CDE Detailed Report

Disease: Spinal Cord Injury
Sub-Domain: Therapies
CRF: Assistive

Displaying 1 - 26 of 26
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
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

(check all that apply)

Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C12682 Orthosis use indicator OrthosisUseInd Whether the participant/subject uses orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) Whether the participant/subject uses orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs) Does the participant/subject use lower extremity orthoses and assistive devices? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Yes (complete section 2)

No references available Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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 No references available Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data 4000

Free-Form Entry

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

(check all that apply)

Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

3165788
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 Manual wheelchair;Power wheelchair;Power assist wheelchair;Other Mobility Device;Positioning Wheelchair;Upper Extremity Devices Manual wheelchair;Power wheelchair;Power assist wheelchair;Other Mobility Device;Positioning Wheelchair;Upper Extremity Devices Alphanumeric No references available Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C19067 Other mobility device other text OthrMobilityDevOTH The free-text field related to 'Other mobility device type' specifying other text. Type of other mobility device that the participant/ subject uses The free-text field related to 'Other mobility device type' specifying other text. Type of other mobility device that the participant/ subject uses Other, specify Alphanumeric No references available Adult;Pediatric Supplemental 3.00 2013-07-21 12:11:21.037 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data 4000

Free-Form Entry

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 Adult;Pediatric Supplemental 3.00 2013-07-21 12:11:21.037 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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 No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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

(check all that apply)

No references available Adult;Pediatric Supplemental 3.00 2013-07-21 12:11:21.037 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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

(check all that apply)

Adult;Pediatric Supplemental 3.00 2013-07-21 12:11:21.037 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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 Yes: Full-time;Part-time Full-time;Part-time Alphanumeric No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C21645 Orthosis walker type OrthosisWalkerTyp Type of walker the participant/subject uses Type of walker the participant/subject uses Yes Anterior;Posterior;Wheeled Anterior;Posterior;Wheeled Alphanumeric

(check all that apply)

No references available Adult;Pediatric Supplemental 3.00 2013-07-21 12:11:21.037 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C12686 Orthosis type use indicator OrthsisTypUseInd Indicator whether the participant/subject currently uses the selected types of orthosis Indicator whether the participant/subject currently uses the selected types of orthosis Device used? Yes;No;Not applicable;Unknown Yes;No;Not applicable;Unknown Alphanumeric No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C21646 Orthosis crutches type OrthosisCrutchesTyp Type of crutches the participant/subject uses Type of crutches the participant/subject uses Yes 1;2;Axillary;Forearm;Lofstrand 1;2;Axillary;Forearm;Lofstrand Alphanumeric

(check all that apply)

No references available Adult;Pediatric Supplemental 3.00 2013-07-21 12:11:21.037 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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 Yes;No Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C21648 Walker wheel number WalkerWheelNum Designates the number of wheels the walker has that the participant/subject uses Designates the number of wheels the walker has that the participant/subject uses Wheeled 2;4 2;4 Alphanumeric

(circle)

No references available Adult;Pediatric Supplemental 3.00 2013-07-21 12:11:21.037 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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 and Positioning Devices Inserts of any type;Supramalleolar orthotic;Ankle-foot orthosis (AFO);Knee-ankle-foot orthosis;Hip-knee-ankle-foot orthosis (HKAFO);Stander;Body jacket/Thoracic-lumbar-sacral orthoses;Reciprocal gait orthoses (RGO);Other, specify;Walker;Crutches;Cane;Upper extremity assistive devices Inserts of any type;Supramalleolar orthotic (SMO);Ankle-foot orthosis (AFO);Knee-ankle-foot orthosis (KAFO);Hip-knee-ankle-foot orthosis (HKAFO);Stander;Body jacket/Thoracic-lumbar-sacral orthoses (TLSO);Reciprocal gait orthoses (RGO);Other, specify;Walker;Crutches;Cane;Upper extremity assistive devices (ex. mobile arm support) Alphanumeric No references available Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C21649 Single orthosis side designator SingOrthSideDsigntr Designates the side that the participant/subject uses a single orthosis. Designates the side that the participant/subject uses a single orthosis. 1 Left;Right Left;Right Alphanumeric

(circle)

No references available Adult;Pediatric Supplemental 3.00 2013-07-21 12:11:21.037 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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;Pediatric Supplemental 3.00 2013-07-21 12:11:21.037 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C21650 Orthosis cane type OrthosisCaneTyp Type of cane the participant/subject uses Type of cane the participant/subject uses Yes 1;2;Quad Base;Single Point 1;2;Quad Base;Single Point Alphanumeric

(check all that apply)

No references available Adult;Pediatric Supplemental 3.00 2013-07-21 12:11:21.037 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C18188 Other mobility device type OthrMobilityDevTyp Type of other mobility device that the participant/ subject uses Type of other mobility device that the participant/ subject uses Other mobility device Scooter;Stroller;Other, specify;Mobile standers;Standing wheelchairs Scooter;Stroller;Other, specify;Mobile standers;Standing wheelchairs Alphanumeric

(check all that apply)

No references available Adult;Pediatric Supplemental 3.00 2013-07-21 12:11:21.037 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

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 Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C18195 Ankle foot orthosis type AnklFootOrthosisTyp Type of ankle-foot orthosis the participant/subject uses Type of ankle-foot orthosis the participant/subject uses Type: Solid;Articulating;Dynamic ankle-foot orthosis style type Solid;Articulating;Dynamic ankle-foot orthosis style type Alphanumeric

(check all that apply)

No references available Adult;Pediatric Supplemental 3.00 2013-07-21 12:11:21.037 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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

(check all that apply)

Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C12679 Mobility device use indicator MobilityDvcUseInd Whether the participant/subject uses a mobility device (e.g., wheelchair) Whether the participant/subject uses a mobility device (e.g., wheelchair) Does the participant/subject use mobility devices? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Yes(complete section 1)
Supplemental - Highly Recommended

No references available Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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

(check all that apply)

No references available Adult;Pediatric Supplemental 3.00 2013-07-21 12:11:21.037 Assistive/Mobility Devices and Orthoses Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

CSV