Medical Acupuncture – Eastern Medicine Meets Western Medicine

Among the most famous medical polemics is the conflict between Eastern and Western medicine. On one side we have spiritually, life energy and holistic remedies; on the other we have science, reason and – as and when needed – medication. In this debate the Western tradition might say that Eastern medicine is not backed up by science and brazenly ignores centuries of medical innovations in favor of a more spiritual treatments. Conversely, an Eastern practitioner might suggest that Western medicine does nothing more than treat the physical, bodily condition – without accounting for the non-physical – through drugs that possibly have a host of side-effects. Thankfully, at the Mount Sinai Department or Rehabilitation Medicine our specialists are able to see the virtues in both philosophies and combine them to work wonders for our patients through medical acupuncture either as a stand-alone treatment or as complement to a comprehensive medical treatment plan. 

Acupuncture comes from ancient Chinese medicine and is a treatment by which fine needles are inserted into specific parts on the body called acupuncture points for therapeutic or preventative purposes. It is a form of complementary or alternative medicine (CAM) to treat a range of musculoskeletal and pain conditions. Acupuncture involves stimulating sensory nerves under the skin and in muscles to help the body produce natural chemicals including pain-relieving endorphins. It is believe that these chemicals are responsible for the benefits attributed to acupuncture. According to the ancient Chinese tradition a life force known as Qi (pronounced chee) flows through the body in channels called meridians, but that when it cannot travel freely throughout the body the result is illness. To restore Qi – and therefore to restore health and prevent sickness – acupuncture is required. 

While a skeptic might find this dubious, there is very good scientific evidence showing that acupuncture can help with a range of pain relief in the body as well as headaches and migraines. There is also evidence that suggest a causal link between acupuncture and relief from nausea and vomiting. However, there are many ailments that acupuncture treats that are simply not based on rigorous scientific evidence, not because there is not any to be found as much as the research has not yet been conducted. While acupuncture on its own can never guarantee the patient’s desired result, a course of acupuncture usually creates better and longer pain relief than a single session. What is more, acupuncture often promotes relaxation and a feeling of improved wellbeing. 

A course of acupuncture sessions will begin with an assessment of general health, medical history and a physical examination. Once completed, depending on the treatment required, you will be asked to sit or lie down and may be asked to remove some cloths so your Mound Sinai medical acupuncturist can easily access certain parts of your body. While the idea of needles being inserted into the skin may sound like a frightening prospect, aside from possible momentary discomfort or a tingling, you should not experience significant pain (of course, if you do, let your acupuncturist know immediately). The needles that will be inserted into your skin are very fine and usually about an inch long. They will always be single use and pre-sterilized and will be disposed of immediately after your session. Up to 12 acupuncture points may be used in a normal session, sometimes more, depending on your condition. The needles will be either inserted just under your skin or slightly deeper to reach muscle tissue. Once they are in place, they may be left in their position for anywhere from a few minutes to up to a half hour. In some cases, your acupuncturist may rotate the needles or stimulate them with a mild electrical current, know as electroacupuncture. Many of our patients use medical acupuncture in addition to certain medications, osteopathic manipulation, joint or trigger point injections, physical therapy, psychotherapy and herbal therapies. Indeed, at the Mount Sinai Department of Rehabilitation Medicine it is not a case of having to choose the evidence-based science of Western medicine over the holistic and spiritual nature of Eastern; rather it is a case of harnessing the robust power of both to intertwine and complement one another to heal you, the patient. 

If you are interested in acupuncture and believe it may be among the treatments for you, please get in touch with our team of medical acupuncturists at the Mount Sinai Department or Rehabilitation Medicine at (212) 241-6321.

One Step at a Time - Exoskeletal Assisted Walking Therapy

Walking has a meaning that transcends the locomotive act of putting one foot in front on the other. The value of movement in both a literal and figurative sense is woven into the fabric of who we are. Words like progress, dynamism and evolution are all positive and words that often inspire, while conversely regression, stasis and devolution are all negative and dispiriting. When we encounter a patient at the Mount Sinai Department of Rehabilitation Medicine whose ability to walk or move has been impaired or limited, for these reasons and more we always consider it a priority to get them back to an independent state whereby they can move either on their own or through the assistance of a walking aid, prosthetic or a wheelchair. And yet, there is another tool at our disposal of which Mount Sinai patients whose ability to walk and/or stand due to paralysis, a spinal cord injury (SCI), a stroke, Parkinson’s disease, multiple sclerosis or a brain injury can take full advantage: exoskeletal assisted walking therapy. 

An exoskeletal walking devise is a wearable motorized exoskeleton that provides the full or partial support required to allow its wearer the ability to amble around their homes, in the community or in a rehabilitation setting. And what can it do for you? It firmly places your newly dynamic two feet on the path where becoming anything and going anywhere is once again possible; it means that your injury and/or condition will no longer have the capacity to relegate you to a position of immobility and being a spectator in life. Exoskeletal assisted walking therapy has the potential to increase self-esteem, enhance your sleep quality, aid in weight loss and improve bowel and bladder function. Our exoskeletal therapy programs can begin as soon as your doctors clears you – in the meantime, let’s learn a bit about the cutting-edge exoskeletal walking devises that await you, including the Ekso GT and the ReWalk.

Ekso GT

The Ekso GT is primarily a rehabilitation tool for those whose walking has been affected by an SCI, a stroke or other condition to help them relearn standing, weight shifting and stepping patterns for walking, as well as improve their speed, stamina, balance and control. It is strapped onto the body and powered by a system of electric motors, levers and hydraulics. Your Mount Sinai physical therapist will use the Ekso GT’s variable assist software to determine how much power and resistance is required to support each side of the your body to get a clear picture of the extent of paralysis as well your rehabilitation progress. Clinical evidence suggests that patients who rehabilitate with the Ekso GT will eventually be able to walk to some degree unassisted by an exoskeletal devise through some combination of improved functional balance, the ability to walk greater distances and increased gait speed.

ReWalk

The ReWalk is also an amazing tool for exoskeletal assisted walking therapy, but what makes it unique is that it is also available for personal use to comfortably navigate your own home or to explore the world on foot. It is an exoskeletal device primarily for people with an SCI but can also be used for people with other conditions that affect or limit walking. It also features a wearable exoskeleton with motorized hip and knee joints and its moves through sensors that detect upper body movements that create a stepping sequence that mimics a natural gait and walking movement. ReWalk can transform the lives of those whose injury has either prevented or limited the ability to walk and will put them in a position in which they can once again literally go wherever their feet will take them!

If you, a friend or family member might benefit from Exoskeletal Assisted Walking Therapy, please get in touch with us at the Mount Sinai Department of Rehabilitation Medicine at (212) 241-6321.

The Most Common Physical Effects of Brain Injury

After a brain injury – particularly a traumatic brain injury (TBI) – the brain’s nerve cells may not send signals between each other as they used to. As a result – aside from a range of possible behavioral and cognitive issues – there will often be physical effects, which might get better quickly during recovery while others might take time or become a lasting problem. The more traumatic a brain injury, the more widespread and longer-lasting the effects will likely be. At the Mount Sinai Department of Rehabilitation Medicine we take brain injury and its effects on directly to help our patients resume active, healthy and independent lives. Our rehabilitation program is a made to suit the individual needs of each patient with a combination of cognitive, physical, occupational, neuropsychologicaland speech therapy. Our brain injury rehabilitation program is one of only two CARF-accredited programs in New York City and patients can also access our CARF-accredited outpatient services once they have been discharged from hospital. 

Below we will discuss the most common physical effects of brain injury and give tips to help manage them.

Headaches

Headaches are very common following a brain injury – thankfully they usually improve over time. For some the pain comes and goes; for others it is a constant. Headaches are often exacerbated by fatigue and stress. Ways to manage include mitigating your stress, resting in a dark and quiet place when the pain is at its worst and avoiding bright sunlight, alcohol and foods that might trigger a headache such as cold items, aged cheese and chocolate.

Poor Sleep

Changed sleeping patterns and poor quality sleep are both very common after a brain injury. It is usual at its worst in the early stages of recovery and will generally tend to get better as time progresses. Many patients will sleep during the day and be awake at night; napping is also common. To help manage poor sleep, do not use your bed for anything besides sleep and sex (e.g. watching TV), ideally have dinner four hours before bedtime and avoid caffeine and exercise once the morning has ended. 

Fatigue

For those who have suffered anything from a mild to a traumatic brain injury, fatigue will be extremely common. Patients will find that their stamina might be dramatically less than what it once was, with even small tasks like getting dressed or walking around the house becoming exhausting. To manage, take regular rest periods during the day, avoid overly taxing social and familial activities and when appropriate have your physical therapist create a safe exercise program to build up stamina. 

Balance and Mobility

Following a brain injury one’s sense of balance can be affected which can make basic mobility an issue. This is a common effect in the early stages of recovery, but it can go away over time with physical therapy. It is important to be aware of this issue and to lie down and rest when a dizzy spell occurs as falls are the leading cause of non-combat TBI. Ways to manage while working with your physical therapist include using a cane or other walking aid and making your home fall-proof by removing rugs, electrical cords and other items on which one could slip, fall and possibly cause another brain injury.

Sensory Impairment

As the brain controls all five of our senses, when brain injury occurs each is at risk of changing. Not much can be done about sensory impairment in the first year of recovery and a ‘wait and see’ approach is often taken in the hope that the patient’s senses will return on their own. The sensation of touch may be reduced, lost or exaggerated; eyesight may be affected and unable to be improved through glasses, taste and smell might go away completely, be altered or replaced with a metallic flavor and one might have muffled hearing or a ringing in the ears (one or both). The best tip is to be patient, know that sensory changes often improve or revert to pre-injury levels and to trust in the medical professionals looking after your rehabilitation.

If you, a friend or family member has suffered a brain injury and you would like to discuss the ways in which the Mount Sinai Department of Rehabilitation Medicine can help, please get in touch with us at (212) 241-6321.