OTD-551: Midterm Exam- Key Terms

client factors

basic structures & functions of a person that are used for occupational performance, edema, range of motion, strength, and endurance are all client factors

mechanical advantage (MA)

ratio that describes how easily a force can move a resistance using a lever

moment arm

the perpendicular distance from the axis of rotation to the line of force (force vector) on a lever

muscle endurance

the ability of a muscle to contract repeatedly or over time without a decrease in force produced

muscle strength

the maximum amount of force that is produced by a muscle in a single contraction

range of motion (ROM)

the arc rotational motion through which a bone moves around a joint; usually measured in degrees

strain

the change in shape of an object that results from the stress placed on it

stress

the force acting on an object, divided by the cross-sectional area of that object

torque

the extent to which a force causes an object to rotate around an axis

apraxia

the inability to perform purposeful actions despite having normal muscle & sensory functions

ataxia

unsteadiness, incoordination, or clumsiness of movement

bradykinesia

slowness of movement

dysmetria

an improper measuring of distance during motor acts; results in overshooting (hypermetria) or undershooting (hypometria) a specific target

flaccidity

a state characterized by a complete absence of muscle tone

paresis (plegia)

weakness of paralysis

spasticity

a velocity-dependent increase in tonic stretch reflexes; also denotes a form of muscular hypertonicity with exaggeration of tendon reflexes

tremor

involuntary rhythmic, oscillatory movements of the body or limbs; tremors that occur during precise intentional movements are known as INTENTION tremors; tremors that occur at rest & stop upon the initiation of voluntary movements are called RESTING tremors

action observation (AO)

a multisensory approach thought to promote neural reorganization via activation of the mirror neuron system; involves a patient watching another person engage in task performance with the intention of imitating the task performance. Observation is typically followed by the patient physically performing the task.

cognitive strategy training (CST)

an intervention that consists of teaching internal & external compensatory approaches to execute activities of daily living (ADLs)

constraint induced movement therapy (CIMT)

an intervention designed to overcome learned nonuse of an impaired limb; involves restraint of the less impaired limb and massed practice of the impaired limb via shaping and standard task practice

experience-dependent neuroplasticity

the brain's ability to change in response to environmental stimuli, experience, and learning

gesture training (GT)

a behavioral training program consisting of gesture-production exercises (i.e., transitive, intransitive-symbolic, intransitive-nonsymbolic gestures).

high amplitude movement training

a training approach that targets production of large amplitude movements, sensory recalibration to recognize these movements as normal, & self-cueing to maintain gains

mental practice (MP)

an intervention that uses the cognitive rehearsal of an action in the absence of physical movements to improve task performance

mirror therapy (MT)

an intervention that uses mirror visual feedback to create the illusion that an impaired limb is moving normally; involves placement of the impaired limb behind a mirror and the patient concentrating on the mirrored reflection of movements made by the less impaired limb in front of the mirror

motor apraxia

a disorder of the production praxis system; loss of access to praxicons (motor plans) so that purposeful movement cannot be produced or achieved because of defective planning and sequencing of movements, even though idea and task purpose are understood

task-oriented training (TOT)

involves practicing common daily life tasks with the intention of acquiring or reacquiring a skill

acquired brain injury (ABI)

head injury that can include traumatic and nontraumatic injuries caused by cardiovascular defects, tumors, substance abuse, environmental exposure, anoxia, bacteria, viruses, nutritional deficiencies, genetic, congenital, and degenerative diseases

agitation

excessive behavior including varied degrees of aggression, disinhibition, restlessness, & confusion. Person may present in an altered state of consciousness.

concussion

a type of traumatic brain injury (TBI) usually caused by a blow to the head, usually reported in sports activities including direct blow, bump, or jolt to the head; effects are usually temporary but can include headaches & problems associated with concentration, memory, balance, and coordination

diffuse axonal injury (DAI)

extensive lesions in white matter tracts over a widespread area following traumatic acceleration/deceleration or rotational injuries; DAI often results in loss of consciousness and could result in persistent vegetative state after severe head trauma

disorders of consciousness (DOC)

a state of reduced wakefulness & awareness due to brain damage

mild traumatic brain injury

a traumatically induced physiological disruption of brain function as manifested by at LEAST one of the following:
i) any period of loss of consciousness
ii) any loss of memory for events immediately before or after the accident
iii) any alteration in mental state at the time of the accident (feeling dazed, disoriented, or confused)
iv) focal neurological deficits that may or may not be transient, but where the severity of the injury does not exceed the following: loss of consciousness of ~30 min or less; after 30 minutes an initial Glasgow coma scale of 13-15; post-traumatic amnesia (PTA) not greater than 24 hours

moderate brain injury

a brain injury resulting in a loss of consciousness from 20 minutes to 6 hours & a Glasgow coma scale of 9-12; moderate TBI is characterized by loss of consciousness for 1-24 hours, PTS for 1-24 hours of the TBI, & abnormal brain imaging results

severe brain injury

a brain injury that results in loss of consciousness or come for more than 24 hours, PTA for more than 24 hours of TBI, and abnormal brain imaging results

traumatic brain injury (TBI)

a form of ABI following an external trauma to the head; a TBI occurs when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue

allodynia

a type of hypersensitivity characterized by the perception of pain in response to a non-painful stimulus

centrally mediated sensation

sensation controlled primarily by the brain and spinal cord, such as stereognosis

desensitization intervention

a type of sensory intervention that involves the application of standardized & sequential textures to relieve hypersensitivity

exteroceptive sensation (superficial sensation)

a type of peripherally mediated sensation perceived locally by sensory receptors in the skin and mucous membranes and consists of touch, pain, and temperature awareness

haptic perception

a type of centrally mediated sensation characterized by identifying and perceiving object features achieved by active exploration of the object

hypersensitivity

a response to sensory information in which ordinary stimuli produce exaggerated or unpleasant sensations

hyperesthesia

a type of hypersensitivity characterized by heightened sensitivity to tactile stimuli

peripherally mediated sensation

is sensation controlled primarily by sensory receptors in the skin, such as light touch.

quantitative sensory testing (QST)

type of assessment; is the standardized application of a stimulus followed by an interpretation of the patient's response in quantitative measures, such as percentage of correct responses.

sensibility

a person's sensitivity to sensory stimulation; considered a patient factor in OT

sensory re-education

a type of sensory intervention in which therapists guide the process of reteaching the brain how to feel & interpret sensory stimulation

assessment

tool used to gather information during the evaluation process

catheterization

a bladder-emptying technique in which a flexible tube (catheter) is inserted into the urethra to drain urine

clonus

an alternating involuntary muscle contraction & relaxation in rapid succession, associated with changes in muscle tone as a consequence of neurological injury or disease

complete injury

a diagnostic label that represents an absence of sensory and motor function in the lowest sacral segments (S4-S5)

crede method

a manual bladder-emptying technique that involves manual application of pressure superficial to the bladder

dermatome

the area of skin innervated by the sensory axons within each segmental nerve. A myotome is a group of muscles innervated by a single spinal nerve; myotomes are used in the diagnostic process of identifying the level of the SCI

ergometry

the study of physical work activity. In rehabilitation, ergometry often involves the use of a stationary bicycle or treadmill.

functional electrical stimulation (FES)

involves the application of electric current to paralyzed muscles in order to cause a muscle contraction

functional level

lowest segment at which strength of important muscles is graded 3+ or above out of 5 on MMT and at which sensation is intact

incomplete injury

A diagnostic label that represents the preservation of any sensory and or motor function below the neurological level that includes the lowest sacral segments S4-S5

motor level

A diagnostic label that quantifies functional outcome expectations; The motor level is identified by the most caudal section of the spinal cord with normal motor function

paraplegia

the loss or impairment in motor and or sensory function in the thoracic lumbar, or sacral segments of the cord, resulting in impairment in the trunk, legs, & pelvic organs & sparing of the arms

sensory level

identified by the most caudal segment of the spinal cord possessing normal sensation to pin prick & light touch; it has implication for functional outcomes

Tetraplegia (quadriplegia)

Loss or impairment in motor and/or sensory function in the cervical segments of the spinal cord and below, resulting in functional impairment in the arms, trunk, legs, and pelvic organs

tracheostomy

a surgically created hole in the trachea through which the tracheostomy tube is inserted; the tracheostomy provides the connection to the ventilator for individuals who cannot breathe spontaneously

Valsalva maneuver

method to facilitate a bowl movement; it involves holding one's breath while bearing down or pushing through the abdomen

Zone of partial preservation

refers to the dermatomes & myotomes caudal to the neurological level that remain partially innervated; over time, strength & sensation, improve, resulting in better functional outcomes

body powered prosthesis (BP)

an upper limb device that operates from an individual's proximal motions (typically the muscles of the shoulders, neck & back)

externally powered (EP) prosthesis

an upper limb device that operates through external power

functional envelope

the area of space in which the patient can effectively operate an UE prosthesis

heterotrophic ossification

bone that abnormally grows in soft tissue where it should not exist & it commonly occurs after trauma to the musculoskeletal system, brain, or spinal cord

hybrid prosthesis

an upper limb device that combines two prosthetic options into one; the most common combination is with a transhumeral prosthesis with a BP elbow and EP terminal device.

musculoskeletal pain

discomfort that occurs in other areas of the body, such as the back, neck, shoulder, or contralateral limb, as a result of overuse or poor body mechanics

myodesis

surgical technique that involves directly suturing muscle or tendon to amputated bone in order to provide optimal distal muscle stabilization

myoplasty

surgical technique that involves suturing muscle to muscle and then placing it over the end of the amputated bone before closing the wound; more commonly used in patients with poor vascular health

neuroma

an injured nerve in which severed nerve fibers from a disorganized mass of nerve cells (neuroma) that is painful with direct pressure

terminal device (TD)

an upper limb prosthetic component that is inserted at the distal end of an upper limb prosthesis and is used to grasp and release objects; may be a hook or hand.

activities of daily living (ADLs)

activities oriented toward taking care of one's body & include bathing, showering, toileting & toilet hygiene, dressing, swallowing & eating, functional mobility, personal device care, personal hygiene & grooming, and sexual activity

- also referred to as personal activities of daily living (PADLs) or basic activities of daily living (BADLs)

adaptive equipment

devices, tools, or products that are used to assist individuals with disabilities to engage in occupations within their natural contexts and environments; also referred to as assistive technology, assistive devices, or adaptive devices

client-centered approach

an approach to service delivery that includes respect for and collaboration with clients (individuals, groups, agencies, governments, or corporations). Therapists involve clients in decision-making, advocate for and with clients to meet needs, and recognize clients experience and knowledge

durable medical equipment (DME)

supplies that provide therapeutic benefit to clients experiencing difficulty or functional deficits resulting from medical conditions or illnesses. DME must be prescribed by physicians or health care providers authorized by state law. DME must be reusable and primarily used in the home.

occupational profile

a component of the occupational therapy evaluation that provides information about clients' occupational histories and experiences, daily living patterns, interests, values, needs, reasons for seeking services, and concerns related to occupational performance and disruption

occupations

activities that individuals, groups, or populations engage in that are meaningful and include activities of daily living, instrumental activities of daily living, rest and sleep, education, work, play, leisure, and social participation

adaptation

the process of modifying items, activities, & environments to promote function

assistive technology

items, equipment, & systems designed to promote function
-may be commercially available, modified, or customized

compensation

the use of techniques that all an individual to complete a desired activity in a modified way

compensatory techniques (strategies)

intentional ways of performing an activity differently

continuum of care

a comprehensive range of health-related services provided over time and across levels of intensity

environmental modification

a change to the physical or human environment designed to promote function

orthotic

a device designed to stabilize a body part, prevent deformity, protect against injury, or assist with function

prosthetic

a device designed to replace the function of a missing body part

remediation

the process of improving or correcting a deficit

aided communication

may include electronic or nonelectronic communication aids & require a child use a symbol system

ex: Picture boards, communication books, electronic systems

assistive technology service

any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device

Alternative and augmentative communication (AAC)

Type of high or low technology device designed to assist or replace verbal/gestural communication, assist individuals with verbal deficits express basic needs, emotions, thoughts, and/or converse with others

autonomy

the right of competent adults to make informed decisions about their own medical care

cognitive rescaling

describes a process of altering the cognitive difficulty information

competence

the ability to do something successfully or efficiently

computer-based communication system

use of specialized software and other modifications but can also carry out other functions such as environmental control

digitized speech

human speech that has been recorded, stored and reproduced

electronic aids for daily living (EADLs)

devices that facilitate the operation of electrical appliances in a given environment for a person with a severe physical disability.

electronic communication

Methods of communication via digital methods such as fax, email, voicemail, or by computer

functional literacy

refers to using reading, writing, and spelling skills to accomplish daily tasks in the home, school, community, and work settings