CDE Detailed Report

Disease: Amyotrophic Lateral Sclerosis
Subdomain Name: Physical/Neurological Examination
CRF: Neuromuscular Examination

Displaying 1 - 23 of 23
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
C11040 Reflex examination result ReflexExamReslt Result of the examination of the reflexes of the specific muscle group Result of the examination of the reflexes of the specific muscle group Reflexes Absent;Diminished;Normal;Brisk Absent;Diminished;Normal;Brisk Alphanumeric

Answer for the specific muscle in both the right and left arms. Choose one.

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11061 Gait assessment result GaitAssmtReslt Result of the gait assessment Result of the gait assessment Gait Assessment Normal;Abnormal;Not assessed Normal;Abnormal;Not assessed Alphanumeric

Record the gait assessment result for each type of gait. Choose one.

 No references available Adult;Pediatric Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C02411 Laterality type LatTyp Laterality type relative to the anatomic site of the body examined or affected Laterality type relative to the anatomic site of the body examined or affected Bilateral;Left;Right;Unknown;Midline Bilateral;Left;Right;Unknown;Midline Alphanumeric

Record the neuromuscular examination results for both the right and left arms.

 Kendall. Muscles: Testing and Function with Posture and Pain, 5th ed. Florence JM, Pandya S, King WM et al. Intrarater reliability of manual muscle test (Medical Research Council Scale) grades in Duchenne's muscular dystrophy. Phys Ther 1992;72:115-126. Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11042 Muscle fasciculations indicator MuscleFasciculationsInd Indicator whether there are fasciculations in the specific muscle or muscle group examined Indicator whether there are fasciculations in the specific muscle or muscle group examined Fasciculations Yes;No;Not assessed Yes;No;Not assessed Alphanumeric

Choose one for each muscle or muscle group

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C17831 Neuromuscular exam additional comments text NeuromusExamAddCommentsTxt Text field to add any comments regarding the examined body segment Text field to add any comments regarding the examined body segment Additional Comments: Alphanumeric No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations 255

Free-Form Entry
C11019 Neuromuscular exam segment type NeuromuscularExamSegmentTyp Type of neuromuscular segment examined Type of neuromuscular segment examined Cranial;Cervical;Thoracic;Lumbosacral Cranial;Cervical;Thoracic;Lumbosacral Alphanumeric No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Multiple Pre-Defined Values Selected
C11043 Muscle tone result MuscleToneReslt Result of the muscle tone assessment Result of the muscle tone assessment Muscle Tone Normal;Flaccid;Spastic Normal;Flaccid;Spastic Alphanumeric

Answer for both sides of the arms and legs. Choose one for each.

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11026 Neuromuscular Exam Muscle weakness indicator NeuromuExmCranlMuscleWeaknInd Indicator whether there is muscle weakness in the muscle or muscle group examined Whether there is muscle weakness in the muscle or muscle group examined Weakness Yes;No;Not assessed;Unknown Yes;No;Not assessed;Unknown Alphanumeric

Answer for each muscle group. Choose one.

 No references available Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11044 Reflex normal indicator ReflexNormalInd Indicator whether the reflexes are normal in the anatomic site examined Indicator whether the reflexes are normal in the anatomic site examined Normal reflexes? Yes;No;Not assessed Yes;No;Not assessed Alphanumeric

Cervical Segment Normal Reflexes - If No is answered, complete "Reflex type" and "Reflex examination result." For all other answers skip to "Muscle strength result." Lumbosacral Segment Normal Reflexes - If No is answered complete "Reflex type" and "Reflex examination result." For all other answers, skip to "Muscle strength result."

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11027 Neuromuscular exam cranial tongue movement result NeuromuExmCranlTongMvmtReslt Result of tongue movement examination Result of tongue movement examination Tongue movements Normal;Slow;No movement;Not assessed Normal;Slow;No movement;Not assessed Alphanumeric

Choose one

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11045 Fasciculations thoracic paraspinal status FascicThorParaspinStatus Status, as presence or absence, of thoracic paraspinal fasciculations Status, as presence or absence, of thoracic paraspinal fasciculations Thoracic paraspinal fasciculations Absent;Present;Not assessed Absent;Present;Not assessed Alphanumeric

Choose one

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11028 Neuromuscular exam cranial dysarthria result NeuromuExmCranlDysarthrReslt Result of speech assessment for dysarthria Result of speech assessment for dysarthria Dysarthria None;Dysarthria;Anarthria;Not assessed None;Dysarthria;Anarthria;Not assessed Alphanumeric

Choose one

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11046 Fasciculations abdominal wall status FascicAbdWallStatus Status, as presence or absence, of abdominal wall fasciculations Status, as presence or absence, of abdominal wall fasciculations Abdominal wall fasciculations Absent;Present;Not assessed Absent;Present;Not assessed Alphanumeric

Choose one

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11029 Neuromuscular exam cranial jaw jerk result NeuromuExmCranlJawJerkReslt Result of jaw jerk evaluation Result of jaw jerk evaluation Jaw Jerk Absent;Present;Brisk;Clonus;Not assessed Absent;Present;Brisk;Clonus;Not assessed Alphanumeric

Choose one

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11047 Reflex superficial abdominal status ReflexSuperficlAbdominalStatus Status, as presence or absence, of superficial abdominal reflexes Status, as presence or absence, of superficial abdominal reflexes Superficial abdominal reflexes Absent;Present;Not assessed Absent;Present;Not assessed Alphanumeric

Choose one

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11031 Neuromuscular exam cervical muscle strength measurement NeuromExmCranlMuscStrgthMeasr Measurement of strength of the specific muscle or muscle group examined Measurement of strength of the specific muscle or muscle group examined Strength Numeric Values

Cervical Segment Neck Strength - Record neck strength using values between 0-5

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Free-Form Entry

 0 5
C11051 Plantar reflex result PlantarReflexReslt Result of the examination of the plantar reflex Result of the examination of the plantar reflex Plantar Normal;Extensor;Indeterminate Normal;Extensor;Indeterminate Alphanumeric

Answer for both right and left legs. Choose one.

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11032 Neuromuscular exam muscle type NeuromuscularExamMuscleTyp Type of muscle or muscle group examined Type of muscle or muscle group examined Muscle Group Upper face;Lower face;Tongue;Neck flexion;Neck extension;Shoulder abduction;Elbow flexors;Elbow extensors;Wrist flexors;Wrist extensors;Finger flexors;Finger extensors;First Dorsal Interosseous;Abductor Digiti Minimi;Abductor pollicis brevis;Hip flexion;Hip extension;Hip abduction;Hip adduction;Knee flexion;Knee extension;Ankle dorsiflexion;Ankle plantar flexion;Ankle inversion;Ankle eversion;Toe extensors;Toe flexors Upper face;Lower face;Tongue;Neck flexion;Neck extension;Shoulder abduction;Elbow flexors;Elbow extensors;Wrist flexors;Wrist extensors;Finger flexors;Finger extensors;First Dorsal Interosseous (FDI);Abductor Digiti Minimi (ADM);Abductor pollicis brevis (APB);Hip flexion;Hip extension;Hip abduction;Hip adduction;Knee flexion;Knee extension;Ankle dorsiflexion;Ankle plantar flexion;Ankle inversion;Ankle eversion;Toe extensors;Toe flexors Alphanumeric

Document the results of the examination of each muscle group or specific muscle

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11054 Reflex type ReflexTyp Type of reflexes examined Type of reflexes examined Reflexes Elbow flexors;Brachioradialis;Elbow extensors;Patellar;Ankle Elbow flexors;Brachioradialis;Elbow extensors;Patellar;Ankle Alphanumeric

Record the results of the reflex assessments for both right and left legs.

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11036 Hoffman reflex result HoffmanReflexReslt Result of the examination of the Hoffman reflex Result of the examination of the Hoffman reflex Hoffman Absent;Present;Not assessed Absent;Present;Not assessed Alphanumeric

Answer for both right and left arms. Choose one.

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11059 Muscle strength result MuscleStrengthReslt Result of the global muscle strength assessment of an arm or leg Result of the global muscle strength assessment of an arm or leg Strength Abnormal;Normal;Not assessed Abnormal;Normal;Not assessed Alphanumeric

Cervical Segment Strength - If Normal is checked for right or left arms, leave "Muscle strength measurement" blank. If Abnormal is checked for right or left arms, complete "Muscle strength measurement." Lumbosacral Segment Strength - If Normal is checked for right or left legs, leave "Muscle strength measurement" blank. If Abnormal is checked for right or left legs, complete "Muscle strength measurement."

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11039 Muscle atrophy indicator MuscleAtrophyInd Indicator whether the examination reveals atrophy in the specific muscle or muscle group Indicator whether the examination reveals atrophy in the specific muscle or muscle group Atrophy Yes;No;Not assessed Yes;No;Not assessed Alphanumeric

Cranial segment atrophy-To be answered only for tongue

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C11060 Gait type GaitTyp Type of gait examined Type of gait examined Gait Type Gait;Gait on heels;Gait on toes Gait;Gait on heels;Gait on toes Alphanumeric

For each gait type record the results of the gait assessment.

 No references available Adult Supplemental 3.00 2013-07-22 16:57:17.79 Neuromuscular Examination Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
CSV