CDE Detailed Report

Disease: content
Subdomain Name: Physical Function
CRF: welcome

Displaying 1 - 12 of 12
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
C20801 Balance Error Scoring System (BESS) - Tandem stance foam surface error count BESSTandemStncFoamSrfcErrorCt Number of errors during tandem stance with non-dominant foot in back on foam surface, as part of Balance Error Scoring System (BESS) Number of errors during tandem stance with non-dominant foot in back on foam surface, as part of Balance Error Scoring System (BESS Tandem stance foam surface error (Optional) Numeric Values

Option: For further assessment, the same 3 stances can be performed on a surface of medium density foam (e.g., approximately 50 cmX40 cmX 6cm)

Bell et al. Systematic Review of the Balance Error Scoring System, Sports Health. 2011 May; 3(3): 287-295.doi: 10.1177/1941738111403122. http://www.carolinashealthcare.org/documents/carolinasrehab/bess_manual_.pdf Adult;Pediatric Supplemental 1.00 2015-05-21 08:51:27.0 Balance Error Scoring System Modified (BESS-Modified) Physical Function Outcomes and End Points

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0 10
C20802 Balance Error Scoring System (BESS) - Foam surface total error count BESSTotalFoamErrorCt Total number of errors while on foam surface, as part of Balance Error Scoring System (BESS) Total number of errors while on foam surface, as part of Balance Error Scoring System (BESS Total Score: Foam surface total error (Optional) Numeric Values

Option: For further assessment, the same 3 stances can be performed on a surface of medium density foam (e.g., approximately 50 cmX40 cmX 6cm)

Bell et al. Systematic Review of the Balance Error Scoring System, Sports Health. 2011 May; 3(3): 287-295.doi: 10.1177/1941738111403122. http://www.carolinashealthcare.org/documents/carolinasrehab/bess_manual_.pdf Adult;Pediatric Supplemental 1.00 2015-05-21 08:51:27.0 Balance Error Scoring System Modified (BESS-Modified) Physical Function Outcomes and End Points

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C20803 Balance Error Scoring System (BESS) - Both firm foam surface total error count BESSTotalErrorCt Total number of errors for both firm and foam surface, as part of Balance Error Scoring System (BESS) Total number of errors for both firm and foam surface, as part of Balance Error Scoring System (BESS B.E.S.S. Total: Firm and foam surfaces total error (Optional) Numeric Values

Option: For further assessment, the same 3 stances can be performed on a surface of medium density foam (e.g., approximately 50 cmX40 cmX 6cm)

Bell et al. Systematic Review of the Balance Error Scoring System, Sports Health. 2011 May; 3(3): 287-295.doi: 10.1177/1941738111403122. http://www.carolinashealthcare.org/documents/carolinasrehab/bess_manual_.pdf Adult;Pediatric Supplemental 1.00 2015-05-21 08:51:27.0 Balance Error Scoring System Modified (BESS-Modified) Physical Function Outcomes and End Points

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C20804 Balance Error Scoring System (BESS) - Foot tested anatomic site BESSFootTestAnatSite Anatomic site of non-dominant foot tested, as part of Balance Error Scoring System (BESS) Anatomic site of non-dominant foot tested, as part of Balance Error Scoring System (BESS Which foot was tested (i.e., which is the non-dominant foot) Left;Right Left;Right Alphanumeric Bell et al. Systematic Review of the Balance Error Scoring System, Sports Health. 2011 May; 3(3): 287-295.doi: 10.1177/1941738111403122. http://www.carolinashealthcare.org/documents/carolinasrehab/bess_manual_.pdf Adult;Pediatric Supplemental 1.00 2015-05-21 08:51:27.0 Balance Error Scoring System Modified (BESS-Modified) Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C21564 Ground surface type GroundSurfTyp The type of ground surface The type of ground surfac Testing surface (hard floor, field, etc.) Alphanumeric Adult;Pediatric Supplemental 1.00 2015-07-28 11:23:36.0 Balance Error Scoring System Modified (BESS-Modified) Physical Function Outcomes and End Points 255

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C20795 Balance Error Scoring System (BESS) - Double leg stance firm surface error count BESSDblLegFirmErrorCt Number of errors during double leg stance with feet together on firm surface, as part of Balance Error Scoring System (BESS) Number of errors during double leg stance with feet together on firm surface, as part of Balance Error Scoring System (BESS Double leg stance first surface error Numeric Values

"The first stance is standing with your feet together with your hands on your hips and with your eyes closed. You should try to maintain stability in that position for 20 seconds. I will be counting the number of times you move out of this position. I will start timing when you are set and have closed your eyes."

Please take your shoes off, roll up your pant legs above ankle (if applicable), and remove any ankle taping (if applicable). This test will consist of 6 - twenty second tests with three different stances on two different surfaces. I will describe the stances as we go along. Standing on a firm surface with feet side by side (touching), hands on the hips and eyes closed.

Bell et al. Systematic Review of the Balance Error Scoring System, Sports Health. 2011 May; 3(3): 287-295.doi: 10.1177/1941738111403122. http://www.carolinashealthcare.org/documents/carolinasrehab/bess_manual_.pdf Adult;Pediatric Supplemental 1.00 2015-05-21 08:51:27.0 Balance Error Scoring System Modified (BESS-Modified) Physical Function Outcomes and End Points

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C21566 Footwear use type FootwearUseTyp The type related to footwear used The type related to footwear use Footwear (shoes, barefoot, braces, tape, etc.) Alphanumeric Adult Supplemental 1.00 2015-07-28 11:30:40.0 Balance Error Scoring System Modified (BESS-Modified) Physical Function Outcomes and End Points 255

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C20796 Balance Error Scoring System (BESS) - Single leg stance firm surface error count BESSSglLegFirmErrorCt Number of errors during single leg stance with non-dominant foot tested on firm surface, as part of Balance Error Scoring System (BESS) Number of errors during single leg stance with non-dominant foot tested on firm surface, as part of Balance Error Scoring System (BESS Single leg stance first surface error Numeric Values

"If you were to kick a ball, which foot would you use? [This will be the dominant foot] Now
stand on your non-dominant foot. The dominant leg should be held in approximately 30 degrees of hip flexion and 45 degrees of knee flexion. Again, you should try to maintain stability
for 20 seconds with your hands on your hips and your eyes closed. I will be counting the number of times you move out of this position. If you stumble out of this position, open your
eyes and return to the start position and continue balancing. I will start timing when you are set and have closed your eyes."

Standing on a firm surface on the non-dominant foot (opposite leg of the preferred kicking leg), the hip is flexed to approximately 30 degrees and knee flexed to approximately 45 degrees. Hands are on the hips and eyes closed.

Bell et al. Systematic Review of the Balance Error Scoring System, Sports Health. 2011 May; 3(3): 287-295.doi: 10.1177/1941738111403122. http://www.carolinashealthcare.org/documents/carolinasrehab/bess_manual_.pdf Adult;Pediatric Supplemental 1.00 2015-05-21 08:51:27.0 Balance Error Scoring System Modified (BESS-Modified) Physical Function Outcomes and End Points

Free-Form Entry

0 10
C20797 Balance Error Scoring System (BESS) - Tandem stance firm surface error count BESSTandemFirmErrorCt Number of errors during tandem stance with non-dominant foot in back on firm surface, as part of Balance Error Scoring System (BESS) Number of errors during tandem stance with non-dominant foot in back on firm surface, as part of Balance Error Scoring System (BESS Tandem stance first surface errors Numeric Values

"Now stand heel-to-toe with your non-dominant foot in back. Your weight should be evenly distributed across both feet. Again, you should try to maintain stability for 20 seconds with
your hands on your hips and your eyes closed. I will be counting the number of times you move out of this position. If you stumble out of this position, open your eyes and return to
the start position and continue balancing. I will start timing when you are set and have closed your eyes."

Standing heel to toe on a firm surface with the non-dominate foot in the back. Heel of the dominant foot should be touching the toe of the non-dominant foot. Hands are on the hips and their eyes are closed.

Bell et al. Systematic Review of the Balance Error Scoring System, Sports Health. 2011 May; 3(3): 287-295.doi: 10.1177/1941738111403122. http://www.carolinashealthcare.org/documents/carolinasrehab/bess_manual_.pdf Adult;Pediatric Supplemental 1.00 2015-05-21 08:51:27.0 Balance Error Scoring System Modified (BESS-Modified) Physical Function Outcomes and End Points

Free-Form Entry

0 10
C20798 Balance Error Scoring System (BESS) - Firm surface total error count BESSTotalFirmErrorCt Total number of errors while on firm surface, as part of Balance Error Scoring System (BESS) Total number of errors while on firm surface, as part of Balance Error Scoring System (BESS Total Score: First surface total error (Optional) Numeric Values

An error is credited to the subject when any of the following occur: 1) moving the hands off of the iliac crests; 2) opening the eyes; 3) step stumble or fall; 4) abduction or flexion of the hip beyond 30; 5) lifting the forefoot or heel off of the testing surface; 6) remaining out of the proper testing position for greater than 5 seconds. The maximum total number of errors for any single condition is 10.

Bell et al. Systematic Review of the Balance Error Scoring System, Sports Health. 2011 May; 3(3): 287-295.doi: 10.1177/1941738111403122. http://www.carolinashealthcare.org/documents/carolinasrehab/bess_manual_.pdf Adult;Pediatric Supplemental 1.00 2015-05-21 08:51:27.0 Balance Error Scoring System Modified (BESS-Modified) Physical Function Outcomes and End Points

Free-Form Entry

0 30
C20799 Balance Error Scoring System (BESS) - Double leg stance foam surface error count BESSDblLegFoamErrorCt Number of errors during double leg stance with feet together on foam surface, as part of Balance Error Scoring System (BESS) Number of errors during double leg stance with feet together on foam surface, as part of Balance Error Scoring System (BESS Double leg stance foam surface errors (Optional) Numeric Values

Option: For further assessment, the same 3 stances can be performed on a surface of medium density foam (e.g., approximately 50 cmX40 cmX 6cm)

Bell et al. Systematic Review of the Balance Error Scoring System, Sports Health. 2011 May; 3(3): 287-295.doi: 10.1177/1941738111403122. http://www.carolinashealthcare.org/documents/carolinasrehab/bess_manual_.pdf Adult;Pediatric Supplemental 1.00 2015-05-21 08:51:27.0 Balance Error Scoring System Modified (BESS-Modified) Physical Function Outcomes and End Points

Free-Form Entry

0 10
C20800 Balance Error Scoring System (BESS) - Single leg stance foam surface error count BESSSglLegFoamErrorCt Number of errors during single leg stance with non-dominant foot tested on foam surface, as part of Balance Error Scoring System (BESS) Number of errors during single leg stance with non-dominant foot tested on foam surface, as part of Balance Error Scoring System (BESS Single leg stance foam surface errors (Optional) Numeric Values

Option: For further assessment, the same 3 stances can be performed on a surface of medium density foam (e.g., approximately 50 cmX40 cmX 6cm)

Bell et al. Systematic Review of the Balance Error Scoring System, Sports Health. 2011 May; 3(3): 287-295.doi: 10.1177/1941738111403122. http://www.carolinashealthcare.org/documents/carolinasrehab/bess_manual_.pdf Adult;Pediatric Supplemental 1.00 2015-05-21 08:51:27.0 Balance Error Scoring System Modified (BESS-Modified) Physical Function Outcomes and End Points

Free-Form Entry

0 10
CSV