CDE Detailed Report
Disease: NeuroRehab
Subdomain Name: Devices
CRF: Devices: Mobility and Manipulation
Displaying 51 - 100 of 139
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C58499 | Transfer device type | TransferDeviceTyp | Type for all transfer devices currently used by the participant/subject | Type for all transfer devices currently used by the participant/subject | If yes, | Transfer bars;Transfer slings/belts;Transfer boards;Lift system (e.g., Hoyer, ceiling track system);Other, specify | Transfer bars;Transfer slings/belts;Transfer boards;Lift system (e.g., Hoyer, ceiling track system);Other, specify | Alphanumeric |
Only answer if transfer devices is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-16 15:38:33.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C18197 | Upper extremity device indicator | UpperExtremityDevInd | Indicator for whether an upper extremity device is used | Indicator for whether an upper extremity device is used | Upper extremity devices | Yes, specify;No;Not applicable;Unknown | Yes, specify;No;Not applicable;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 |
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| C19141 | Discipline other text | DisciplineOTH | The free text field related to "Discipline types" specifying other text. The type of discipline | The free text field related to "Discipline types" specifying other text. The type of disciplin | Other (specify) | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2014-05-29 10:32:54.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 4000 |
Free-Form Entry |
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| C58477 | Cane stick use laterality type | CaneStickUseLateralTyp | Laterality type with which the participant/subject uses their cane/stick | Laterality type with which the participant/subject uses their cane/stick | If yes, | Unilateral;Bilateral | Unilateral;Bilateral | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-12 14:27:43.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C12685 | Wheelchair use frequency | WheelchairUseFreq | Frequency with which the participant/subject uses their wheelchair, if applicable | Frequency with which the participant/subject uses their wheelchair, if applicable | If Yes | Full-time;Part-time | Full-time;Part-time | Alphanumeric |
If the participant/subject uses a manual wheelchair or power wheelchair then record the extent of use. Choose one option. |
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 |
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| C58575 | Activity daily living device type use indicator | ActivDailyLivingDevcTypUseInd | Indicator whether the participant/subject currently uses the selected types of activity of daily living devices | Indicator whether the participant/subject currently uses the selected types of activity of daily living device | Device used? | Yes;No;Not applicable;Unknown | Yes;No;Not applicable;Unknown | Alphanumeric |
For each activity daily living device type record if it is used. Choose one for each device type. |
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 |
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| C21654 | Back brace indicator | BackBraceInd | Indicator of whether the participant/subject wears a type of orthosis for the spine | Indicator of whether the participant/subject wears a type of orthosis for the spine | Do you wear a body jacket/back brace/TSLO | No;Yes | No;Yes | Alphanumeric | 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 |
3165788 | ||||||||
| C10702 | Walking own unable reason | WalkingOwnUnableRsn | Reason why the participant/subject is unable to walk on his/her own | Reason why the participant/subject is unable to walk on his/her own | If participant/subject is unable to walk on their own, indicate reason why. | Alphanumeric |
After answering this question skip to "Wheelchair primary mobility means age value", "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." |
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 | 255 |
Free-Form Entry |
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| C58489 | Seat lie position device type | SeatLiePositionDeviceTyp | Type of seated or lying position device currently used by the participant/subject | Type of seated or lying position device currently used by the participant/subject | Seated or Lying Position Device | Abduction wedge;Serial casting;Saddle seats/Bolster seats;Seat inserts;Corner chair | Abduction wedge;Serial casting;Saddle seats/Bolster seats;Seat inserts;Corner chair | Alphanumeric |
Only answer if seated or lying position device is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-16 13:53:49.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C18153 | Data unknown text | DataUnknwnTxt | The free-text field to Mark an "X" in to record if data are unknown or not available | The free-text field to Mark an "X" in to record if data are unknown or not availabl | Unknown | Alphanumeric |
If age unknown, leave age blank and choose Unknown. |
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 | 20 |
Free-Form Entry |
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| C58626 | Transfer device type other text | TransferDevTypeOthrTxt | Text describing the presence of any other transfer device used | Text describing the presence of any other transfer device use | Other, specify | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-11-02 16:02:13.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 255 |
Free-Form Entry |
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| C56951 | Walker use type | WalkerUseTyp | Type of walker which the participant/subject uses, if applicable | Type of walker which the participant/subject uses, if applicable | Type of walker | Front or Forward Walker (no wheels, two-wheeled, or four wheeled);Reverse Rolling Walker | Front or Forward Walker (no wheels, two-wheeled, or four wheeled);Reverse Rolling Walker | Alphanumeric |
If the participant/subject uses a walker, then record the type used. Choose one option. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2017-08-07 11:32:24.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C10718 | Wheelchair use indicator | WheelchairUseInd | Indicator whether the participant/subject uses a wheelchair | Indicator whether the participant/subject uses a wheelchair | Indicate if the participant/subject uses a wheelchair. | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
If "No" or "Unknown" skip to "Walking other assistive device 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 |
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| C58500 | Transportation device type other text | TransportDeviceTypOtherTxt | Text describing the presence of any other transfer device used | Text describing the presence of any other transfer device use | Other, specify | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-16 15:58:24.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 255 |
Free-Form Entry |
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| C18198 | Ankle foot orthosis use type | AnklFootOrthosisUseTyp | Type of use for ankle-foot orthosis | Type of use for ankle-foot orthosis | Use: | Walking;Resting splints | Walking;Resting splints | 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 |
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| C19493 | Spinal cord injury upper extremity assistive device use frequency value | SCIUPAssistDevUseFreqVal | The frequency of use of assistive devices for upper extremity in spinal cord injury | The frequency of use of assistive devices for upper extremity in spinal cord injur | Use of assistive devices used to enhance upper extremity function | Never or less than monthly;Not daily, but one or more times weekly;Not weekly, but one or more times monthly;Used daily | Never or less than monthly;Not daily, but one or more times weekly;Not weekly, but one or more times monthly;Used daily | Alphanumeric |
UEDEVICE- (all equipment like splints, adaptive equipment, surface functional electrical stimulation (FES), etc.) |
http://www.nature.com/sc/journal/v52/n9/full/sc201487a.html | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2014-06-17 23:41:18.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C58479 | Orthosis laterality type | OrthosisLateralityTyp | Laterality type of orthoses used by participant/subject | Laterality type of orthoses used by participant/subject | If yes, | Unilateral;Bilateral | Unilateral;Bilateral | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-12 17:17:20.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C12686 | Orthosis type use indicator | OrthsisTypUseInd | Indicator whether the participant/subject currently uses the selected types of orthosis | Indicator whether the participant/subject currently uses the selected types of orthosis | Device used? | Yes;No;Not applicable;Unknown | Yes;No;Not applicable;Unknown | Alphanumeric |
Indicate whether the participant/subject currently uses the selected types of orthosis. |
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 |
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| C58577 | Eat drink assistive device type | EatDrinkAssistDeviceTyp | Type of eating / drinking device currently used by the participant/subject | Type of eating / drinking device currently used by the participant/subjec | Device used? | Cutlery / Chopsticks;Plates / Bowls;Cups, Mugs, Drinking Aids (e.g., Straws, Grip Adapters / Attachments);Stoppers and Funnels;Bib / Clothing Protectors;Feeding Systems (enteral / parenteral);Feeding Apparatus (manual);Food Guards;Other, specify | Cutlery / Chopsticks;Plates / Bowls;Cups, Mugs, Drinking Aids (e.g., Straws, Grip Adapters / Attachments);Stoppers and Funnels;Bib / Clothing Protectors;Feeding Systems (enteral / parenteral);Feeding Apparatus (manual);Food Guards;Other, specify | Alphanumeric |
Only answer if eating / drinking assistive device is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-06-29 13:18:07.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C21655 | Back brace frequency type | BackBraceFreqTyp | Describes how long the participant/subject wears the body jacket/back brace/TSLO | Describes how long the participant/subject wears the body jacket/back brace/TSLO | If yes, | All the time;Day only;Night only | All the time;Day only;Night only | 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 |
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| C10706 | Walking difficulty age support first needed value | WlkDffcltyAgeNdIntrmitSuprtVal | Age of participant/subject when intermittent support first needed for walking | Value of participant/subject's age at which she or he first needed intermittent support for walking | If participant/subject needs intermittent 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 |
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| C58490 | Position device type other text | PositionDeviceTypOthrTxt | Text describing the presence of any other positioning device used | Text describing the presence of any other positioning device use | Other, specify | Alphanumeric |
Specify whether positioning devices other than Seated or Lying Position Device, Stander and Truncal Support Devices are used. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-16 14:04:03.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 255 |
Free-Form Entry |
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| C18176 | Therapy rehabilitation indicator | TherapyRehabInd | Indicator for whether the participant/subject uses other therapy or rehabilitation procedures besides the use of mobility devices, orthoses, and positioning devices | Indicator for whether the participant/subject uses other therapy or rehabilitation procedures besides the use of mobility devices, orthoses, and positioning devices | Besides use of mobility devices, orthoses, and positioning devices, does the participant/ subject utilize other therapies? | 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 |
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| C58630 | Crutch use laterality type | CrutchUseLateralTyp | Laterality type with which the participant/subject uses their crutches | Laterality type with which the participant/subject uses their crutche | Laterality of type of crutches used. | Unilateral;Bilateral | Unilateral;Bilateral | Alphanumeric |
Select laterality for type of crutches used. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-12 14:27:43.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C56952 | Crutch use type | CrutchUseTyp | Type of crutches which the participant/subject uses, if applicable | Type of crutches which the participant/subject uses, if applicable | Type of crutches | Lofstrand or Forearm Crutches;Underarm;Other, specify | Lofstrand or Forearm Crutches;Underarm;Other, specify | Alphanumeric |
If the participant/subject uses crutches, then record the type used. Choose one option. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2017-08-07 11:44:13.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C10719 | Wheelchair use age started value | WheelchairUseStrtAgeVal | Age of the participant/subject when he/she began using a wheelchair | Value of the participant/subject's age at which he/she began using a wheelchair | If yes to wheelchair, indicate age participant/subject began using wheelchair. | Numeric Values |
Answer should be recorded in years. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 4.00 | 2013-07-11 15:03:49.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Free-Form Entry |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
