CDE Detailed Report
Disease: NeuroRehab
Subdomain Name: Devices
CRF: Devices: Mobility and Manipulation
Displaying 51 - 100 of 139
Subdomain Name: Devices
CRF: Devices: Mobility and Manipulation
Displaying 51 - 100 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C58577 | Eat drink assistive device type | EatDrinkAssistDeviceTyp | Type of eating / drinking device currently used by the participant/subject | Type of eating / drinking device currently used by the participant/subjec | Device used? | Cutlery / Chopsticks;Plates / Bowls;Cups, Mugs, Drinking Aids (e.g., Straws, Grip Adapters / Attachments);Stoppers and Funnels;Bib / Clothing Protectors;Feeding Systems (enteral / parenteral);Feeding Apparatus (manual);Food Guards;Other, specify | Cutlery / Chopsticks;Plates / Bowls;Cups, Mugs, Drinking Aids (e.g., Straws, Grip Adapters / Attachments);Stoppers and Funnels;Bib / Clothing Protectors;Feeding Systems (enteral / parenteral);Feeding Apparatus (manual);Food Guards;Other, specify | Alphanumeric |
Only answer if eating / drinking assistive device is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-06-29 13:18:07.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C19493 | Spinal cord injury upper extremity assistive device use frequency value | SCIUPAssistDevUseFreqVal | The frequency of use of assistive devices for upper extremity in spinal cord injury | The frequency of use of assistive devices for upper extremity in spinal cord injur | Use of assistive devices used to enhance upper extremity function | Never or less than monthly;Not daily, but one or more times weekly;Not weekly, but one or more times monthly;Used daily | Never or less than monthly;Not daily, but one or more times weekly;Not weekly, but one or more times monthly;Used daily | Alphanumeric |
UEDEVICE- (all equipment like splints, adaptive equipment, surface functional electrical stimulation (FES), etc.) |
http://www.nature.com/sc/journal/v52/n9/full/sc201487a.html | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2014-06-17 23:41:18.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C10706 | Walking difficulty age support first needed value | WlkDffcltyAgeNdIntrmitSuprtVal | Age of participant/subject when intermittent support first needed for walking | Value of participant/subject's age at which she or he first needed intermittent support for walking | If participant/subject needs intermittent support for walking, indicate age of participant when support first needed. | 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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| C58490 | Position device type other text | PositionDeviceTypOthrTxt | Text describing the presence of any other positioning device used | Text describing the presence of any other positioning device use | Other, specify | Alphanumeric |
Specify whether positioning devices other than Seated or Lying Position Device, Stander and Truncal Support Devices are used. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-16 14:04:03.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 255 |
Free-Form Entry |
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| C18176 | Therapy rehabilitation indicator | TherapyRehabInd | Indicator for whether the participant/subject uses other therapy or rehabilitation procedures besides the use of mobility devices, orthoses, and positioning devices | Indicator for whether the participant/subject uses other therapy or rehabilitation procedures besides the use of mobility devices, orthoses, and positioning devices | Besides use of mobility devices, orthoses, and positioning devices, does the participant/ subject utilize other therapies? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-21 12:11:21.037 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C58630 | Crutch use laterality type | CrutchUseLateralTyp | Laterality type with which the participant/subject uses their crutches | Laterality type with which the participant/subject uses their crutche | Laterality of type of crutches used. | Unilateral;Bilateral | Unilateral;Bilateral | Alphanumeric |
Select laterality for type of crutches used. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-12 14:27:43.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C21655 | Back brace frequency type | BackBraceFreqTyp | Describes how long the participant/subject wears the body jacket/back brace/TSLO | Describes how long the participant/subject wears the body jacket/back brace/TSLO | If yes, | All the time;Day only;Night only | All the time;Day only;Night only | 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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| C56952 | Crutch use type | CrutchUseTyp | Type of crutches which the participant/subject uses, if applicable | Type of crutches which the participant/subject uses, if applicable | Type of crutches | Lofstrand or Forearm Crutches;Underarm;Other, specify | Lofstrand or Forearm Crutches;Underarm;Other, specify | Alphanumeric |
If the participant/subject uses crutches, then record the type used. Choose one option. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2017-08-07 11:44:13.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C10719 | Wheelchair use age started value | WheelchairUseStrtAgeVal | Age of the participant/subject when he/she began using a wheelchair | Value of the participant/subject's age at which he/she began using a wheelchair | If yes to wheelchair, indicate age participant/subject began using wheelchair. | 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 |
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| C58501 | Transportation device type | TransportDeviceTyp | Type for all transportation devices currently used by the participant/subject | Type for all transportation devices currently used by the participant/subject | If yes, | Adaptive car seat/Booster seat;Other, specify;Seating restraints (e.g., Manual, Electronic, Torso, Wheel Wells);Vehicle Lifts (e.g., Platform/Rotary);Vehicle with driver modifications | Adaptive car seat/Booster seat;Other, specify;Seating restraints (e.g., Manual, Electronic, Torso, Wheel Wells);Vehicle Lifts (e.g., Platform/Rotary);Vehicle with driver modifications | Alphanumeric |
Only answer if transportation devices is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-16 16:05:13.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C18200 | Therapeutic stretching type | TherapuStretchTyp | Type of stretching therapy | Type of stretching therapy | Stretching | Active;Passive | Active;Passive | 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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| C58480 | AFO type | AFOTyp | Type of ankle-foot orthosis (AFO) used by the participant/subject | Type of ankle-foot orthosis (AFO) used by the participant/subject | If yes, | Solid;Articulating;Dynamic Ankle Foot Orthosis (DAFO);Posterior Leaf Spring (PLS);Carbon Fiber | Solid;Articulating;Dynamic Ankle Foot Orthosis (DAFO);Posterior Leaf Spring (PLS);Carbon Fiber | Alphanumeric |
Only answer if Ankle-foot Orthosis is answered Yes. Choose all that apply. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-13 09:33:55.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C12688 | Orthosis knee ankle foot orthosis ischial weight bearing indicator | OrthsisKnAnkFoOIschlWgtBrngInd | Indicator whether any knee-ankle-foot orthosis (KAFO) currently used by the participant/subject is ischial weight bearing | Indicator whether any knee-ankle-foot orthosis (KAFO) currently used by the participant/subject is ischial weight bearing | Yes, ischial weight bearing? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Only answer if Knee-ankle-foot Orthosis is answered Yes. Choose one. |
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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| C58578 | Eat drink assistive device type other text | EatDrinkAssistDeviceTypOthrTxt | Text describing the presence of any other eating / drinking device used | Text describing the presence of any other eating / drinking device use | Other, specify | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-06-29 13:52:08.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 255 |
Free-Form Entry |
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| C21639 | Fall details assistive device type | FallDetAssistDevTyp | Type of assistive device(s) the participant/subject was using when the fall recorded in the Falls Diary occurred | Type of assistive device(s) the participant/subject was using when the fall recorded in the Falls Diary occurre | If you fell while walking, were you using an assistive device | Cane;One crutch;Other, please specify;Two crutches;Walker | Cane;One crutch;Other, please specify;Two crutches;Walker | Alphanumeric |
Choose all that apply. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-22 16:57:17.79 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C10707 | Walking difficulty age permanent support started value | WlkDffcltyAgeNeedPermSuportVal | Age of participant/subject when permanent support first needed walking | Value of participant/subject's age at which she or he first needed permanent support for walking | If participant/subject needs permanent support for walking, indicate age of participant when support first needed. | 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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| C58491 | Activity daily living device type | ADLDeviceTyp | Type for all activity of daily living devices currently used by the participant/subject | Type for all activity of daily living devices currently used by the participant/subjec | ADL Devices | Eating / Drinking Assistive Devices;Bathing Devices;Toileting Devices | Eating / Drinking Assistive Devices;Bathing Devices;Toileting Devices | Alphanumeric |
For each ADL device type record if it is used. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-16 14:07:02.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C18181 | Therapy rehabilitation session duration | TherapuRehabSessDur | Duration of a therapy or rehabilitation session | Duration of a therapy or rehabilitation session | Duration | 15 minutes;30 minutes;45 minutes;60 minutes;Other, specify | 15 minutes;30 minutes;45 minutes;60 minutes;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 |
Single Pre-Defined Value Selected |
minute | ||||||||
| C58631 | Position device type use indicator | PositionDeviceTypUseInd | Indicator whether the participant/subject currently uses the selected types of positioning devices | Indicator whether the participant/subject currently uses the selected types of positioning device | Devices Used? | No;Yes | No;Yes | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-06-28 12:11:42.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C21656 | Orthosis other type | OrthosisOtherTyp | Other types of orthoses used by the participant/subject | Other types of orthoses used by the participant/subject | Do you use any other type of orthosis | Hip;Neck;Shoulder | Hip;Neck;Shoulder | 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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| C56953 | Cane stick use type | CaneStickUseTyp | Type of cane which the participant/subject uses, if applicable | Type of cane which the participant/subject uses, if applicable | If yes, | Quad cane;Single Point Cane | Quad cane;Single Point Cane | Alphanumeric |
If the participant/subject uses a cane, then record the type used. Choose one option. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2017-08-07 12:12:38.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C10720 | Walking other assistive device use indicator | WalkOthrAssistiveDevUseInd | Indicator whether the participant/subject uses any other assistive device for walking | Indicator whether the participant/subject uses any other assistive device for walking | Indicate if the participant/subject uses any other assistive device. | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
If "No" or "Unknown" skip to "Walking primary assistive device daily use duration". |
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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| C58567 | Dynamic upper extremity orthosis splint frequency use laterality type | DynUEOrthoSplntUseFreqLatrlTyp | Laterality type of dynamic upper extremity orthosis splints frequency used by participant/subject | Laterality type of dynamic upper extremity orthosis splints frequency used by participant/subjec | If yes, | Left;Right | Left;Right | Alphanumeric |
Only answer if dynamic upper extremity orthosis/splints is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-06-27 11:42:16.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C18870 | Mobility device other text | MobilityDvcOTH | The free-text field related to 'Mobility device type' specifying other text. Type for all mobility devices currently used by the participant/subject | The free-text field related to 'Mobility device type' specifying other text. Type for all mobility devices currently used by the participant/subject | Other, specify | Alphanumeric |
Specify whether mobility devices other than Manual wheelchair, Power assist wheelchair, Power wheelchair, Scooter, Medical/Adaptive Stroller, Walker, Gait Trainer/Weight Supported Walkers, Crutches, Cane / Stick, Other Mobility Device are used. 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 | 4000 |
Free-Form Entry |
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| C58481 | Dynamic upper extremity orthosis splint use anatomic site | DynmUEOrthoSplntUseAnatSite | Anatomic site of the dynamic upper extremity orthosis/splints use | Anatomic site of the dynamic upper extremity orthosis/splints use | Anatomic Site: | Thumb;Wrist/hand;Hand/Fingers;Elbow | Thumb;Wrist/hand;Hand/Fingers;Elbow | Alphanumeric |
Only answer if dynamic upper extremity orthosis/splints is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-13 10:18:13.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C12943 | Orthosis type | OrthosisTyp | Type of orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) | Type of orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) | Orthoses | Wrist splints;Wrist splints - night use;Ankle-foot orthosis (AFO);Ankle-foot orthosis (AFO) - night use;Abduction wedge;Knee immobilizer(s);Stander;Positioning/feeding chair;Compression garment;Other upper extremity device;Other lower extremity device;Other, specify;Dynamic Lower Extremity Stretching Orthosis/Splints;Dynamic Upper Extremity Orthosis/Splints;Hip-knee-ankle-foot orthosis (HKAFO);Shoe Inserts of any type;Knee-ankle-foot orthosis (KAFO);Static Lower Extremity Stretching Orthosis/Splints;Static Upper Extremity Orthosis/Splints;Supramalleolar orthotic (SMO) | Wrist splints;Wrist splints - night use;Ankle-foot orthosis (AFO);Ankle-foot orthosis (AFO) - night use;Abduction wedge;Knee immobilizer(s);Stander;Positioning/feeding chair;Compression garment;Other upper extremity device;Other lower extremity device;Other, specify;Dynamic Lower Extremity Stretching Orthosis/Splints;Dynamic Upper Extremity Orthosis/Splints;Hip-knee-ankle-foot orthosis (HKAFO);Shoe Inserts of any type;Knee-ankle-foot orthosis (KAFO);Static Lower Extremity Stretching Orthosis/Splints;Static Upper Extremity Orthosis/Splints;Supramalleolar orthotic (SMO) | Alphanumeric |
For each orthosis 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 |
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| C58617 | Mobility device use propel type | MobilityDeviceUsePropelTyp | Propel type the participant/subject uses their mobility device(s), if applicable | Propel type the participant/subject uses their mobility device(s), if applicable | Propel | Independent;Partial Independence;Dependent;Other, specify | Independent;Partial Independence;Dependent;Other, specify | Alphanumeric |
If the participant/subject uses mobility device(s) then record the propulsion use. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-11-02 09:29:16.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C21640 | Fall details assistive device specify text | FallDetAssisDevSpecfyTxt | The free-text field to specify the other type of assistive device used when the fall recorded in the Falls Diary occurred | The free-text field to specify the other type of assistive device used when the fall recorded in the Falls Diary occurre | Other, please specify | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-17 09:26:36.973 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 255 |
Free-Form Entry |
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| C10708 | Wheelchair primary mobility means age value | WheelchairPrimMobilMeanAgeVal | Age of participant/subject when they first began to use a wheelchair as their primary means of mobility | Age of participant/subject when they first began to use a wheelchair as their primary means of mobilit | If participant/subject uses a wheelchair as their primary means of mobility, indicate age of participant when they first began to use a wheelchair as their primary means of mobility. | Numeric Values |
Answer should be recorded in years. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2022-01-10 15:20:49.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Free-Form Entry |
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| C58492 | Bath device type | BathDeviceTyp | Type for all bathing devices currently used by the participant/subject | Type for all bathing devices currently used by the participant/subject | If yes, | Bath Chair/Bench;Bathroom grab bars;Other, specify;Removable Shower Head;Roll-in Shower | Bath Chair/Bench;Bathroom grab bars;Other, specify;Removable Shower Head;Roll-in Shower | Alphanumeric |
Only answer if bathing devices is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-16 14:15:24.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C18182 | Therapy rehabilitation frequency | TherapuRehabFreq | Frequency the participant/subject received the therapy or rehabilitation | Frequency the participant/subject received the therapy or rehabilitation | Frequency | 0;1;2;3;4;5;6;7 | 0;1;2;3;4;5;6;7 | Numeric Values |
days/week |
CDISC SDTM Frequency Terminology (http://www.cancer.gov/cancertopics/cancerlibrary/terminologyresources/cdisc) | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-21 12:11:21.037 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C58875 | Therapy or rehabilitation received status other text | TherRehabReceStatusOthrTxt | The free-text field related to 'Therapy or rehabilitation received status' specifying other text. Status of therapy or rehabilitation services received by the participant/subject | The free-text field related to 'Therapy or rehabilitation received status' specifying other text. Status of therapy or rehabilitation services received by the participant/subjec | Other, specify | Alphanumeric |
No instructions available |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2020-05-18 15:29:15.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 255 |
Free-Form Entry |
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| C21667 | Therapy rehabilitation ICD 10 CM code | TherpyRehabICD10CMCd | ICD-10-CM code that describes the therapy or rehabilitation received by the participant/subject | ICD-10-CM code that describes the therapy or rehabilitation received by the participant/subject | Type(s) of rehabilitation therapy/services received | Alphanumeric |
Code the therapy or rehabilitation service received using the ICD-10-CM codes to enable data aggregation. |
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM): https://www.cdc.gov/nchs/icd/icd10cm.htm | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2013-07-20 10:21:25.65 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 255 |
Free-Form Entry |
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| C56954 | Dynamic upper extremity orthosis splint use frequency type | DynmUEOrthoSplntUseFreqTyp | Frequency type with which the participant/subject uses their dynamic upper extremity orthosis/splints, if applicable | Frequency type with which the participant/subject uses their dynamic upper extremity orthosis/splints, if applicable | If yes, | Daytime use;Full-time use;Part-time use;Night time use | Daytime use;Full-time use;Part-time use;Night time use | Alphanumeric |
Only answer if dynamic upper extremity orthosis/splints is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2017-08-07 12:54:36.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C10721 | Walking other assistive device use age started value | WalkOthrAssistDevUseStrtAgeVal | Age of the participant/subject when he/she began using the other assistive device for walking | Value of the participant/subject's age at which he/she began using the other assistive device for walking | If yes to other assistive device, indicate age participant/subject began using other assistive device. | Numeric Values |
Answer should be recorded in years. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-11 15:03:49.2 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Free-Form Entry |
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| C58568 | Dynamic upper extremity orthosis splint use anatomic site laterality type | DynUEOrthSplnUseAnatSiteLatTyp | Laterality type of dynamic upper extremity orthosis splints anatomic site used by participant/subject | Laterality type of dynamic upper extremity orthosis splints anatomic site used by participant/subjec | If yes, | Left;Right | Left;Right | Alphanumeric |
Only answer if dynamic upper extremity orthosis/splints is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-06-27 11:49:04.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C18883 | Orthosis other text | OrthosisOTH | The free-text field related to 'Orthosis type' specifying other text. Type of orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) | The free-text field related to 'Orthosis type' specifying other text. Type of orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) | Other, specify | Alphanumeric |
Specify whether orthoses other than Wrist splints, Wrist splints - night use, Ankle-foot orthosis (AFO), Ankle-foot orthosis (AFO) - night use, Supramalleolar orthotic (SMO), Abduction wedge, Knee immobilizer(s), Knee-ankle-foot orthosis (KAFO), Stander, Positioning/feeding chair, Compression garment, Other upper extremity device, Other lower extremity device, Shoe inserts of any type, Hip-knee-ankle-foot orthosis (HKAFO), Dynamic Upper Extremity Orthosis/Splints, Static Upper Extremity Orthosis/Splints, Dynamic Lower Extremity Stretching Orthosis/Splints, or Static Lower Extremity Stretching Orthosis/Splints are used. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-25 08:54:08.2 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 4000 |
Free-Form Entry |
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| C58482 | Static upper extremity orthosis splint use frequency type | StaticUEOrthoSplntUseFreqTyp | Frequency type with which the participant/subject uses their static upper extremity orthosis/splints, if applicable | Frequency type with which the participant/subject uses their static upper extremity orthosis/splints, if applicable | If yes, | Daytime use;Full-time use;Part-time use;Night time use | Daytime use;Full-time use;Part-time use;Night time use | Alphanumeric |
Only answer if static upper extremity orthosis/splints is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2017-08-07 12:54:36.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C14286 | Therapy or rehabilitation received status | TherRehabReceStatus | If the participant/ subject was assessed for rehabilitation therapy/services, describes the status of therapy/services | If the participant/ subject was assessed for rehabilitation therapy/services, describes the status of therapy/service | Were rehabilitation therapy/services received | Received rehabilitation therapy during hospitalization;Did not receive rehabilitation therapy because symptoms resolved;Ineligible to receive rehabilitation therapy due to impairment severity or medical issues;Other, specify | Received rehabilitation therapy during hospitalization;Did not receive rehabilitation therapy because symptoms resolved;Ineligible to receive rehabilitation therapy due to impairment severity or medical issues (i.e.: poor prognosis, patient unable to tolerate rehabilitation therapeutic regimen);Other specify | Alphanumeric |
Choose all that apply. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-06-21 00:00:00.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C58618 | Mobility device use propel type other text | MobilDeviceUsePropelTypOthrTxt | Text describing other propulsion type of mobility device use | Text describing other propulsion type of mobility device us | Other, specify | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-12 13:56:59.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 255 |
Free-Form Entry |
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| C21644 | Orthosis stander type | OrthosisStanderTyp | Type of stander the participant/subject uses | Type of stander the participant/subject uses | Yes | Dynamic;Mobile;Prone;Static;Supine | Dynamic;Mobile;Prone;Static;Supine | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-21 12:11:21.037 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C10709 | Walking assistive device indicator | WalkAssistiveDeviceInd | Indicator of whether the participant/subject uses an assistive device for walking | Indicator of whether the participant/subject uses an assistive device for walking | Indicate if the participant/subject uses an assistive device. | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one. History can also be obtained from a family member, friend, or chart/ medical record. If the informant is unable to answer the question or is deemed unreliable (e.g., the participant/ subject has dementia) the history should be obtained from the medical record. Unknown includes the scenario where information is not documented in the medical record. Choose one. If answer is "No" skip to Therapy or rehabilitation received status. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-11 15:03:49.2 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C58493 | Activity Daily Living device type other text | ADLDeviceTypOtherTxt | Text describing the presence of any other activity of daily living device used | Text describing the presence of any other activity of daily living device use | Other, specify | Alphanumeric |
Specify whether ADL devices other than Eating / Drinking Assistive Devices, Bathing Devices, and Toileting Devices are used. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-16 14:54:50.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 255 |
Free-Form Entry |
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| C18183 | Wheelchair driven subject indicator | WheelchairDriveSubjInd | Indicator for whether the power wheelchair is driven by the participant/subject | Indicator for whether the power wheelchair is driven by the participant/subject | Is the wheelchair driven by the participant/ subject? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-21 12:11:21.037 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C58879 | Assistive device use indicator | AssistiveDvcUseInd | Whether the participant/subject uses an assistive device (e.g., wheelchair) | Whether the participant/subject uses an assistive device (e.g., wheelchair | Provided with assistive devices | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric |
Choose one. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2020-05-18 15:41:02.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C22612 | Home modification provide indicator | HomeModProvideInd | Indicates if the participant/subject was provided with any home modifications | Indicates if the participant/subject was provided with any home modification | Provided with home modifications? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.10 | 2022-01-12 13:16:08.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| 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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| 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 |
