CDE Detailed Report

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

Displaying 101 - 139 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
C58495 Toilet device type ToiletDeviceTyp Type for all toileting devices currently used by the participant/subject Type for all toileting devices currently used by the participant/subject If yes, Toilet chair/Commode;Toilet Riser/Adaptive Seat Over Toilet;Bathroom grab bars;Other, specify Toilet chair/Commode;Toilet Riser/Adaptive Seat Over Toilet;Bathroom grab bars;Other, specify Alphanumeric

Only answer if toileting devices is answered Yes.

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-16 15:04:12.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C18190 Regular daily tilt indicator RegDailyTiltInd Indicator for whether the participant/subject has a regular daily tilt in the positioning of wheelchair Indicator for whether the participant/subject has a regular daily tilt in the positioning of wheelchair Regular/daily tilt Yes;No;Not applicable;Unknown Yes;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

C58882 Assistive device other text AssistiveDvcOthrTxt The free-text field related to 'Assistive device type' specifying other text. Type for all assistive devices currently used by the participant/subject The free-text field related to 'Assistive device type' specifying other text. Type for all assistive devices currently used by the participant/subjec Other, specify Alphanumeric

No instructions available

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2020-05-18 15:57:51.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data 255

Free-Form Entry

C22614 Home medical equipment other text HomeMedEquipmentOTH The free-text field related to Home medical equipment type' specifying other text. If the participant/ subject was provided with any home medical equipment, describes the type(s) of equipment received The free-text field related to Home medical equipment type' specifying other text. If the participant/ subject was provided with any home medical equipment, describes the type(s) of equipment receive Other, specify Alphanumeric

No instructions available

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2016-07-12 11:58:37.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data 4000

Free-Form Entry

C12679 Mobility device use indicator MobilityDvcUseInd Whether the participant/subject uses a mobility device (e.g., wheelchair) Whether the participant/subject uses a mobility device (e.g., wheelchair) Does the participant use mobility devices? Yes;No;Unknown Yes;No;Unknown Alphanumeric

No instructions available

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

C58571 Dynamic lower extremity stretch orthosis splint frequency use laterality type DynLEStrOrtSplnUseFreqLatrlTyp Laterality type of dynamic lower extremity stretching orthosis splints frequency used by participant/subject Laterality type of dynamic lower extremity stretching orthosis splints frequency used by participant/subjec If yes, Left;Right Left;Right Alphanumeric

Only answer if dynamic lower extremity stretching 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

C19067 Other mobility device other text OthrMobilityDevOTH The free-text field related to 'Other mobility device type' specifying other text. Type of other mobility device that the participant/ subject uses The free-text field related to 'Other mobility device type' specifying other text. Type of other mobility device that the participant/ subject uses 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 4000

Free-Form Entry

C58473 Mobility device use frequency type MobilityDeviceUseFreqTyp Frequency type with which the participant/subject uses their mobility device(s), if applicable Frequency type with which the participant/subject uses their mobility device(s), if applicable If yes Full-time;Part-time Full-time;Part-time Alphanumeric

If the participant/subject uses mobile device(s) 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

C58485 Dynamic lower extremity stretch orthosis splint use anatomic site DynLEStrchOrthSplntUseAnatSite Anatomic site of the dynamic lower extremity stretching orthosis/splints use Anatomic site of the dynamic lower extremity stretching orthosis/splints use Anatomic Site: Ankle;Knee;Hip Ankle;Knee;Hip Alphanumeric

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

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-13 11:14:58.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C17511 Walking difficulty age need intermittent support indicator WlkDfcltyAgeNdIntrmtSuprtInd Indicator used when participant/subject age when needing intermittent support for walking Indicator used when participant/subject age when needing intermittent support for walking If participant/subject needs intermittent support for walking, indicate age of participant when support first needed. Unknown Unknown Alphanumeric

Leave age blank if unknown and choose Unknown.

No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-15 16:08:48.687 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected

C58621 Stand time use type StandTimeUseTyp Type stand time used by the participant/subject Type stand time used by the participant/subject If yes, Number of minutes per day;Number of days per week Number of minutes per day;Number of days per week Alphanumeric

Only answer if stander position device is answered Yes.

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-11-02 13:27:56.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C21649 Single orthosis side designator SingOrthSideDsigntr Designates the side that the participant/subject uses a single orthosis Designates the side that the participant/subject uses a single orthosi Unilateral Left;Right Left;Right 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

C10712 Walking use 2 cane crutch indicator WalkUse2CaneCrutchInd Indicator whether the participant/subject uses two canes or crutches for walking Indicator whether the participant/subject uses two canes or crutches for walking Indicate if the participant/subject uses two canes/crutches. Yes;No;Unknown Yes;No;Unknown Alphanumeric

If "No" or "Unknown" skip to "Walker 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

C58496 Toilet device type other text ToiletDeviceTypOtherTxt Text describing the presence of any other toileting device used Text describing the presence of any other toileting device use Other, specify Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-16 15:17:18.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data 255

Free-Form Entry

C18191 Serial cast start date SerialCastStartDate Date on which the serial casting therapy started Date on which the serial casting therapy started Start Date Date or Date & Time 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

Free-Form Entry

C59011 Walking primary assistive device daily use duration not applicable status WlkPrmAstDvDlyUseDurNotAppStat Status indicating that the amount of time per day using the primary assistive walking device does not apply to the subject/participant Status indicating that the amount of time per day using the primary assistive walking device does not apply to the subject/participan Indicate the amount of time the participant/subject uses the primary assistive walking device. N/A N/A Alphanumeric

No instructions available

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2022-01-10 10:21:19.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected

C22899 Gross Motor Function Classification System (GMFCS) - Level scale GMFCSLevelScl The scale level as reference to the Gross Motor Function Classification System (GMFCS) The scale level as reference to the Gross Motor Function Classification System (GMFCS GMFCS Level Level I;Level II;Level III;Level IV;Level V Children walk at home, school, outdoors and in the community. They can climb stairs without the use of a railing. Children perform gross motor skills such as running and jumping, but speed, balance and coordination are limited.;Children walk in most settings and climb stairs holding onto a railing. They may experience difficulty walking long distances and balancing on uneven terrain, inclines, in crowded areas or confined spaces. Children may walk with physical assistance, a hand held mobility device or used wheeled mobility over long distances. Children have only minimal ability to perform gross motor skills such as running and jumping.;Children walk using a hand-held mobility device in most indoor settings. They may climb stairs holding onto a railing with supervision or assistance. Children use wheeled mobility when traveling long distances and may self-propel for shorter distances.;Children use methods of mobility that require physical assistance or powered mobility in most settings. They may walk for short distances at home with physical assistance or use powered mobility or a body support walker when positioned. At school, outdoors and in the community children are transported in a manual wheelchair or use powered mobility.;Children are transported in a manual wheelchair in all settings. Children are limited in their ability to maintain antigravity head and trunk postures and control leg and arm movements. Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2016-12-07 13:11:56.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected

C58474 Mobility device use distance type MobilityDeviceUseDistanceTyp Distance use type with which the participant/subject uses their mobility device(s), if applicable Distance use type with which the participant/subject uses their mobility device(s), if applicable Use distance Long distance;Short distance Long distance;Short distance Alphanumeric

If the participant/subject uses mobility device(s) then record the distance use. Choose one option.

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-12 12:20:58.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected

C12682 Orthosis use indicator OrthosisUseInd Whether the participant/subject uses orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) Whether the participant/subject uses orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) Does the participant use orthoses? Yes;No;Unknown Yes;No;Unknown 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

C58572 Dynamic lower extremity stretch orthosis splint use anatomic site laterality type DynLEStrOrtSplnUsAnatSitLatTyp Laterality type of dynamic lower extremity stretching orthosis splints anatomic site used by participant/subject Laterality type of dynamic lower extremity stretching orthosis splints anatomic site used by participant/subjec If yes, Left;Right Left;Right Alphanumeric

Only answer if dynamic lower extremity stretching 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

C19068 Upper extremity device specify text UpperExtremityDevST The free-text field related to 'Upper extremity device indicator'. Indicator for whether an upper extremity device is used The free-text field related to 'Upper extremity device indicator'. Indicator for whether an upper extremity device is used Yes, 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 4000

Free-Form Entry

C58486 Static lower extremity stretch orthosis splint use frequency type StatLEStrchOrthSplntUseFreqTyp Frequency type with which the participant/subject uses their static lower extremity stretching orthosis/splints, if applicable Frequency type with which the participant/subject uses their static lower extremity stretching 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 lower extremity stretching orthosis/splints is answered Yes.

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-13 11:24:20.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C17512 Walking difficulty age need permanent support indicator WlkDffcltyAgeNeedPrmSuprtInd Indicator related to age of participant/subject needing permanent support for walking Indicator related to age of participant/subject needing permanent support for walking If participant/subject needs permanent support for walking, indicate age of participant when support first needed. Unknown Unknown Alphanumeric

Leave age blank and choose Unknown.

No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-15 16:08:48.687 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected

C58622 Number minutes day duration NumberMinutesDayDur Duration in minutes per day a stander used by the participant/subject Duration in minutes per day a stander used by the participant/subject Number of minutes per day Numeric Values

Enter the number of minutes a stander is used per day, if applicable.

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-11-02 13:37:37.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Free-Form Entry

0 1440
C21651 Upper extremity orthosis type UpperExtrmtyOrthosisTyp Type of upper extremity orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) the participant/subject uses Type of upper extremity orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) the participant/subject uses Upper Extremity Orthoses Elbow orthosis;Hand only;Wrist hand orthosis Elbow orthosis;Hand only;Wrist hand orthosis 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

Multiple Pre-Defined Values Selected

C10697 Fall rate FallRate Rate that reflects the participant's/subject's current frequency of falling Rate that reflects the participant's/subject's current frequency of falling Indicate the description that reflects the participant's/subject's current rate of falls. Normal;Rare falling;Occasional falls;Falls multiple times a week or requires device to prevent falls;Unable to stand Normal;Rare falling (less than once a month);Occasional falls (once a week to once a month);Falls multiple times a week or requires device to prevent falls;Unable to stand Alphanumeric

Choose only one.

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

C10713 Walking cane or crutches pair use age started value WalkUse2CaneCrutchStrtAgeVal Age of the participant/subject when he/she began using two canes or crutches for walking Value of the participant/subject's age at which he/she began using two canes or crutches for walking If yes to canes/ crutches, indicate age participant/subject began using two canes/crutches. 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

C58497 Transfer transportation device type TransferTransportDeviceTyp Type for all transfer/transportation devices currently used by the participant/subject Type for all transfer/transportation devices currently used by the participant/subject Transfer/Transportation Transfer Devices;Transportation Devices;Other, specify Transfer Devices;Transportation Devices;Other, specify Alphanumeric

For each transfer/transportation device type record if it is used.

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-16 15:24:35.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C18192 Serial cast stop date SerialCastStopDate Date on which the serial casting therapy ended Date on which the serial casting therapy ended Stop Date Date or Date & Time 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

Free-Form Entry

C22900 Manual Ability Classification System (MACS) - Level scale MACSLevelScl The scale level related to the Mini-Manual Ability Classification System (MACS) The scale level related to the Mini-Manual Ability Classification System (MACS MACS Level Level I;Level II;Level III;Level IV;Level V Handles objects easily and successfully.;Handles most objects but with somewhat reduced quality and/or speed of achievement.;Handles objects with difficulty, needs help to prepare and/or modify activities.;Handles a limited selection of easily managed objects in adapted situations.;Does not handle objects and has severely limited ability to perform even simple actions. Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2016-12-07 13:36:23.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected

C58475 Mobility device use location type MobilityDeviceUseLocationTyp Use location type where the participant/subject uses their mobility device(s), if applicable Use location type where the participant/subject uses their mobility device(s), if applicable Used at Home;School/Work;Community;Other, specify Home;School/Work;Community;Other, specify Alphanumeric

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

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-12 13:27:46.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C12683 Mobility device type MobilityDvcTyp Type for all mobility devices currently used by the participant/subject Type for all mobility devices currently used by the participant/subject Mobility Devices Other, specify;Manual wheelchair;Power assist wheelchair;Power wheelchair;Scooter;Medical/Adaptive Stroller;Walker;Gait Trainer/Weight Supported Walkers;Crutches;Cane / Stick;Other Mobility Device Other, specify;Manual wheelchair;Power assist wheelchair;Power wheelchair;Scooter;Medical/Adaptive Stroller;Walker;Gait Trainer/Weight Supported Walkers;Crutches;Cane / Stick;Other Mobility Device Alphanumeric

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

Multiple Pre-Defined Values Selected

C58573 Static lower extremity stretch orthosis splint frequency use laterality type StcLEStrOrtSplnUseFreqLatrlTyp Laterality type of static lower extremity stretching orthosis splints frequency used by participant/subject Laterality type of static lower extremity stretching orthosis splints frequency used by participant/subjec If yes, Left;Right Left;Right Alphanumeric

Only answer if static lower extremity stretching 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

C19136 Rehabilitation services assessment/reception indicator RehabServicesAessmentInd Indicator for the assessment for or reception of rehabilitation services Indicator for the assessment for or reception of rehabilitation services Patient was assessed for/received rehabilitation services? No;Yes;Unknown No;Yes;Unknown Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-05-29 10:15:57.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected

C58487 Static lower extremity stretch orthosis splint use anatomic site StaLEStrchOrthSplntUseAnatSite Anatomic site of the static lower extremity stretching orthosis/splints use Anatomic site of the static lower extremity stretching orthosis/splints use Anatomic Site: Ankle;Knee;Hip Ankle;Knee;Hip Alphanumeric

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

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-13 11:27:48.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C17517 Wheelchair primary mobility means age indicator WheelchairPrimMobilMeanAgeInd Indicator used related age of participant/subject when they first began to use a wheelchair as their primary means of mobility Indicator used related 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. Unknown Unknown Alphanumeric

Choose Unknown if age is not known.

No references available Adult NeuroRehab Supplemental-Highly Recommended 3.10 2022-01-10 15:23:58.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected

C58623 Number days week count NumberDayWeekCt Count of days per week a stander used by the participant/subject Count of days per week a stander used by the participant/subject Number of days per week Numeric Values

Enter the number of days a stander is used per week, if applicable.

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-11-02 13:37:37.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Free-Form Entry

0 7
C21652 Elbow wrist orthosis type ElbowWristOrthosisTyp Type of elbow or wrist orthosis the participant/subject uses Type of elbow or wrist orthosis the participant/subject uses Yes Day;Dynamic;Night;Static Day;Dynamic;Night;Static Alphanumeric

Choose all that apply.

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

C10699 Sitting ability status SittingAbilityStatus Status that reflects the participant's/subject's current ability to sit Status that reflects the participant's/subject's current ability to sit Indicate the description that reflects the participant's/subject's current ability to sit. Can sit only with extensive support;Slight imbalance of the trunk, but needs no back support;Unable to sit;Unable to sit without back support;Without any difficulty Can sit only with extensive support (geriatric chair, posy, etc.);Slight imbalance of the trunk, but needs no back support;Unable to sit;Unable to sit without back support;Without any difficulty Alphanumeric

Choose only one.

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

CSV