Alexey Nastaskin has worked as an occupational therapist for nearly two decades treating patients with neurologic disorders at MossRehab Elkins Park. He also invented a hand splint that helps prevent hand deformity and decrease pain for patients with spastic paresis (damage to upper motor neurons).

What inspired you to become an occupational therapist?

I wanted a career where I could explore my creativity and be innovative while making a difference in the lives of others. Occupational therapists must be creative to find solutions to patient challenges. I don’t follow a standard set of instructions. Rather, I determine what approach works best for a patient based on their assessment and goals. I often think outside the box, and that requires creativity.

What is your educational background and training?

I graduated from Thomas Jefferson University (TJU) in 2004 with a Master of Science in Occupational Therapy. I completed fieldwork at Thomas Jefferson University Hospital for inpatient and outpatient acute care and a year-long graduate course at TJU to gain specialty expertise in neurological treatment. I also advanced my competencies by attending different courses at MossRehab over the years.

What is your work history with MossRehab?

I joined MossRehab in 2005, rotating through the different inpatient units at Elkins Park such as stroke, traumatic brain injury and spinal cord injury. The diverse experience helped me become a well-rounded therapist. Moving to outpatient services in the same hospital, I care for individuals with different disabilities and disorders. Because I rotated through different inpatient units, I felt I could offer a great deal to outpatients. I even developed a hand splint to protect the joint and decrease pain. It is used by therapists in MossRehab’s outpatient and inpatient occupational therapy clinics.

What is your specialty? 

I specialize in treating patients who had a stroke as well as splinting and casting for spastic and flaccid hemiparesis (weakness or paralysis to the body.) I’m also an upper extremity (hands, arms) robotic rehabilitation specialist and certified in Kinesio Taping, which involves applying a specialty tape to the body as a therapeutic tool.

Who are your patients? 

I care for patients who had a stroke, spinal cord injury, traumatic brain injury or another neurologic disorder. I often get referrals for patients with multiple disorders. Patients can be complex and have orthopedic and neurologic impairments simultaneously. My background in treating different inpatients and outpatients gives me the confidence to care for patients with different diagnoses.

What is the role of an occupational therapist in the rehabilitation of your patients?

A big misconception is that an occupational therapist (OT) only focuses on rehabilitation of the upper extremities of the body. We look at the whole person including physical, emotional and cognitive issues, and provide therapy that brings them to a better level of independence. If a patient has a serious neurological disability, their goal might be to move from the wheelchair to the bed so that they don’t burden the caregiver. This also gives the patient a level of independence. An OT will determine what activities in therapy might motivate and inspire a patient to make them satisfied in life.  

What is your approach to therapy?

I take a client-­centered approach to address an individual’s specific health needs to reach desired outcomes. Rather than going through a checklist, I learn about the patient and work with them on an individualized basis. It takes several sessions to get to know the person and identify what motivates and interests them. Based on my assessment, I can create a treatment plan on how they want to get better.

Can you tell us about the splint that you developed for patients?

I created a hand splint for patients with upper extremity impairments such as spasticity (involuntary muscle resistance or a muscle’s associated reaction), flaccidity (soft, limp muscle), and hand paresis (muscle weakness). The splint maintains a person's hand in a more functional position than traditional splints for proper joint alignment and prevention of finger deformity. Worn at night or throughout the day, it helps maximize soft tissue alignment, prevents soft tissue contraction and decreases pain and swelling. Based on high patient satisfaction, the splint is used by therapists in our outpatient and inpatient occupational therapy clinics. 

Do you use any robotic technology to support OT? 

I use robotics as part of my arm and hand therapies, including the Armeo®Spring (weight-supported robotic for patients’ arms), Armeo®Senso (self-directed arm therapy with sensors that provide feedback on movements) and the Amadeo (finger-hand rehabilitation). I participated as the data collector on ArmeoSpring research. The company (Hocoma) that invented the machine asked MossRehab to evaluate its effectiveness with specific populations to address certain problems. For example, our research examined how the ArmeoSpring could control or decrease the onset of muscle rigidity or spasticity through robotic exercise. My role was to take the patient through an Armeo exercise program and record performance for analysis by the research team. 

MossRehab also was the first hospital in the United States to utilize the Amadeo for finger rehabilitation. It offers both gaming exercises and electromyography (EMG) triggering that enables us to view muscle activity, even for patients with little or no function in their fingers. Finger digits are placed in the EMG device that’s connected through the robot, which records and displays muscle activation measured by the EMG. Visual feedback shows the level of activity for specific muscles. The Amadeo also features a variety of activities that use movement to grasp or release an object. The games help the patient increase repetitions in rehab exercises while the visual feedback shows their progress and accomplishments to further engage in activities.

Learn more about Therapeutic Gaming in our three-part series.

What inspires you on the job?

I’m rewarded by my patients’ achievements or inspiration to achieve greater functionality towards independence. I had a patient who experienced a 9 out of 10 level of pain. Using physician prescribed medication intervention and therapeutic exercises, home-based exercises, proper positioning, and patient monitoring, we reduced the patient’s pain level to a minimum. The patient was able to resume their day-to-day routine activities with less pain and more comfort. I enjoy forming close working relationships with patients and paying attention to small details that make a difference in their recovery.

What are your interests outside of work?

Soccer, skiing and ice hockey – I was a semi-professional soccer player in my younger years.  

What is the last book that you read?

I just read Extreme Ownership: How U.S. Navy SEALS Lead and Win. It is written by Jocko Willink, a retired and decorated Navy SEAL. The book focuses on how to become a better leader in any environment.

What is your life motto?

Day-to-day problems motivate me to find solutions. Challenges drive my day. I try to get better at my weaknesses and do better. I also try something different each year. This year, I decided to get an electric guitar and learn how to play. Personal enrichment is important.

Learn more about MossRehab’s occupational therapy services.