CDE Detailed Report

Disease: NeuroRehab
Subdomain Name: Devices
CRF: Devices: Mobility and Manipulation

Displaying 51 - 100 of 139
CDE ID CDE Name Variable Name Definition Short Description Question Text Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guidance) Subdomain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C58501 Transportation device type TransportDeviceTyp Type for all transportation devices currently used by the participant/subject Type for all transportation devices currently used by the participant/subject If yes, Adaptive car seat/Booster seat;Other, specify;Seating restraints (e.g., Manual, Electronic, Torso, Wheel Wells);Vehicle Lifts (e.g., Platform/Rotary);Vehicle with driver modifications Adaptive car seat/Booster seat;Other, specify;Seating restraints (e.g., Manual, Electronic, Torso, Wheel Wells);Vehicle Lifts (e.g., Platform/Rotary);Vehicle with driver modifications Alphanumeric

Only answer if transportation devices is answered Yes.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-16 16:05:13.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C18200 Therapeutic stretching type TherapuStretchTyp Type of stretching therapy Type of stretching therapy Stretching Active;Passive Active;Passive Alphanumeric

Choose all that apply.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-21 12:11:21.037 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C58480 AFO type AFOTyp Type of ankle-foot orthosis (AFO) used by the participant/subject Type of ankle-foot orthosis (AFO) used by the participant/subject If yes, Solid;Articulating;Dynamic Ankle Foot Orthosis (DAFO);Posterior Leaf Spring (PLS);Carbon Fiber Solid;Articulating;Dynamic Ankle Foot Orthosis (DAFO);Posterior Leaf Spring (PLS);Carbon Fiber Alphanumeric

Only answer if Ankle-foot Orthosis is answered Yes. Choose all that apply.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-13 09:33:55.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C12688 Orthosis knee ankle foot orthosis ischial weight bearing indicator OrthsisKnAnkFoOIschlWgtBrngInd Indicator whether any knee-ankle-foot orthosis (KAFO) currently used by the participant/subject is ischial weight bearing Indicator whether any knee-ankle-foot orthosis (KAFO) currently used by the participant/subject is ischial weight bearing Yes, ischial weight bearing? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Only answer if Knee-ankle-foot Orthosis is answered Yes. Choose one.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-24 11:38:01.2 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C58578 Eat drink assistive device type other text EatDrinkAssistDeviceTypOthrTxt Text describing the presence of any other eating / drinking device used Text describing the presence of any other eating / drinking device use Other, specify Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-06-29 13:52:08.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data 255

Free-Form Entry
C21639 Fall details assistive device type FallDetAssistDevTyp Type of assistive device(s) the participant/subject was using when the fall recorded in the Falls Diary occurred Type of assistive device(s) the participant/subject was using when the fall recorded in the Falls Diary occurre If you fell while walking, were you using an assistive device Cane;One crutch;Other, please specify;Two crutches;Walker Cane;One crutch;Other, please specify;Two crutches;Walker Alphanumeric

Choose all that apply.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C10707 Walking difficulty age permanent support started value WlkDffcltyAgeNeedPermSuportVal Age of participant/subject when permanent support first needed walking Value of participant/subject's age at which she or he first needed permanent support for walking If participant/subject needs permanent support for walking, indicate age of participant when support first needed. Numeric Values

Answer should be recorded in years.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-11 15:03:49.2 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Free-Form Entry
C58491 Activity daily living device type ADLDeviceTyp Type for all activity of daily living devices currently used by the participant/subject Type for all activity of daily living devices currently used by the participant/subjec ADL Devices Eating / Drinking Assistive Devices;Bathing Devices;Toileting Devices Eating / Drinking Assistive Devices;Bathing Devices;Toileting Devices Alphanumeric

For each ADL device type record if it is used.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-16 14:07:02.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C18181 Therapy rehabilitation session duration TherapuRehabSessDur Duration of a therapy or rehabilitation session Duration of a therapy or rehabilitation session Duration 15 minutes;30 minutes;45 minutes;60 minutes;Other, specify 15 minutes;30 minutes;45 minutes;60 minutes;Other, specify Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-21 12:11:21.037 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected

 minute
C58631 Position device type use indicator PositionDeviceTypUseInd Indicator whether the participant/subject currently uses the selected types of positioning devices Indicator whether the participant/subject currently uses the selected types of positioning device Devices Used? No;Yes No;Yes Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-06-28 12:11:42.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C21656 Orthosis other type OrthosisOtherTyp Other types of orthoses used by the participant/subject Other types of orthoses used by the participant/subject Do you use any other type of orthosis Hip;Neck;Shoulder Hip;Neck;Shoulder Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-21 12:11:21.037 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C56953 Cane stick use type CaneStickUseTyp Type of cane which the participant/subject uses, if applicable Type of cane which the participant/subject uses, if applicable If yes, Quad cane;Single Point Cane Quad cane;Single Point Cane Alphanumeric

If the participant/subject uses a cane, then record the type used. Choose one option.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2017-08-07 12:12:38.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C10720 Walking other assistive device use indicator WalkOthrAssistiveDevUseInd Indicator whether the participant/subject uses any other assistive device for walking Indicator whether the participant/subject uses any other assistive device for walking Indicate if the participant/subject uses any other assistive device. Yes;No;Unknown Yes;No;Unknown Alphanumeric

If "No" or "Unknown" skip to "Walking primary assistive device daily use duration".

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-11 15:03:49.2 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C58567 Dynamic upper extremity orthosis splint frequency use laterality type DynUEOrthoSplntUseFreqLatrlTyp Laterality type of dynamic upper extremity orthosis splints frequency used by participant/subject Laterality type of dynamic upper extremity orthosis splints frequency used by participant/subjec If yes, Left;Right Left;Right Alphanumeric

Only answer if dynamic upper extremity orthosis/splints is answered Yes.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-06-27 11:42:16.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C18870 Mobility device other text MobilityDvcOTH The free-text field related to 'Mobility device type' specifying other text. Type for all mobility devices currently used by the participant/subject The free-text field related to 'Mobility device type' specifying other text. Type for all mobility devices currently used by the participant/subject Other, specify Alphanumeric

Specify whether mobility devices other than Manual wheelchair, Power assist wheelchair, Power wheelchair, Scooter, Medical/Adaptive Stroller, Walker, Gait Trainer/Weight Supported Walkers, Crutches, Cane / Stick, Other Mobility Device are used. For each mobility device type record if it is used.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-25 08:54:08.2 Devices: Mobility and Manipulation Devices Treatment/Intervention Data 4000

Free-Form Entry
C58481 Dynamic upper extremity orthosis splint use anatomic site DynmUEOrthoSplntUseAnatSite Anatomic site of the dynamic upper extremity orthosis/splints use Anatomic site of the dynamic upper extremity orthosis/splints use Anatomic Site: Thumb;Wrist/hand;Hand/Fingers;Elbow Thumb;Wrist/hand;Hand/Fingers;Elbow Alphanumeric

Only answer if dynamic upper extremity orthosis/splints is answered Yes.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-13 10:18:13.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C12943 Orthosis type OrthosisTyp Type of orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) Type of orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) Orthoses Wrist splints;Wrist splints - night use;Ankle-foot orthosis (AFO);Ankle-foot orthosis (AFO) - night use;Abduction wedge;Knee immobilizer(s);Stander;Positioning/feeding chair;Compression garment;Other upper extremity device;Other lower extremity device;Other, specify;Dynamic Lower Extremity Stretching Orthosis/Splints;Dynamic Upper Extremity Orthosis/Splints;Hip-knee-ankle-foot orthosis (HKAFO);Shoe Inserts of any type;Knee-ankle-foot orthosis (KAFO);Static Lower Extremity Stretching Orthosis/Splints;Static Upper Extremity Orthosis/Splints;Supramalleolar orthotic (SMO) Wrist splints;Wrist splints - night use;Ankle-foot orthosis (AFO);Ankle-foot orthosis (AFO) - night use;Abduction wedge;Knee immobilizer(s);Stander;Positioning/feeding chair;Compression garment;Other upper extremity device;Other lower extremity device;Other, specify;Dynamic Lower Extremity Stretching Orthosis/Splints;Dynamic Upper Extremity Orthosis/Splints;Hip-knee-ankle-foot orthosis (HKAFO);Shoe Inserts of any type;Knee-ankle-foot orthosis (KAFO);Static Lower Extremity Stretching Orthosis/Splints;Static Upper Extremity Orthosis/Splints;Supramalleolar orthotic (SMO) Alphanumeric

For each orthosis type record if it is used.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-25 08:54:08.2 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C58617 Mobility device use propel type MobilityDeviceUsePropelTyp Propel type the participant/subject uses their mobility device(s), if applicable Propel type the participant/subject uses their mobility device(s), if applicable Propel Independent;Partial Independence;Dependent;Other, specify Independent;Partial Independence;Dependent;Other, specify Alphanumeric

If the participant/subject uses mobility device(s) then record the propulsion use.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-11-02 09:29:16.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C21640 Fall details assistive device specify text FallDetAssisDevSpecfyTxt The free-text field to specify the other type of assistive device used when the fall recorded in the Falls Diary occurred The free-text field to specify the other type of assistive device used when the fall recorded in the Falls Diary occurre Other, please specify Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-17 09:26:36.973 Devices: Mobility and Manipulation Devices Treatment/Intervention Data 255

Free-Form Entry
C10708 Wheelchair primary mobility means age value WheelchairPrimMobilMeanAgeVal Age of participant/subject when they first began to use a wheelchair as their primary means of mobility Age of participant/subject when they first began to use a wheelchair as their primary means of mobilit If participant/subject uses a wheelchair as their primary means of mobility, indicate age of participant when they first began to use a wheelchair as their primary means of mobility. Numeric Values

Answer should be recorded in years.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.10 2022-01-10 15:20:49.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Free-Form Entry
C58492 Bath device type BathDeviceTyp Type for all bathing devices currently used by the participant/subject Type for all bathing devices currently used by the participant/subject If yes, Bath Chair/Bench;Bathroom grab bars;Other, specify;Removable Shower Head;Roll-in Shower Bath Chair/Bench;Bathroom grab bars;Other, specify;Removable Shower Head;Roll-in Shower Alphanumeric

Only answer if bathing devices is answered Yes.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-16 14:15:24.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C18182 Therapy rehabilitation frequency TherapuRehabFreq Frequency the participant/subject received the therapy or rehabilitation Frequency the participant/subject received the therapy or rehabilitation Frequency 0;1;2;3;4;5;6;7 0;1;2;3;4;5;6;7 Numeric Values

days/week

 CDISC SDTM Frequency Terminology (http://www.cancer.gov/cancertopics/cancerlibrary/terminologyresources/cdisc) Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-21 12:11:21.037 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C58875 Therapy or rehabilitation received status other text TherRehabReceStatusOthrTxt The free-text field related to 'Therapy or rehabilitation received status' specifying other text. Status of therapy or rehabilitation services received by the participant/subject The free-text field related to 'Therapy or rehabilitation received status' specifying other text. Status of therapy or rehabilitation services received by the participant/subjec Other, specify Alphanumeric

No instructions available

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2020-05-18 15:29:15.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data 255

Free-Form Entry
C21667 Therapy rehabilitation ICD 10 CM code TherpyRehabICD10CMCd ICD-10-CM code that describes the therapy or rehabilitation received by the participant/subject ICD-10-CM code that describes the therapy or rehabilitation received by the participant/subject Type(s) of rehabilitation therapy/services received Alphanumeric

Code the therapy or rehabilitation service received using the ICD-10-CM codes to enable data aggregation.

 International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM): https://www.cdc.gov/nchs/icd/icd10cm.htm Adult NeuroRehab Supplemental-Highly Recommended 1.00 2013-07-20 10:21:25.65 Devices: Mobility and Manipulation Devices Treatment/Intervention Data 255

Free-Form Entry
C56954 Dynamic upper extremity orthosis splint use frequency type DynmUEOrthoSplntUseFreqTyp Frequency type with which the participant/subject uses their dynamic upper extremity orthosis/splints, if applicable Frequency type with which the participant/subject uses their dynamic upper extremity orthosis/splints, if applicable If yes, Daytime use;Full-time use;Part-time use;Night time use Daytime use;Full-time use;Part-time use;Night time use Alphanumeric

Only answer if dynamic upper extremity orthosis/splints is answered Yes.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2017-08-07 12:54:36.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C10721 Walking other assistive device use age started value WalkOthrAssistDevUseStrtAgeVal Age of the participant/subject when he/she began using the other assistive device for walking Value of the participant/subject's age at which he/she began using the other assistive device for walking If yes to other assistive device, indicate age participant/subject began using other assistive device. Numeric Values

Answer should be recorded in years.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-11 15:03:49.2 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Free-Form Entry
C58568 Dynamic upper extremity orthosis splint use anatomic site laterality type DynUEOrthSplnUseAnatSiteLatTyp Laterality type of dynamic upper extremity orthosis splints anatomic site used by participant/subject Laterality type of dynamic upper extremity orthosis splints anatomic site used by participant/subjec If yes, Left;Right Left;Right Alphanumeric

Only answer if dynamic upper extremity orthosis/splints is answered Yes.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-06-27 11:49:04.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C18883 Orthosis other text OrthosisOTH The free-text field related to 'Orthosis type' specifying other text. Type of orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) The free-text field related to 'Orthosis type' specifying other text. Type of orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) Other, specify Alphanumeric

Specify whether orthoses other than Wrist splints, Wrist splints - night use, Ankle-foot orthosis (AFO), Ankle-foot orthosis (AFO) - night use, Supramalleolar orthotic (SMO), Abduction wedge, Knee immobilizer(s), Knee-ankle-foot orthosis (KAFO), Stander, Positioning/feeding chair, Compression garment, Other upper extremity device, Other lower extremity device, Shoe inserts of any type, Hip-knee-ankle-foot orthosis (HKAFO), Dynamic Upper Extremity Orthosis/Splints, Static Upper Extremity Orthosis/Splints, Dynamic Lower Extremity Stretching Orthosis/Splints, or Static Lower Extremity Stretching Orthosis/Splints are used.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-25 08:54:08.2 Devices: Mobility and Manipulation Devices Treatment/Intervention Data 4000

Free-Form Entry
C58482 Static upper extremity orthosis splint use frequency type StaticUEOrthoSplntUseFreqTyp Frequency type with which the participant/subject uses their static upper extremity orthosis/splints, if applicable Frequency type with which the participant/subject uses their static upper extremity orthosis/splints, if applicable If yes, Daytime use;Full-time use;Part-time use;Night time use Daytime use;Full-time use;Part-time use;Night time use Alphanumeric

Only answer if static upper extremity orthosis/splints is answered Yes.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2017-08-07 12:54:36.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C14286 Therapy or rehabilitation received status TherRehabReceStatus If the participant/ subject was assessed for rehabilitation therapy/services, describes the status of therapy/services If the participant/ subject was assessed for rehabilitation therapy/services, describes the status of therapy/service Were rehabilitation therapy/services received Received rehabilitation therapy during hospitalization;Did not receive rehabilitation therapy because symptoms resolved;Ineligible to receive rehabilitation therapy due to impairment severity or medical issues;Other, specify Received rehabilitation therapy during hospitalization;Did not receive rehabilitation therapy because symptoms resolved;Ineligible to receive rehabilitation therapy due to impairment severity or medical issues (i.e.: poor prognosis, patient unable to tolerate rehabilitation therapeutic regimen);Other specify Alphanumeric

Choose all that apply.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-06-21 00:00:00.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C58618 Mobility device use propel type other text MobilDeviceUsePropelTypOthrTxt Text describing other propulsion type of mobility device use Text describing other propulsion type of mobility device us Other, specify Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-12 13:56:59.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data 255

Free-Form Entry
C21644 Orthosis stander type OrthosisStanderTyp Type of stander the participant/subject uses Type of stander the participant/subject uses Yes Dynamic;Mobile;Prone;Static;Supine Dynamic;Mobile;Prone;Static;Supine Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-21 12:11:21.037 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C10709 Walking assistive device indicator WalkAssistiveDeviceInd Indicator of whether the participant/subject uses an assistive device for walking Indicator of whether the participant/subject uses an assistive device for walking Indicate if the participant/subject uses an assistive device. Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one. History can also be obtained from a family member, friend, or chart/ medical record. If the informant is unable to answer the question or is deemed unreliable (e.g., the participant/ subject has dementia) the history should be obtained from the medical record. Unknown includes the scenario where information is not documented in the medical record. Choose one. If answer is "No" skip to Therapy or rehabilitation received status.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-11 15:03:49.2 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C58493 Activity Daily Living device type other text ADLDeviceTypOtherTxt Text describing the presence of any other activity of daily living device used Text describing the presence of any other activity of daily living device use Other, specify Alphanumeric

Specify whether ADL devices other than Eating / Drinking Assistive Devices, Bathing Devices, and Toileting Devices are used.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-16 14:54:50.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data 255

Free-Form Entry
C18183 Wheelchair driven subject indicator WheelchairDriveSubjInd Indicator for whether the power wheelchair is driven by the participant/subject Indicator for whether the power wheelchair is driven by the participant/subject Is the wheelchair driven by the participant/ subject? Yes;No;Unknown Yes;No;Unknown Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-21 12:11:21.037 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C58879 Assistive device use indicator AssistiveDvcUseInd Whether the participant/subject uses an assistive device (e.g., wheelchair) Whether the participant/subject uses an assistive device (e.g., wheelchair Provided with assistive devices No;Yes;Unknown No;Yes;Unknown Alphanumeric

Choose one.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2020-05-18 15:41:02.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C22612 Home modification provide indicator HomeModProvideInd Indicates if the participant/subject was provided with any home modifications Indicates if the participant/subject was provided with any home modification Provided with home modifications? Yes;No;Unknown Yes;No;Unknown Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 1.10 2022-01-12 13:16:08.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C58470 Transfer transportation device use indicator TransferTransportDevUseInd Indicator of whether the participant/subject uses any transfer/transportation devices Indicator of whether the participant/subject uses any transfer/transportation devices Does the participant use transfer/transportation devices? Yes, specify;No Yes, specify;No Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-25 08:54:08.2 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C10722 Walking primary assistive device daily use duration WalkPrimryAssistvDevDlyUseDur Duration for which the participant/subject uses her or his primary assistive walking device on a daily basis Duration for which the participant/subject uses her or his primary assistive walking device on a daily basis Indicate the amount of time the participant/subject uses the primary assistive walking device. Numeric Values

Answer should be recorded in hours:minutes format (HH:MM) and should be less than 24 hours. If subject/participant does not use an assistive walking device, leave blank and choose N/A.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-11 15:03:49.2 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Free-Form Entry
C58569 Static upper extremity orthosis splint frequency use laterality type StatcUEOrthSplntUseFreqLatTyp Laterality type of static upper extremity orthosis splints frequency used by participant/subject Laterality type of static upper extremity orthosis splints frequency used by participant/subjec If yes, Left;Right Left;Right Alphanumeric

Only answer if static upper extremity orthosis/splints is answered Yes.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-06-27 12:05:23.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C18914 Durable medical equipment other text DurableMedEquipmentOTH The free-text field related to 'Durable medical equipment type' specifying other text. If the participant/ subject was provided with any durable medical equipment, describes the type(s) of equipment received The free-text field related to 'Durable medical equipment type' specifying other text. If the participant/ subject was provided with any durable medical equipment, describes the type(s) of equipment receive Other, specify Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-06-21 00:00:00.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data 4000

Free-Form Entry
C58483 Static upper extremity orthosis splint use anatomic site StaticUEOrthoSplntUseAnatSite Anatomic site of the static upper extremity orthosis/splints use Anatomic site of the static upper extremity orthosis/splints use Anatomic Site: Thumb;Wrist/hand;Hand/Fingers;Elbow Thumb;Wrist/hand;Hand/Fingers;Elbow Alphanumeric

Only answer if static upper extremity orthosis/splints is answered Yes.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-13 10:47:12.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C14292 Durable medical equipment indicator DurableMedEquipmentInd Indicates if the participant/ subject was provided with any durable medical equipment Indicates if the participant/ subject was provided with any durable medical equipmen Provided with durable medical equipment? Yes;No;Unknown Yes;No;Unknown Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-06-21 00:00:00.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C58619 Truncal support device type TruncalSupportDeviceTyp Type of truncal support device type currently used by the participant/subject Type of truncal support device type currently used by the participant/subject Truncal Support Devices Neoprene trunk support;Thoracic-lumbar-sacral orthoses (TLSO);Body jacket;Sitting support orthosis (SSO);Other, specify Neoprene trunk support;Thoracic-lumbar-sacral orthoses (TLSO);Body jacket;Sitting support orthosis (SSO);Other specify Alphanumeric

Only answer if truncal support devices is answered Yes.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-11-02 11:59:06.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C21645 Orthosis walker type OrthosisWalkerTyp Type of walker the participant/subject uses Type of walker the participant/subject uses Yes Anterior;Posterior;Wheeled Anterior;Posterior;Wheeled Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-21 12:11:21.037 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C10710 Walking 1 cane use indicator Walk1CaneUseInd Indicator whether the participant/subject uses one cane for walking Indicator whether the participant/subject uses one cane for walking Indicate if the participant/subject uses a cane. Yes;No;Unknown Yes;No;Unknown Alphanumeric

If "No" or "Unknown" skip to "Walking cane or crutches pair use indicator."

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-11 15:03:49.2 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected
C58494 Bath device type other text BathDeviceTypOtherTxt Text describing the presence of any other bathing device used Text describing the presence of any other bathing device use Other, specify Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-16 15:02:41.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data 255

Free-Form Entry
C18188 Other mobility device type OthrMobilityDevTyp Type of other mobility device that the participant/ subject uses Type of other mobility device that the participant/ subject uses Other mobility device Scooter;Stroller;Other, specify;Mobile standers;Standing wheelchairs Scooter;Stroller;Other, specify;Mobile standers;Standing wheelchairs Alphanumeric

Choose all that apply.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-21 12:11:21.037 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C58880 Assistive device type AssistiveDvcTyp Type for all assistive devices currently used by the participant/subject Type for all assistive devices currently used by the participant/subjec IF YES, current type(s) of assistive devices AFO/ brace/ prosthetic/ orthotic/ splints;Cane (Straight/ Tripod/ Quad);Walker;Power wheelchair;Scooter;Manual wheelchair;Adaptive or Activities of Daily Living (ADL) equipment (e.g., modified eating utensils, reachers, etc.);Other, specify AFO/ brace/ prosthetic/ orthotic/ splints;Cane (Straight/ Tripod/ Quad);Walker;Power wheelchair;Scooter;Manual wheelchair;Adaptive or Activities of Daily Living (ADL) equipment (e.g., modified eating utensils, reachers, etc.);Other, specify Alphanumeric

Choose all that apply.

 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2020-05-18 15:46:31.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
C22613 Home modification durable medical equipment type HomeModDurableMedEquipmentTyp If the participant/ subject was provided with any home modification durable medical equipment, describes the type(s) of equipment received If the participant/ subject was provided with any home modification durable medical equipment, describes the type(s) of equipment receive If YES, type(s) of home equipment used Stair lifts;Exterior ramp;Elevator;Bathroom renovations (i.e. grab bars, hand held shower head);Other, specify Stair lifts;Exterior ramp;Elevator;Bathroom renovations (i.e. grab bars, hand held shower head);Other, specify Alphanumeric

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 No references available Adult NeuroRehab Supplemental-Highly Recommended 1.10 2022-01-12 13:19:27.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
CSV