Alex Moroz, M.D.

Mobile Health: Exploring Attitudes Among Physical Medicine and Rehabilitation Physicians Toward this Emerging Element of Health Delivery
Elwood, Douglas; Diamond, Matthew C; Heckman, Jeffrey; Bonder, Jaclyn H; Beltran, Jacqueline E; Moroz, Alex; Yip, Jeffrey
2011 Jul;3(7):678-680, PM&R
— id: 135578, year: 2011, vol: 3, page: 678, stat: Journal Article,

Medical aspects of disability : a handbook for the rehabilitation professional
Flanagan, Steven R; Zaretsky, Herbert H; Moroz, Alex
New York : Springer, c2011,
Part I: An introduction to key topics and issues -- Introduction / Kate Parkin, John R. Corcoran, and Tara Denham --Part II: Disabling conditions and disorders -- Disabling conditions seen in AIDS and HIV infection / Jennifer Sayanlar, Fran R. Wallach, and Adam B. Stein -- Alzheimer's disease / Barry Reisberg ... [et al.] -- Traumatic brain injury / Brian Im ... [et al.] -- Rehabilitation in burns / Alan W. Young, W. Scott Dewey, and Steven E. Wolf -- The role of rehabilitation in cancer patients / Reema Batra and Parul Jajoo -- Cardiovascular disorders / Ana Mola, Jonathan H. Whiteson, and Mariano J. Rey -- Chronic pain syndromes / Christopher G. Gharibo and M. Fahad Khan -- Diabetes mellitus / David G. Marrero -- Epilepsy / Robert T. Fraser, John W. Miller, and Erica K. Johnson -- Speech, language, hearing, and swallowing disorders / Nancy Eng and Patricia Kerman Lerner -- Hematological disorders / Bruce G. Raphael -- Developmental disabilities / Richard J. Morris and Yvonne P. Morris -- Neuromuscular disorders / Jeffrey M. Cohen, Marissa Cohler, and Ludmilla Bronfin -- Musculoskeletal disorders / Joseph E. Herrera, Jung Woo Ma, and Pete-Gaye Nation -- Pediatric disorders: cerebral palsy and spina bifida / Joan T. Gold and David Salsberg -- Geriatric rehabilitation / Monwara Hassan, Adrian Cristian, and Teina Daley -- Introduction to peripheral vascular disorders / Glenn R. Jacobowitz -- Limb deficiency / Jeffrey M. Cohen and Joan E. Edelstein -- Organ transplantation and rehabilitation / Jeffrey M. Cohen, Mark Young, and Bryan O'Young -- Psychiatric disabilities / Marina Kukla and Gary R. Bond -- Pulmonary disorders / Frederick A. Bevelaqua and Susan Garritan -- Chronic kidney disease / Kotresha Neelakantappa and Jerome Lowenstein -- Rheumatic diseases / Sicy H. Lee and Steven B. Abramson -- Spinal cord injury / Jung Ahn and Jeffrey Berliner -- Stroke / Michal Eisenberg and Ira Rashbaum -- Visual impairments / Bruce P. Rosenthal and Roy Gordon Cole --Part III: Special topics -- Complementary and alternative medicine / Alex Moroz and Robert A. Schulman -- Rehabilitation nursing: educating patients toward independence / Jeanne Dzurenko -- Social work in physical medicine and rehabilitation / Patrick Inniss -- The computer revolution, disability, and assistive technology / Mark A. Young and Bryan O'Young -- Trends in medical rehabilitation delivery and payment systems / Mary C. Ellis and Kristofer J. Hagglund -- Legislation and rehabilitation professionals / Susanne M. Bruyere, Sara A. Van Looy, and Thomas P. Golden -- Accreditation--a quality framework in the consumer-centric era / Brian J. Boon -- Challenges and opportunities for quality in rehabilitation / Dale C. Strasser -- Telerehabilitation: solutions to distant and international care / Andrew J. Haig -- Future directions of rehabilitation research / Tamara Bushnik
— id: 2304, year: 2011, vol: , page: , stat: ,

Complementary and alternative medicine
Moroz, Alex; Schulman, Robert A
Medical aspects of disability : a handbook for the rehabilitation professional New York : Springer, c2011,
— id: 5798, year: 2011, vol: , page: ?, stat: Chapter,

Implementation of Peer Review into a Physical Medicine and Rehabilitation Program and its Effect on Professionalism
Bonder, Jaclyn; Elwood, Douglas; Heckman, Jeffrey; Pantel, Austin; Moroz, Alex
2010 Feb;2(2):117-124, PM&R
OBJECTIVE: To examine the effects of implementing a peer review evaluation system on residents' attitudes and perceptions of professionalism, a core competency of the Accreditation Council for Graduate Medical Education (ACGME), in a Physical Medicine and Rehabilitation (PM&R) program. DESIGN: Four classes of residents were divided prospectively into a control and an intervention group. All residents were asked to complete a survey regarding their attitudes and perceptions on both peer review and professionalism. Only 2 of these classes participated in a newly adopted peer review evaluation system, after which time all participants were again asked to fill out the surveys. SETTING: Residents were from a PM&R residency program at an urban tertiary care medical center. PARTICIPANTS: All residents who completed the entire survey preintervention and postintervention were included. METHODS: The intervention was the introduction of peer review into residents' evaluation assessments. All residents filled out a survey with questions relating to peer review and professionalism before and after this intervention. MAIN OUTCOME MEASUREMENTS: Outcomes include understanding how residents perceive various attributes of professionalism, peer review, and the interconnection of the 2. RESULTS: Data analysis using SPSS was performed using survey scores for 46 residents preintrodution and postintroduction of a peer review evaluation system. Analysis revealed that residents who participated in the peer review process were more likely to agree that certain aspects of daily patient care, behaviors, and concepts were components of professionalism. However, they continued to believe that residents are ultimately not responsible for their colleagues' professionalism and that peer review might be harmful to a residency program. CONCLUSION: This study introduces an interesting dichotomy. Peer review clearly influences resident outlook on professionalism and yet there is a high suspicion regarding its implementation. If appropriately implemented, peer review may be a potent method of enhancing the education of this ACGME requirement
— id: 107938, year: 2010, vol: 2, page: 117, stat: Journal Article,

Assessing patient expectations and concerns in a physical medicine and rehabilitation unit: a real-time snapshot
Elwood, Douglas; Heckman, Jeffrey; Bonder, Jaclyn; Pantel, Austin; Blatz, Daniel; Moroz, Alex; Ben-Roohi, Moshe
2010 Jun;2(6):521-527, PM&R
INTRODUCTION: To evaluate patient expectations, concerns, and satisfaction during physical medicine and rehabilitation (PM&R) inpatient hospitalization. Patients were also asked to comment on what resources might benefit them during their stay. DESIGN: More than 150 PM&R patients were asked to fill out a self-administered survey in a cross-sectional design. Patients receiving care under 5 other specialties (general medicine, obstetrics and gynecology, general surgery, orthopedics, and neurology) also were surveyed to determine whether qualitative differences existed between PM&R and other departments. In all, more than 1100 patients were given surveys to complete. Patients rated how concerned they were with more than 20 elements of their hospitalization, ranging from quality of food to pain management. Questions were divided into 2 sections: retrospectively before hospitalization and during current admission. SETTING: This study was completed in a large tertiary care PM&R facility with an adjoining medical center in an urban area. PARTICIPANTS: Patients were given the option to complete this survey in an anonymous fashion during their hospital stay. All those who did so were included in this analysis. Six different specialties were represented in the final tally, but the emphasis was on the PM&R department. MAIN OUTCOME MEASUREMENTS: The survey itself included more than 20 questions regarding the details of patients' hospital stays and how concerned they were with them. These categories included plans after discharge, duration of hospitalization, pain management, follow-up of medical issues, cost, insurance, and familiarity with diagnosis, physician, and medications. Other outcomes included patient input into what interventions they thought would most benefit them as well as a global satisfaction rating. RESULTS: Data analysis was performed with SPSS. Tukey tests provided comparison information across specialties. The response rate within PM&R was 68% (n = 128), whereas for all specialties combined it was 54% (n = 606). Multiple factors were found to be significant when examining expectations versus actual admission concerns. Most prominently within PM&R, patients indicated that they were less concerned during their admission than they thought they would be about potential duration of hospitalization (P < .001), understanding of diagnosis (P < .04), follow-up of medical issues (P < .01), and plan of care (P < .001), among others. However, patient expectations in other areas did not change or were negatively affected, such as help at home (P < .05), plans for discharge (P < .001), family involvement at home (P < .01), and future pain management at home (P < .05). Furthermore, qualitative comparisons among other specialties demonstrated differences in many areas. CONCLUSION: Results support the idea that the multidisciplinary approach inherent in PM&R positively alters many patient expectations related to outcomes. This has direct relevance to patient satisfaction and outcomes and warrants further investigation. The authors offer some potential interventions for future improvement in this area
— id: 138170, year: 2010, vol: 2, page: 521, stat: Journal Article,

Immediate and follow-up effects of a brief disability curriculum on disability knowledge and attitudes of PM&R residents: a comparison group trial
Moroz, Alex; Gonzalez-Ramos, Gladys; Festinger, Trudy; Langer, Karen; Zefferino, Stephanie; Kalet, Adina
2010 ;32(8):e360-e364, Medical teacher
BACKGROUND: Humanistic attitudes are essential in physicians and therefore supporting them is a key component in graduate medical education (GME). The importance of a physician's attitude toward people with disability is especially relevant within the rehabilitation discipline, as prevailing attitudes and misconceptions can be potential barriers to successful diagnosis and treatment. AIM: This study was designed to examine the relationship between participation in a brief disability sensitivity training and knowledge of disability and attitudes of physical medicine and rehabilitation (PM&R) residents toward people with disability. METHODS: A daylong training for residents consisted of lectures and a panel presentation that covered (1) disability facts, (2) personal stories of people with disabilities, and (3) medical evaluation of disability. The presentations were followed by a simulation experience where resident pairs (one assigned to a wheel chair, the other a 'caretaker') performed various tasks. This was followed by a group discussion of their experience. Three instruments were administered prior to the training: (1) a brief demographic questionnaire, (2) 30 multiple choice questions measuring various aspects of knowledge about disability, and (3) the Scale of Attitudes toward Disabled Persons, Form R (SADP). After the training experience, the knowledge instrument and the SADP were re-administered along with a series of items to measure various aspects of students' satisfaction with the training. The three instruments described were re-administered 3 months post-training. RESULTS: There was significant immediate gain in both the disability knowledge and the attitude scores among trainees as compared to a control group of physiatry residents in standard medical training. Knowledge gains of the disability sensitivity training group did not persist, but attitude toward disability gains remained at the 3 months follow up. CONCLUSION: After a brief curriculum in disability knowledge and sensitivity for PM&R physicians in training, there was a short-term improvement in disability knowledge and an improvement in disability attitudes sustained at 3 months
— id: 111614, year: 2010, vol: 32, page: e360, stat: Journal Article,

Stroke and neurodegenerative disorders: 4. Community integration
Edgley, Steven R; Lew, Henry L; Moroz, Alex; Chae, John; Lombard, Lisa A; Reddy, Cara Camiolo
2009 Mar;1(3 Suppl):S27-S34, PM&R
OBJECTIVE: This self-directed learning module highlights common rehabilitation issues in stroke survivors with chronic impairments with emphasis on community integration. It is part of the study guide on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on management of shoulder pain, management of hypertonia, secondary stroke prevention, vocational reintegration including strategies for return to driving, and treatment of sexual dysfunction following stroke. The goal of this article is to improve the learner's ability to implement community integration strategies after a stroke
— id: 133669, year: 2009, vol: 1, page: S27, stat: Journal Article,

Exploring systems-based practice in a sample of physical medicine and rehabilitation residency programs
Elwood, Douglas; Kirschner, Jonathan S; Moroz, Alex; Berliner, Jeff
2009 Mar;1(3):223-228, PM&R
OBJECTIVE: This study explores physical medicine and rehabilitation (PM&R) residents' attitudes, knowledge, and perception of health care policy in the context of systems-based practice, one of the Accreditation Council for Graduate Medical Education's core competencies for residency training. DESIGN: A cross-sectional, observational design was used via survey administration. These surveys were categorized into 6 different sections: (1) general health care policy; (2) resident awareness of and involvement in policy matters; (3) specific policy pertaining to physical medicine and rehabilitation; (4) rehabilitation alternatives to acute care; (5) documentation; and (6) educational exposure. Residents filled the survey anonymously, noting only their postgraduate year and program name for identification. SETTING: This study was conducted at 3 large PM&R residency programs in Pennsylvania, New Jersey, and New York. PARTICIPANTS: Residents participating in this study totaled 32 from Program A, 26 from Program B, and 18 from Program C. METHODS: Residents at all 3 programs were asked to complete a 34-question survey. In total, 57 surveys were evaluated. The response rates for completing the entire survey for the 3 programs were 81% (26 of 32), 73% (19 of 26), and 67% (12 of 18). The overall response rate was 75%. Not all residents at each program were given surveys to complete. MAIN OUTCOME MEASURES: This study explored resident's attitudes, knowledge, and perception of healthcare policy. Outcomes included understanding how residents feel about the extent of their general policy education, their awareness of current issues and the organizational entities that shape these policies, and whether they should be exposed to these topics within the setting of their training programs. Responses were measured on a 1 (strongly disagree) to 9 (strongly agree) scale. Specific paired t-tests were performed on select questions to further validate the responses. RESULTS: Residents uniformly agree that healthcare policy is an important aspect of medical education and should be taught within their residency programs but do not feel that they currently play an active role in affecting change (8.1 +/- 0.8 vs. 3.4 +/- 1.6, P < .001). They admit to not being aware of how to get involved but would like to delve more into these issues (3.9 +/- 1.5 vs. 7.1 +/- 1.5, P = .01). Pertaining to PM&R-specific policy, residents believe that functional ability trumps diagnosis as the most important determinant for admission to an acute inpatient facility (7.5 +/- 1.2 vs. 5.9 +/- 1.8, P < .001). Although residents see the importance of documentation, they indicate they are not adequately trained in this area (8.2 +/- 0.7 vs. 3.9 +/- 1.1, P = .04). Finally, residents acknowledge they have limited understanding of other rehabilitation delivery options or insurance companies (5.5 +/- 1.2 and 3.5 +/- 1.7). CONCLUSION: Systems-based practice is a core requirement of residency training yet has not been extensively studied. This study suggests that residents find systems-based issues important to their overall education but are not sufficiently or effectively addressed in residency. The healthcare delivery environment including PM&R is rapidly changing. It is imperative that residents are equipped with the knowledge of and ability to adapt to these changes
— id: 111608, year: 2009, vol: 1, page: 223, stat: Journal Article,

Epidural steroid injections: An update on mechanisms of injury and safety
Gharibo C.; Koo C.; Chung J.; Moroz A.
2009 ;13(4):266-271, Techniques in Regional Anesthesia & Pain Management
Epidural steroid injections (ESIs) are the most commonly performed intervention in the United States to manage chronic and subacute low back and neck pain with radiculopathy. ESIs have been used for decades for the treatment of discogenic and osteoarthritic radicular conditions originating from the cervical, thoracic, and lumbar spine, as well as spondylosis, nonspecific radiculitis, and spinal stenosis. With the ever-increasing use of epidural steroids, there has been a disproportionate increase in popularity of transforaminal ESIs in particular. Since 2002, there has been a growing body of largely transforaminal epidural steroid case report literature that describes paralysis, stroke, and death that immediately follows the performance of these procedures. These complications are thought to be related to a combination of factors, which may include the technique used, underlying pathophysiology that is being treated, anatomical variations in the blood supply, as well as the specific injectate used. This article discusses the pathogenesis of these complications and puts the role of steroids in their causation into perspective. copyright 2009 Elsevier Inc. All rights reserved
— id: 106364, year: 2009, vol: 13, page: 266, stat: Journal Article,

Stroke and neurodegenerative disorders: 3. Poststroke rehabilitation
Lew, Henry L; Lombard, Lisa A; Reddy, Cara Camiolo; Moroz, Alex; Edgley, Steven R; Chae, John
2009 Mar;1(3 Suppl):S19-S26, PM&R
OBJECTIVE: This self-directed learning module highlights rehabilitation strategies in poststroke rehabilitation. It is part of the study guide on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on typical clinical presentations, recovery patterns, and traditional and innovative therapeutic interventions in poststroke rehabilitation such as constraint-induced movement therapy, treadmill training, functional electrical stimulation, robot-aided therapy, virtual reality treatment, cortical stimulation, speech therapy for aphasia, and orthotic management. The goal of this article is to influence the learner's knowledge on the delivery of poststroke rehabilitation treatment
— id: 133668, year: 2009, vol: 1, page: S19, stat: Journal Article,

Stroke and neurodegenerative disorders: 2. Poststroke medical complications
Lombard, Lisa A; Reddy, Cara Camiolo; Moroz, Alex; Lew, Henry L; Chae, John; Edgley, Steven R
2009 Mar;1(3 Suppl):S13-S18, PM&R
OBJECTIVE: This self-directed learning module highlights common poststroke medical complaints encountered on an inpatient rehabilitation unit. It is part of the study guide on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on the differential diagnosis, evaluation and management of chest pain, mental status changes, weight loss and poor motivation in stroke patients. The goal of this article is to expand the learner's knowledge of how to diagnose and manage common medical complications of stroke patients in rehabilitation
— id: 133667, year: 2009, vol: 1, page: S13, stat: Journal Article,

Rehabilitation interventions in Parkinson disease
Moroz, Alex; Edgley, Steven R; Lew, Henry L; Chae, John; Lombard, Lisa A; Reddy, Cara Camiolo; Robinson, Keith M
2009 Mar;1(3 Suppl):S42-S48, PM&R
OBJECTIVE: This self-directed learning module provides an evidence-based update of exercise-based rehabilitation interventions to treat Parkinson disease (PD). It is part of the study guide on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This focused review emphasizes treatment of locomotion deficits, upper limb motor control deficits, and hypokinetic dysarthria. New dopaminergic agents and deep brain stimulation are facilitating longer periods of functional stability for patients with PD. Adjunctive exercise-based treatments can therefore be applied over longer periods of time to optimize function before inevitable decline from this neurodegenerative disease. As function deteriorates in patients with PD, the role of caregivers becomes more critical, thus training caregivers is of paramount importance to help maintain a safe environment and limit caregiver anxiety and depression. The overall goal of this article is to enhance the learner's existing practice techniques used to treat PD through exercise-based intervention methods
— id: 132874, year: 2009, vol: 1, page: S42, stat: Journal Article,

Stroke and neurodegenerative disorders: 1. Stroke management in the acute care setting
Reddy, Cara Camiolo; Moroz, Alex; Edgley, Steven R; Lew, Henry L; Chae, John; Lombard, Lisa A
2009 Mar;1(3 Suppl):S4-12, PM&R
OBJECTIVE: This self-directed learning module highlights management of stroke in the acute care setting. It is part of the study guide on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on initial assessment and management of acute ischemic and hemorrhagic stroke, descriptions of posterior circulation and lacunar stroke, and criteria for admission to acute inpatient rehabilitation after stroke and secondary stroke prevention. The goal of this article is to improve the learner's ability to identify, treat and manage a patient with a stroke in the acute care setting
— id: 133666, year: 2009, vol: 1, page: S4, stat: Journal Article,

Evaluation of an elderly faller by medical students and rehabilitation residents
Rolita, Lydia; Ark, Tavinder K; Moroz, Alex; Lanyi, Valery; Southwell, Julianne; Sutin, David
2009 Apr;57(4):709-713, Journal of the American Geriatrics Society
As part of the development of a curriculum for medical students and rehabilitation residents at New York University School of Medicine, an Objective Structured Clinical Examination (OSCE) station was developed for formative evaluation. The goal was to determine the existing knowledge and competence of medical students and rehabilitation residents in the analysis and treatment of a geriatric patient with a history of falls. This OSCE station was designed to focus on three specific clinical skills needed in assessing the elderly faller. The OSCE station was a standardized patient (SP) encounter with a 75-year-old man presenting with falls. Seventy-five medical students and 41 rehabilitation medicine residents participated in the study. There was high agreement between the SP and a geriatric physician used to assess performance on gait (Cronbach alpha=0.918) and orthostatic blood pressure (Cronbach alpha=0.887) assessment. Of the medical students, 43.5% did not check orthostatic blood pressure, 56.8% did not evaluate gait, and 92.0% did not consider assistive device prescription. Only 20.0% checked both orthostatic blood pressure and gait. Likewise, 73.8% of residents did not check orthostatic blood pressure, 38.1% did not evaluate gait and 92.9% did not consider assistive device prescription. Only 19.0% checked both orthostatic blood pressure and gait. The results of this examination are alarming and suggest that education regarding the approach to an elderly person who falls is inadequate, leaving students and residents poorly prepared to take care of the 'silver tsunami.'
— id: 111643, year: 2009, vol: 57, page: 709, stat: Journal Article,

Functional recovery of a patient with complex regional pain syndrome in an inpatient pain rehabilitation program : a case report
Feldman DD; Vitale KC; Gusmorino P; Snow B; Shen H; Jimenez A; Moroz A; Knotkova H
2008 ;1(3):319-326, Journal of pain management
— id: 90956, year: 2008, vol: 1, page: 319, stat: Journal Article,

Evaluation of an elderly faller by medical students and rehabilitation residents
Rolita, L; Sutin, D; Ali, E; Ark, T; Moroz, A; Lanyi, V
2008 APR ;56(4):S42-S43, Journal of the American Geriatrics Society
— id: 78723, year: 2008, vol: 56, page: S42, stat: Journal Article,

Treatment of carpal tunnel syndrome with medical acupuncture (Medical Acupuncture 20, 3, (163-167))
Schulman R.A.; Liem B.; Moroz A.
2008 ;20(4):301-, Medical acupuncture
— id: 91421, year: 2008, vol: 20, page: 301, stat: Journal Article,

Treatment of carpal tunnel syndrome with medical acupuncture
Schulman RA; Liem B; Moroz A
2008 ;20(3):163-167, Medical acupuncture
— id: 90957, year: 2008, vol: 20, page: 163, stat: Journal Article,

Hemiplegia
Diller, Leonard; Moroz, Alex
Medical aspects of disability : a handbook for the rehabilitation professional New York, NY, US: Springer Publishing Co, 2005,
The focus of this chapter is hemiplegia, specifically addressing functional limitations, psychological problems, treatment, and vocational rehabilitation. Outcome prediction and future research are also highlighted.
— id: 4090, year: 2005, vol: , page: 649, stat: Chapter,

Rehabilitation of movement disorders
Bogey, Ross A; Elovic, Elie P; Bryant, Phillip R; Geis, Carolyn C; Moroz, Alex; O'Neill, Bryan J
2004 Mar;85(3 Suppl 1):41-45, Archives of physical medicine & rehabilitation
Bogey RA, Elovic EP, Bryant PR, Geis CC, Moroz A, O'Neill BJ. Rehabilitation of movement disorders. 2004;85(3 Suppl 1):S41-5. This self-directed learning module highlights several movement disorders. These include dystonia, chorea, tremors, and myoclonus. A description of the clinical presentation and associated disease processes is presented. Although the discussion on treatment focuses on pharmacologic intervention, surgical options are presented when appropriate. Other movement disorders (ie, parkinsonism) are discussed elsewhere in the Study Guide.Overall article objectives: (a) To define the various symptoms and etiologies of dystonia; (b) to define chorea and its treatment; (c) to define tremors, including associated neurologic disorders, plus pharmacologic and potential surgical interventions; and (d) to describe the symptoms, classification, and treatment of primary and secondary myoclonus
— id: 42134, year: 2004, vol: 85, page: 41, stat: Journal Article,

Stroke and neurodegenerative disorders. 3. Stroke: rehabilitation management
Bogey, Ross A; Geis, Carolyn C; Bryant, Phillip R; Moroz, Alex; O'neill, Bryan J
2004 Mar;85(3 Suppl 1):15-20, Archives of physical medicine & rehabilitation
Bogey RA, Geis CC, Bryant PR, Moroz A, O'Neill BJ. Stroke and neurodegenerative disorders. 3. Stroke: rehabilitation management. 2004;85(3 Suppl 1):S15-20. This self-directed learning module highlights common rehabilitation issues in stroke survivors. Topics include spasticity, constraint-induced movement therapy, partial body weight-supported treadmill training, virtual reality training, vestibular retraining, aphasia treatment, and cognitive retraining. It is part of the study chapter on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation.Overall article objectives (a) To identify and review the treatment options for poststroke spasticity; (b) to review the use of body weight-supported treadmill training in stroke patients; (c) to describe virtual reality training as an adjunct in stroke rehabilitation; (d) to review vestibular rehabilitation; (e) to discuss advances in aphasia treatment; (f) to discuss cognitive retraining; and (g) to provide an update on treatment of neglect syndromes
— id: 42136, year: 2004, vol: 85, page: 15, stat: Journal Article,

Stroke and neurodegenerative disorders. 4. Neurodegenerative disorders
Bryant, Phillip R; Geis, Carolyn C; Moroz, Alex; O'neill, Bryan J; Bogey, Ross A
2004 Mar;85(3 Suppl 1):21-33, Archives of physical medicine & rehabilitation
Bryant PR, Geis CC, Moroz A, O'Neill BJ, Bogey RA. Stroke and neurodegenerative disorders. 4. Neurodegenerative disorders. 2004;85(3 Suppl 1):S21-33. This self-directed learning module highlights diagnosis, treatment, and rehabilitation issues in patients with neurodegenerative disorders, including multiple sclerosis (MS), Parkinson's disease, and amyotrophic lateral sclerosis (ALS). It is part of the study guide on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the differential diagnosis, diagnostic evaluation, medical management, and rehabilitation issues in MS. Similarly, the differential diagnosis treatment and rehabilitation in Parkinson's disease is discussed. Electrodiagnosis, pharmacologic treatment, and rehabilitation options for ALS are also discussed.Overall article objective To review the differential diagnosis, evaluation, medical treatment, and rehabilitation management of patients with MS, Parkinson's disease, and ALS
— id: 42135, year: 2004, vol: 85, page: 21, stat: Journal Article,

Stroke and neurodegenerative disorders. 2. Stroke: comorbidities and complications
Moroz, Alex; Bogey, Ross A; Bryant, Phillip R; Geis, Carolyn C; O'Neill, Bryan J
2004 Mar;85(3 Suppl 1):11-14, Archives of physical medicine & rehabilitation
Moroz A, Bogey RA, Bryant PR, Geis CC, O'Neill BJ. Stroke and neurodegenerative disorders. 2. Stroke: comorbidities and complications. 2004;85(3 Suppl 1):S11-4. This self-directed learning module highlights diagnosis and treatment of comorbidities and complications encountered by patients with stroke. It is part of the study guide on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on cardiopulmonary complications and examines neurologic sequelae, risk factors for falls, and prevention strategies. It also discusses upper-limb pain, fatigue, and depression and highlights diagnosis and management of genitourinary complications.Overall article objective To summarize common comorbidities and complications encountered by patients after stroke
— id: 42137, year: 2004, vol: 85, page: 11, stat: Journal Article,

Convalescence care for seniors of lower Manhattan: an interdisciplinary outreach, rehabilitation, and education model
Moroz, Alex; Schoeb, Veronika; Fan, Grace; Vitale, Kenneth; Lee, Mathew
2004 Mar;27(1):75-78, International journal of rehabilitation research
The purpose of this study was to test the efficacy of an interdisciplinary geriatric outreach, rehabilitation, and education program for seniors. Community-dwelling Chinese seniors in lower Manhattan were recruited through outreach activities (17 educational workshops, three community health fairs, media interviews) and community physician referrals to offer rehabilitation services. The instrument administered at entry and exit included questions about pain intensity, quality of life, activities of daily living (ADLs), and an assessment of a variety of intrinsic and extrinsic barriers to life participation. The sample included 70 seniors (53 women) with a mean age of 70.5 +- 7.48 years (range 60-93 years old) of whom 86% were Cantonese-speaking Chinese. The barriers-to-life participation assessment revealed cultural, communication, transportation, and physical environmental barriers as well as insufficient financial resources. Thirty-four patients who completed the program showed a significant improvement in quality of life. Patients' reports reflected a high degree of satisfaction with the program. Interdisciplinary team-oriented patient care, including a physiatrist, social worker, and rehabilitation staff, may result in good outcomes and high patient satisfaction in ambulatory community seniors
— id: 45288, year: 2004, vol: 27, page: 75, stat: Journal Article,

Adherence to acupuncture treatment for chronic pain
Moroz, Alex; Spivack, Stacy; Lee, Mathew H M
2004 Oct;10(5):739-740, Journal of alternative & complementary medicine
— id: 95516, year: 2004, vol: 10, page: 739, stat: Journal Article,

Stroke and neurodegenerative disorders. 1. Acute stroke evaluation, management, risks, prevention, and prognosis
O'Neill, Bryan J; Geis, Carolyn C; Bogey, Ross A; Moroz, Alex; Bryant, Phillip R
2004 Mar;85(3 Suppl 1):3-10, Archives of physical medicine & rehabilitation
O'Neill BJ, Geis CC, Bogey RA, Moroz A, Bryant PR. Stroke and neurodegenerative disorders. 1. Acute stroke evaluation, management, risks, prevention, and prognosis. 2004;85(3 Suppl 1):S3-10. This self-directed learning module highlights recent developments in the acute care of stroke patients, prediction of outcome after stroke, evaluation of risk factors, secondary prevention of stroke, and the evaluation of the young adult with stroke. It is part of the study guide on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article contains sections on the acute evaluation and management of the stroke patient, prediction of functional outcome after stroke, and secondary prevention of stroke. Special emphasis is given to the evaluation of the young adult with stroke.Overall article objectives (a) To summarize the acute evaluation and management of stroke, particularly in the young stroke patient; and (b) to review the risk factors for stroke and secondary prevention measures
— id: 42138, year: 2004, vol: 85, page: 3, stat: Journal Article,

Convalescence care for seniors in lower Manhattan - An interdisciplinary approach to community rehabilitation
Moroz, A; Schoeb, V; Fan, G; Lee, M
2003 OCT-DEC ;19(4):291-297, Topics in geriatric rehabilitation
Application of principles of rehabilitation medicine to community health is an area of great importance to the care of the elderly. New York City has a high percentage of Chinese immigrants. The complexity of age and cultural and communication difficulties require special attention, and an interdisciplinary approach is essential for success. The 'Convalescence Care for Seniors of Lower Manhattan,' a program located at New York University Downtown Hospital, is able to reach out successfully to an underserved Chinese population in Lower Manhattan. Through educational workshops, health fairs, and physician referrals, patients were able to receive the benefit of a functional approach
— id: 55422, year: 2003, vol: 19, page: 291, stat: Journal Article,

Comprehensive deep venous thrombosis prevention strategy after total-knee arthroplasty
Ragucci, Mark V; Leali, Alex; Moroz, Alex; Fetto, Joseph
2003 Mar;82(3):164-168, American journal of physical medicine & rehabilitation
OBJECTIVE: Venous thromboembolism after total-knee arthroplasty represents a common early postoperative complication resulting in significant morbidity. Despite this, the optimal prophylactic regimen is controversial. The prevalence of venous thromboembolism has been cited as high as 35% in patients receiving pharmacologic prevention alone. We investigated the efficacy of a comprehensive prevention protocol encompassing the use of epidural anesthesia, aspirin, venous foot compression pumps, and early mobilization in a series of consecutive total-knee arthroplasties. DESIGN: A series of 100 consecutive total-knee arthroplasty patients were enrolled into the prospective trial. All patients were allowed full weight bearing on the first postoperative day and ambulation as tolerated. Venous foot compression pumps and aspirin were used immediately after surgery in the totality of subjects. Seventy-five percent of the patients were transferred to an acute rehabilitation service during the first postoperative week. The presence of deep-vein thrombosis was subsequently determined with the routine use of venous duplex scans. RESULTS: Three patients (3%) demonstrated evidence of distal deep-vein thrombosis. No patient had symptomatic pulmonary embolism. CONCLUSION: The combination of epidural anesthesia, aspirin, immediate postoperative venous foot compression pumps, and early ambulation together seem to be a more effective approach to prevent the occurrence of thromboembolic events after knee replacements than pharmacologic prevention alone
— id: 34130, year: 2003, vol: 82, page: 164, stat: Journal Article,

Evolution of the Koch model of the biomechanics of the hip: clinical perspective
Fetto, Joseph; Leali, Alex; Moroz, Alex
2002 ;7(6):724-730, Journal of orthopaedic science
Over the past several decades numerous researchers have revisited the model of the biomechanics of the hip first predicated by John Koch in 1917. The contributions of Blount (1956), Frankel (1960), Pauwels (1976), Toridis (1969), Rybicki (1972), Fetto (1994, 1995), Ling (1996), and Lu (1997, 1998) among others created a more complete picture. The present article briefly reviews the previous biomechanical concept and its clinical inconsistencies and offers a model that includes the dynamic and static input of the soft tissues. The action of the iliotibial band (ITB) and the vastus lateralis-gluteus medius complex (as static and dynamic tension bands lateral to the femur) counterbalance the varus bending torque of the loads acting on the hip, transforming the tensile stresses in the lateral femur (as hypothesized by Koch) into compressive stresses. The inclusion of the soft tissues, extending the previous model, widens our understanding of the forces acting on the hip. Thus, a variety of clinical observations can be better explained in a comprehensive theoretical framework
— id: 33059, year: 2002, vol: 7, page: 724, stat: Journal Article,

Prevencion de trombosis venosa profunda y tromboembolisma pulmonar despues de cirurgias de reemplazo articular
Leali A; Fetto J; Moroz A; Kieran O
2002 ;67(1):16-20, Revista de la Asociacion Argentina de Orthopedia y Traumatologia
— id: 33068, year: 2002, vol: 67, page: 16, stat: Journal Article,

Prevention of thromboembolic disease after non-cemented hip arthroplasty. A multimodal approach
Leali, A; Fetto, J; Moroz, A
2002 Apr;68(2):128-134, Acta orthopaedica Belgica
Thromboembolism following total hip arthroplasty is a common complication that may result in significant morbidity and mortality. Despite this, optimal prophylactic regimen is controversial. We investigated the efficacy of a comprehensive approach encompassing the use of aspirin, intermittent compression devices ('foot pumps'), and early mobilization in a cohort of 200 consecutive patients after non-cemented total hip replacements. The surgical procedures were carried out under epidural anesthesia in most cases (91%). All patients were allowed full weight bearing and received ambulation training starting on the first post-operative day. Ankle-high pneumatic boots ('foot pumps') and aspirin (325 mg p.o./qd) were used immediately after surgery. The presence of deep vein thrombosis was determined with the routine use of venous duplex scans on post-operative day number 5 to 10 (mean 6.8). The duration of the follow-up was 3 months. No patients were lost to follow-up. Four distal DVT's (2%) were detected in three patients. None of the patients developed symptomatic pulmonary embolism during the follow-up period. There were no major wound complications. Venous thromboembolic disease after hip replacement surgery is largely associated with postoperative immobilization and venous stasis. It is the authors' opinion that a prevention strategy should include mechanical as well as pharmacological measures. The concomitant use of epidural anesthesia, 'foot pumps', aspirin and early full weight bearing ambulation may be effective in further reducing the incidence of DVT after surgery
— id: 32121, year: 2002, vol: 68, page: 128, stat: Journal Article,

Reflex sympathetic dystrophy: a comprehensive review
Moroz A; Leali A; Lee MHM; Liu A
2002 ;14(3&4):291-306, Critical reviews in physical medicine & rehabilitation
— id: 34134, year: 2002, vol: 14, page: 291, stat: Journal Article,

Computerized infrared imaging as an objective tool in evaluating a clarinetist with performance pain: A case report
Cabrera, I; Moroz, A; Ma, YC; Lee, MHM
2001 DEC ;16(4):161-164, Medical problems of performing artists
Performance-induced pain in musicians can be a debilitating and career-threatening problem. However, solutions such as early intervention and prevention have been shown ro be efficacious. In addition to clinical examinations, an objective measurement of pain while playing would be a valuable assessment tool in monitoring a performer's pain complaint, as subjective observations are more often difficult to obtain and interpret. Computerized infrared imaging (CII) is an objective and noninvasive test that records cutaneous temperature. A close interrelationship between pain fibers and cutaneous temperature exist. To examine the use of CII in evaluating musicians with performance-induced pain, the authors report a case study of professional clarinetist seen with complaints of right sided performance-induced pain. Infrared images obtained before, during, and after playing indicated changes in asymmetry that correlated with his pain complaints. This cases report introduces CII as an effective objective assessment tool for evaluating musicians with performance-induced pain
— id: 55323, year: 2001, vol: 16, page: 161, stat: Journal Article,

Reflex sympathetic dystrophy with hidradenitis suppurativa exacerbation: a case report
Moroz A; Lee MH; Clark J
2001 Mar;82(3):412-414, Archives of physical medicine & rehabilitation
Reflex sympathetic dystrophy (RSD) or complex regional pain syndrome type 1, is characterized by spontaneous pain or allodynia and hyperalgesia disproportionate to the inciting event, multiperipheral nerve involvement, edema, vasomotor or sudomotor change, and possible loss of function. It has been described in relation to various insults, including a number of infectious and inflammatory conditions. We report a case of a patient who developed RSD 1 week after an exacerbation of hidradenitis suppurativa, a rare chronic inflammatory disease of apocrine sweat glands. The patient responded well to a combination of range-of-motion exercises, thermal modalities, and oral steroids. Hidradenitis suppurativa should be considered when searching for an etiology of new onset RSD
— id: 26772, year: 2001, vol: 82, page: 412, stat: Journal Article,

Important qualities in physiatrists: perceptions of rehabilitation team members and patients
Moroz A; Prufer N; Rosen Z; Eisenberg C
2000 Jun;81(6):812-816, Archives of physical medicine & rehabilitation
OBJECTIVE: To determine the personal qualities important in physiatrists as described by patients and rehabilitation team members. DESIGN: An oral survey. SETTING: Adult rehabilitation service at a teaching rehabilitation institution affiliated with an academic medical center. PARTICIPANTS: Convenience sample of 171 people including inpatients, rehabilitation nurses, occupational and physical therapists, and resident and full-time attending physicians. INTERVENTIONS: Two questions to elicit the personal qualities that were considered important in a physical medicine and rehabilitation physician. MAIN OUTCOME MEASURES: Subjects' responses grouped as personal qualities (personality), working qualities (professionalism), competence, caring, and collegiality. RESULTS: Caring and competence qualities were the most important to patients. Collegiality and caring were valued most by the rehabilitation staff. Personal qualities and competence were of relatively greater importance to the physiatrists. CONCLUSIONS: There was significant variability in the relative. value assigned to each of the five groups of traits among the respondents. Knowledge of the desires and expectations of the people involved in the rehabilitation process may benefit rehabilitation patients, physicians, and staff
— id: 11645, year: 2000, vol: 81, page: 812, stat: Journal Article,

Issues in acupuncture research: the failure of quantitative methodologies and the possibilities for viable, alternative solutions
Moroz A
1999 ;27(1-2):95-103, American journal of acupuncture
Thirty years of active acupuncture research have failed to unequivocally demonstrate its clinical efficacy. Certain characteristics of acupuncture are difficult to fit into an experimental study. Many researchers mention selection of appropriate controls, single- or double-blind research design, and application of relevant outcome measures as areas causing most difficulties. Also cited are the variability of acupuncture techniques, difficulty of standardizing acupuncture treatments, inadequate population size, significant variability of response to treatments, the use of a distinctive terminology, and importance of practitioner's experience. Acupuncture and Chinese traditional medicine are based on a unique philosophical model, and the instruments of biomedical research may be inadequate and inappropriate. In contrast to the quantitative experimental method, introspective self-observation and qualitative observation are offered as a means of studying the effectiveness of acupuncture
— id: 6259, year: 1999, vol: 27, page: 95, stat: Journal Article,

Questions that have no answers
Moroz A
1999 ;8(2):6-6, PM&R resident
— id: 33069, year: 1999, vol: 8, page: 6, stat: Journal Article,

Hydrocephalus and cognitive decline in myotonic dystrophy: case report and literature review
Moroz A; Kalva S
1998 Aug;79(8):1022-1023, Archives of physical medicine & rehabilitation
Myotonic dystrophy is a rare genetic neuromuscular disorder with multisystem involvement. Hydrocephalus and cognitive deterioration are not commonly considered part of adult-onset myotonic dystrophy. This report describes a case of progressive distal muscle weakness, cognitive decline, and longstanding ventricular enlargement. Review of the literature suggests that hydrocephalus may be associated with myotonic dystrophy while progressive cognitive decline is rare in the adult form of the disease
— id: 7698, year: 1998, vol: 79, page: 1022, stat: Journal Article,

East-West medicine: irreconcilably complementary
Moroz A
1994 ;22(4):369-374, American journal of acupuncture
— id: 34131, year: 1994, vol: 22, page: 369, stat: Journal Article,