CDE Detailed Report
Disease: system
Subdomain Name: Devices
CRF: files
Displaying 1 - 50 of 139
Subdomain Name: Devices
CRF: files
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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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| 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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| 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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| 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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| 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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| 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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| 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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| 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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| 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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| 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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| 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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| 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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| 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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| 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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| 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 |
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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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 | ||||||||
| 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 |
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| 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 |
