CDE Detailed Report
Disease: system
Subdomain Name: Devices
CRF: files
Displaying 1 - 50 of 139
Subdomain Name: Devices
CRF: files
Displaying 1 - 50 of 139
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Question Text | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guidance) | Subdomain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C21651 | Upper extremity orthosis type | UpperExtrmtyOrthosisTyp | Type of upper extremity orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) the participant/subject uses | Type of upper extremity orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) the participant/subject uses | Upper Extremity Orthoses | Elbow orthosis;Hand only;Wrist hand orthosis | Elbow orthosis;Hand only;Wrist hand orthosis | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-25 08:54:08.2 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C10697 | Fall rate | FallRate | Rate that reflects the participant's/subject's current frequency of falling | Rate that reflects the participant's/subject's current frequency of falling | Indicate the description that reflects the participant's/subject's current rate of falls. | Normal;Rare falling;Occasional falls;Falls multiple times a week or requires device to prevent falls;Unable to stand | Normal;Rare falling (less than once a month);Occasional falls (once a week to once a month);Falls multiple times a week or requires device to prevent falls;Unable to stand | Alphanumeric |
Choose only one. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-11 15:03:49.2 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C58486 | Static lower extremity stretch orthosis splint use frequency type | StatLEStrchOrthSplntUseFreqTyp | Frequency type with which the participant/subject uses their static lower extremity stretching orthosis/splints, if applicable | Frequency type with which the participant/subject uses their static lower extremity stretching orthosis/splints, if applicable | If yes, | Daytime use;Full-time use;Part-time use;Night time use | Daytime use;Full-time use;Part-time use;Night time use | Alphanumeric |
Only answer if static lower extremity stretching orthosis/splints is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-13 11:24:20.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C17512 | Walking difficulty age need permanent support indicator | WlkDffcltyAgeNeedPrmSuprtInd | Indicator related to age of participant/subject needing permanent support for walking | Indicator related to age of participant/subject needing permanent support for walking | If participant/subject needs permanent support for walking, indicate age of participant when support first needed. | Unknown | Unknown | Alphanumeric |
Leave age blank and choose Unknown. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-15 16:08:48.687 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C58622 | Number minutes day duration | NumberMinutesDayDur | Duration in minutes per day a stander used by the participant/subject | Duration in minutes per day a stander used by the participant/subject | Number of minutes per day | Numeric Values |
Enter the number of minutes a stander is used per day, if applicable. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-11-02 13:37:37.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Free-Form Entry |
0 | 1440 | ||||||||
| C22900 | Manual Ability Classification System (MACS) - Level scale | MACSLevelScl | The scale level related to the Mini-Manual Ability Classification System (MACS) | The scale level related to the Mini-Manual Ability Classification System (MACS | MACS Level | Level I;Level II;Level III;Level IV;Level V | Handles objects easily and successfully.;Handles most objects but with somewhat reduced quality and/or speed of achievement.;Handles objects with difficulty, needs help to prepare and/or modify activities.;Handles a limited selection of easily managed objects in adapted situations.;Does not handle objects and has severely limited ability to perform even simple actions. | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2016-12-07 13:36:23.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C10713 | Walking cane or crutches pair use age started value | WalkUse2CaneCrutchStrtAgeVal | Age of the participant/subject when he/she began using two canes or crutches for walking | Value of the participant/subject's age at which he/she began using two canes or crutches for walking | If yes to canes/ crutches, indicate age participant/subject began using two canes/crutches. | Numeric Values |
Answer should be recorded in years. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 4.00 | 2013-07-11 15:03:49.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Free-Form Entry |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 | ||||||||
| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| C58499 | Transfer device type | TransferDeviceTyp | Type for all transfer devices currently used by the participant/subject | Type for all transfer devices currently used by the participant/subject | If yes, | Transfer bars;Transfer slings/belts;Transfer boards;Lift system (e.g., Hoyer, ceiling track system);Other, specify | Transfer bars;Transfer slings/belts;Transfer boards;Lift system (e.g., Hoyer, ceiling track system);Other, specify | Alphanumeric |
Only answer if transfer devices is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-16 15:38:33.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C18197 | Upper extremity device indicator | UpperExtremityDevInd | Indicator for whether an upper extremity device is used | Indicator for whether an upper extremity device is used | Upper extremity devices | Yes, specify;No;Not applicable;Unknown | Yes, specify;No;Not applicable;Unknown | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-21 12:11:21.037 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C19141 | Discipline other text | DisciplineOTH | The free text field related to "Discipline types" specifying other text. The type of discipline | The free text field related to "Discipline types" specifying other text. The type of disciplin | Other (specify) | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2014-05-29 10:32:54.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 4000 |
Free-Form Entry |
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| C58477 | Cane stick use laterality type | CaneStickUseLateralTyp | Laterality type with which the participant/subject uses their cane/stick | Laterality type with which the participant/subject uses their cane/stick | If yes, | Unilateral;Bilateral | Unilateral;Bilateral | Alphanumeric | 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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| C12685 | Wheelchair use frequency | WheelchairUseFreq | Frequency with which the participant/subject uses their wheelchair, if applicable | Frequency with which the participant/subject uses their wheelchair, if applicable | If Yes | Full-time;Part-time | Full-time;Part-time | Alphanumeric |
If the participant/subject uses a manual wheelchair or power wheelchair then record the extent of use. Choose one option. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-24 11:38:01.2 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C58575 | Activity daily living device type use indicator | ActivDailyLivingDevcTypUseInd | Indicator whether the participant/subject currently uses the selected types of activity of daily living devices | Indicator whether the participant/subject currently uses the selected types of activity of daily living device | Device used? | Yes;No;Not applicable;Unknown | Yes;No;Not applicable;Unknown | Alphanumeric |
For each activity daily living device type record if it is used. Choose one for each device type. |
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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| C21654 | Back brace indicator | BackBraceInd | Indicator of whether the participant/subject wears a type of orthosis for the spine | Indicator of whether the participant/subject wears a type of orthosis for the spine | Do you wear a body jacket/back brace/TSLO | No;Yes | No;Yes | Alphanumeric | 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 |
3165788 | ||||||||
| C10702 | Walking own unable reason | WalkingOwnUnableRsn | Reason why the participant/subject is unable to walk on his/her own | Reason why the participant/subject is unable to walk on his/her own | If participant/subject is unable to walk on their own, indicate reason why. | Alphanumeric |
After answering this question skip to "Wheelchair primary mobility means age value", "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." |
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 | 255 |
Free-Form Entry |
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| C58489 | Seat lie position device type | SeatLiePositionDeviceTyp | Type of seated or lying position device currently used by the participant/subject | Type of seated or lying position device currently used by the participant/subject | Seated or Lying Position Device | Abduction wedge;Serial casting;Saddle seats/Bolster seats;Seat inserts;Corner chair | Abduction wedge;Serial casting;Saddle seats/Bolster seats;Seat inserts;Corner chair | Alphanumeric |
Only answer if seated or lying position device is answered Yes. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-16 13:53:49.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Multiple Pre-Defined Values Selected |
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| C18153 | Data unknown text | DataUnknwnTxt | The free-text field to Mark an "X" in to record if data are unknown or not available | The free-text field to Mark an "X" in to record if data are unknown or not availabl | Unknown | Alphanumeric |
If age unknown, leave age blank and choose Unknown. |
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 | 20 |
Free-Form Entry |
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| C58626 | Transfer device type other text | TransferDevTypeOthrTxt | Text describing the presence of any other transfer device used | Text describing the presence of any other transfer device use | Other, specify | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-11-02 16:02:13.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 255 |
Free-Form Entry |
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| C56951 | Walker use type | WalkerUseTyp | Type of walker which the participant/subject uses, if applicable | Type of walker which the participant/subject uses, if applicable | Type of walker | Front or Forward Walker (no wheels, two-wheeled, or four wheeled);Reverse Rolling Walker | Front or Forward Walker (no wheels, two-wheeled, or four wheeled);Reverse Rolling Walker | Alphanumeric |
If the participant/subject uses a walker, then record the type used. Choose one option. |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2017-08-07 11:32:24.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C10718 | Wheelchair use indicator | WheelchairUseInd | Indicator whether the participant/subject uses a wheelchair | Indicator whether the participant/subject uses a wheelchair | Indicate if the participant/subject uses a wheelchair. | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
If "No" or "Unknown" skip to "Walking other assistive device use indicator". |
No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 3.00 | 2013-07-11 15:03:49.2 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
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| C58500 | Transportation device type other text | TransportDeviceTypOtherTxt | Text describing the presence of any other transfer device used | Text describing the presence of any other transfer device use | Other, specify | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-16 15:58:24.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data | 255 |
Free-Form Entry |
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| C18198 | Ankle foot orthosis use type | AnklFootOrthosisUseTyp | Type of use for ankle-foot orthosis | Type of use for ankle-foot orthosis | Use: | Walking;Resting splints | Walking;Resting splints | 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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| 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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| C58479 | Orthosis laterality type | OrthosisLateralityTyp | Laterality type of orthoses used by participant/subject | Laterality type of orthoses used by participant/subject | If yes, | Unilateral;Bilateral | Unilateral;Bilateral | Alphanumeric | No references available | Adult | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2018-04-12 17:17:20.0 | Devices: Mobility and Manipulation | Devices | Treatment/Intervention Data |
Single Pre-Defined Value Selected |
