CDE Detailed Report

Disease: content
Sub-Domain: Functional Outcomes
CRF: welcome

Displaying 1 - 23 of 23
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (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
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

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

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

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

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

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

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

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

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

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
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

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

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

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

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

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

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

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

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

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

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

CSV