CDE Detailed Report

Disease: Cerebral Palsy
Subdomain Name: Therapies
CRF: External Devices - CP

Displaying 1 - 50 of 81
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
C58630 Crutch use laterality type CrutchUseLateralTyp Laterality type with which the participant/subject uses their crutches Laterality type with which the participant/subject uses their crutche Laterality of type of crutches used. Unilateral;Bilateral Unilateral;Bilateral Alphanumeric

Select laterality for type of crutches used.

Adult;Pediatric Supplemental 1.00 2018-04-12 14:27:43.0 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C58631 Position device type use indicator PositionDeviceTypUseInd Indicator whether the participant/subject currently uses the selected types of positioning devices Indicator whether the participant/subject currently uses the selected types of positioning device Devices Used? Alphanumeric Adult;Pediatric Supplemental 1.00 2018-06-28 12:11:42.0 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C58632 Access communication device type another body part specify text AccComDevTypAnothrBodPrtSpcTxt Text describing the presence of another body part for type of access communication device used Text describing the presence of another body part for type of access communication device use Another body part, specify Alphanumeric

Specify the type of another body part used.

Adult;Pediatric Supplemental 1.00 2018-11-30 15:33:00.0 External Devices - CP Therapies Treatment/Intervention Data 255

Free-Form Entry

C58570 Static upper extremity orthosis splint use anatomic site laterality type StcUEOrthSplnUseAnatSiteLatTyp Laterality type of static upper extremity orthosis splints anatomic site used by participant/subject Laterality type of static upper extremity orthosis splints anatomic site used by participant/subjec If yes, Left;Right Left;Right Alphanumeric

Only answer if static upper extremity orthosis/splints is answered Yes.

No references available Adult;Pediatric Supplemental 1.00 2018-06-27 12:08:20.0 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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;Pediatric Supplemental 1.00 2018-04-13 11:24:20.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

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

Adult;Pediatric Supplemental 1.00 2018-04-16 15:24:35.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C58620 Truncal support device type other text TruncalSupportDeviceTypOthrTxt Text describing the presence of any other truncal support device used Text describing the presence of any other truncal support device used Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2018-11-02 12:19:54.0 External Devices - CP Therapies Treatment/Intervention Data 255

Free-Form Entry

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 Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 External Devices - CP Therapies Treatment/Intervention Data 4000

Free-Form Entry

C58508 Dedicate speech generating device manufacturer name DedicSpeechGenertngManufcName Name of manufacturer of dedicated speech generating device Name of manufacturer of dedicated speech generating device Specify device manufacturer Alphanumeric

Specify manufacturer and device (e.g., Attainment GoTalk 20, Dynavox Maestro, PRC Accent 1000, Ablenet Step-by-Step)

Adult;Pediatric Supplemental 1.00 2018-04-16 20:58:28.0 External Devices - CP Therapies Treatment/Intervention Data 255

Free-Form Entry

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 references available. Adult;Pediatric Supplemental 1.00 2018-04-12 13:56:59.0 External Devices - CP Therapies Treatment/Intervention Data 255

Free-Form Entry

C58571 Dynamic lower extremity stretch orthosis splint frequency use laterality type DynLEStrOrtSplnUseFreqLatrlTyp Laterality type of dynamic lower extremity stretching orthosis splints frequency used by participant/subject Laterality type of dynamic lower extremity stretching orthosis splints frequency used by participant/subjec If yes, Left;Right Left;Right Alphanumeric

Only answer if dynamic lower extremity stretching orthosis/splints is answered Yes.

No references available Adult;Pediatric Supplemental 1.00 2018-06-27 11:42:16.0 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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;Pediatric Supplemental 1.00 2018-04-13 11:27:48.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

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 Transfer Devices and Transportation Devices are used.

Adult;Pediatric Supplemental 1.00 2018-04-16 15:31:54.0 External Devices - CP Therapies Treatment/Intervention Data 255

Free-Form Entry

C58621 Stand time use type StandTimeUseTyp Type stand time used by the participant/subject Type stand time used by the participant/subject If yes, Number of minutes per day;Number of days per week Number of minutes per day;Number of days per week Alphanumeric

Only answer if stander position device is answered Yes.

Adult;Pediatric Supplemental 1.00 2018-11-02 13:27:56.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

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;Pediatric Supplemental 1.00 2017-08-07 11:32:24.0 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C58509 Dedicate speech generating device name DedicSpeechGenertngDevceName Name of dedicated speech generating device Name of dedicated speech generating device Specify device Alphanumeric

Specify manufacturer and device (e.g., Attainment GoTalk 20, Dynavox Maestro, PRC Accent 1000, Ablenet Step-by-Step)

Adult;Pediatric Supplemental 1.00 2018-04-16 21:00:06.0 External Devices - CP Therapies Treatment/Intervention Data 255

Free-Form Entry

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;Pediatric Supplemental 1.00 2018-04-12 14:27:43.0 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C58572 Dynamic lower extremity stretch orthosis splint use anatomic site laterality type DynLEStrOrtSplnUsAnatSitLatTyp Laterality type of dynamic lower extremity stretching orthosis splints anatomic site used by participant/subject Laterality type of dynamic lower extremity stretching orthosis splints anatomic site used by participant/subjec If yes, Left;Right Left;Right Alphanumeric

Only answer if dynamic lower extremity stretching orthosis/splints is answered Yes.

No references available Adult;Pediatric Supplemental 1.00 2018-06-27 11:49:04.0 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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;Pediatric Supplemental 1.00 2018-04-16 11:43:18.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

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.

Adult;Pediatric Supplemental 1.00 2018-04-16 15:38:33.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

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

Adult;Pediatric Supplemental 1.00 2018-11-02 13:37:37.0 External Devices - CP Therapies Treatment/Intervention Data

Free-Form Entry

0 1440
C56952 Crutch use type CrutchUseTyp Type of crutches which the participant/subject uses, if applicable Type of crutches which the participant/subject uses, if applicable Type of crutches Lofstrand or Forearm Crutches;Underarm;Other, specify Lofstrand or Forearm Crutches;Underarm;Other, specify Alphanumeric

If the participant/subject uses crutches, then record the type used. Choose one option.

No references available Adult;Pediatric Supplemental 1.00 2017-08-07 11:44:13.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C58510 Nonspeak communication device type NonSpeakCommunDevTyp Type for all non-speaking communication devices currently used by the participant/subject Type for all non-speaking communication devices currently used by the participant/subject If yes, Communication Book or Board;Pictures/Picture Exchange Communication System (PECS);Other, specify Communication Book or Board;Pictures/Picture Exchange Communication System (PECS);Other specify Alphanumeric

Only answer if non-speaking communication devices is answered Yes.

No references available. Adult;Pediatric Supplemental 1.00 2018-04-16 21:28:20.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C58478 Orthoses type OrthosesTyp Type for all orthoses currently used by the participant/subject Type for all orthoses currently used by the participant/subject Orthoses Ankle-foot orthosis (AFO);Dynamic Lower Extremity Stretching Orthosis/Splints;Dynamic Upper Extremity Orthosis/Splints;Hip-knee-ankle-foot orthosis (HKAFO);Shoe Inserts of any type;Knee-ankle-foot orthosis (KAFO);Other Orthosis, specify;Static Lower Extremity Stretching Orthosis/Splints;Static Upper Extremity Orthosis/Splints;Supramalleolar orthotic (SMO) Ankle-foot orthosis (AFO);Dynamic Lower Extremity Stretching Orthosis/Splints;Dynamic Upper Extremity Orthosis/Splints;Hip-knee-ankle-foot orthosis (HKAFO);Shoe Inserts of any type;Knee-ankle-foot orthosis (KAFO);Other Orthosis, specify;Static Lower Extremity Stretching Orthosis/Splints;Static Upper Extremity Orthosis/Splints;Supramalleolar orthotic (SMO) Alphanumeric

For each orthoses type record if it is used

No references available. Adult;Pediatric Supplemental 1.00 2018-04-12 16:55:27.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

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;Pediatric Supplemental 1.00 2018-06-27 11:42:16.0 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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;Pediatric Supplemental 1.00 2018-04-16 13:53:49.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

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 Adult;Pediatric Supplemental 1.00 2018-04-16 15:58:24.0 External Devices - CP Therapies Treatment/Intervention Data 255

Free-Form Entry

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

Adult;Pediatric Supplemental 1.00 2018-11-02 13:37:37.0 External Devices - CP Therapies Treatment/Intervention Data

Free-Form Entry

0 7
C56953 Cane stick use type CaneStickUseTyp Type of cane which the participant/subject uses, if applicable Type of cane which the participant/subject uses, if applicable If yes, Quad cane;Single Point Cane Quad cane;Single Point Cane Alphanumeric

If the participant/subject uses a cane, then record the type used. Choose one option.

No references available Adult;Pediatric Supplemental 1.00 2017-08-07 12:12:38.0 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C58511 Nonspeak communication device type other text NonSpeakCommunDevTypOtherTxt Text describing the presence of any other type of non-speaking communication device used Text describing the presence of any other type of non-speaking communication device use Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2018-04-16 21:31:02.0 External Devices - CP Therapies Treatment/Intervention Data 255

Free-Form Entry

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;Pediatric Supplemental 1.00 2018-04-12 17:17:20.0 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

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;Pediatric Supplemental 1.00 2018-04-13 11:27:48.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C12673 Position device use indicator PositionDevUseInd Indicator of whether the participant/subject uses any positioning devices Indicator of whether the participant/subject uses any positioning devices Does the participant use positioning devices? Yes, specify;No Yes, specify;No Alphanumeric

If Yes, (complete section 3)

No references available. Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C58490 Position device type other text PositionDeviceTypOthrTxt Text describing the presence of any other positioning device used Text describing the presence of any other positioning device use Other, specify Alphanumeric

Specify whether positioning devices other than Seated or Lying Position Device, Stander and Truncal Support Devices are used.

Adult;Pediatric Supplemental 1.00 2018-04-16 14:04:03.0 External Devices - CP Therapies Treatment/Intervention Data 255

Free-Form Entry

C58501 Transportation device type TransportDeviceTyp Type for all transportation devices currently used by the participant/subject Type for all transportation devices currently used by the participant/subject If yes, Adaptive car seat/Booster seat;Other, specify;Seating restraints (e.g., Manual, Electronic, Torso, Wheel Wells);Vehicle Lifts (e.g., Platform/Rotary);Vehicle with driver modifications Adaptive car seat/Booster seat;Other, specify;Seating restraints (e.g., Manual, Electronic, Torso, Wheel Wells);Vehicle Lifts (e.g., Platform/Rotary);Vehicle with driver modifications Alphanumeric

Only answer if transportation devices is answered Yes.

Adult;Pediatric Supplemental 1.00 2018-04-16 16:05:13.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

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.

Adult;Pediatric Supplemental 1.00 2018-11-02 14:02:36.0 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C56954 Dynamic upper extremity orthosis splint use frequency type DynmUEOrthoSplntUseFreqTyp Frequency type with which the participant/subject uses their dynamic upper extremity orthosis/splints, if applicable Frequency type with which the participant/subject uses their dynamic upper extremity orthosis/splints, if applicable If yes, Daytime use;Full-time use;Part-time use;Night time use Daytime use;Full-time use;Part-time use;Night time use Alphanumeric

Only answer if dynamic upper extremity orthosis/splints is answered Yes.

No references available Adult;Pediatric Supplemental 1.00 2017-08-07 12:54:36.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C58512 Access communication device type AccessCommunDevTyp Type for all access communication devices currently used by the participant/subject Type for all access communication devices currently used by the participant/subject Uses: Another body part, specify;Brain computer interface;Eye gaze;Finger;Head or chin pointer;One or more switches, device scans between messages;Other, specify Another body part, specify;Brain computer interface;Eye gaze;Finger;Head or chin pointer;One or more switches, device scans between messages;Other, specify Alphanumeric

Only answer if access communication devices is answered Yes.

No references available. Adult;Pediatric Supplemental 1.00 2018-04-16 21:33:56.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C58480 AFO type AFOTyp Type of ankle-foot orthosis (AFO) used by the participant/subject Type of ankle-foot orthosis (AFO) used by the participant/subject If yes, Solid;Articulating;Dynamic Ankle Foot Orthosis (DAFO);Posterior Leaf Spring (PLS);Carbon Fiber Solid;Articulating;Dynamic Ankle Foot Orthosis (DAFO);Posterior Leaf Spring (PLS);Carbon Fiber Alphanumeric

Only answer if Ankle-foot Orthosis is answered Yes. Choose all that apply.

No references available. Adult;Pediatric Supplemental 1.00 2018-04-13 09:33:55.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

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.

Adult;Pediatric Supplemental 1.00 2018-06-28 12:11:42.0 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value 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 use mobility devices? Yes;No;Unknown Yes;No;Unknown Alphanumeric

If Yes, (complete section 1)

No references available. Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C58491 Activity daily living device type ADLDeviceTyp Type for all activity of daily living devices currently used by the participant/subject Type for all activity of daily living devices currently used by the participant/subjec ADL Devices Eating / Drinking Assistive Devices;Bathing Devices;Toileting Devices Eating / Drinking Assistive Devices;Bathing Devices;Toileting Devices Alphanumeric

For each ADL device type record if it is used

No references available. Adult;Pediatric Supplemental 1.00 2018-04-16 14:07:02.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C58502 Communication devices category type CommunicationDevCatTyp Type of category for all communication devices currently used by the participant/subject Type of category for all communication devices currently used by the participant/subject Communication Devices Speaking Communication Device;Non-Speaking Communication Device;Access Communication Device;Other, specify Speaking Communication Device;Non-Speaking Communication Device;Access Communication Device;Other, specify Alphanumeric

For each communication device type record if it is used

No references available. Adult;Pediatric Supplemental 1.10 2022-01-07 16:02:40.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C58625 Communication device type use indicator CommunicationDevTypeUseInd 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 communication device type record if it is used. Choose one for each device type.

Adult;Pediatric Supplemental 1.00 2018-11-02 14:10:33.0 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C58470 Transfer transportation device use indicator TransferTransportDevUseInd Indicator of whether the participant/subject uses any transfer/transportation devices Indicator of whether the participant/subject uses any transfer/transportation devices Does the participant use transfer/transportation devices? Yes, specify;No Yes, specify;No Alphanumeric

If Yes, (Complete section 5)

No references available. Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C58513 Access communication device type other text AccessCommunDevTypOtherTxt Text describing the presence of any other type of access communication device used Text describing the presence of any other type of access communication device use Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2018-04-16 22:32:50.0 External Devices - CP Therapies Treatment/Intervention Data 255

Free-Form Entry

C58481 Dynamic upper extremity orthosis splint use anatomic site DynmUEOrthoSplntUseAnatSite Anatomic site of the dynamic upper extremity orthosis/splints use Anatomic site of the dynamic upper extremity orthosis/splints use Anatomic Site: Thumb;Wrist/hand;Hand/Fingers;Elbow Thumb;Wrist/hand;Hand/Fingers;Elbow Alphanumeric

Only answer if Dynamic Upper extremity orthosis/splints is answered Yes.

No references available Adult;Pediatric Supplemental 1.00 2018-04-13 10:18:13.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C58577 Eat drink assistive device type EatDrinkAssistDeviceTyp Type of eating / drinking device currently used by the participant/subject Type of eating / drinking device currently used by the participant/subjec Device used? Cutlery / Chopsticks;Plates / Bowls;Cups, Mugs, Drinking Aids (e.g., Straws, Grip Adapters / Attachments);Stoppers and Funnels;Bib / Clothing Protectors;Feeding Systems (enteral / parenteral);Feeding Apparatus (manual);Food Guards;Other, specify Cutlery / Chopsticks;Plates / Bowls;Cups, Mugs, Drinking Aids (e.g., Straws, Grip Adapters / Attachments);Stoppers and Funnels;Bib / Clothing Protectors;Feeding Systems (enteral / parenteral);Feeding Apparatus (manual);Food Guards;Other, specify Alphanumeric

Only answer if eating / drinking assistive device is answered Yes.

No references available Adult;Pediatric Supplemental 1.00 2018-06-29 13:18:07.0 External Devices - CP 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 use orthoses? Yes;No;Unknown Yes;No;Unknown Alphanumeric

If Yes, (complete section 2)

No references available. Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 External Devices - CP Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C58492 Bath device type BathDeviceTyp Type for all bathing devices currently used by the participant/subject Type for all bathing devices currently used by the participant/subject If yes, Bath Chair/Bench;Bathroom grab bars;Other, specify;Removable Shower Head;Roll-in Shower Bath Chair/Bench;Bathroom grab bars;Other, specify;Removable Shower Head;Roll-in Shower Alphanumeric

Only answer if bathing devices is answered Yes.

No references available. Adult;Pediatric Supplemental 1.00 2018-04-16 14:15:24.0 External Devices - CP Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

CSV