Informed decision making in translating assessment scales in Physical Therapy

1 Introduction

As a derivative of the more comprehensive interdiscipline of Translation Studies, Corpus-based Translation Studies (CBTS) is concerned with identifying, describing, and explaining the universal and specific features of translation, through deductive (top-down) and inductive (bottom-up) approaches, combining and exploiting a variety of data, and envisaging both the product and process of translation (notably, Kruger 2002). The empirical nature of CBTS is widely acknowledged, involving the collection of original/source texts and/or translated/target texts enabling the analysis of the translators’ behaviour in compliance with translation norms and laws (mainly from a process-oriented perspective) and with quality assurance standards (from a product-oriented perspective, focusing on translation evaluation in terms of accuracy and relevance); the two perspectives can be said to intersect, especially in translator training (see Laviosa 2002). In this context, it can be said that CBTS was born through the interplay of descriptive translation studies and corpus linguistics in their concern to describe language in use as an instance of text production for communicative purposes. Olohan (2002, 422) explains that decisions regard “which particular texts might be included in a corpus to be used to study that particular kind of translation,” and that corpus analysis relates to norms or regularities of translators’ behaviour (a major concern of descriptive translation scholars). In other words, corpora are designed and used to meet the requirements of representativeness and comparability and to show translation patterns.

2 Principled ways of corpus design and use

Corpora should be widely and systematically used, adding value to both translation research and practice, as they provide alternative sources of authority, empirical data, and authentic material to be creatively and constructively used for (notably, Kiraly 2003):

• the retrieval of grammatical, lexical, terminological, and stylistic equivalents;

• the development of thematic competence (subject-specific knowledge);

• assessment of translation effectiveness and efficiency;

• the refinement of a well-founded specific methodology.

  In this climate of opinion, although on a sceptical note, Kübler (2011, 67–8) links the design and use of corpora to all the stages of translation (performance and delivery) as follows:

• during the documentation phase, which the author considers essential since the translator needs to get acquainted (if not knowledgeable) with the content of the source text, the terminology involved (from a bilingual perspective, to secure standardization), and the stylistic conventions in the source and target text alike;

• during the translation phase, in which the translator is supposed to solve the recurrent or major problems identified in the previous stage, while also making sure that he/she is able to deliver a natural and error-free translation;

• during the revision phase when the translator checks the accuracy and fluency of the product to be delivered to the client/users and, where appropriate, seeks alternative strategies and solutions.

  Kübler (2011, 67–8) goes further and proposes a stepwise procedure – for example, the first stage involves:

• the identification of the specialized field and of the genre to which the document to be translated belongs (including text type);

• the compilation of the corpus;

• terminology work – information mining with a view to fully understanding the key concepts and related terms and to providing fit-for-purpose solutions;

• the acquisition of further information with respect to bridging linguistic and cultural gaps in translation.

  Admittedly, we plead not only for using corpus analysis in specialized translation, but also for raising awareness of the fact that compiling corpora is a time-consuming activity that professional translators cannot afford (in terms of time, effort, and financial costs if we think of the dedicated software). It is vital that theory and practice should merge at this point (the sooner the better), that corpora designed by researchers should become available to the market, and that translators should seek more actively to integrate them into their work in order to enhance productivity and quality. Conversely, Bernardini (2006) raises the question of how to reach translators who are eager to learn about corpora – her suggestion is to design such translator-oriented (e)materials, having immediate relevance so that they will gain a competitive advantage over the web, translation memories, dictionaries, and glossaries. In other words, “corpus design and corpus searching tools should be made more user-friendly, and ideally integrated with CAT tools” (Bernardini 2006, 21).

  More concretely, corpus use in real-life scenarios (in the work environment) encompasses the following dimensions:

• development of corpus analysis skills;

• development of corpus evaluation skills;

• development of corpus knowledge management skills;

• development of the ability to recognize and understand different types of corpora and their relevance for specific translation tasks and projects;

• use of corpus evidence in the decision-making process with respect to translation strategies, methods, and procedures.

Different types of corpora might be called for, depending on the translation task – it is but natural to understand that not all of them are equally available or useful and that although gathered in a principled way (not at random), the texts making up a corpus provide different linguistic information that can be analysed for various purposes. We do agree with Kübler (2011) that the ideal tool seems to be the parallel corpus, especially in specialized translation, a parallel corpus being defined as a collection of source texts fully aligned with their translations in the target language (notably, Lefer 2020, 257). The (real) downside is given by the fact that parallel corpora do not come for many language pairs and domains – it is what we specifically experience with the English–Romanian language pair and with the medical field.

3 Knowledge management in CBTS

Drawing on Zerhouni (2005) who heralds new pathways for ‘re-engineering the clinical research enterprise’, i.e. for developing collaborative research strategies and systematic changes of the research infrastructure, we add that the recognition of the importance of medical translation studies in conjunction with medical research will contribute to bridging the gap between theory and practice, while also boosting the medical translator’s status and role as a communicator and mediator, taking full responsibility when transferring specialized knowledge.

According to Bowen and Graham (2013), the term knowledge translation is directly connected with competence studies and knowledge management science within the biomedical paradigm, going from knowledge generation to knowledge transfer, therefore promoting knowledge use to potential knowledge users while seeking to engage them in appropriate and meaningful ways. Importing this concept in translation studies, we envisage ‘moving knowledge into action’ (Bowen and Graham 2013) as manyfold and stepwise:

• participatory research of translation theorists with a view to not only mapping the market (catering to professional translator’s needs and interests beyond survival levels), but also shaping the industry;

• collaboration between medical translators and monolingual experts in the field in a mutually beneficial relationship (a kind of strategic partnership), having regard to the co-production and dissemination of knowledge in bilingual or multilingual settings; unfortunately, medical translators do not enjoy prestige and are not credited for their work, while doctors or qualified staff (healthcare providers) are not likely to make better translators by virtue of mastering medical knowledge. Furthermore, this collaboration may result in a more accurate diagnosis (needs analysis) of the market from a sociological perspective. In other words, translators need to know for whom they translate, who are the users of the target text, and what are their expectations;

• making information available in an accessible and user-friendly manner; this can be viewed as another layer of collaborative engagement between medical translators and (end) users as prospective adopters of new knowledge, hence facilitating translation assessment and its wider applicability.

Medical activity and research need evidence-based practice (EBP), an approach integrating available reliable evidence with client choice and the clinician’s expertise and experience, to enhance clinical decision regarding assessment and therapeutic intervention (Zerhouni 2005, Zidarov et al. 2013). Likewise, translation practice and theory should underpin an evidence-based mechanism, partly deriving from an empirical focus. Within this framework, CBTS need to inform and support practice via compilation of specialized parallel corpora to be made available to the professional translators to improve quality and boost their productivity (notably, Vandeghinste et al. 2019).

Even if EBP has developed strategies for expanding and improving the body of knowledge and its application, there are still gaps between research and use of the research outcomes in practice (Lomas 2007). This a serious problem also in Physical Therapy (PT) because the vast majority of physical therapists do not use the research findings to the required extent (Jette and Keysor 2003). Under the circumstances, it becomes vital to develop new strategies and ways for knowledge translation, for optimizing the utilization of research findings in the field of PT where the relationship between research and practice is not sustainable, to say the least. Actually, mainstream literature hints at the barriers in knowledge translation in the field of Physical Therapy due, for instance, to the fact that many of the PT-related information intersects other medical fields, affecting the specificity of this domain (notably, Jette and Keysor 2003).

The question arises: What are the factors that limit the physical therapists’ and clinicians’ access to the results of EBP and how would it be possible to increase their access? The answers seem to lead to a new approach integrating the specific requirements, as well as global organizational/institutional and contextual factors. Admittedly, the medical translator becomes a knowledge broker creating links between all the stakeholders: researchers, policy makers, managers, and clinicians (Ziam et al. 2009).

4 Building the corpus to fit for purpose

We have managed to compile a specialized corpus (in full compliance with the criteria of corpus design, i.e. representativeness, size, topic, and homogeneity – notably, Corpas Pastor and Seghiri Domínguez 2010) so as to secure knowledge translation in the medical field, narrowing focus to PT. More specifically, our arguments in relation to the selection and use (including translation purposes) of assessment scales run as follows:

• The assessment scales are currently used to establish the functional diagnosis of people referred to rehabilitation programmes (in Romania and elsewhere);

• The scales are applied following the diagnosis of injury or trauma in any pathology;

• The scales predominantly relate to neurological pathology;

• Although they are widely used, there is no recognized translation of these scales into Romanian – for some of them, there is no available translation at all, and for others, translation is provisional;

• In chronic neurological pathology, the scales are used to monitor the patient’s evolution, to permanently adjust the therapy intervention programme;

• The scales are applied at the beginning of the therapy programme, and, subsequently, at a time interval of 3–6 months;

• They are highly specific and necessary for establishing the degree of disability of the persons with neuromotor impairment, which, once again, indicates how important it is to accurately understand, transfer, and manage the information they contain.

In what follows, we shall provide a brief description of the parallel corpus, consisting of six source texts in English and six target texts in Romanian:

1. Assessing stroke – scores and scales, developed by Julie Fussner and Cesar Valesco, American Stroke Association//Evaluarea accidentului vascular cerebral – scoruri și scale

2. Berg Functional Balance Scale, adapted from Katherine Berg et al. 1992, ‘Measuring balance in the elderly: validation of an instrument’//Scala pentru echilibru Berg

3. BESTest Balance Evaluation – Systems Test, developed by Fay Horak (2008), Oregon Health and Sciences University//Scala pentru echilibru BESTest

4. The Fugl-Meyer Assessment Upper Extremity (FMA-UE), developed by Axel Fugl-Meyer et al. (1975), University of Gotenburg//Scala Fugl-Meyer – evaluarea funcției senzoriomotorii

5. Functional Gait Assessment, developed by Wristley et al. (2004), State University of New York, University at Buffalo//Scala de evaluare a mersului

6. Motor Assessment Scale//Scala de evaluare motorie

We also specify that we undertook the translation into Romanian as there is no officially recognized translation of these documents, and in clinical practice, specialists use versions available on the internet (for instance on https://www.romedic.ro/, https://paginadenursing.ro/), or in-house produced versions, which, obviously, raises the question of their reliability. Moreover, we closely collaborated with the medical staff from Policlinica pentru Sportivi Craiova (Sports Medical Centre of Craiova) and researchers/professors from the Department of PT and Sport Medicine, Faculty of Physical Education and Sport, University of Craiova, for four main reasons:

• to ensure that the equivalence of English terminology into Romanian is recognized, i.e. it is recognized by practitioners in the field and used in professional communication;

• to secure referential accuracy, i.e. the right contextual meaning is used in translation;

• to boost trust in the work of language specialists (translators being in focus) as able to meet an important market demand and thus help bridging translation theory and practice in the medical field;

• to strengthen collaborative work with the users of translation – in this case, both researchers and clinical medical staff.

5 Corpus analysis framework to secure informed decision making in medical translation

We have selected the following terms as key notions in the analysed texts and classified them according to their degree of specialization and the translation-related problems they raise, coupled with terminology management issues in an attempt to justify our solutions and to provide an analysis framework able to be recontextualized. By showcasing, we shall provide explanations regarding our translation choices wherever we have spotted specific problems, or in the cases where we consider that further awareness should be raised.

• Anatomical parts (including their functions):

  gait/stepping/walking = mers

  Comments: both gait and walking are recorded as medical terms (synonyms). The difference lies not only in the fact that the former term is associated with a higher level of formality and specialization. According to The British Medical Association Illustrated Medical Dictionary (2018), walking refers to ‘movement of the body by lifting the feet alternately and bringing one foot into contact with the ground before the other starts to leave it’, and ‘gait is determined by body shape, size, and posture’. Stepping, like walking, involves duration; it is the least frequent term among the three. As seen, there is a single Romanian counterpart for the three terms; hence, the distinctions between the English terms are not covered.

  grasp/grip = prehensiune

  Comments: Năstase et al. (1998) provide several equivalents for grasp, belonging to either the informal style – apucare, prindere, strângere, strânsoare – or formal style – prehensiune. On the other hand, grasp and grip seem to operate as absolute synonyms, although grasp has a higher frequency (in our corpus, too). We prefer the equivalent prehensiune since the translated texts clearly address a specialized audience (healthcare professionals).

  hips = șold

  Comments: we are perfectly aware of the existence of doublets as register-related synonyms of șold in Romanian: articulaţia coxofemurală, articulaţia şoldului. We prefer the term belonging to the informal register (șold) due to its contextual use – it appears in the instructions given to the patient during the assessment process.

  ischium = zona ischidiacă

  Comments: if we look the word up in bilingual specialized dictionaries, we are provided the equivalent ischionul, osul ischion (Năstase et al. 1998). However, if we search up-to-date databases containing medical texts, the usual rendering when addressing the expert population is zona ischidiacă.

  neck = gât

  Comments: the term neck may refer to different anatomical parts: “a constricted section, such as the part of the body that connects the head with the trunk. Other such constrictions are the neck of the humerus and the neck of the uterus” (Mosby’s Dictionary of Medicine, Nursing & Health Professions, 2013). Therefore, the context will orient the translator towards gât or col.

  plantar = plantar

  Comments: the adjective plantar derives from the noun planta in Romanian, which is the synonym of the less formal term talpă. Again, doublets are created, even if asymmetrically: in English, the noun sole seems to enjoy higher frequency by comparison with the adjective plantar denoting the same anatomical part.

  pose/posture/stance = poziție, postură

  Comments: this time, doublets appear both in English and in Romanian. In English, pose and stance are marked as deliberate, whereas posture is neutral. In Romanian, the second term is more formal, even if they are replaceable in many contexts.

  protraction = protracție

  Contextually, the terms refer to muscle extension forwards. In other medical (con)texts, protraction may designate “a low amount of therapeutic radiation delivered continuously over a relatively long period” (Mosby’s Dictionary of Medicine, Nursing & Health Professions, 2013). As an adjective, protracted also creates ambiguity: it means prolonged, lengthened, activating the negative connotation longer than expected or hoped for.

  spine = coloană vertebrală

  Comments: we prefer the formal term coloană vertebrală to șira spinării, which is colloquial, on account of the fact that the adjective spinal, deriving from spine, enters numerous collocations where it is usually rendered by formal equivalents: spinal column – coloană vertebrală, rahis; spinal muscle – mușchi spinal, spinal nerve – nerv spinal, spinal shock – siderație medulară, etc. (Rusu 2004).

  synergist = muşchi synergist

  Comments: the nouns synergy/synergism (used in free variation) actualize different specialized meanings in different contexts: “1. the process in which two organs, substances, or agents work simultaneously to enhance the function and effect of one another. 2. the coordinated action of a set of muscles that work together to produce a specific movement, as in a reflex action. 3. a combined action of different parts of the autonomic nervous system, as in the sympathetic and parasympathetic innervation of secreting cells of the salivary glands, with both systems having a secretory effect. 4. the interaction of two or more drugs to produce a certain effect, as in the exaggerated response to tyramine in a person who is treated with a monoamine oxidase inhibitor” (Mosby’s Dictionary of Medicine, Nursing & Health Professions, 2013).

  toe = deget la picior

  Comments: English lexicalizes differently the digits of the hand and of the foot, i.e. by fingers and toes, respectively. Romanian uses post-modification and a strategy of explicitation: degete de la mână and degete de la picior.

  wrist = încheietura mâinii

  Comments: wrist may also be rendered by more formal equivalents: carp, articulaţia radiocarpiană. However, the less formal equivalent is preferred in the context of PT, especially in the interaction with the patient. We draw attention to the fact that in our corpus, wrist is translated by pumn to secure referential accuracy – for instance, wrist extension = extensia pumnului, radial deviation of wrist = devierea radială a pumnului, etc.

• Diseases (including symptoms and severity measurement)

  cerebral infarct/(ischaemic) stroke = infarct cerebral/accident vascular cerebral (AVC)/atac cerebral

  Comments: in medical English, stroke is the most frequent term – in our corpus, it is used exclusively to the detriment of its synonym. In Romanian, atac cerebral is an informal equivalent, and accident vascular cerebral (AVC) and infarct cerebral are the formal equivalents. Statistically, accident vascular cerebral is the preferred term; nevertheless, replaced by its acronym is most of the contexts of occurrence.

  deficit = deficit

  Comments: we opt for the more generic and formal term deficit via transfer, as motivated by its high frequency in specialized texts in Romanian. We are fully aware that other equivalents are available: afectare, tulburare, dereglare (Năstase et al. 1998); however, we consider deficit the optimal one (see also Rusu 2004). Năstase et al. (1998) provide deficiență (translating back as deficiency) as a synonym of deficit – we specify that the coverage area of deficit is larger than that of deficiență, and, at the same time, deficiență acquires the meaning of carență (a lack or shortage of something) which it does not share with deficit (Mosby’s Dictionary of Medicine, Nursing & Health Professions, 2013).

  depression = depresie

  Comments: depression is a high ambiguous term, referring to several medical conditions – at the physiological level, it indicates a decrease of a vital function activity (Ro. reducere); mentally, it designates a mood disturbance characterized by feelings of sadness, despair, and discouragement, according to Mosby’s Dictionary of Medicine, Nursing & Health Professions, 2013) (Ro. depresie). The term may also be used with reference to anatomy: a depressed area, hollow, or fossa (Ro. depresiune, fosă).

  disability = dizabilitate

  Comments: disability and handicap are perceived as partial or near synonyms; the former term implies a lower degree of functional limitation, and it is preferred instead of handicap even when the impairment is serious due to hedging and mitigation strategies in English. In Romanian, dizabilitate as the direct equivalent of disability is beginning to gain ascendancy over handicap – the latter term is still in use in the medical jargon (although it has acquired a negative connotation in colloquial language).

  droop/palsy/paralysis = paralizie

  Comments: we acknowledge a linguistic gap: the three terms being indiscriminately equated to paralizie in Romanian. In English, droop is less formal than the other two; the main difference between the English terms lies in collocation: face droop vs Bell’s palsy, cerebral palsy, Erb’s palsy vs flaccid paralysis, spastic paralysis (Mosby’s Dictionary of Medicine, Nursing & Health Professions, 2013).

  fatigue = oboseală cronică

  Comments: the English term fatigue indicates high intensity (see Mosby’s Dictionary of Medicine, Nursing & Health Professions, 2013: ‘a state of exhaustion or loss of strength and endurance’ with reference to muscles), which is lost in the Romanian recognized translation oboseală (see Năstase et al. 1998, Rusu 2004).

  (blood) glucose = glicemie

  Comments: Collocation is of paramount importance in detecting the right contextual meaning of glucose; as a standalone word, it is rendered by glucoză, whereas in association with blood, it refers to the level of glucose in circulation, conveyed by glicemie in translation.

  history = istoric

  Comments: as a specialized medical term, history refers to “the systematic account of the medical, emotional, and psychosocial occurrences in a patient’s life and of factors in the family, ancestors, and environment that may have a bearing on the patient’s condition” (Mosby’s Dictionary of Medicine, Nursing & Health Professions, 2013), being conveyed by antecedente, foaie de observaţie clinică; anamneză in bilingual medical dictionaries (see Năstase et al. 1998, Rusu 2004). However, mainstream literature in Romanian uses istoric on a more frequent basis, which justifies our choice in the translation of motor assessment scales in the field of PT.

  impairment = afectare, disfuncționalitate, dizabilitate, tulburare

  Comments: Năstase et al. (1998) suggest deteriorare as an equivalent of impairment, besides the metaphorical renderings şubrezire, zdruncinare, ruinare, adding the specification a sănătății. We discard the last three options since they belong to the colloquial style that does not feature motor assessment scales (our source texts). We propose contextual renderings that fit for purpose: afectare (in relation to neurological impairment = afectare neurologică), tulburare (to render stroke-related impairment = tulburările legate de AVC), disfuncționalitate (impairment in either foot = disfuncționalitate a piciorului), dizabilitate (mild/moderate/severe impairment = dizabilitate medie/moderată/severă). Therefore, we reinforce the idea of reference to metadata, i.e. specialized texts/discourse in the corresponding field, which should become routinely available data, orienting the translator towards the optimal equivalent. We also note the overspecialization of terms in Romanian due to collocational restrictions. If we consider the synonymic series of impairment, we have the following order according to severity: disease → impairment → disability → handicap. (Source: International Classification of Impairments, Disabilities, and Handicaps. A manual of classification relating to the consequences of disease).

  injury = leziune

  Comments: we consistently rendered injury by leziune in our translation. Năstase et al. (1998) provide several equivalents – rană, leziune, plagă, traumă, traumatism, while richly exemplifying the contexts of occurrence for each of the terms: athletic injury = traumatism sportive, brain injury = traumatism craniocerebral, contrecoup injury – leziune cerebrală, immunospecific injury – leziune imunologică, internal injury – leziune a viscerelor, rectal injuri – plagă ștanțată. If we compare the terms injury – wound – trauma, injury is the generic term in the series, and trauma is associated with the highest degree of severity (it may be life-threatening). Besides, as indicated by mainstream literature and practitioners in the field, recovery from injuries is more frequently associated with PT, whereas traumatic injuries can require surgical procedures to fix. Wounds may be caused by accidents as well as by surgical interventions, and they are typically associated with a risk of infection (see MedlinePlus).

  pain = durere

  Comments: pain is a neutral term in English just like its Romanian counterpart durere, the degree of intensity resulting from pre-determination, i.e. from the qualifying adjective: “it may be mild or severe, chronic or acute, lancinating, burning, dull or sharp” (Mosby’s Dictionary of Medicine, Nursing & Health Professions, 2013). On the other hand, its synonym ache is marked as ‘dull, persistent’. We emphasize the linguistic gap, both terms being rendered in Romanian by the unique equivalent durere.

  sensitivity = sensibilitate

  Comments: Sensitivity and sensibility are considered confusables in ordinary and medical language alike; in translation, they act as false friends or deceptive cognates. From a medical point of view, sensibility represents the general ability to perceive physical and psychological sensations, whereas sensitivity is more restricted indicating either the capacity to react to a stimulus or susceptibility to a substance (drug, antigen) – see Mosby’s Dictionary of Medicine, Nursing & Health Professions (2013).

  symptom/complaint = symptom/acuză

  Comments: in Romanian, the term acuză (noun) is marked as subjective and can function as a synonym of symptom, the latter being more formal. It is important to state that sign (translated as semn) is marked as objective and that symptoms are accompanied by signs (see Mosby’s Dictionary of Medicine, Nursing & Health Professions, 2013).

  wheelchair dependent = dependent de scaunul cu rotile

  Comments: in Romanian, there is no consensus about the optimal equivalent of wheelchair dependent; besides the rendering dependent de scaunul cu rotile, imobilizat în scaunul cu rotile, țintuit în scaunul cu rotile, legat de scaunul cu rotile, în scaunul cu rotile circulate as parallel terminology.

• Procedures, protocols

  ambulatory = ambulatoriu

  Comments: the term ambulatory has acquired two distinct specialized meanings: “1. pertaining to a patient who is not confined to bed. 2. pertaining to a health service for people who are not hospitalized” (see Mosby’s Dictionary of Medicine, Nursing & Health Professions, 2013). In Romanian, the corresponding term ambulatoriu refers indirectly to the patient, specific reference being made to the treatment or institution providing healthcare service to home-based patients: “1. (d. tratamente medicale) care nu necesită spitalizare. 2. instituție medico-sanitară în care se acordă bolnavilor asistență medicală fără internare” (https://www.dex.md/definitie/ambulator).

  rehabilitation = recuperare

  Comments: the Romanian equivalent also indicates that the process follows a disabling disease (see Mosby’s Dictionary of Medicine, Nursing & Health Professions, 2013 and Năstase et. al. 1998).

  screening = screening

  Comments: two meanings are recorded in specialized dictionaries, with reference to both English and Romanian (see Mosby’s Dictionary of Medicine, Nursing & Health Professions, 2013 and Năstase et. al. 1998). Thus, screening may refer to ‘1. a preliminary test or examination to detect the most characteristic sign or signs of a disorder; 2. the examination of a large sample of a population to detect a specific disease, such as hypertension’. The suggested equivalents are radioscopie and screening, respectively. We retained the latter due to contextual clues (the diagnosis of ischaemia and depression being involved in the selected texts).

  treatment = tratament

  Comments: according to Mosby’s Dictionary of Medicine, Nursing & Health Professions (2013), treatment refers to ‘the care and management of a patient to combat, ameliorate, or prevent a disease, disorder, or injury’, cure is positively connoted as ‘restoration to health of a person afflicted with a disease’ or ‘the favorable outcome of the treatment’, while therapy seems to be all-inclusive, covering the meanings of both treatment and cure. Importantly, Romanian preserves all these semantic distinctions in the series tratament – cură – terapie (as direct equivalents) – see also Năstase et al. (1998).

• Healthcare professionals

physician = doctor

Note: in English, physician and doctor are interchangeable. However, there are contexts in which they cannot replace each other since doctor is an umbrella term – that is the reason for which it often collocates with medical to refer to a specialist in medicine (doctor is also a scientific title connected to a research field). We acknowledge a linguistic gap, since the only available equivalent for both physician and doctor is doctor in Romanian.

occupational therapist = terapeut ocupațional

physical therapist/physiotherapist = kinetoterapeut/fizioterapeut

therapist = terapeut

Comments: we have grouped all these terms since they may generate confusion in translation. To clarify meaning, we let us analyse their full definitions as provided by Mosby’s Dictionary of Medicine, Nursing & Health Professions (2013):

occupational therapist (OT), an allied health professional who is nationally certified. The OT uses purposeful activity and interventions to maximize the independence and health of any client who is limited by physical injury or illness, cognitive impairment, psychosocial dysfunction, mental illness, or a developmental or learning disability. Services include the assessment, treatment, and education of the client or family; interventions directed toward developing daily living skills, work readiness, or work performance; and facilitation of the development of sensory-motor, perceptual, or neuromuscular functioning or range of motion.

physical therapist (PT), a person who is licensed in the examination, evaluation, and treatment of physical impairments through the use of special exercise, application of heat or cold, and other physical modalities. The goal is to assist persons who are physically challenged to maximize independence and improve mobility, self-care, and other functional skills necessary for daily living.

Therefore, the main difference lies in the fact that the occupational therapist focuses on the patient’s ability to improve the performance of daily activities, whereas the physical therapist concentrates on the recovery and/or improvement of the patient’s motor skills. In Romanian, terapeut ocupațional corresponds to occupational therapist, kinetoterapeut to physical therapist, and fizioterapeut to physiotherapist. Therapist is a generic term denoting a healthcare professional, having terapeut as an equivalent in Romanian (also an all-encompassing term).

6 Conclusions

The corpus-based analysis points to the medical translator’s competence at work, from a reflective perspective, while building an evidence-based mechanism to support theoretical claims and basic assumptions in practice. As seen, the recurrent and serious problems lie in the management of terminology, many medical terms having multiple references. Moreover, if we consider the language pair English–Romanian, we note that terminology is far from being standardized – one possible explanation lies in the cultural asymmetries since medical research and writing are far from homogenous, being authored, validated, and legitimated in different disciplinary cultures. As for reusables, there is no universal prescription, only guidelines based on empirical studies and meant to raise awareness rather than ‘treat’ or ‘cure’. The standardization of terminology, although a requirement, cannot be done in the foreseeable future, in our opinion. One of the main reasons is that in spite of the various online tools to analyse, extract, and manage terminologies, there is still much work to be done so as to align them with existing parallel corpora. Furthermore, highly reliable bilingual or multilingual databases including Romanian are scarce, and they cannot ensure effective and efficient knowledge sharing among translators, not to mention the fact that new words are coined in impressive amounts in a short time.