Physical Rehabilitation Medicine

A Glossary of Terms Frequently Used by Speech, Occupational, and Physical Therapists

Last updated: 8 April 2021


Amyotrophic lateral sclerosis (ALS)

A progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord.

Acceptance and commitment therapy (ACT)

A unique empirically based psychological intervention that uses acceptance and mindfulness strategies, together with commitment and behavior change strategies, to increase psychological flexibility.

Activities of Daily Living (ADLs)

Activities that are performed daily such as bathing, dressing, grooming, and feeding.

Acute care

Medically-related care given at or near the time of the acute event that hospitalized the patient; a hospital inpatient rehabilitation center.

Aging in place

The ability to live in one's own home and community safely, independently, and comfortably, regardless of age, income, or ability level

Aglossia

A congenital defect resulting in a partial development or complete absence of a tongue.

Agraphia

Loss of the ability to write.

Alexia

Loss of the ability to read.

Alternative nutrition and hydration (ANH)

Food and liquid intake via nasogastric tube (NG) or percutaneous endoscopic gastrostomy (PEG).

Ambulation

Walking.

Anomic aphasia

A type of aphasia where individuals have word retrieval impairments and cannot express the words they want to say (particularly nouns and verbs). Anomia is a deficit of expressive language.

Anosognosia

A lack of ability to perceive the realities of one's own condition. Often perceived as a person's inability to accept that they have a condition that matches up with their symptoms or a formal diagnosis.

Anterior spillage

Food or liquid falling out of the mouth due to poor lip strength/coordination.

Aphasia

Partial or complete loss of language. Can impact reading, writing, speaking, and understanding. Is not a loss of intelligence.

Aphonia

Loss of voice.

Apraxia

Inability to voluntarily perform certain skilled movements even though the muscle is strong enough.

Apraxia of speech

A motor speech disorder in which a person has access to language but cannot coordinate the placement of oral speech mechanisms. You may often see “groping,” or the attempt to speak with mouth open but no speech sounds produced.

Aspiration

Inhaling of food or liquids into the lungs.

Ataxia

Movement impaired from brain damage that causes a lack of coordination, unsteady movement and poor balance.

Augmentative assistive communication (AAC)

Any device that helps a person communicate wants, needs, and ideas. It can be low-tech, such as a picture board, or high-tech such as a tablet app.

Automatic speech

Social speech such as “Hi, I’m fine,” produced without actually requiring conscious thought.

Autonomic dysreflexia

A syndrome in which there is a sudden onset of excessively high blood pressure. It is more common in people with spinal cord injuries that involve the thoracic nerves of the spine or above (T6 or above).

Bariatric

Bariatrics is the branch of medicine that deals with the causes, prevention, and treatment of obesity.

Basal ganglia

A group of subcortical nuclei responsible primarily for motor control, as well as other roles such as motor learning, executive functions and behaviors, and emotions.

Bath salts

Psychoactive designer street drugs that emerged in the United States in 2010. Causes acute paranoia and psychosis, including hallucinations.

Bell’s palsy

A condition that causes a temporary weakness or paralysis of the muscles in the face. It can occur when the nerve that controls your facial muscles becomes inflamed, swollen, or compressed. The condition causes one side of your face to droop or become stiff.

Borg scale

A self-rating of perceived exertion during exercise.

Broca's aphasia

Individuals with Broca's aphasia have trouble speaking fluently but their comprehension can be relatively preserved.

Broca’s area

A region in the frontal lobe of the dominant hemisphere, usually the left, of the brain with functions linked to speech production.

Candidiasis

An infection caused by a yeast (a type of fungus) called Candida. Also called thrush. Can appear as white fuzz on tongue and is a concern for increasing risk of aspiration pneumonia for people with dysphagia (difficulty swallowing).

Cerebellum

A major structure of the hindbrain that is located near the brainstem. This part of the brain is responsible for coordinating voluntary movements. It is also responsible for a number of functions including motor skills such as balance, coordination, and posture.

Cerebral palsy (CP)

A congenital group of disorders that affect a person's ability to move and maintain balance and posture

Cerebrum

The largest part of the brain containing the cerebral cortex (of the two cerebral hemispheres), as well as several subcortical structures, including the hippocampus, basal ganglia, and olfactory bulb.

Chemo brain

A common term used by cancer survivors to describe thinking and memory problems that can occur during and after cancer treatment. Chemo brain can also be called chemo fog, cancer-related cognitive impairment, or cognitive dysfunction.

Chronic obstructive pulmonary disease (COPD)

A chronic inflammatory lung disease that causes obstructed airflow from the lungs.

Complex regional pain syndrome (CRPS)

A form of chronic pain that usually affects an arm or a leg. CRPS typically develops after an injury, a surgery, a stroke or a heart attack. The pain is out of proportion to the severity of the initial injury.

Conduction aphasia

A type of aphasia in which the main impairment is in the inability to repeat words or phrases.

Confabulation

A type of memory error in which gaps in a person's memory are unconsciously filled with fabricated, misinterpreted, or distorted information. When someone confabulates, they are confusing things they have imagined with real memories. A person who is confabulating is not intentionally lying.

Congenital

Present at birth.

Congestive heart failure (CHF)

A chronic condition in which the heart doesn't pump blood as well as it should.

Constraint-induced therapy (CIMT)

A specialized approach used to increase the use of a limb affected or weakened as the result of a stroke or brain injury. CIMT aims at decreasing the effects of learned non-use.

Corticobulbar (or corticonuclear) tract

A neural motor pathway connecting the motor cortex in the cerebral cortex to the medullary pyramids, which are part of the brainstem's medulla oblongata (also called "bulbar") region, and are primarily involved in carrying the motor function of the non-oculomotor cranial nerves. The corticobulbar tract is one of the pyramidal tracts, the other being the corticospinal tract.

Corticospinal tract

A motor pathway that carries efferent information from the cerebral cortex to the spinal cord. It is responsible for the voluntary movements of the limbs and trunk. The path starts in the motor cortex, where the bodies of the first-order neurons lie.

Cerebrovascular accident, or CVA (stroke)

Cerebrovascular Accident; damage to the brain caused by a gradual or sudden disruption in the blood vessels.

Craniotomy

The surgical removal of part of the bone from the skull to expose the brain. Specialized tools are used to remove the section of bone called the bone flap. The bone flap is temporarily removed, then replaced after the brain surgery has been done.

Decubitus (pressure sore)

Bedsore.

Deep brain stimulation (DBS)

A surgery to implant a device that sends electrical signals to brain areas responsible for body movement. Electrodes are placed deep in the brain and are connected to a stimulator device. Similar to a heart pacemaker, a neurostimulator uses electric pulses to regulate brain activity.

Diplopia

Double vision.

Disease modifying therapies

Treatments that can reduce the activity and progression of multiple sclerosis (MS).

Dysarthria

Impairment in articulation due to weakness in the mouth, tongue and jaw, causing slurred speech.

Dyslexia

A general term for disorders that involve difficulty in learning to read or interpret words, letters, and other symbols, but that do not affect general intelligence.

Dysphagia

Impairment in swallowing.

Dyspraxia

A brain-based motor disorder. It affects fine and gross motor skills, motor planning, and coordination. It's not related to intelligence, but it can sometimes affect cognitive skills. Dyspraxia is sometimes used interchangeably with developmental coordination disorder.

Dystonia

A movement disorder in which a person's muscles contract uncontrollably. The contraction causes the affected body part to twist involuntarily, resulting in repetitive movements or abnormal postures. Dystonia can affect one muscle, a muscle group, or the entire body.

Emotional lability

Impairment of emotional control after brain damage; usually expressed in frequent, brief episodes of spontaneous crying or laughing with no obvious reason; usually resolves during stroke recovery.

Encephalopathy

A broad term for any brain disease that alters brain function or structure.

Esophagram

An inspection of the esophagus. The test is conducted as a part of a series of tests carried out on the upper and the middle regions of the GI tract. This test is performed using fluoroscopy, barium, and x-rays. Since barium is a contrast material, it is used as a marker.

Esophagus

Tube to the stomach.

Esophagogastroduo-denoscopy (EGD) or upper endoscopy

A procedure in which a thin scope with a light and camera at its tip is used to look inside the upper digestive tract, including the esophagus, stomach, and first part of the small intestine, called the duodenum. It's also called an upper endoscopy, or an esophagogastroduodenoscopy.

Executive functions

A set of mental skills that include working memory, flexible thinking, and self-control. We use these skills every day to learn, work, and manage daily life. Trouble with executive function can make it hard to focus, follow directions, and handle emotions, among other things.

Exercise

Active exercise is motion performed by a person without assistance; passive exercise is motion performed entirely by another person.

Expiratory muscle strength training (EMST)

A series of exercises designed to improve expiratory muscle strength to improve cough, swallow, and voice function.

Expressive aphasia

Loss of power to speak, write or gesture.

Extended care

Care that may require a long period of time beyond acute care; services are provided in some type of Extended Care Facility such as a skilled nursing facility, an intermediate care facility, a convalescent home or a specialized care facility for a specific type of problem.

Extrapyramidal system

A part of the motor system network causing involuntary actions. The system is called extrapyramidal to distinguish it from the tracts of the motor cortex that reach their targets by traveling through the pyramids of the medulla.

Extremity

A limb; upper extremities are basically the arms and hands; lower extremities, the legs and feet.

Fiberoptic endoscopic evaluation of swallowing (FEES)

A procedure used to assess how well you swallow. During the procedure, a speech-language pathologist (SLP) passes a thin, flexible instrument through your nose. Then the SLP views parts of your throat as you swallow.

Field Cut (Hemianopsia)

Damage to the optic nerve that results in blindness in one half of each eye; limits vision to only one side.

Flaccid

Without voluntary movement, such as a flaccid arm.

Foley Catheter

A tube and bag attached to the patient for collection of urine.

Free water protocol

Allows patients who are NPO or on thickened liquids to have ice chips/water between meals when following specific guidelines.

Frontal lobe

The part of the brain that controls important cognitive skills in humans, such as emotional expression, problem solving, memory, language, judgment, and sexual behaviors. It is, in essence, the “control panel” of our personality and our ability to communicate.

Gait

Manner or method of walking.

Gastroesophageal reflux disease (GERD)

a digestive disorder that occurs when acidic stomach juices, or food and fluids back up from the stomach into the esophagus. GERD affects people of all ages—from infants to older adults. This is especially a concern for those with dysphagia (difficulty swallowing) and are at risk of aspiration.

Glasgow Coma Scale (GCS)

A clinical scale used to reliably measure a person's level of consciousness after a brain injury. The GCS assesses a person based on their ability to perform eye movements, speak, and move their body. These three behaviors make up the three elements of the scale: eye, verbal, and motor.

Global aphasia

A disorder caused by damage to the parts of your brain that control language. A person with global aphasia may only be able to produce and understand a handful of words. Often, they can't read or write.

Grab Bar

A bar solidly fixed to the wall to provide support, such as in a bathtub.

Graded motor imagery (GMI)

A type of therapy used for complex pain and movement problems. It’s a process of training your brain away from pain using specific imagery (imagined or real).

Granulomas

Small lumps of immune cells that form in your body in areas where there is infection or inflammation.

Hemi-wheelchair

Wheelchair propelled with one hand.

Hemiparesis

Muscle weakness or partial paralysis on one side of the body that can affect the arms, legs, and facial muscles.

Hemiplegia

Paralysis on one side of the body.

Hemiwalker

Walker/cane combination held in one hand.

Hip prosthesis

Artificial replacement of the head of the femur (hip joint).

Hospice

A type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by reducing pain and suffering.

House-Brackmann Facial Function

One of several analysis tools developed to quantify facial function and provide reproducible information. It is a widely accepted system, simple, sensitive, accurate and reliable - grading facial function in six steps from normal (HB I) to total paralysis (HB VI).

Huntington’s disease

An inherited condition in which nerve cells in the brain break down over time.

Hyoid-laryngeal excursion

Usually assessed by a speech therapist, this movement of the various structures of the swallow (in and around the larynx) may help indicate swallow function status.

Hyperkinesia

A state of excessive restlessness which is featured in a large variety of disorders that affect the ability to control motor movement, such as Huntington's disease. It is the opposite of hypokinesia, which refers to decreased bodily movement, as commonly manifested in Parkinson's disease.

Hypertension

Abnormally high blood pressure; can lead to stroke or heart disease.

Hyponatremia

A condition that occurs when the level of sodium in the blood is too low. With this condition, the body holds onto too much water. This dilutes the amount of sodium in the blood and causes levels to be low.

Symptoms include nausea, headache, confusion, and fatigue.

Hypoxic brain injury

Brain injuries that form due to a restriction on the oxygen being supplied to the brain. The restricted flow of oxygen causes the gradual death and impairment of brain cells.

Incontinent

Inability to control urine or bowel movements.

Intelligibility

Refers to the perceptual quality of speech, which can be affected by both language and speech impairments.

Intracranial hemorrhages

Occurs when a blood vessel within the skull is ruptured or leaks. It can result from physical trauma (as occurs in head injury) or nontraumatic causes (as occurs in hemorrhagic stroke) such as a ruptured aneurysm.

Korsakoff syndrome

A chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1). Korsakoff syndrome is most commonly caused by alcohol misuse.

Locked-in syndrome

A state of wakefulness and awareness with quadriplegia and paralysis of the lower cranial nerves, resulting in inability to show facial expression, move, speak, or communicate, except by coded eye movements.

LSVT

Originally called Lee Silverman Voice Therapy (LSVT), this therapy program now encompasses voice therapy as well as physical therapy (LSVT BIG) for people with Parkinson’s disease. It is rooted in theories of basal ganglia dysfunction related to the disease.

Manual therapy

Also called manipulative therapy, is a physical treatment primarily used by physical therapists, physiotherapists, or occupational therapists to treat musculoskeletal pain and disability; it mostly includes kneading and manipulation of muscles, joint mobilization and joint manipulation.

Medical trauma

Emotional and physical responses to pain, injury, serious illness, medical procedures and frightening treatment experiences. There are lots of different experiences related to illness, injury or medical treatment that can be difficult, uncomfortable or frightening.

Melodic intonation therapy (MIT)

An evidence-based treatment method that uses intoning (singing) to improve expressive language in people with aphasia.

Meltable solid

Foods that “melt” or soften readily with saliva and then break apart easily. Example: Cheese puffs. Can be recommended for patients who have dysphagia (difficulty swallowing).

Mild cognitive impairment (MCI)

The stage between the expected cognitive decline of normal aging and the more serious decline of dementia. It's characterized by problems with memory, language, thinking, or judgment.

Modified barium swallow study (MBSS)

An x-ray that allows the radiologist (who specializes in using x-rays) and speech-language pathologist (SLP) to identify root causes of dysphagia (difficulty swallowing).

Multiple sclerosis (MS)

A disease in which the immune system eats away at the protective covering of nerves.

Muscular dystrophy

A group of inherited diseases that damage and weaken your muscles over time. This damage and weakness is due to the lack of a protein called dystrophin, which is necessary for normal muscle function. The absence of this protein can cause problems with walking, swallowing, and muscle coordination.

Myasthenia gravis (MG)

A neuromuscular disorder that causes weakness in the skeletal muscles, which are the muscles your body uses for movement. It occurs when communication between nerve cells and muscles becomes impaired.

Neuromuscular electrical stimulation (NMES)

Uses a device that sends electrical impulses to nerves. This input causes muscles to contract. The electrical stimulation can increase strength and range of motion, and offset the effects of disuse.

NG Tube

Placed through the nose to the stomach for feeding.

Odynophagia

Pain when swallowing.

Oral mech exam or oral motor exam

Usually performed by a speech therapist, this examination looks at the cranial nerves as well as function and status of the face and mouth in relation to speech and swallowing.

Orthosis

Braces, splints, other devices that are applied to a part of the body for supportive, assistive, adaptive, preventive or corrective purposes.

Ostomy

An artificial opening in an organ of the body, created during an operation such as a colostomy, ileostomy, or gastrostomy; a stoma.

Palliative care

An interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex illness.

Paraphasia

A type of language output error commonly associated with aphasia, and characterized by the production of unintended syllables, words, or phrases during the effort to speak.

Paraplegia

Paralysis of the lower part of the body.

Parkinson’s disease

A brain disorder that leads to shaking, stiffness, and difficulty with walking, balance, and coordination. Parkinson's symptoms usually begin gradually and get worse over time. As the disease progresses, people may have difficulty walking and talking.

PEG Tube

A feeding tube placed through the abdominal wall to the stomach.

Perception

The ability to take in information from the environment and to make sense of it; for example to know where your body is in space or to know your right side from your left.

Perseveration

Continuation of an activity or spoken utterance even after the stimulus has been removed.

Person-centered care

Defined by the World Health Organization as “empowering people to take charge of their own health rather than being passive recipients of services.” This care strategy is based on the belief that patient views, input, and experiences can help improve overall health outcomes.

Physiatrist

Physician specialist in physical medicine and rehabilitation.

Pocketing

Getting food caught between cheek and gum on paralyzed side of face.

Positioning

Placing the body in positions that are the most conducive to preventing: spasticity, contractures, pressure sores, and impaired breathing.

Post-traumatic amnesia (PTA)

A state of confusion that occurs immediately following a traumatic brain injury (TBI) in which the injured person is disoriented and unable to remember events that occur after the injury. The person may be unable to state their name, where they are, and what time it is.

Postoperative cognitive dysfunction

A new cognitive impairment arising after a surgical procedure.

Pragmatics

The rules of language that allow a person to know when and how to say what to whom; includes nonverbal language and situational interpretation.

Presbylaryngis

Atrophy of the vocal folds.

Presbyphagia

Difficulty swallowing related to the effects of aging.

Primary progressive aphasia (PPA)

A neurological syndrome in which language capabilities become slowly and progressively impaired. Unlike other forms of aphasia that result from stroke or brain injury, PPA is caused by neurodegenerative diseases, such as Alzheimer's Disease or Frontotemporal Lobar Degeneration.

Proprioception

The awareness of the position and placement of any part of the body.

Prosody

The patterns of rhythm and sound used in speech.

Prospective memory

A form of memory that involves remembering to perform a planned action or recall a planned intention at some future point in time. Prospective memory tasks are common in daily life and range from the relatively simple to extreme life-or-death situations.

Prosthesis

Artificial replacement for a part of the body.

Pseudobulbar affect (PBA)

A condition that's characterized by episodes of sudden uncontrollable and inappropriate laughing or crying. Pseudobulbar affect typically occurs in people with certain neurological conditions or injuries, which might affect the way the brain controls emotion.

Quad cane

A cane with four legs to provide a broader base of support.

Quadriplegia

Paralysis affecting all four extremities of the body.

Rancho Los Amigos Scale

This scale is commonly used by both medical and rehabilitation providers to measure and track cognitive recovery after traumatic brain injury. It is a 10-point scale, although many medical professionals only use the first eight levels.

Range of motion (ROM)

Movement of a joint through all the passive motions that the anatomy of the joint will permit.

Receptive aphasia

The inability to comprehend spoken, written, or gestural language.

Reminiscence therapy

A treatment that uses all the senses — sight, touch, taste, smell and sound — to help individuals with dementia remember events, people and places from their past lives. As part of the therapy, care partners may use objects in various activities to help individuals with recall of memories.

Sarcopenic dysphagia

A swallowing difficulty associated with loss of mass, strength and generalized muscular function. Its prevalence is higher among elderly patients and those with malnutrition or with disuse of the swallowing musculature.

Semantic Feature Analysis (SFA)

A therapy technique that focuses on the meaning-based properties of nouns.

Sialorrhea

Medical term for drooling.

Silent aspiration

When someone is aspirating (taking food/liquid/bacteria into their lungs) without overt signs and symptoms such as coughing, choking, or watery eyes.

Skilled Nursing Facility (SNF)

An institutional setting where continuous nursing/medical care is provided; specific criteria must be met for admission, such as a particular medical need or therapeutic need.

Spaced retrieval (SR)

A therapeutic technique, or modality, that utilizes high repetition with minimal variation to access motor/procedural learning to facilitate recall of facts or strategies. The goal is accurate recall of information over progressively longer periods of time.

Spasmodic dysphonia

A voice disorder that causes involuntary spasms in the muscles of the voice box or larynx. This causes the voice to break and have a tight, strained or strangled sound.

Spasticity

A condition in which muscles stiffen or tighten, preventing normal fluid movement. The muscles remain contracted and resist being stretched, thus affecting movement, speech and gait.

Speaking value or Passy Muir valve (brand name)

When placed on the hub of the tracheostomy tube or in-line with the ventilator circuit, the Passy Muir® Valve redirects air flow through the vocal folds, mouth and nose enabling voice and improved communication.

Splint

A light-weight one-piece device fitted to support a body part in a desired position.

Spontaneous recovery period

With spontaneous recovery after traumatic brain injury, even in the absence of training or rehabilitation, there is resolution of injury and functional change in close time proximity after injury which plateaus within three months for focal injury and six months for diffuse injury (Chen, Epstein and Stern, 2010).

Spoon theory

A way of describing the experience of chronic illness and its limitations using a metaphor of spoons that represent energy use throughout the day. (Based on the work of Christine Miserandino).

Tardive dyskinesia

A condition affecting the nervous system, often caused by long-term use of some psychiatric drugs.

TIA (mini-stroke)

Cerebrovascular Accident; damage to the brain caused by a gradual or sudden disruption in the blood vessels.

Trachea

Tube to the lungs.

Tracheostomy (also called tracheotomy)

A medical procedure — either temporary or permanent — that involves creating an opening in the neck in order to place a tube into a person's trachea. The tube is inserted through a cut in the neck below the vocal cords. This allows air to enter the lungs.

Transcortical motor aphasia

Transcortical motor aphasia resembles Broca's aphasia, but patients are able to repeat.

Transfer

Movement from one position to another, usually from one object to another such as from a bed to a chair.

Transfer board or slide board

Board with tapered ends used to bridge the gap between two objects during the transfer of an individual.

Transitional brain Injury

Care specific to a person with a brain injury who requires continuation of therapies with emphasis on behavioral and adjustment issues for community re-entry.

Trismus

Commonly called lockjaw, is reduced opening of the jaws (limited jaw range of motion). It may be caused by spasm of the muscles of mastication or a variety of other causes. Temporary trismus occurs much more frequently than permanent trismus.

Unilateral neglect or left neglect

A condition, after damage to one brain hemisphere occurs, where the person becomes unaware of and inattentive to one side of the body. This is usually the side opposite to the half of the brain that was damaged.

Urinary tract infection (UTI)

An infection in any part of the urinary system, the kidneys, bladder, or urethra. Symptoms can include confusion and other cognitive impairments.

Variance form

A quasi-binding legal document sometimes required by healthcare facilities for patients to sign when electing not to follow swallow guidelines recommended by a speech-language pathologist.

Videofluoroscopic swallow study (VFSS)

Also known as modified barium swallow study (MBSS), VFSS is a radiographic procedure that provides a direct, dynamic view of oral, pharyngeal, and upper esophageal function during swallowing. During this procedure, the SLP presents food and liquid mixed with barium.

Walker

Device used to provide broad base for walking.

Wernicke's aphasia

A type of aphasia where the ability to grasp the meaning of spoken words and sentences is impaired, while the ease of producing connected speech is not very affected.

Wernicke's area

The region of the brain that is important for language development. It is located in the temporal lobe on the left side of the brain and is responsible for the comprehension of speech, while Broca's area is related to the production of speech.

Xerostomia

Dry mouth.