CDE Detailed Report
Disease: content
Subdomain Name: Devices
CRF: welcome
Displaying 1 - 50 of 139
Subdomain Name: Devices
CRF: welcome
Displaying 1 - 50 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
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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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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
Choose all that apply. |
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 |
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| 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 |
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| C12673 | Position device use indicator | PositionDevUseInd | Indicator of whether the participant/subject uses any positioning devices | Indicator of whether the participant/subject uses any positioning devices | Does the participant/subject use positioning devices? | Yes, specify;No | Yes, specify;No | Alphanumeric |
Choose one. If a positioning device is used specify the type. |
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 |
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| C58570 | Static upper extremity orthosis splint use anatomic site laterality type | StcUEOrthSplnUseAnatSiteLatTyp | Laterality type of static upper extremity orthosis splints anatomic site used by participant/subject | Laterality type of static upper extremity orthosis splints anatomic site 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 12:08:20.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C19066 | Therapy rehabilitation session other text | TherapyRehabSessOTH | The free-text field related to 'Therapy rehabilitation session duration' specifying other text. Duration of a therapy or rehabilitation session | The free-text field related to 'Therapy rehabilitation session duration' specifying other text. Duration of a therapy or rehabilitation session | 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 |
minute | |||||||||
| C58471 | ADL device use indicator | ADLDevUseInd | Indicator of whether the participant/subject uses any ADL (activities of daily living) devices | Indicator of whether the participant/subject uses any ADL (activities of daily living) devices | Does the participant use ADL 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 |
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| C58484 | Dynamic lower extremity stretch orthosis splint use frequency type | DynmLEStrchOrthSplntUseFreqTyp | Frequency type with which the participant/subject uses their dynamic lower extremity stretching orthosis/splints, if applicable | Frequency type with which the participant/subject uses their dynamic 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 dynamic lower extremity stretching orthosis/splints is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-13 10:55:59.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C14293 | Durable medical equipment type | DurableMedEquipmentTyp | If the participant/ subject was provided with any durable medical equipment, describes the type(s) of equipment received | If the participant/ subject was provided with any durable medical equipment, describes the type(s) of equipment receive | If YES, type(s) of durable medical equipment | Bedside commode;Hospital bed;Bathroom grab bars;Raised toilet seats;Shower seats;Suction devices;Oxygen;Other, specify | Bedside commode;Hospital bed;Bathroom grab bars;Raised toilet seats;Shower seats;Suction devices;Oxygen;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 |
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| C58620 | Truncal support device type other text | TruncalSupportDeviceTypOthrTxt | Text describing the presence of any other truncal support device used | Text describing the presence of any other truncal support device used | Other, specify | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-11-02 12:19:54.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 255 |
Free-Form Entry |
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| C21648 | Walker wheel number | WalkerWheelNum | Designates the number of wheels the walker has that the participant/subject uses | Designates the number of wheels the walker has that the participant/subject uses | Wheeled | 2;4 | 2;4 | 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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| C10711 | Walking cane use age started value | WalkCaneUseStrtAgeVal | Age of the participant/subject when he/she began using a cane for walking | Value of the participant/subject's age at which he/she began using a cane for walking | If yes to cane, indicate age participant/subject began using a cane. | 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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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
