ACTIVITIES OF DAILY LIVING (ADLs)

ADLs are the components of an individual�s self-care routine, including bathing, dressing, grooming and meal preparation. Following is a glossary of some terms you may hear in discussions about patient care.

AFFECT:  The motor expression of emotion; how the person appears externally as opposed to how he or she feels; a brain-injured patient�s affect may not signify the feeling(s) he or she is actually experiencing.

AFO:  Ankle-foot orthosis; a short leg brace.

AMBULATE:  To walk.

AMNESIA:  The loss or impairment of memory function resulting from brain dysfunction.

ANEURYSM:  A localized, abnormal blood filled dilation (stretching) of a blood vessel resulting from weakness in the vessel wall.

ANOMIA:  A loss of the ability to recall the names of objects.

ANOXIA:  A lack of oxygen caused by respiratory or circulatory problems. 

ANTICONVULSANT:  Medications used to control or prevent seizures.

APHASIA:  A loss of previously acquired language function resulting from damage to the brain, typically including impaired comprehension, reading, writing, spelling and speech production.

APRAXIA:  A loss of the ability to execute complex movements without actual impairment of muscles, senses, coordination or comprehension; a brain-injured survivor may be able to perform an activity spontaneously but not on command.

ASPIRATION:  The result of swallowing dysfunction in which food, liquid or secretions enter the lungs rather than the stomach.

ASSISTIVE DEVICE:  Special or modified equipment that helps the disabled person function (i.e. cane, special eating utensil, hearing aid).

ATAXIA:  An inability to coordinate voluntary muscular movements.

ATTENTION SPAN:  The length of time a person can concentrate on a task or event.

BED MOBILITY:  A person�s ability to move himself or herself on a mat or bed, as by rolling, sitting or lying down.

BEHAVIOR MODIFICATION:  A form of therapy that uses a system of rewards and other responses to encourage appropriate behavior patterns and to discourage inappropriate ones.  Specific management strategies are used, with the ultimate goal of teaching the individual to control his or her own behavior without imposed consequences.

BILATERAL:  Both sides of the body.

CATHETER:  A tube used to permit the injection or withdrawal of fluids; 1) Foley: inserted into the bladder for draining urine; 2)condom:  placed over the penis for draining urine.

CLONUS:  A sustained series of rhythmic spasms, usually seen in ankles and wrists, caused by alternating contractions and partial relaxations of a muscle.

COGNITION:  The mental processes of all aspects of knowledge and conscious intellectual activity, including thinking, planning, problem solving, remembering, concentrating and imagining.

COGNITIVE RETRAINING:  Developing or relearning the processes involved in conscious intellectual activity.

COMPREHENSION:  The ability to understand or draw meaning from what is seen (visual comprehension), what is heard (auditory comprehension) or what is touched (tactile comprehension).

CONCRETE THINKING:  The literal interpretation of language; the inability to understand similarities between situations.

CONFABULATION:  Inaccurate recollection due to memory loss often results in the individual�s apparently making up stories.�

CONTINENCE:  The ability to control bowel and bladder functions.

CONTRACTURE:  A shortening of a muscle or tendon resulting in joint stiffness of joint immobility.

CONTUSION:  A bruise (of the brain tissue).

DECUBITUS:  A bed sore; an ulceration of the skin that requires topical treatment and body positioning to heal.

DENIAL:  A lack of awareness of one�s self, one�s problems or one�s effect on others.

DEPRESSION:  A specific psychiatric disorder marked by low self-esteem, a significant increase or decrease in appetite, a significant change in sleep patterns, sadness, inactivity, lack of participation in therapy, etc.; sometimes loosely used to refer to depressed mood.

DIFFUSE AXONAL INJURY:  Widespread microscopic injury to axons (nerve fibers), along with injury to specific brain structures including the upper brainstem.

DIPLOPIA:  Double vision.

DYSARTHRIA:  Unclear, slurred speech caused by weakness or incoordination of the muscles used to produce speech sounds.

DYSPHAGIA:  Difficulty swallowing.

EXTENSION:  The straightening of a joint.

FINE MOTOR ACTIVITIES:  Activities such as writing or tying a shoelace that involve small, complex movements.

FLACCID:  Lacking firm muscle tone.

FLEXION:  The bending of a joint.

FOLEY:  A urinary catheter, which allows urine to drain from the bladder into an external collecting device.

FUNCTIONAL:  Able to use skills at a fairly independent level in daily activities; it does not imply that a patient has returned to normal.�  For example a patient may express his or her wants or needs with minor speech errors.  This is not perfect or exact as the function may have been before the brain injury, but it allows the patient to function in the environment without difficulty.  

GAIT TRAINING:  Ambulation training; instruction in walking with or without special equipment.

GASTROSTOMY TUBE:  A tube, which leads directly into the stomach, allowing nutritional formulas, fluids and medication to be administered.

GLASGOW COMA SCALE:  One scale used to measure coma levels, based on numerical scores for eye opening, speech and body movements. (total score ranges from 3 to 15).

GROSS MOTOR ACTIVITIES:  Activities such as sitting up and standing, which involve large movement of body parts.

HEMATOMA:  A blood clot.

HEMIPARESIS:  Partial or incomplete paralysis of muscles on one side of the body.

HEMORRHAGE:  Internal or external bleeding, usually occurring rapidly and in large quantities.

HETEROTOPIC OSSIFICATION (HO):  Inflammation and deposition of calcium forming along areas within muscle tissue.

HYDROCEPHALUS:  An abnormal increase in the amount of cerebrospinal fluid within the cranial cavity, accompanied by expansion of the cerebral ventricles; a neuro-surgically placed shunt tube can drain this excess fluid to the abdomen, sometimes resulting in improved clinical function.

INCONTINENCE:  The inability, due to physical and/or cognitive problems, to control urination and bowel movements.

INFARCTION:  An area of tissue where cells die from a lack of blood supply; in the brain, a stroke.

INSIGHT:  The ability to appreciate or comprehend one�s deficits. 

MEMORY:  The power or process of recalling or reproducing what has been learned or retained; 1) Immediate: recall of what is said without delay; 2)recent: recall of new information from day to day; 3) remote: recall of the past.

MOTOR PLANNING PROBLEM:  Difficulty performing coordinated movements, resulting from no actual muscle weakness or damage; dyspraxia.

MUSCLE TONE:  The normal degree of tension in a muscle.

NASOGASTRIC TUBE (NG TUBE):  A tube leading directly through the nose into the stomach, allowing for nutritional formulas, fluids and medications to be administered.

NEUROPSYCHOLOGY:  A science concerned with understanding how brain dysfunction affects cognitive, emotional and behavioral performance.

NON-PURPOSEFUL MOVEMENT:  Random movement; body movement that has no apparent purpose.

NPO:  A medical abbreviation for a physician�s order that the patient is to receive nothing by mouth, possibly due to swallowing difficulty, special testing procedures or impending surgery.

ORIENTATION:  An accurate awareness of the existing situation with reference to time, place and identity of persons, evidence of new learning.

ORTHOTIC:  A device designed for the support of weak joints or muscles (i.e. splint and brace).

PARALYSIS:  Inability to move a muscle or group of muscles voluntarily.

PARESIS:  Partial or incomplete paralysis.

PERCEPTION:  Awareness of the elements of the environment through physical sensation (size, shape, color, distance, etc.).

PERCEPTUAL-MOTOR:  The interaction of sensory perception with muscular activities (i.e. hand-eye coordination).

PERSEVERATION:  Uncontrolled involuntary repetition of speech or activity; difficulty changing topics, tasks or activities.

PHYSIATRIST:  A physician with special training in rehabilitation medicine.

PLATEAU:  A continued absence of significant improvement.

POST-TRAUMATIC AMNESIA:  The inability to recall day-to-day events as the result of a recent trauma, such as brain injury.

PREMORBID:  Before the injury.

PRESSURE AREA:  A sore or discolored area of the skin caused by continued pressure, which could eventually develop into a bed sore.

PRONE:  Lying face down.

PROSTHESIS:  An artificial limb or appendage.

RANGE OF MOTION (ROM):  The range of movement available in a joint, measured by degrees; 1) Passive: when the therapist moves the joint (PROM); 2) active: when the individual moves the joint (AROM).

REFLEX:   An involuntary response to a stimulus.

REHABILITATION:  A comprehensive, interdisciplinary system of medical and therapeutic treatment that enables an injured or impaired person to reach the highest degree of cognitive and physical independence possible.

RETROGRADE AMNESIA:  The inability to recall events that occurred during a specific period of time before the injury. This period usually becomes shorter as the individual improves.

SEIZURE:  A convulsion caused by an electrical discharge in the brain ranging in intensity from generalized shaking with loss of consciousness to episodic strange feelings or sensations.

SELECTIVE ATTENTION:  The ability to focus attention on one specific thing or task for a given period of time.

SENSATION:  A mental process due to immediate stimulation of the senses (touch, sight, hearing smell and taste), often as distinguished from awareness of the process (perception).

SENSORY STIMULATION:  Arousing the brain through any of the senses.

SERIAL CASTING:  The use of fiberglass casting on specific joints to increase range of motion.

SHEARING INJURY:  Diffuse brain damage caused by area of the brain tissue moving in the same direction at different speeds.

SHORT-TERM MEMORY:  The ability to learn new information.

SLING:  A soft support for injured or weakened extremities.

SPASM:  A sudden, involuntary muscle contraction.

SPASTICITY:  The state of exaggerated muscle response, causing stiff awkward movements and abnormally increased muscle tone.

SPLINT:  An orthotic device used to protect or immobilize a joint to reduce muscle tension, increase range of motion and/or allow greater functional use of the body part.

STRUCTURE:  To organize information to simplify and make sense of a task, an activity or the surroundings.

SUBDURAL HEMATOMA:  A swelling containing blood that is located above the brain and underneath the lining membrane (dura), often accompanied by a contusion; problems are most severe when the brainstem is compressed by pressure from the overlying hematoma.

SUPINE:  Lying on one�s back.

TANGENTIAL SPEECH:  Conversation that wanders from the initial topic.

TEAM CONFERENCE:  A regularly scheduled meeting of all members of the interdisciplinary treatment team for discussion of a patient�s progress, therapy goals and plans and discharge planning issues.

TETRAPARESIS:  Partial or incomplete paralysis of all four limbs of the body.

TRACHEOSTOMY TUBE:  A tube leading from the exterior of the throat into the windpipe (trachea) to allow for an adequate exchange of air.

TRACKING:  Visually following with the eyes.

TRANSFER:  Methods of getting to and from a wheelchair, bed, toilet, etc.

TREMOR:  A trembling or shaking, usually about a joint.