CDE Detailed Report
Disease: Amyotrophic Lateral Sclerosis
Sub-Domain: Functional Outcomes
CRF: Performance-Oriented Mobility Assessment (POMA)
Displaying 1 - 23 of 23
Sub-Domain: Functional Outcomes
CRF: Performance-Oriented Mobility Assessment (POMA)
Displaying 1 - 23 of 23
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Question Text | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guideline) | Sub Domain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C11951 | Performance-Oriented Mobility Assessment (POMA) - gait initiation score | POMAGaitInitiationScore | Score to report semiquantitative assessment for gait of the participant/subject immediately as they begin walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for gait of the participant/subject immediately as they begin walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Initiation of Gait | 0;1 | 0 = Any hesitancy or multiple attempts to start;1 = No hesitancy | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11962 | Performance-Oriented Mobility Assessment (POMA) - gait subtotal score | POMAGaitSubtotalScore | The subtotal score from all gait related questions from a semiquantitative assessment of the participant/subject for the Tinetti Performance-Oriented Mobility Assessment (POMA) | The subtotal score from all gait related questions from a semiquantitative assessment of the participant/subject for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Gait Score | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Free-Form Entry |
0 | 12 | ||||||||
| C11941 | Performance-Oriented Mobility Assessment (POMA) - balance seated score | POMABalanceSeatScore | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance while seated in a hard armless chair for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance while seated in a hard armless chair for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Sitting balance | 0;1;2 | Unable to maintain position (marked slide forward or leans forward or to side);Leans or slides in chair;Steady, safe, upright | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11952 | Performance-Oriented Mobility Assessment (POMA) - gait right step length score | POMAGaitRightStepLengthScore | Score to report semiquantitative assessment for gait of the participant/subject examining the right foot swing for step length while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for gait of the participant/subject examining the right foot swing for step length while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Step length and height - Right foot swing | 0;1 | 0 = Does not pass left stance foot with step;1 = Passes left stance foot | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11963 | Performance-Oriented Mobility Assessment (POMA) - mobility total score | POMAMobilityTotalScore | The total score for all fields that reports a semiquantitative assessment of the mobility of the participant/subject for the Tinetti Performance-Oriented Mobility Assessment (POMA) | The total score for all fields that reports a semiquantitative assessment of the mobility of the participant/subject for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Total Mobility Score | Numeric Values |
Combines Balance Score plus Gait Score |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Free-Form Entry |
0 | 28 | ||||||||
| C11942 | Performance-Oriented Mobility Assessment (POMA) - balance arise score | POMABalanceAriseScore | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance when arising from a hard armless chair for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance when arising from a hard armless chair for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Arise | 0;1;2 | 0 = Unable without help;1 = Able, but uses arm to help;2 = Able without use of arms | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11953 | Performance-Oriented Mobility Assessment (POMA) - gait left step length score | POMAGaitLeftStepLengthScore | Score to report semiquantitative assessment for gait of the participant/subject examining the left foot swing for step length while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for gait of the participant/subject examining the left foot swing for step length while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Step length and height - Left foot swing | 0;1 | 0 = Does not pass right stance foot with step;1 = Passes right stance foot | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11943 | Performance-Oriented Mobility Assessment (POMA) - balance attempt arise score | POMABalanceAttemptAriseScore | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance when attempting to arise from a hard armless chair for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance when attempting to arise from a hard armless chair for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Attempts to arise | 0;1;2 | 0 = Unable without help;1 = Able, but requires more than one attempt;2 = Able to arise with one attempt | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11954 | Performance-Oriented Mobility Assessment (POMA) - gait right step clearance score | POMAGaitRightStepClearScore | Score to report semiquantitative assessment for gait of the participant/subject examining the right foot swing for step height and clearance while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for gait of the participant/subject examining the right foot swing for step height and clearance while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Step length and height - Right foot swing | 0;1 | 0 = Right foot does not clear floor completely with step;1 = Right foot completely clears floor | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11944 | Performance-Oriented Mobility Assessment (POMA) - balance immediate stand score | POMABalanceImmedStandScore | Score to report semiquantitative assessment for the ability of the participant/subject to maintain standing balance immediately after arising from a hard armless chair for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for the ability of the participant/subject to maintain standing balance immediately after arising from a hard armless chair for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Immediate standing balance (first 5 seconds) | 0;1;2 | 0 = Unsteady (staggers, moves feet, marked trunk sway);1 = Steady but uses walker or cane or grabs other object for support;2 = Steady without walker or cane or other support | Numeric Values |
First 5 seconds. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11955 | Performance-Oriented Mobility Assessment (POMA) - gait left step clearance score | POMAGaitLeftStepClearScore | Score to report semiquantitative assessment for gait of the participant/subject examining the left foot swing for step height and clearance while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for gait of the participant/subject examining the left foot swing for step height and clearance while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Step length and height - Left foot swing | 0;1 | 0 = Left foot does not clear floor completely with step;1 = Left foot completely clears floor | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11945 | Performance-Oriented Mobility Assessment (POMA) - balance stand score | POMABalanceStandScore | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance when standing for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance when standing for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Standing balance | 0;1;2 | 0 = Unsteady;1 = Steady, but with wide stance (medial heels more than 4 inches apart) or uses cane, walker or other support;2 = Narrow stance without support | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11956 | Performance-Oriented Mobility Assessment (POMA) - gait step symmetry score | POMAGaitStepSymmScore | Score to report semiquantitative assessment for gait of the participant/subject examining equality of step length between lower extremities while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for gait of the participant/subject examining equality of step length between lower extremities while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Step Symmetry | 0;1 | 0 = Right and left step length not equal (estimate);1 = Right and left step length appear equal | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11946 | Performance-Oriented Mobility Assessment (POMA) - balance nudge score | POMABalanceNudgeScore | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance while standing when a sternal nudge is applied for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance while standing when a sternal nudge is applied for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Nudge | 0;1;2 | 0 = Begins to fall;1 = Staggers, grabs, but catches self;2 = Steady | Numeric Values |
Subject at maximum position with feet as close together as possible. Examiner pushes lightly on subject's sternum with palm of hand 3 times. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11957 | Performance-Oriented Mobility Assessment (POMA) - gait step continuity score | POMAGaitStepContinScore | Score to report semiquantitative assessment for gait of the participant/subject examining continuity of walking pace while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for gait of the participant/subject examining continuity of walking pace while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Step Continuity | 0;1 | 0 = Stopping or discontinuity between steps;1 = Steps appear continuous | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11947 | Performance-Oriented Mobility Assessment (POMA) - balance eyes closed score | POMABalanceEyesClosedScore | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance when standing with eyes closed for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance when standing with eyes closed for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Eyes closed | 0;1 | 0 = Unsteady;1 = Steady | Numeric Values |
Subject at maximum position |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11958 | Performance-Oriented Mobility Assessment (POMA) - gait path score | POMAGaitPathScore | Score to report semiquantitative assessment for gait of the participant/subject examining ability to maintain steady pathway while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for gait of the participant/subject examining ability to maintain steady pathway while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Path | 0;1;2 | 0 = Marked deviation;1 = Mild or moderate deviation, or uses a walking aid;2 = Straight without walking aid | Numeric Values |
Estimated in relation to floor tiles, 12 inches wide. Observe excursion of one foot over about 10 feet of course. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11948 | Performance-Oriented Mobility Assessment (POMA) - balance turning steps score | POMABalanceTurnStepScore | Score to report semiquantitative assessment for the ability of the participant/subject to move in continuous steps when turning around 360 degrees for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for the ability of the participant/subject to move in continuous steps when turning around 360 degrees for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Turn 360 degrees | 0;1 | 0 = Discontinuous steps;1 = Continuous steps | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11959 | Performance-Oriented Mobility Assessment (POMA) - gait trunk support score | POMAGaitTrunkSupportScore | Score to report semiquantitative assessment for gait of the participant/subject examining ability to maintain steady balance of the trunk of the body while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for gait of the participant/subject examining ability to maintain steady balance of the trunk of the body while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Trunk | 0;1;2 | 0 = Marked sway or uses walking aid;1 = No sway, but flexion of knees or back or spread arms out while walking;2 = No sway, no flexion, no use of arms and no walking aid | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11949 | Performance-Oriented Mobility Assessment (POMA) - balance turning steady score | POMABalanceTurnSteadyScore | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance when turning around 360 degrees for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance when turning around 360 degrees for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Turn 360 degrees | 0;1 | 0 = Unsteady (grabs, staggers);1 = Steady | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11960 | Performance-Oriented Mobility Assessment (POMA) - gait heel stance score | POMAGaitHeelStanceScore | Score to report semiquantitative assessment for gait of the participant/subject examining stance and position of heels while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for gait of the participant/subject examining stance and position of heels while walking down hallway or across room for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Walk Stance | 0;1 | 0 = Heels apart;1 = Heels almost touching while walking | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11950 | Performance-Oriented Mobility Assessment (POMA) - balance sit down score | POMABalanceSitDownScore | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance as they sit down onto a hard armless chair for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Score to report semiquantitative assessment for the ability of the participant/subject to maintain balance as they sit down onto a hard armless chair for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Sit down | 0;1;2 | Unable without help or collapses (plops) into chair or lands off center of chair;Able and does not meet criteria for 0 or 2;Sits in a smooth, safe motion and ends with buttocks against back of chair and thighs centered on chair | Numeric Values |
Immediately after told to "go" |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11961 | Performance-Oriented Mobility Assessment (POMA) - balance subtotal score | POMABalanceSubtotalScore | The subtotal score from all balance related questions from a semiquantitative assessment of the participant/subject for the Tinetti Performance-Oriented Mobility Assessment (POMA) | The subtotal score from all balance related questions from a semiquantitative assessment of the participant/subject for the Tinetti Performance-Oriented Mobility Assessment (POMA) | Balance Score | Numeric Values |
Refer to instructions on form. |
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119-26. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Performance-Oriented Mobility Assessment (POMA) | Functional Outcomes | Outcomes and End Points |
Free-Form Entry |
0 | 16 |
