Domain 1

Dyspnea

Shortness of breath due to impaired breathing in response to activity or at rest, may require:
• medical attention
• modification to activity demands
• instruction in breathing techniques
• dyspnea control postures

Motor apraxia

Neurobehavioral deficit characterized by difficulty planning and sequencing the motor movements needed to complete a task (e.g., attempting to reposition the bristles of a toothbrush to brush teeth when moving it from one side of the mouth to the other)

Bulimia nervosa

Eating disorder characterized by:
• fear of gaining weight
• binge eating followed by purging (e.g., vomiting, or use of laxatives/diuretics) secondary to excessive concern about body weight

Emotional regulation development: Self-regulation phase

Phase of emotion regulation development, occurring between 36 months of age and older

Characterized by emerging:
• flexibility to adapt to unexpected change
• self-awareness
• capacity to evaluate own behavior

Social play

Play occupation that includes:
• interaction with and emotionally relating to others
• behavior and skills to develop and progress through childhood

Cubital tunnel syndrome

Pain, numbness, and paresthesia in the ring and small fingers due to ulnar nerve compression at the elbow, symptoms are associated with direct compression of the nerve or repetitive or sustained flexing the elbow beyond 90°

Conservative intervention may include:
• activity modification
• orthotic positioning
• neural gliding exercises
• ergonomic education

Constructive play

Play occupation that involves using objects/toys to produce or build something (e.g., put together a puzzle)

Egocentrism

Inability to consider perspectives or beliefs other than one's own (i.e., a person who is egocentric sees themselves as the center of attention)

May result in a belief of being above rules and consequences

Schizophrenia

Psychotic thought disorder with altered sense of reality, symptoms may include:
• hallucinations and delusions
• disturbance in thinking and behavior
• emotional blunting, social isolation, and cognitive changes

stereognosis

Also known as haptic or tactile gnosia

Right/left discrimination

The ability to differentiate one side of the body from the other, impairments may cause:
• decreased ability to follow directional instructions
• difficulty with spatial relations

Alzheimer’s disease (AD): Mild Stage

Stage of Alzheimer’s disease progression associated with:
• difficulty remembering new information
• getting lost
• challenges with money management
• increased time to complete ADL and routines
• mood and personality change

Cognitive Flexibility

A component of executive functioning that involves the ability to think about various ideas simultaneously and switch between different ideas

Pediatric Quality of Life Inventory (PedsQL)

Standardized pediatric measure for children with acute and chronic health conditions as well as healthy children used to assess health related quality of life

Features of the test include:
• appropriate for ages 2 to 18 years

Expected functional outcome: Spinal cord injury Level C6

Expected functional outcome after SCI:
• independent respiratory function with reduced vital capacity; may need assistance for a productive cough
• minimal to total assistance for bowel and bladder management with adaptive devices
• some assistance for basic ADL
• may need some assistance for outdoor wheelchair propulsion in a manual wheelchair
• may need some assistance for transfers and bed mobility with adaptive devices
• total assistance for standing

deQuervain’s tenosynovitis

Inflammation of the abductor pollicis longus and extensor pollicis brevis, resulting in pain, crepitation and swelling over the radial styloid, Finklestein’s test is typically positive

Conservative intervention includes:
• activity modification
• orthotic positioning
• tendon gliding exercises
• ergonomic education

Procedural memory

Type of long-term memory associated with knowing how to perform learned skills and actions (e.g., how to ride a bicycle, tie shoes)

Clasp-knife rigidity

Reflexive abnormal motor response due to a cortical lesion in which a spastic muscle suddenly releases tension and gives way in response to passive stretch

Semantic memory

Type of declarative long-term memory associated with retrieval of common knowledge, including vocabulary and general facts (e.g., colors, names of political leaders, capitals of countries)

Alzheimer’s disease (AD): Severe stage

Stage of Alzheimer’s disease progression associated with:
• inability to communicate
• dependent in ADL
• dysphagia and increased risk of aspiration
• incontinence

Visual accommodation

A mechanism of the eye that allows clarity of vision when a visual stimulus moves close to or away from the eyes

Phantom sensation

Following amputation, experience of perceiving sensory input from residual limb that is no longer present, may include constant or intermittent itching, pain, or burning

Anterolateral approach

Post-surgical hip precaution approach that includes the following:
• no hip extension (e.g., do not step backward with affected leg)
• no external rotation (e.g., do not let the leg turn outward)

Step-down unit

A unit in a hospital setting that provides less intensive care and focuses on support needed to progress toward discharge

Muscle grade 2/5

Score may range from:
• poor (-): able to initiate movement in gravity-minimized plane
• poor: incomplete ROM in gravity-minimized plane
• poor (+): complete ROM in gravity-minimized plane

Complex regional pain syndrome: Stage III

Atrophic stage of CRPS that typically lasts several years or more after injury or trauma, characterized by:
• decrease in pain intensity
• irreversible changes in skin and joints
• persistent edema – unresponsive to intervention
• bony demineralization
• severe muscle atrophy
• joint contractures

Stage of motor learning: Skill achievement

Stage of motor learning development, occurring between 6–9 months of age

Characterized by:
• high adaptability
• both perceptual learning and increased self-organization
• using action patterns that are orderly and efficient

Clonus

Reflexive abnormal motor movements in response to a tendon stretch (as in reflex testing), indicative of a cortical lesion, characterized by a series of involuntary rhythmic contraction and relaxation of the muscle (shaking basically)

Splitting

Strain between therapist-client relationship and/or interprofessional team members where the staff response to manipulative behaviors of a client include:
• blurring professional boundaries
• creating team division

Stage 3 pressure ulcer

Stage of pressure ulcer characterized by:
• full-thickness skin loss
• open wound that looks like a crater
• wound extends into the fat layer but not to the tendon, muscle, or bone

Temperament

Behavioral attributes of a personality that influence social interactions in nine areas:

• activity level
• intensity of response
• rhythmicity
• approach or withdrawal
• attention span
• threshold of response
• distractibility
• quality of mood
• adaptability

Pretend play

Play occupation that involves making objects/toys perform intended actions (e.g., pretending to use a phone to talk)

Also referred to as symbolic or imaginary play

Myasthenia gravis

Autoimmune motor unit disorder, characterized by:
• ptosis and double vision
• possible difficulty with chewing, swallowing, and speech
• weakness and fatigue that increases throughout the day

Intervention may include:
• energy conservation and work simplification education
• sleep hygiene strategies
• recommendation of adapted and assistive devices
• activity modification

Central scotoma

Impaired central vision

Expected functional outcome: Spinal cord injury Level T2-T12

Expected functional outcome after SCI:
• independent to modified independence for basic ADL
• modified independence for bowel and bladder management
• modified independence for bed mobility, transfer, and standing
• independent wheelchair mobility

Ape hand deformity

Hand deformity secondary to a median nerve injury in the proximal forearm or at the wrist, presents with atrophy of the thenar eminence and inability to abduct and oppose the thumb

Intervention includes orthotic positioning to maintain palmar abduction and opposition

Two-point discrimination test

Sensory screening test involves applying pressure to the fingertips with client vision occluded, typically using a commercially available disk or caliper with two tips spaced from 1-10 millimeter intervals, responses to pressure indicate functional sensation as follows:
• 1-5 mm = Normal
• 6-10 mm = Fair
• 11-15 mm = Poor
• One point perceived = Protective sensation only
• No points perceived = Absent protective sensation

Stage of team development: Storming

Stage of team development characterized by:
• conflict and lack of cohesion within the team
• frustration among team participants
• low levels of trust within the team
• resistance of team members to take on tasks
• unachieved optimal levels of work performance

Oculomotor dysfunction

Visual impairment characterized by lack of efficient eye movements and eye-tracking skills due to a cranial nerve lesion or neural disruption of the extraocular muscles, functional deficits may include difficulties with:
• reading speed
• copying skills
• writing skills

Classification of UE amputations

• Interscapular = loss of the entire arm plus the shoulder girdle/scapular region

• Shoulder disarticulation = limb is absent through the shoulder joint

• Transhumeral = limb loss through the humerus

  • Long transhumeral = more humerus remains

  • Short transhumeral = less humerus remains

• Elbow disarticulation = limb loss through the elbow joint

• Transradial = limb loss through the forearm, below the elbow

  • Long transradial = more forearm remains

  • Short transradial = less forearm remains

• Wrist disarticulation = hand is absent through the wrist joint

• Transmetacarpal = loss occurs through the metacarpals of the hand, so part of the hand remains

The easiest memory rule is:

“Disarticulation” = through a joint
“Trans-” = through a bone/segment

Synovectomy

A surgical procedure used to remove the synovial membrane that lines a joint

Atelectasis

Partial or fully collapsed lung

Signs and symptoms include:
• rapid and shallow breathing
• dyspnea
• low oxygen saturation
• increased heart rate

Box and Blocks test

Standardized test to assess unilateral gross manual dexterity

Features of the test include:
• moving blocks from one side of a box to the other
• appropriate for ages 6 years and older

Basic vital sign: respiratory rate

12-20 breaths per min

Supervised

Level of assistance where a client requires occasional verbal assistance to safely complete a task

Duchenne muscular dystrophy

Inherited genetic disorder resulting in muscular weakness and atrophy of the proximal musculature of the pelvis and shoulder girdle, symptoms more common in males and detected around 3 years of age

Results in gradual loss of independent ambulation and progressive deterioration of musculature of the trunk, neck, and distal extremities

Cognition typically remains unaffected

Musculoskeletal system: Changes associated with aging

Changes associated with aging include:
• decrease in bone density
• sarcopenia
• decline in skeletal flexibility and mobility
• joint degeneration

Prospective memory

Type of memory associated with remembering to perform an action or event planned for a future date (e.g., attend a medical appointment, take medication, pay a bill)

Canadian Occupational Performance Measure (COPM)

Occupational performance evaluation and outcome measurement tool that measures perceived capacity and satisfaction in the areas of self-care, productivity, and leisure

Expected functional outcome: Spinal cord injury Level C5

Expected functional outcome after SCI:
• independent respiratory function with reduced vital capacity; may need assistance for a productive cough
• total assistance for bowel and bladder management
• independent self-feeding with adaptive devices
• assistance for grooming with adaptive devices
• total assistance for bathing

Expected functional outcome: Spinal cord injury Level L1-L5

Expected functional outcome after SCI:
• independent in ADL and bed mobility
• ambulate with assistive devices
• may use wheelchair for distance; independent with loading and unloading from the vehicle
• independent driving with hand controls

Disabilities of the Arm, Shoulder, and Hand (DASH)

Standardized self-report questionnaire to assess physical function and symptoms in upper limb musculoskeletal disorders, commonly used to collect outcomes information

Features of the test include:
• 30 items related to upper extremity function
• appropriate for ages 18 years and older

Expected functional outcome: Spinal cord injury Level C1-3

Expected functional outcome after SCI:
• ventilator dependent
• total physical assistance for BADL & IADL
• able to direct care needs

Health Belief model

Practice model includes tenet that an individual's perception of health combined with their environment impacts selection of behaviors that influence health

Ulnar drift

Hand deformity where MCP joints deviate to the small finger side of the hand, commonly associated with rheumatoid arthritis

Intensified by functional activities requiring power grasp and lateral pinch

Volumetric Displacement

Method used to measure and monitor UE edema, involves using a commercially-available water tank

Steps include filling the tank with water, immersing the hand and distal forearm into the tank, then measuring the amount of water displaced after immersion
Comparisons are made between two hands

Strabismus

A condition in which the eyes do not align when looking at an object; may impact:
• accurately reaching for objects
• reading

Autonomic dysreflexia

Potentially life-threatening acute medical condition caused by overreaction of the autonomic nervous system to stimulation, commonly associated with a SCI above T6 level, characteristic symptoms include:
• pounding headache
• chills and flushed skin
• anxiety
• excessively high blood pressure
• perspiration
• bradycardia

Long-term memory

Type of memory associated with storing information for an extended duration of time

Three types:
• episodic
• semantic
• procedural

Grasp Pattern

• Cylindrical grasp = fingers wrap around an object with the thumb opposing, like holding a cup, bottle, or hammer handle.

• Power grasp = the object is held firmly against the palm with the fingers flexed; used when strength is more important than precision, like carrying a heavy handle or gripping a tool.

• Tripod grasp = a precision grasp using the thumb, index finger, and middle finger, like holding a pencil.

Macular degeneration 

Progressive age-related visual condition, characterized by:
• atrophy of the macula (posterior part of the retina)
• decrease in central visual acuity
• blurry, distorted, or low vision

Intervention may include:
• magnification devices
• lighting recommendations
• color and contrast enhancements
• visual skills training

Hypertrophic scar

Type of scar formation caused by an overproduction of collagen and increased vascularity, characterized by:
• initially appearing as raised, thick, erythematous, possibly in a circular or spiral pattern
• progressively becomes flatter and more pliable as the wound matures and collagen fibers relax

Functional Capacity Evaluation (FCE)

Objective evaluation process, also referred to as work capacity evaluation/assessment, to determine
functional and physical abilities related to essential job tasks

Muscle grade 3/5

Muscle grade assigned for:
• fair strength observed where movement is noted against gravity

Score may range from:
• fair (-): incomplete ROM against gravity
• fair: full ROM against gravity with no resistance applied
• fair(+): full ROM against gravity and slight resistance

Stage of team development: Performing

Stage of team development characterized by:
• effective team capacity
• reciprocity of respect for roles
• high trust level
• optimal levels of productivity

Huntington’s disease

Genetically-inherited degenerative neurological disease typically beginning between 30-50 years of age, characterized by choreiform movements, decline in thinking and reasoning skills, alterations in mood

Interventions focus on supporting engagement in occupation and may include:
• environmental modification
• assistive devices
• augmentative communication devices
• dysphagia management
• cognitive strategies
• seating and mobility
• caregiver training

Expected functional outcome: Spinal cord injury Level C7-T1

Expected functional outcome after SCI:
• independent respiratory function
• assistance for bowel management
• modified independence for basic ADL
• some assistance for standing
• modified independence for bed mobility and transfer
• independent driving with modifications

Resource teacher

Member of the IEP team who provides academic support to the student and consultative recommendations to the team regarding inclusion capacity, learning and/or behavioral strategies, and student-focused curriculum-based needs

In-hand manipulation

Skill requiring control of the palmar arches of the hand to grasp and control objects

Five patterns include:
• finger-to-palm translation
• palm-to-finger translation
• shift
• simple rotation
• complex rotation

Chronological age

Age of individual since birth, calculated by subtracting birth date from current date

Nervous system: Changes associated with aging

Changes associated with aging include:
• brain atrophy
• decrease in nerve conduction velocity
• reduced ability to maintain homeostasis
• decline in cognitive processing: memory, reaction time, processing speed, and problem-solving

Deep partial thickness burn

Type of burn typically associated with:
• direct contact or lengthy exposure to a heat source
• complete destruction of epidermis and most of the dermis
• redness and large blisters
• high risk of hypertrophic scar or contractures

Stereopsis

The ability to see 3-dimensional objects and perceive depth; may be impaired by:
• monocular vision
• strabismus

Model of Human Occupation (MOHO)

Practice model that includes the following tenet:
individuals are a product of their own volition, habituation, and performance with an appreciation for the effect of the environment

Emotional regulation development: Control phase

Phase of emotion regulation development, occurring between 12-18 months of age

Characterized by:
emerging awareness of social demands
• varying levels of inhibition and compliance
• self-initiated monitoring related to an understanding of consequences

Spinal stenosis

Narrowing of intervertebral foramen often compressing the nerve as it exits the spinal column, symptoms may include:
• referred pain
• paresthesia
• muscle weakness
• sensory changes

Temporal lobe

Major functions of this lobe of the cerebral cortex include:
• long-term memory
• receptive language (left temporal lobe)
• processing of sensory information (auditory and visual)

Osteotomy

A surgical procedure used to change the length or position of a bone

Caregiver education

Collaborative client-centered teaching approach used to advise family and relevant others on:
• plan of care and goals
• resources
• discharge planning
• home programs

Includes assessing the ability to carry out health care recommendations

Interdisciplinary team

Team in which health care providers collaboratively determine client goals with discipline specific interventions being combined with use of complimentary, shared approaches

Task-oriented approach

Motor recovery intervention approach that includes:
• repetition of movement during meaningful, client-centered, daily activities
• activity analysis and consideration for the interaction between person, environment, and occupation

Confabulation

A memory impairment that causes an individual to share false details of situations, memories of past events, or personal information without the intention to deceive

Spondylosis

Degenerative process in the spine and typically associated with osteoarthritis, symptoms may include:
• pain
• neurological changes
• motor impairment

Individualized education program (IEP) team

Professionals involved in developing the individualized education program, including the student and relevant others, such as:
• parents or guardians
• general education teacher
• special education teacher
• representative from school system
• related services professionals

Neurologic deficits associated with right hemisphere dysfunction

Deficits typically associated with damage to this hemisphere of the brain include:
• left hemiparesis or hemiplegia
• sensory impairment on left side of body
• unilateral body and spatial neglect
• motor apraxia on left side
• visual field cut on left side
• visuospatial problems
• attention deficits
• decreased insight into deficits

** Deficits depend on the specific area of the right hemisphere that is damaged.

Interagency team

Inclusive team of care professionals that includes the primary care team and outside agencies to optimize client outcome

Beneficial during times of transition

Basic vital sign: oxygen saturation

Arterial blood gas measured using a pulse oximeter

Normal range = 95-100%

Cognitive Behavioral Therapy (CBT)

Intervention with basic tenet that a change in thinking or in assumptions will result in a change in behavior

Commonly used with client’s who have:
• anxiety disorder
• substance abuse
• mood disorder

Case manager

Member of the interprofessional team responsible for the coordination of services deemed medically or educationally necessary for an individual

Bipolar disorders

Mood condition that manifests as manic, depressive, or mixed episodes:
• type I is primarily manic
• type II is primarily depressive

Deep vein thrombosis: Preventive strategies

Used with patients who are high-risk for developing blood clot in the legs and include:
• compression hosiery
• calf-pumping exercises
• functional mobility

Intracranial pressure (ICP)

Measured via internal probe to determine pressure inside the skull

Normal range is below 20 mmHg. Therapeutic parameters are client-specific and are directed by the physician and the care team.

Righting reactions

Postural reflex present from approximately 3 months to 6 months of age that functions to orient the body in response to visual and vestibular input

Examples include:
• neck on body
• body on body
• body on head

Kyphosis

Excessive posterior curvature of the spine

Emotional regulation development: Sensorimotor modulation phase

Phase of emotion regulation development, occurring between 3-9 months of age

Characterized by:
• enjoyment of sensorimotor play
• sensory exploration
• possible sensory modulation challenges

Systemic lupus erythematosus

• joint pain and swelling
• skin lesions
• fatigue
• Raynaud’s phenomenon
• dyspnea
• alterations in cognition

Aphasia

Receptive and/or expressive language impairment secondary to a brain lesion

Typically sub-categorized as:
• global
• anomic
• Broca’s
• Wernicke’s
• conduction
• transcortical

Stage of motor learning: Perceptual learning

Occurs in child development between 3-6 months

Characterized by:
• more accurate and direct reaching
• reaching to the midline
• emerging ability to combine reach and grasp with two hands

Criterion-referenced test

Type of standardized test includes comparing abilities of a client to a defined list of skills or level of performance
Examples include:
• School Function Assessment
• Gross-Motor Function Measure

Stage of team development: Forming

Stage of team development characterized by:
• introductions to team members
• generally positive and polite interactions
• unclear team member role delineations
• leader-dominated role