Jonas Sokolof | Weill Cornell Medicine (original) (raw)

Papers by Jonas Sokolof

American Journal of Lifestyle Medicine, 2020

Chronic diseases pose many challenges to health care providers and the health care system from a ... more Chronic diseases pose many challenges to health care providers and the health care system from a human capital, logistic, and financial perspective. To overcome these challenges, efficient and effective health care delivery models that address multiple chronic conditions need to be leveraged. Shared medical appointments are one potential solution to address these issues. This article offers a brief history of group visits and shared medical appointments and reviews the available data regarding their outcomes. It describes the benefits of using lifestyle medicine as the primary therapeutic modality within a shared medical appointment to treat, reverse, and prevent chronic disease. Key considerations and action steps for the implementation of lifestyle medicine shared medical appointments (LMSMAs) are outlined and the potential delivery of these services via telehealth is explored.

American Journal of Physical Medicine & Rehabilitation

Breast Cancer and Gynecologic Cancer Rehabilitation, 2021

Abstract Aromatase inhibitor (AI) musculoskeletal syndrome (AIMSS) is very common in women taking... more Abstract Aromatase inhibitor (AI) musculoskeletal syndrome (AIMSS) is very common in women taking an AI as part of their breast cancer treatment. Although the exact cause of AIMSS is not clearly known, there is speculation that estrogen has an important role in the proper function of joints and the reduction in estrogen as part of this treatment can contribute to the development of joint symptomatology in users. The early identification and initiation of treatment can help reduce pain, minimize loss of function, and maximize quality of life. Physiatrists can have a very important role in the assessment and treatment of this disabling condition.

Essentials of Physical Medicine and Rehabilitation, 2008

International Journal of Rehabilitation Research, 2018

Prehabilitation benefits among patients undergoing various oncological surgeries have been demons... more Prehabilitation benefits among patients undergoing various oncological surgeries have been demonstrated. However, the effects of presurgical exercise and fitness on postoperative ipsilateral upper extremity recovery outcomes in patients with breast cancer surgery are less evident. A systematic review was performed to assess the effects of preoperative exercise and fitness on postmastectomy recovery. Systematic literature search was performed in 12 electronic databases. Study eligibility was accessed using the PICOS (Participants, Interventions, Comparison, Outcome and Study Design) criteria. Six eligible studies were found: three cohort-control and three prospective observational studies. One randomized-controlled trial showed that prehabilitation was beneficial in shoulder range of motion (ROM) and upper extremity functional recovery. One cohort-control study demonstrated that preoperative exercises reduced postoperative pain without increasing the risk of developing a seroma. A prospective cohort study showed that preoperatively active individuals had a significantly better chance of feeling recovered physically at 3 weeks after surgery. Baseline ipsilateral grip strength, shoulder flexion, and abduction ROM were reliable predictors of shoulder flexion and abduction ROM and grip strength improvements at 1 month following breast cancer surgery. One study showed that preoperative conditioning alone without postoperative rehabilitation was insufficient to aid recovery. Implementing exercise program and optimizing preoperative fitness, especially shoulder ROM, before breast cancer surgery in conjunction with individualized rehabilitation program may benefit postmastectomy ipsilateral upper extremity recovery.

CA: A Cancer Journal for Clinicians, 2019

Multiple organizations around the world have issued evidence-based exercise guidance for patients... more Multiple organizations around the world have issued evidence-based exercise guidance for patients with cancer and cancer survivors. Recently, the American College of Sports Medicine has updated its exercise guidance for cancer prevention as well as for the prevention and treatment of a variety of cancer health-related outcomes (eg, fatigue, anxiety, depression, function, and quality of life). Despite these guidelines, the majority of people living with and beyond cancer are not regularly physically active. Among the reasons for this is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise. The authors propose using the American College of Sports Medicine's Exercise Is Medicine initiative to address this practice gap. The simple proposal is for clinicians to assess, advise, and refer patients to either home-based or community-based exercise or for further evaluation and intervention in outpatient rehabilitation. To do this will require care coordination with appropriate professionals as well as change in the behaviors of clinicians, patients, and those who deliver the rehabilitation and exercise programming. Behavior change is one of many challenges to enacting the proposed practice changes. Other implementation challenges include capacity for triage and referral, the need for a program registry, costs and compensation, and workforce development. In conclusion, there is a call to action for key stakeholders to create the infrastructure and cultural adaptations needed so that all people living with and beyond cancer can be as active as is possible for them.

Rehabilitation is an essential component of the multidisciplinary approach to the treatment of pa... more Rehabilitation is an essential component of the multidisciplinary approach to the treatment of pain. Rehabilitation is especially important in the oncologic setting. Accurate assessment, coordination of care, and education of patients and family should begin early to maximize recovery and to maintain function.

Essentials of Interventional Cancer Pain Management, 2018

Pain in the cancer patient is often multifactorial related to disease burden, chemotherapy, radia... more Pain in the cancer patient is often multifactorial related to disease burden, chemotherapy, radiation, and other treatments. Osteopathic manipulation therapy (OMT) may be used to provide effective and conservative therapy for complications or dysfunction due to medical and surgical treatment of the cancer patient. Examples of diagnoses to utilize OMT include scar tissue, radiation-induced fibrosis, trismus, axial spine pain, and many others.

American Journal of Physical Medicine & Rehabilitation

Archives of Physical Medicine and Rehabilitation, 2006

To determine the strength of the associations between pedometer scores (7-d mean) and self-report... more To determine the strength of the associations between pedometer scores (7-d mean) and self-reported measures of psychologic adjustment and pain coping in chronic pain patients. Design: Correlational study. Setting: Interdisciplinary clinic in the community. Participants: 18 patients with back pain for 6 months or longer. Interventions: In an initial validity phase, 4 pedometer brands were tested in treadmill walking. The model selected for the study was found to be accurate to 90% or higher across 4 experimenters at typical walking speeds 3.2 to 4.8km (2Ϫ3mph), but inaccurate at very slow pace 1.6km (1mph). Self-report measures were completed in a single session, followed by self-recording of total daily footsteps over 7 days. Main Outcome Measures: Pedometer, Beck Depression InventoryϪII (BDI), Tampa Scale for Kinesophobia (TSK), and Multidimensional Pain Inventory (MPI). Results: There were no significant correlations between mean daily pedometer scores and scores on the TSK, BDI, or MPI pain severity subscale. Correlation with the MPI activity score was low (rϭ.25) and nonsignificant, consistent with poor insight. There was a moderate inverse correlation between pedometer scores and the MPI dysfunctional dimension (rϭ.47, PϽ.05). The strongest correlation occurred with social factors, whereby pedometer scores decreased as patients reported less MPI interpersonal distress (rϭ.83, PϽ.001), consistent with greater social acceptance of the illness role. This was accounted for by an inverse relationship between "social support" of pain behavior (rϭϪ.70, PϽ.01) and pedometer scores. Conclusions: These findings indicate that self-reports of activity by chronic pain patients are not accurate, and that pedometers may provide an index of positive and negative influences of psychologic factors on illness behavior.

Essentials of Physical Medicine and Rehabilitation, 2008

The oncologist, Jan 10, 2016

: Abnormal activation of hedgehog pathway signaling is a key driver in the pathogenesis of basal ... more : Abnormal activation of hedgehog pathway signaling is a key driver in the pathogenesis of basal cell carcinoma (BCC). Vismodegib, a first-in-class small-molecule inhibitor of hedgehog pathway signaling, is approved by regulatory authorities for the treatment of adults who have metastatic BCC or locally advanced BCC that has recurred after surgery, or who are not candidates for surgery and who are not candidates for radiation. A second inhibitor, sonidegib, was also recently approved for the same patient group with locally advanced BCC. Adverse events (AEs) commonly observed in hedgehog pathway inhibitor (HPI)-treated patients include muscle spasms, ageusia/dysgeusia, alopecia, weight loss, and asthenia (fatigue). These AEs are thought to be mechanistically related to inhibition of the hedgehog pathway in normal tissue. Although the severity of the majority of AEs associated with HPIs is grade 1-2, the long-term nature of these AEs can lead to decreased quality of life, treatment interruption, and in some cases discontinuation, all of which might affect clinical outcome. The incidence, clinical presentation, putative mechanisms, and management strategies for AEs related to HPIs in advanced BCC are described. These observations represent the first step toward the development of mechanism-based preventive and management strategies. Knowledge of these AEs will allow health care professionals to provide appropriate counseling and supportive care interventions, all of which will contribute to improved quality of life and optimal benefit from therapy. The hedgehog pathway inhibitors (HPIs) vismodegib and sonidegib represent a therapeutic breakthrough for patients with advanced basal cell carcinoma. However, the nature of the low-grade adverse events (AEs) commonly observed in HPI-treated patients, including muscle spasms, ageusia/dysgeusia, alopecia, weight loss, and fatigue, can impact clinical outcomes as a result of decreased quality of life and treatment discontinuation. The incidence, clinical presentation, putative mechanisms, and management strategies for AEs related to administration of HPIs are described, with the goal of enabling health care professionals to provide appropriate counseling and supportive care interventions to their patients.

American Journal of Lifestyle Medicine, 2020

Chronic diseases pose many challenges to health care providers and the health care system from a ... more Chronic diseases pose many challenges to health care providers and the health care system from a human capital, logistic, and financial perspective. To overcome these challenges, efficient and effective health care delivery models that address multiple chronic conditions need to be leveraged. Shared medical appointments are one potential solution to address these issues. This article offers a brief history of group visits and shared medical appointments and reviews the available data regarding their outcomes. It describes the benefits of using lifestyle medicine as the primary therapeutic modality within a shared medical appointment to treat, reverse, and prevent chronic disease. Key considerations and action steps for the implementation of lifestyle medicine shared medical appointments (LMSMAs) are outlined and the potential delivery of these services via telehealth is explored.

American Journal of Physical Medicine & Rehabilitation

Breast Cancer and Gynecologic Cancer Rehabilitation, 2021

Abstract Aromatase inhibitor (AI) musculoskeletal syndrome (AIMSS) is very common in women taking... more Abstract Aromatase inhibitor (AI) musculoskeletal syndrome (AIMSS) is very common in women taking an AI as part of their breast cancer treatment. Although the exact cause of AIMSS is not clearly known, there is speculation that estrogen has an important role in the proper function of joints and the reduction in estrogen as part of this treatment can contribute to the development of joint symptomatology in users. The early identification and initiation of treatment can help reduce pain, minimize loss of function, and maximize quality of life. Physiatrists can have a very important role in the assessment and treatment of this disabling condition.

Essentials of Physical Medicine and Rehabilitation, 2008

International Journal of Rehabilitation Research, 2018

Prehabilitation benefits among patients undergoing various oncological surgeries have been demons... more Prehabilitation benefits among patients undergoing various oncological surgeries have been demonstrated. However, the effects of presurgical exercise and fitness on postoperative ipsilateral upper extremity recovery outcomes in patients with breast cancer surgery are less evident. A systematic review was performed to assess the effects of preoperative exercise and fitness on postmastectomy recovery. Systematic literature search was performed in 12 electronic databases. Study eligibility was accessed using the PICOS (Participants, Interventions, Comparison, Outcome and Study Design) criteria. Six eligible studies were found: three cohort-control and three prospective observational studies. One randomized-controlled trial showed that prehabilitation was beneficial in shoulder range of motion (ROM) and upper extremity functional recovery. One cohort-control study demonstrated that preoperative exercises reduced postoperative pain without increasing the risk of developing a seroma. A prospective cohort study showed that preoperatively active individuals had a significantly better chance of feeling recovered physically at 3 weeks after surgery. Baseline ipsilateral grip strength, shoulder flexion, and abduction ROM were reliable predictors of shoulder flexion and abduction ROM and grip strength improvements at 1 month following breast cancer surgery. One study showed that preoperative conditioning alone without postoperative rehabilitation was insufficient to aid recovery. Implementing exercise program and optimizing preoperative fitness, especially shoulder ROM, before breast cancer surgery in conjunction with individualized rehabilitation program may benefit postmastectomy ipsilateral upper extremity recovery.

CA: A Cancer Journal for Clinicians, 2019

Multiple organizations around the world have issued evidence-based exercise guidance for patients... more Multiple organizations around the world have issued evidence-based exercise guidance for patients with cancer and cancer survivors. Recently, the American College of Sports Medicine has updated its exercise guidance for cancer prevention as well as for the prevention and treatment of a variety of cancer health-related outcomes (eg, fatigue, anxiety, depression, function, and quality of life). Despite these guidelines, the majority of people living with and beyond cancer are not regularly physically active. Among the reasons for this is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise. The authors propose using the American College of Sports Medicine's Exercise Is Medicine initiative to address this practice gap. The simple proposal is for clinicians to assess, advise, and refer patients to either home-based or community-based exercise or for further evaluation and intervention in outpatient rehabilitation. To do this will require care coordination with appropriate professionals as well as change in the behaviors of clinicians, patients, and those who deliver the rehabilitation and exercise programming. Behavior change is one of many challenges to enacting the proposed practice changes. Other implementation challenges include capacity for triage and referral, the need for a program registry, costs and compensation, and workforce development. In conclusion, there is a call to action for key stakeholders to create the infrastructure and cultural adaptations needed so that all people living with and beyond cancer can be as active as is possible for them.

Rehabilitation is an essential component of the multidisciplinary approach to the treatment of pa... more Rehabilitation is an essential component of the multidisciplinary approach to the treatment of pain. Rehabilitation is especially important in the oncologic setting. Accurate assessment, coordination of care, and education of patients and family should begin early to maximize recovery and to maintain function.

Essentials of Interventional Cancer Pain Management, 2018

Pain in the cancer patient is often multifactorial related to disease burden, chemotherapy, radia... more Pain in the cancer patient is often multifactorial related to disease burden, chemotherapy, radiation, and other treatments. Osteopathic manipulation therapy (OMT) may be used to provide effective and conservative therapy for complications or dysfunction due to medical and surgical treatment of the cancer patient. Examples of diagnoses to utilize OMT include scar tissue, radiation-induced fibrosis, trismus, axial spine pain, and many others.

American Journal of Physical Medicine & Rehabilitation

Archives of Physical Medicine and Rehabilitation, 2006

To determine the strength of the associations between pedometer scores (7-d mean) and self-report... more To determine the strength of the associations between pedometer scores (7-d mean) and self-reported measures of psychologic adjustment and pain coping in chronic pain patients. Design: Correlational study. Setting: Interdisciplinary clinic in the community. Participants: 18 patients with back pain for 6 months or longer. Interventions: In an initial validity phase, 4 pedometer brands were tested in treadmill walking. The model selected for the study was found to be accurate to 90% or higher across 4 experimenters at typical walking speeds 3.2 to 4.8km (2Ϫ3mph), but inaccurate at very slow pace 1.6km (1mph). Self-report measures were completed in a single session, followed by self-recording of total daily footsteps over 7 days. Main Outcome Measures: Pedometer, Beck Depression InventoryϪII (BDI), Tampa Scale for Kinesophobia (TSK), and Multidimensional Pain Inventory (MPI). Results: There were no significant correlations between mean daily pedometer scores and scores on the TSK, BDI, or MPI pain severity subscale. Correlation with the MPI activity score was low (rϭ.25) and nonsignificant, consistent with poor insight. There was a moderate inverse correlation between pedometer scores and the MPI dysfunctional dimension (rϭ.47, PϽ.05). The strongest correlation occurred with social factors, whereby pedometer scores decreased as patients reported less MPI interpersonal distress (rϭ.83, PϽ.001), consistent with greater social acceptance of the illness role. This was accounted for by an inverse relationship between "social support" of pain behavior (rϭϪ.70, PϽ.01) and pedometer scores. Conclusions: These findings indicate that self-reports of activity by chronic pain patients are not accurate, and that pedometers may provide an index of positive and negative influences of psychologic factors on illness behavior.

Essentials of Physical Medicine and Rehabilitation, 2008

The oncologist, Jan 10, 2016

: Abnormal activation of hedgehog pathway signaling is a key driver in the pathogenesis of basal ... more : Abnormal activation of hedgehog pathway signaling is a key driver in the pathogenesis of basal cell carcinoma (BCC). Vismodegib, a first-in-class small-molecule inhibitor of hedgehog pathway signaling, is approved by regulatory authorities for the treatment of adults who have metastatic BCC or locally advanced BCC that has recurred after surgery, or who are not candidates for surgery and who are not candidates for radiation. A second inhibitor, sonidegib, was also recently approved for the same patient group with locally advanced BCC. Adverse events (AEs) commonly observed in hedgehog pathway inhibitor (HPI)-treated patients include muscle spasms, ageusia/dysgeusia, alopecia, weight loss, and asthenia (fatigue). These AEs are thought to be mechanistically related to inhibition of the hedgehog pathway in normal tissue. Although the severity of the majority of AEs associated with HPIs is grade 1-2, the long-term nature of these AEs can lead to decreased quality of life, treatment interruption, and in some cases discontinuation, all of which might affect clinical outcome. The incidence, clinical presentation, putative mechanisms, and management strategies for AEs related to HPIs in advanced BCC are described. These observations represent the first step toward the development of mechanism-based preventive and management strategies. Knowledge of these AEs will allow health care professionals to provide appropriate counseling and supportive care interventions, all of which will contribute to improved quality of life and optimal benefit from therapy. The hedgehog pathway inhibitors (HPIs) vismodegib and sonidegib represent a therapeutic breakthrough for patients with advanced basal cell carcinoma. However, the nature of the low-grade adverse events (AEs) commonly observed in HPI-treated patients, including muscle spasms, ageusia/dysgeusia, alopecia, weight loss, and fatigue, can impact clinical outcomes as a result of decreased quality of life and treatment discontinuation. The incidence, clinical presentation, putative mechanisms, and management strategies for AEs related to administration of HPIs are described, with the goal of enabling health care professionals to provide appropriate counseling and supportive care interventions to their patients.