CDE Detailed Report

Disease: NeuroRehab
Subdomain Name: Devices
CRF: Devices: Mobility and Manipulation

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
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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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
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

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

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

C58497 Transfer transportation device type TransferTransportDeviceTyp Type for all transfer/transportation devices currently used by the participant/subject Type for all transfer/transportation devices currently used by the participant/subject Transfer/Transportation Transfer Devices;Transportation Devices;Other, specify Transfer Devices;Transportation Devices;Other, specify Alphanumeric

For each transfer/transportation device type record if it is used.

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-16 15:24:35.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C18192 Serial cast stop date SerialCastStopDate Date on which the serial casting therapy ended Date on which the serial casting therapy ended Stop 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

C58475 Mobility device use location type MobilityDeviceUseLocationTyp Use location type where the participant/subject uses their mobility device(s), if applicable Use location type where the participant/subject uses their mobility device(s), if applicable Used at Home;School/Work;Community;Other, specify Home;School/Work;Community;Other, specify Alphanumeric

If the participant/subject uses mobility device(s) then record the location use.

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-12 13:27:46.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C12683 Mobility device type MobilityDvcTyp Type for all mobility devices currently used by the participant/subject Type for all mobility devices currently used by the participant/subject Mobility Devices Other, specify;Manual wheelchair;Power assist wheelchair;Power wheelchair;Scooter;Medical/Adaptive Stroller;Walker;Gait Trainer/Weight Supported Walkers;Crutches;Cane / Stick;Other Mobility Device Other, specify;Manual wheelchair;Power assist wheelchair;Power wheelchair;Scooter;Medical/Adaptive Stroller;Walker;Gait Trainer/Weight Supported Walkers;Crutches;Cane / Stick;Other Mobility Device Alphanumeric

For each mobility device type record if it is 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

Multiple Pre-Defined Values Selected

C58573 Static lower extremity stretch orthosis splint frequency use laterality type StcLEStrOrtSplnUseFreqLatrlTyp Laterality type of static lower extremity stretching orthosis splints frequency used by participant/subject Laterality type of static lower extremity stretching orthosis splints frequency used by participant/subjec If yes, Left;Right Left;Right Alphanumeric

Only answer if static 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

C19136 Rehabilitation services assessment/reception indicator RehabServicesAessmentInd Indicator for the assessment for or reception of rehabilitation services Indicator for the assessment for or reception of rehabilitation services Patient was assessed for/received rehabilitation services? No;Yes;Unknown No;Yes;Unknown Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-05-29 10:15:57.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected

C10699 Sitting ability status SittingAbilityStatus Status that reflects the participant's/subject's current ability to sit Status that reflects the participant's/subject's current ability to sit Indicate the description that reflects the participant's/subject's current ability to sit. Can sit only with extensive support;Slight imbalance of the trunk, but needs no back support;Unable to sit;Unable to sit without back support;Without any difficulty Can sit only with extensive support (geriatric chair, posy, etc.);Slight imbalance of the trunk, but needs no back support;Unable to sit;Unable to sit without back support;Without any difficulty 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

C58487 Static lower extremity stretch orthosis splint use anatomic site StaLEStrchOrthSplntUseAnatSite Anatomic site of the static lower extremity stretching orthosis/splints use Anatomic site of the static lower extremity stretching orthosis/splints use Anatomic Site: Ankle;Knee;Hip Ankle;Knee;Hip 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 11:27:48.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C17517 Wheelchair primary mobility means age indicator WheelchairPrimMobilMeanAgeInd Indicator used related age of participant/subject when they first began to use a wheelchair as their primary means of mobility Indicator used related 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. Unknown Unknown Alphanumeric

Choose Unknown if age is not known.

No references available Adult NeuroRehab Supplemental-Highly Recommended 3.10 2022-01-10 15:23:58.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected

C58623 Number days week count NumberDayWeekCt Count of days per week a stander used by the participant/subject Count of days per week a stander used by the participant/subject Number of days per week Numeric Values

Enter the number of days a stander is used per week, 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 7
C21652 Elbow wrist orthosis type ElbowWristOrthosisTyp Type of elbow or wrist orthosis the participant/subject uses Type of elbow or wrist orthosis the participant/subject uses Yes Day;Dynamic;Night;Static Day;Dynamic;Night;Static Alphanumeric

Choose all that apply.

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

C22908 Physical therapy adaptive equipment orthotic session type PTAEOrthoticSessionTyp The type of session related to adaptive equipment or orthotics related to the physical therapy The type of session related to adaptive equipment or orthotics related to the physical therap AE/Orthotic Prescription;Fabrication;Maintenance/repair;Ergonomic intervention;Training;Fitting/Adjustment Prescription;Fabrication;Maintenance/repair;Ergonomic intervention;Training;Fitting/Adjustment Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2016-12-08 08:16:44.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C10714 Walker use indicator WalkerUseInd Indicator whether the participant/subject uses a walker Indicator whether the participant/subject uses a walker Indicate if participant/subject uses a walker. Yes;No;Unknown Yes;No;Unknown Alphanumeric

No instructions available

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

C58498 Transfer transportation device type other text TrnsfrfTransprtDevcTypOtherTxt Text describing the presence of any other transfer/transportation device used Text describing the presence of any other transfer/transportation device use Other, specify Alphanumeric

Specify whether transfer/transportation devices other than those included in Transfer and Transportation Devices are used.

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-16 15:31:54.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data 255

Free-Form Entry

C18193 Support stand use indicator SuprtStandUseInd Indicator for whether the participant/subject has a supported standing use in the positioning of wheelchair Indicator for whether the participant/subject has a supported standing use in the positioning of wheelchair Supported standing use 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

C58476 Mobility device use location type other text MobilDeviceUseLocatnTypOthrTxt Text describing the presence of any other mobility device location use Text describing the presence of any other mobility device location us Other, specify Alphanumeric

No instructions available

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

C12684 Mobility device type use indicator MobltyDevTypUseInd Indicator whether the participant/subject currently uses the selected types of mobility device Indicator whether the participant/subject currently uses the selected types of mobility device Device used? Yes;No;Not applicable;Unknown Yes;No;Not applicable;Unknown Alphanumeric

For each mobility device type record if it is used. Choose one for each device type.

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

C58574 Static lower extremity stretch orthosis splint use anatomic site laterality type StaLEStrOrthSplntUsAnStLatTyp Side of the body of the anatomic site of the static lower extremity stretching orthosis/splints use Side of the body of the anatomic site of the static lower extremity stretching orthosis/splints use If yes, Left;Right Left;Right 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 11:27:48.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C19140 Discipline types DisciplineTypes The types of disciplines relevant to rehabilitation services The types of disciplines relevant to rehabilitation services Type of Therapy Art, music or play therapy;Child life therapy;Exercise physiology/kinesiology;Occupational therapy;Other, specify;Personal trainer;Physical therapy;Psychology;Respiratory therapy;Social work/case management;Speech language pathology;Supplemental nursing;Therapeutic recreation Art, music or play therapy;Child life therapy;Exercise physiology/kinesiology;Occupational therapy;Other, specify;Personal trainer;Physical therapy;Psychology;Respiratory therapy;Social work/case management;Speech language pathology;Supplemental nursing;Therapeutic recreation Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-05-29 10:28:06.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected

C21653 Hand Orthosis Type HandOrthosisTyp Type of hand orthosis the participant/subject uses Type of hand orthosis the participant/subject uses Yes Day;Night Day;Night Alphanumeric

Choose all that apply.

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

C10701 Walking difficulty level status WalkingDifficultyLvlStatus Status that reflects the participant's/subject's current level of walking difficulty Status that reflects the participant's/subject's current level of walking difficulty Indicate the description that reflects the participant's/subject's current level of difficulty walking. Without any difficulty;With some difficulties walking or getting around;With difficulty, difficulty walking interfered with activities of daily living;Participant unable to walk on their own Without any difficulty;With some difficulties walking or getting around;With difficulty, difficulty walking interfered with activities of daily living;Participant unable to walk on their own Alphanumeric

No instructions available

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

C58488 Position device type PositionDeviceTyp Type for all positioning devices currently used by the participant/subject Type for all positioning devices currently used by the participant/subject Positioning Devices Seated or Lying Position Device;Stander;Truncal Support Devices;Other, specify Seated or Lying Position Device;Stander;Truncal Support Devices;Other, specify Alphanumeric

For each positioning device type record if it is used.

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-04-16 11:43:18.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C17970 Positioning device text PositioningDevTxt Text specification of any positioning device currently used by the participant/subject Text specification of any positioning device currently used by the participant/subject Positioning Devices, specify 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 255

Free-Form Entry

C58624 Transfer transportation device type use indicator TransfrTransportDevTypUseInd Indicator whether the participant/subject currently uses the selected types of transfer/transportation devices Indicator whether the participant/subject currently uses the selected types of transfer/transportation devices Device Used? Yes;No;Not applicable Yes;No;Not applicable Alphanumeric

For each transfer/transportation device type record if it is used. Choose one for each device type.

No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2018-11-02 14:02:36.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Single Pre-Defined Value Selected

C22911 Physical therapy orthoses type PTOrthosesTyp The type of orthoses as related to the physical therapy The type of orthoses as related to the physical therap Orthoses AFO;SMO;FO;HKAFO;TLSO;Serial casting knee;Serial casting ankle;Knee immobilizer;Neuroprosthesis (FES);KAFO;Elastic wraps/suits;Therapeutic taping;Shoe insert off the shelf Ankle foot orthosis;Supramalleolar orthosis;Foot orthosis;Hip knee ankle foot orthosis;Thoraco-lumbo-sacral orthosis;Serial casting knee;Serial casting ankle;Knee immobilizer;Neuroprosthesis (FES);Knee ankle foot orthosis;Elastic wraps/suits;Therapeutic taping;Shoe insert off the shelf Alphanumeric No references available Adult NeuroRehab Supplemental-Highly Recommended 1.00 2016-12-08 08:16:44.0 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C10715 Walker use age started value WalkerUseStrtAgeVal Age of the participant/subject when he/she began using a walker Value of participant/subject's age at which he/she began using a walker If yes to walking, indicate age participant/subject began using a walker. Numeric Values

Answer should be recorded in years.

No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-11 15:03:49.2 Devices: Mobility and Manipulation Devices Treatment/Intervention Data

Free-Form Entry

CSV