AOBPMR PM&R key terms

A velocity-dependent increase in muscle tone caused by hyperexcitability of the stretch reflex after upper motor neuron injury, producing resistance to passive movement that rises as the limb is moved faster.

Increased muscle tone that is constant regardless of movement speed, affecting both agonist and antagonist muscles, classically producing lead-pipe or cogwheel resistance in basal ganglia disorders such as Parkinson disease.

The constellation of findings after injury to the corticospinal and related tracts, including weakness, spasticity, hyperreflexia, clonus, and loss of fine dexterity, with preservation of bulk and reflexes below the lesion.

Injury to the anterior horn cell, motor root, or peripheral nerve, producing flaccid weakness, muscle atrophy, fasciculations, and diminished or absent reflexes in the affected distribution.

A six-point clinical scale grading resistance to passive stretch from 0 (no increase in tone) to 4 (rigid limb), with a 1+ category for catch followed by minimal resistance through less than half the range.

A measure that grades spasticity by comparing the angle at which passive movement meets resistance during fast versus slow stretch, capturing velocity-dependent tone separately from fixed contracture.

Rhythmic involuntary muscle contractions evoked by sudden sustained stretch, most often tested at the ankle, reflecting hyperactive stretch reflexes from upper motor neuron dysfunction.

Extension of the great toe with fanning of the other toes when the lateral sole is stroked, indicating corticospinal tract dysfunction in adults beyond infancy.

A classification of pressure injuries by depth, from stage 1 nonblanchable erythema through stage 4 full-thickness loss exposing fascia, muscle, or bone, with separate categories for unstageable and deep tissue injury.

Formation of mature lamellar bone in soft tissue outside the skeleton, typically after trauma, burns, or spinal cord and brain injury, presenting as localized pain, swelling, and restricted joint range.

Measures used to prevent clot formation in immobilized patients, including mechanical compression and pharmacologic anticoagulation, chosen by balancing bleeding risk against venous thromboembolism risk.

Lower urinary tract dysfunction caused by neurologic disease or injury, classified by lesion level into upper motor neuron patterns with detrusor overactivity and lower motor neuron patterns with areflexia and retention.

The volume of urine remaining in the bladder after voiding, measured by catheterization or bladder scan, used to detect incomplete emptying and guide bladder management decisions.

A life-threatening syndrome in spinal cord injury at or above T6 in which noxious stimuli below the lesion trigger hypertension, bradycardia, headache, and diaphoresis from unopposed sympathetic outflow.

A standardized classification of spinal cord injury using sensory and motor levels and sacral sparing to assign grades A through E, where A is complete and E is normal function.

Damage to the spinal cord from trauma or disease producing motor, sensory, and autonomic deficits below the level of injury, with prognosis and rehabilitation shaped by completeness and level.

Acquired brain damage from external mechanical force, ranging from mild concussion to severe injury with prolonged coma, producing cognitive, behavioral, and physical impairments that guide rehabilitation planning.

A 3-to-15 point score summing eye opening, verbal response, and motor response, used to grade severity of acute brain injury and track neurologic change over time.

An eight-level description of cognitive and behavioral recovery after brain injury, from no response through purposeful appropriate behavior, used to set expectations and plan rehabilitation.

The dose of therapy, measured in minutes per day and days per week, delivered after stroke; higher organized multidisciplinary intensity is associated with better functional outcomes.

A stroke rehabilitation approach that restrains the less affected upper limb while shaping intensive task practice of the affected limb, indicated for patients with some active wrist and finger extension.

An 18-item instrument scoring self-care, mobility, and cognition from 1 (total assistance) to 7 (complete independence), used to track rehabilitation progress and predict burden of care.

A ten-item measure of independence in basic activities of daily living, scored 0 to 100, widely used to describe functional status and change in rehabilitation populations.

A study recording electrical activity of muscle with needle electrodes at rest and during contraction, used to localize nerve, root, plexus, or muscle disease and to guide chemodenervation.

Measurement of the speed and amplitude of electrical signals traveling along a stimulated nerve, used to detect demyelinating versus axonal peripheral nerve disorders.

Nerve root dysfunction producing pain and sensory or motor deficits in a dermatomal or myotomal pattern, commonly from disc herniation or foraminal stenosis in the cervical or lumbar spine.

The area of skin supplied by a single spinal nerve root, mapped clinically to localize the level of neurologic injury or root compression.

The group of muscles innervated by a single spinal nerve root, tested by manual muscle testing to identify the level of root or cord involvement.

A gamma-aminobutyric acid type B agonist used orally or intrathecally to reduce spasticity; abrupt withdrawal can cause seizures and rebound spasticity, so tapering is required.

An implanted device delivering baclofen directly into cerebrospinal fluid for severe generalized spasticity, allowing lower systemic doses but requiring monitoring for catheter failure and withdrawal.

Focal chemodenervation used to reduce spasticity in selected muscles, often guided by electromyography or ultrasound, with effects lasting roughly three months.

The arc through which a joint moves, measured actively by patient effort or passively by examiner movement, used to detect contracture, guide stretching, and monitor response to therapy.

Fixed shortening of muscle, tendon, or joint capsule that limits passive range of motion, prevented by positioning, stretching, and early mobilization in immobilized patients.

Repositioning, support surfaces, skin inspection, and nutritional support used to prevent tissue breakdown in patients with limited mobility or sensation.

The sequence from initial contact of one foot to the next contact of the same foot, divided into stance and swing phases, used to describe and analyze abnormal walking patterns.

Selection of canes, crutches, or walkers matched to the patient's weight-bearing status, strength, balance, and endurance, with training in safe technique and energy conservation.

The match between the residual limb and the prosthetic socket, where excessive pressure causes skin breakdown and inadequate contact causes instability and pain during ambulation.

Regional muscle pain arising from taut bands and trigger points that reproduce the patient's pain when palpated, treated with stretching, injections, and correction of contributing factors.

Needle injection of local anesthetic or dry needling into a palpable taut band to relieve myofascial pain, followed by stretch and restoration of normal muscle function.

Disproportionate persistent pain after injury with autonomic, sensory, and motor changes, often in a limb, diagnosed clinically and treated with early mobilization, desensitization, and pain control.

Application of low-voltage electrical current through surface electrodes to modulate pain, thought to act through gate control and endogenous opioid mechanisms, with electrode placement over or near the painful area.