Glossary of Terms

Understanding Brain Injury II - Neurologic Rehabilitation - An Educational Guide Edited by: David S. Kushner, M.D. Glossary Rehabilitation & Medical Terms Insurance Terms

Abnormal Postural Sway - Greater than normal tone of muscles used to maintain the body in ordinary postures.

Abstract Thinking - Style of thinking in which concepts and ideas are understood and later applied in problem solving.

Acalculia - Inability to solve simple arithmetic problems.

Acute - Sharp, severe, having sudden onset and short course.

Acute Rehabilitation Program - Primary emphasis is on the early phase of rehabilitation, which usually begins as soon as the patient is medically stable.

ADL'S - Activities of daily living. Routine self care such as feeding, grooming, dressing, hathing and toileting activities.

Agnosia - Loss of the ability to recognize the meaning of a sensory stimulus. For example, visual agnosia is the inability to recognize familiar objects by sight.

Agraphia - Inability to express thoughts in writing. The inability to write words, numbers or letters.

Anosntia - Loss of smell.

Aphasia - Loss of the ability to verbally express oneself and/or to understand language.

Behavior Disorders - Abnormal patterns of behavior, such as violent, destructive actions, that prevent acceptable participation in a social setting.

Biofeedback - A process in which information, such as heart rate, skin temperature, or electrical activity of muscles, is recorded and then relayed back as a signal on a computer screen so that the individual becomes aware of any alteration in the activity.

Case Management - The process of facilitating the access of a patient to appropriate rehabilitation and support programs and coordination of the delivery of services.

Closed Head Injury - Trauma to the head that does not penetrate the skull, but injures the brain.

Cognition - The conscious process of the mind by which individuals perceive, think, and remember.

Coma - A state of unconsciousness from which the patient cannot be aroused, even by powerful stimulation. The unawareness of self or environment.

Day Care - A service provided during ordinary working hours for the patient who requires supervision, including assistance with medication, meal preparation, dressing or moving about.

Diffuse axonal Injury (DAI) - The widespread structural injury and disruption of axons, the wires of communication that exist between brain cells, that results from the forces of trauma.

Diffuse Brain Damage - Injury to the brain in many different areas rather than in one location. Diffuse damage is common in severe traumatic brain injuries.

Diplopia - Double vision; the perception of two images of a single object. Dysarthria - Difficulty in forming words and articulating often because of disturbances of oral muscle control when speaking.

Dysmetria - Inability to coordinate a movement of the extremities.

Executive Function - An organizational cognitive brain function that allows for available information to be used in planning, prioritizing, sequencing, self-monitoring, selfcorrecting, inhibiting, initiating, controlling, or altering behavior.

Extended Care Facility - A residential facility for the patient who require.s 24-hour nursing care or rehabilitative therapy on a less intensive basis than in an inpatient comprehensive rehabilitation center.

Flaccid - Lacking normal muscle tone; limp.

Glasgow Coma Scale - A standardized measure used by paramedics, nurse, and emergency physicians to establish the level of awareness in neurologically impaired persons following an acute traumatic brain injury by assessing responsiveness in three areas: eye opening, motor response, and verbal response.

Hemiparesis - Weakness of one side of the body. Hemiplegia - Paralysis of one side of the body.

Impulse Control - The ability to withhold socially inappropriate verbal or motor responses.

Independent Living Program - Community-based living to maximize a person's ability to be self-directed; allows an individual to live in his or her own home; usually combined with the opportunity to work when possible.

Logbook-- A diary-like listing of an individual's daily activities, which can be used to help remind the person of upcoming events.

Mild Traumatic Brain Injury - A concussion. A concussion is manifested at the time of trauma by confusion and amnesia of less than 24 hours of duration often without a preceding loss of consciouness. Loss of consciousness, if any, does not exceed the duration of 1/2 hour.

Moderate Brain Injury - Brain injury manifested at the time of trauma by loss of consciousness of more than 1/2 hour but less than 6 hours in duration.

Motor Control, Fine - Delicate, intricate movements used in such activities as writing, buttoning buttons, or piano playing.

Motor Control, Gross - Large, strong movements used in such activities as chopping wood, grasping large objects or kicking a ball..

Non-ambulatory - Not able to walk.

Orthosis - Splint or brace designed to improve function or provide stability.

Outpatient - The patient residing outside the hospital but returning on a regular basis for more therapeutic services.

Paraparesis - Weakness affecting the lower limbs.

Paraplegia - Paralysis of the lower half of the body.

Persistent Vegetative State - A condition in which the patient is unable to speak or follow simple commands and does not respond in any psychologically meaningful way. The transition from coma to one of vegetative condition reflects changes from a period of no response to the internal or external environment, other than reflexively, to a state of wakefulness but with no indication of awareness. Normal levels of blood pressure and respiration are automatically maintained. Sleep-wake cycles may also be maintained.

Plateau - A temporary or more permanent leveling off of the recovery process.

Pre-Morbld Condition - Characteristic of an individual present before a disease or injury.

Quadrlplegia - Paralysis of both arms and legs.

Random Movement - An action of moving without obvious reason, purpose, or conscious effort.

Range of Motion - The range of movement at a joint.

Rehabilitation Engineering - Use of technical advances to help improve the quality of life for persons with disabilities.

Respite Care - Program that allows person and family to adapt to the residual deficits of brain injury; noninterventinal model to address socialization and recreation.

Seizure - An uncontrolled discharge of nerve cells, which may spread to other cells throughout the brain. The sudden attack may be accompanied by loss of bowel and bladder control, loss of awareness, and abnormal movements. (See p.6)

Shunt, CSF - A procedure for draining excessive fluid from the brain. A surgically placed tube that drains spinal fluid from the brain ventricles to the abdominal cavity, heart, or large veins of the neck.

Specialty Services - These are rehabilitation services or programs developed for patients having special needs such as programs for those patients who are respiratordependent, visually-impaired, or those requiring substance abuse treatment services.

Spontaneous Recovery - Recovery that occurs as damaged tissue heals.

Transitional Living - Training for living in a setting of greater independence; typical lengths of stay vary with an individual's ability to acquire community reentry skills.

Unilateral Neglect - Impaired attention to one side of the body. This usually occurs on the side opposite the area of the brain injury and usually in association with right parietal lobe brain injuries.

Vegetative State - A state of survival after brain injury in which consciousness is altered to the degree that apparent wakefulness is regained but without conscious purposeful mental function. The patient is wakeful but is unaware and unresponsive to his or her surroundings. (See also persistant vegetative state.)

Visual Field Deficit -Inability to see objects in a specific region of view ordinarily perceived by both eyes.

Aggregate Indemnity - The maximum dollar amount that may be collected for any disability.

Carrier - The insurance company responsible to pay the losses or for coverage of medical costs.

Case Reserve - The dollar amount stated in a claim file that represents the estimate of the amount to be paid.

Claims Service Representative - A person who investigates losses and settles claims for an insurance carrier or the insured.

Double Indemnity - A policy provision usually associated with death, which doubles payment of a designated benefit when certain kinds of accidents occur.

Elimination Period - A period of time between the period of disability and the start of disability income insurance benefits, during which no benefits are payable.

Medicaid - A government funded program for persons, regardless of age, whose income and resources are insufficient to pay for health care. Qualification requirements are defined by the federal and state government.

Medicare - A government funded insurance program for disabled or aged persons. Qualification requirements are defined by the federal government.

Premium - Periodic payment needed to maintain an active insurance policy.

Residual Disability Benefits - A provision in an insurance policy that provides benefits in proportion to a reduction of earnings that result from a partial disability. Rider - A document that amends the policy or certificate benefits or provisions. It may increase or decrease benefits, waive the condition of coverage, or in any other way amend the original contract.

Third Party Funding - Reimbursement for services rendered to a person in which an entity other than the recipient is responsible for the payments, eg. an insurance company.

Underwriter - A company that receives premiums and accepts responsibility for the fulfillment of the insurance policy contract; or the company employee who decides whether or not the insurance company should assume a particular risk; or the agent who sells the policy.

Waiver - An agreement attached to a policy that exempts from coverage certain types of disabilities or injuries.