P

Paraplegia
Paralysis of the legs (from the waist down).

Parietal Lobe
One of the two parietal lobes of the brain located behind the frontal lobe at the top of the brain.

Perception
The ability to make sense of what one sees, hears, feels, tastes or smells. Perceptual losses are often very subtle, and the patient and/or family may be unaware of them.

Perseveration
The inappropriate persistence of a response in a current task which may have been appropriate for a former task. Perseverations may be verbal or motoric.

Persistent Vegetative State (PVS)
A long-standing condition in which the patient utters no words and does not follow commands or make any response that is meaningful.

Phonation
The production of sound by means of vocal cord vibration.

Physiatrist
Pronounced Fizz ee at' rist. A physician who specializes in physical medicine and rehabilitation. Some physiatrists are experts in neurologic rehabilitation, trained to diagnose and treat disabling conditions. The physiatrist examines the patient to assure that medical issues are addressed; provides appropriate medical information to the patient, family members and members of the treatment team. The physiatrist follows the patient closely throughout treatment and oversees the patient's rehabilitation program.

Physical Therapist
The physical therapist evaluates components of movement, including: muscle strength, muscle tone, posture, coordination, endurance, and general mobility. The physical therapist also evaluates the potential for functional movement, such as ability to move in the bed, transfers and walking and then proceeds to establish an individualized treatment program to help the patient achieve functional independence.

Plasticity
The ability of cellular or tissue structures and their resultant function to be influenced by an ongoing activity.

Plateau
A temporary or permanent leveling off in the recovery process.

Post Traumatic Amnesia (PTA)
A period of hours, weeks, days or months after the injury when the patient exhibits a loss of day-to-day memory. The patient is unable to store new information and therefore has a decreased ability to learn. Memory of the PTA period is never stored, therefore things that happened during that period cannot be recalled. May also be called Anterograde Amnesia.

Posture
The attitude of the body. Posture is maintained by low-grade, continuous contraction of muscles which counteract the pull of gravity on body parts. Injury to the nervous system can impair the ability to maintain normal posture, for example holding up the head.

Pre-Morbid Condition
Characteristics of an individual present before the disease or injury occurred.

Problem-Solving Skill
Ability to consider the probable factors that can influence the outcome of each of various solutions to a problem, and to select the most advantageous solution. Individuals with deficits in this skill may become "immobilized" when faced with a problem. By being unable to think of possible solutions, they may respond by doing nothing.

Prognosis
The prospect as to recovery from a disease or injury as indicated by the nature and symptoms of the case.

Program/Service Types
The following program/service categories describe the array of organized services (not mutually exclusive) and not an exhaustive list available for the rehabilitation of persons with brain injury:

Acute Rehabilitation
Based in a medical facility; accepts patient as soon as medically stable; focuses on intensive physical and cognitive restorative services in early months after injury; typical length of stay one week to several months (short term); identifiable team and program with specialized unit.

Behavior Disorders
For the patient exhibiting patterns of behavior preventing participation in active rehabilitation, including destructive patient behavior to self and others; continuum of controlled settings.

Community Integration Program
Provides services designed to accomplish functional outcomes focused on home and community integration, including productive activity. Services may be provided in residential facilities, day treatment programs, the consumer's home. They may be of short-term (several weeks) or long-term duration (several months).

Independent Living
Community-based to maximize a person's ability to be empowered and self-directed; allows an individual to live in one's own home with maximum personal control over how services are delivered, combined with the opportunity to work as appropriate.

Lifelong Living
For persons discharged from rehabilitation who need ongoing lifetime supports; located in residential or skilled nursing environment; structured activities available on individual and group basis.

Postacute Rehabilitation
Are programs designed to provide intensive, 24-hour rehabilitation to improve cognitive, physical, emotional, and psychosocial abilities, to facilitate better independent living skills. Facilities typically provide a full spectrum of clinical therapies, as well as life-skills training in a residential setting.

Residential Services
Assumes a 24-hour residential environment outside the home and includes 24-hour provision of or access to support personnel capable of meeting the client's needs. (Adopted by the PostAcute Committee of ISIG on Head Injury October 28, 1991.)

Subacute
May follow a period of acute rehabilitation; not necessarily hospital based; typical length of rehabilitation stay 6-24 months (short to intermediate term); stay based on demonstrated improvement; identifiable team and program with specialized unit.

Supervised Living
Setting is a home which is like other homes in the neighborhood in terms of size and number of residents. Consumers are provided individualized care, supervision, support and training services to maximize and/or maintain function and self-direction. Staff is present at night and other times when the consumer is present.

Supported Independent Living
Setting is a home chosen by the consumer who is primarily independent. Program offers support to assist the resident in maximizing and/or maintaining independence and self-direction. Staff is available as needed and at planned intervals to offer assistance and support but not to provide supervision.

Transitional Living
Non-medical residential program providing training for living in a setting of greater independence. The primary focus is on teaching functional skills and compensating for abilities that cannot be restored.

Vocational Evaluation
An organized and comprehensive service staffed by specialists who systematically and comprehensively utilize work activities (real or simulated) and/or educational services as the focal point for educational and vocational assessment and exploration. In addition, psychological testing, counseling, social summaries, occupational information, etc., are other evaluation tools that are used. It incorporates the medical, psychological, social, vocational, educational, cultural, and economic data for establishment and attainment of individual goals.

Prone
Lying on one's stomach.

Proprioception
The sensory awareness of the position of body parts with or without movement. Combination of kinesthesia and position sense.

Psychologist
A professional specializing in counselling, including adjustment to disability. Psychologists use tests to identify personality and cognitive functioning. This information is shared with team members to assure consistency in approaches. The psychologist may provide individual or group psychotherapy for the purpose of cognitive retraining, management of behavior and the development of coping skills by the patient/client and members of the family.