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
C10715 Walker use age started value WalkerUseStrtAgeVal Age of the participant/subject when he/she began using a walker Value of participant/subject's age at which he/she began using a walker If yes to walking, indicate age participant/subject began using a walker. 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
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
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
C22911 Physical therapy orthoses type PTOrthosesTyp The type of orthoses as related to the physical therapy The type of orthoses as related to the physical therap Orthoses AFO;SMO;FO;HKAFO;TLSO;Serial casting knee;Serial casting ankle;Knee immobilizer;Neuroprosthesis (FES);KAFO;Elastic wraps/suits;Therapeutic taping;Shoe insert off the shelf Ankle foot orthosis;Supramalleolar orthosis;Foot orthosis;Hip knee ankle foot orthosis;Thoraco-lumbo-sacral orthosis;Serial casting knee;Serial casting ankle;Knee immobilizer;Neuroprosthesis (FES);Knee ankle foot orthosis;Elastic wraps/suits;Therapeutic taping;Shoe insert off the shelf Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2016-12-08 08:16:44.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
CSV