and guidance after the Chinese team returns to Anshan Rehabilitation Hospital. MedStar NRH staff will also continue consultation on request after the exchange program has ended.

New Medical Staff Named: Scott Lepre, MD, has joined the MedStar NRH medical staff as director of inpatient rehabilitation medicine

programs at MedStar Union Memorial Hospital in Baltimore.

Before joining the MedStar NRH staff, Dr. Lepre was a clinical associate in the department of Physical Medicine and Rehabilitation at Johns Hopkins University

Justin Carter, MS

News BriefsIn RemembranceJustin Carter, MS, administrative director of the Christoph Ruesch Research Center at MedStar NRH, died suddenly this past February. He was a dedicated member of Team NRH, and his work administering the hospital’s research endeavors was critical to advancing the future of rehabilitation research.

At his memorial service, John Rockwood, MedStar NRH president, called Justin curious, intelligent and compassionate. “Of Justin’s most special gifts, the one on the top of my list, was his ability to connect to people in meaningful ways,” he told participants. “Justin embodied the culture that makes MedStar NRH such a special place, and his legacy serves as a blueprint for

all of us to continue a journey that he cared so deeply about.”

School of Medicine and provided inpatient consultations at the Johns Hopkins Hospital. He obtained his medical degree from the Georgetown University School of Medicine in 2004 and completed his residency in Physical Medicine and Rehabilitation at the Hospital of the University of Pennsylvania.

MedStar NRH Establishes New PM&R Fellowships: Zachary Gustin, MD, has received the first-ever MedStar NRH Sports Medicine fellowship. Dr. Guston

received his medical degree from Georgetown University and completed his residency in PM&R at Stanford University. Two additional fellowships in spinal cord injury and interventional pain are also under development at MedStar NRH.

Mindy Bixby, DO, (left) is the current brain injury fellow, and in 2011,

Thomas Chang, MD, (right) was awarded the first MedStar NRH pediatric rehabilitation fellowship.

6 MedStar National Rehabilitation Network

Update from the Christoph Ruesch Research Center

Improving Arm Amputee Training, Increasing Prostheses Use In three clinical trials under the direction of Principal Investigator Alexander Dromerick, MD, director of the Neuroscience Research Center, researchers are evaluating success or failure of current training methods, and hoping to unravel the neurophysiologic mechanisms that are key to successful prostheses use.

“What we are learning through our clinical practice and through research is already impacting care, not just for these patients, but for patients with brain injury and other illnesses, as well,” Holley says.

Study 1: Measuring Success or Failure: Testing Training Protocols— and Evaluation Tools

While the ultimate goal of therapy is improved day-to-day function for people with upper extremity amputation, there is little data proving the value of one training method over another—or of the standard tools used to evaluate treatment. And as prosthetic design has become more sophisticated, evaluation of training methods hasn’t kept pace.

MedStar NRH researchers are conducting two sub-studies as precursors to a larger clinical trial, which will focus on developing more effective interventions for people with upper arm extremity amputation.

In one sub-study, “we are asking chronic prosthesis users to perform a series of tasks in the lab and evaluating their performance,” Holley explains. “Then an hour later, we retest them using the same evaluation tool. With consistency of all factors, results of both assessments should be the same,” he says. “If results vary, that may mean we aren’t using an effective tool to measure performance.”

The second sub-study is examining commonly utilized training methods in the use of prosthetic arms. “We are providing 20-hours of conventional therapy to a group of long-time prostheses-users, and measuring performance before and after training,” Holley adds.

More than 50,000 amputations occur in the U.S. every year, with upper extremity amputation accounting for nearly 30 percent of this annual total.

An estimated 100,000 Americans are living with amputation of the hand or arm—the result of trauma, vascular disease, cancer or congenital limb abnormalities. But fewer than 50 percent have ever received prosthesis fitting or training—and of those who have a prosthetic arm, many don’t use it routinely.

“Very few people that use upper extremity prosthetics use them naturally, on a subconscious level, much as a normal limb would be used,” says Rahsaan Holley, MedStar NRH Research Occupational Therapist, who leads the hospital’s unique specialty clinic for arm amputees, one of just a few nationwide.

“There aren’t many facilities that have focused so much attention on patients with upper extremity amputation. And we’re attracting patients from all over the world,” he explains. The program also boasts a robust research program, which is earning an international reputation for excellence.

“We are gaining a new understanding of how the brain functions to initiate an action, such as reaching for an object and grasping it in your hand. We are hoping to replicate that action to the use of a prosthetic arm,” says Holley.

“As we understand more about how the brain works, we can design better prostheses, create more effective training in the use of artificial arms—and even improve surgical techniques that will enhance patients’ ability to operate prostheses following amputation.”

Rahsaan Holley, MS, OTR/L, MedStar NRH Research Occupational Therapist, leads a unique specialty clinic for arm amputees, one of just a few nationwide, and conducts groundbreaking arm amputee research.

“There aren’t many facilities that have focused so much attention on patients with upper extremity amputations.” — Rahsaan Holley, MS, OTR/L

Patient RecruitmentThe Arm Amputee Research Program continues to recruit users of prosthetic arms to participate in its clinical studies. Individuals with arm amputations who currently own and utilize prostheses are eligible to participate.

For more information, please contact: Rahsaan J. Holley, MS, OTR/L Research Occupational Therapist 202-877-1875

This information may help clarify effective training methods—and reinforce the value of training even years after the amputation.

Study 2: Lab Performance vs. Real Life

In another study, researchers are evaluating the relationship between laboratory measures of prosthesis use with subjective and objective measures of every day prosthesis use.

“We are recruiting long-time prostheses users and assessing how they use their artificial arm in the laboratory. We are using standard tools to measure their gross and fine motor performance, trunk compensation, and grip motor control,” Holley explains. “Patients also complete questionnaires to ‘self-report’ their use of their prostheses.

“Then during a 48-hour period while patients go about their daily lives, an innovative sensor collects data about their actual use.”

Participants wear the sensor, called an accelerometer, on both wrists like a watch. It detects and captures data about functional movement. “The data will help us determine if patients are really using the prostheses to help them function day-to-day, and how accurate our evaluation tools are in measuring performance.”

Study 3: The Neuro-Physiological Mechanisms of Success

We know that through rehabilitation, adaptive plasticity occurs in the brain—even in patients with relatively mild motor impairments. In stroke, for example, a phenomenon known as inter-hemispheric inhibition (IHI) can become unbalanced—stronger on one side than the other—but this seems to improve after rehabilitative training.

Previous research has shown that after unilateral below-elbow arm amputation, the motor cortex of the brain that controls movement of that arm is affected. As the brain tries to reorganize after this event, nearby areas of the brain expand into the brain areas that previously represented the amputated muscles—an action that may result in unbalanced IHI. Some evidence indicates that excessive IHI in the unaffected hemisphere of the

brain could negatively affect motor performance of the intact arm.

In this study, researchers are “mapping” these mechanisms by using Transcranial Magnetic Stimulation (TMS) and an innovative neuronavigation computer system called BrainSight. [See page 2 for more on TMS.]

TMS is a safe, non-invasive method of stimulating the brain with a brief magnetic field, which can induce motor responses. An anatomical MRI of the brain is loaded into the BrainSight’s computer software and reflective markers are placed on the participant’s forehead. As the participant performs reaching movements, BrainSight produces real-time images to confirm the locations of the brain affected by the stimulus.

These images should help untangle the interaction between the affected and unaffected hemispheres after amputation—information that will improve our understanding of how people acquire the motor skill necessary to use their prostheses effectively, and that could reveal some possible unexpected benefits of gaining these skills. This may ultimately lead to more emphasis on prosthetic training in the future, development of better training methods, and improved prosthesis design.

New Dimensions • Spring 2012 7

MedStar NRH researchers are using the IM2 robotic arm to evaluate speed and accuracy of reaching in study partici-pants’ prosthetic arms (above), and “mapping” interaction between affected and unaffected hemispheres of the brain after amputation using TMS and neuronavigation (below).

MedStar National Rehabilitation Hospital 102 Irving Street NWWashington, D.C. 20010-2949202-877-4NRHmedstarnrh.org

Thomas J. Collamore, Chairman, Board of Directors John D. Rockwood, PresidentMichael Yochelson, MD, Vice President and Chief Medical Officer Kenneth A. Samet, FACHE, President and CEO, MedStar Health

New Dimensions is published by Marketing & Strategic DevelopmentRobert S. Hartmann, Vice President Emily R. Turk, Writer-Editor

MedStar NRH is accredited by:

CARF, the Commission on Accreditation of Rehabilitation Facilities

The Joint Commision

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MedStar NRH Perspectives Michael Yochelson, MD, MBA, VP of Medical Affairs and Chief Medical Officer

Earlier this year, we underwent a significant branding initiative when we changed our name from National

Rehabilitation Hospital to MedStar National Rehabilitation Network. This rebranding reinforces the

fact that we are more than just a hospital, but a network of care providing inpatient, day treatment and

outpatient services at over 30 locations in Washington, DC, Maryland and Northern Virginia.

and medical center associated with Georgetown University. The system also includes a number of other healthcare service components from home care to research.

Being part of a large health care system has many advantages. Through the years, we have developed partnerships with other MedStar Health hospitals that have greatly enhanced our clinical services, educational programs and research.

Today we lead a cooperative PM&R residency program with MedStar

Georgetown University Hospital. We have productive research partnerships within MedStar Health that blend basic research with translational studies in the clinical setting; over the years, this has greatly enhanced rehabilitation practice nationally and internationally. And relationships with acute care facilities allow us to jumpstart recovery from the onset of injury or illness.

In the future, we will build on this concept of care delivery as MedStar Health continues to nurture cooperative programs among its members and with organizations throughout the region.

It also represents our long-standing relationship with MedStar Health, the Baltimore-Washington, DC, region’s largest healthcare system with over 6,000 physicians and 100 community locations.

MedStar Health’s nine member hospitals stretch from northern Baltimore County to Southern Maryland. It includes nationally respected acute care facilities such as MedStar Washington Hospital Center, the mid-Atlantic region’s largest tertiary hospital and trauma center; and MedStar Georgetown University Hospital, an internationally respected academic

Connect to MedStar NRH at medstarnrh.org.

quick Referral to MedStar NRH Expertise Inpatient care: 202-877-1152 • Day treatment: 202-877-1945 • Outpatient services: 202-877-1621

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PAIDLUTH/TIM, MD

PERMIT NO. 550