Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 1 | BalanceSit | 3340 | Dynamic Balance Sitting | 1989-10-01 - Variable Added |
Form 1 | BalanceStand | 3341 | Dynamic Balance Standing | 1989-10-01 - Variable Added |
Form 2 | BalanceSitF | 3589 | PE - Dynamic Balance Sitting | 1989-10-01 - Variable Added |
Form 2 | BalanceStandF | 3590 | PE - Dynamic Balance Standing | 1989-10-01 - Variable Added |
PHYSICAL EXAM - ARCHIVE
Definition
These variables document selected areas of the physical examination performed as part of the physiatric physical evaluation within 72 hours following admission to rehabilitation (Form 1) and at time of the first annual follow-up evaluation (Form 2).
Form
[X] Form 1
[X] Form 2
Source
- Form 1 - Physical exam completed by designated staff (physician, physical therapist, etc.)
- Form 2 - In-person physical exam completed by data collector.
Characteristics
PEAUD (Auditory Function) was asked from 1990 to 2002 but no data is available. Definition = This variable describes the patient’s auditory function measured at time of the physiatric physical evaluation *performed within 72 hours following admission to rehabilitation (Form 1) and at time of the first annual follow-up evaluation (Form 2). Form 2 data collection began on 10/01/1994.
BALANCE - ARCHIVE
Definition
Includes subjective feeling of movement within or around oneself characterized by dizziness, vertigo. Evaluate both dynamic standing and sitting balance measured at time of the physiatric physical evaluation performed within 72 hours following admission to rehabilitation (Form 1) and first annual follow-up evaluation only (Form 2).
Form
[X] Form 1
[X] Form 2
Source
- Form 1 - Physical exam completed by designated staff (physician, physical therapist, etc.)
- Form 2 - In-person physical exam completed by data collector.
Variables
Codes and Values
ID 3340
For Form: [Form 1]
For Variables: [BalanceSit]
Code | Description |
|---|---|
1 | Grossly Normal |
2 | Mildly Impaired ( Can maintain dynamic balance with some difficulty ) |
3 | Grossly Impaired ( Cannot maintain dynamic balance ) |
7 | Not Testable |
9 | Unknown |
ID 3341
For Form: [Form 1]
For Variables: [BalanceStand]
Code | Description |
|---|---|
1 | Grossly Normal |
2 | Mildly Impaired ( Can maintain dynamic balance with some difficulty ) |
3 | Grossly Impaired ( Cannot maintain dynamic balance ) |
7 | Not Testable |
9 | Unknown |
ID 3589
For Form: [Form 2]
For Variables: [BalanceSitF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Grossly Normal |
2 | Mildly Impaired ( Can maintain dynamic balance with some difficulty ) |
3 | Grossly Impaired ( Cannot maintain dynamic balance ) |
7 | Not Testable |
8 | Not Applicable: Not first year follow-up |
9 | Unknown ( No evaluation performed ) |
ID 3590
For Form: [Form 2]
For Variables: [BalanceStandF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Grossly Normal |
2 | Mildly Impaired ( Can maintain dynamic balance with some difficulty ) |
3 | Grossly Impaired ( Cannot maintain dynamic balance ) |
7 | Not Testable |
8 | Not Applicable: Not first year follow-up |
9 | Unknown ( No evaluation performed ) |
History
No history found for the Domain.
COORDINATION - ARCHIVE
Definition
This variable describes the coordination in all four extremities as identified by the finger-to-nose test and the heel-to-shin test measured at time of the physiatric physical evaluation performed within 72 hours following admission to rehabilitation (Form 1) and first annual follow-up evaluation only (Form 2).
Form
[X] Form 1
[X] Form 2
Source
- Form 1 - Physical exam completed by designated staff (physician, physical therapist, etc.)
- Form 2 - In-person physical exam completed by data collector.
Details
Must be documented as “finger to nose” and “heel to shin” testing. If this documentation is not present, use the “unknown” code (9). Data are collected for the right and left, upper and lower extremities.
Variables
Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 1 | CoordLLE | 3377 | Cerebellar Motor Coordination Left Lower Extremity | 1989-10-01 - Variable Added |
Form 1 | CoordLUE | 3378 | Cerebellar Motor Coordination Left Upper Extremity | 1989-10-01 - Variable Added |
Form 1 | CoordRLE | 3379 | Cerebellar Motor Coordination Right Lower Extremity | 1989-10-01 - Variable Added |
Form 1 | CoordRUE | 3380 | Cerebellar Motor Coordination Right Upper Extremity | 1989-10-01 - Variable Added |
Form 2 | CoordLLEF | 3643 | PE - Cerebellar Motor Coordination Left LE | 1989-10-01 - Variable Added |
Form 2 | CoordLUEF | 3644 | PE - Cerebellar Motor Coordination Left UE | 1989-10-01 - Variable Added |
Form 2 | CoordRLEF | 3645 | PE - Cerebellar Motor Coordination Right LE | 1989-10-01 - Variable Added |
Form 2 | CoordRUEF | 3646 | PE - Cerebellar Motor Coordination Right UE | 1989-10-01 - Variable Added |
Codes and Values
ID 3377
For Form: [Form 1]
For Variables: [CoordLLE]
Code | Description |
|---|---|
1 | Normal Coordination |
2 | Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed ) |
3 | Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed ) |
4 | Severe Incoordination/Ataxia ( Unable to perform test ) |
7 | Not Testable |
9 | Unknown |
ID 3378
For Form: [Form 1]
For Variables: [CoordLUE]
Code | Description |
|---|---|
1 | Normal Coordination |
2 | Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed ) |
3 | Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed ) |
4 | Severe Incoordination/Ataxia ( Unable to perform test ) |
7 | Not Testable |
9 | Unknown |
ID 3379
For Form: [Form 1]
For Variables: [CoordRLE]
Code | Description |
|---|---|
1 | Normal Coordination |
2 | Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed ) |
3 | Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed ) |
4 | Severe Incoordination/Ataxia ( Unable to perform test ) |
7 | Not Testable |
9 | Unknown |
ID 3380
For Form: [Form 1]
For Variables: [CoordRUE]
Code | Description |
|---|---|
1 | Normal Coordination |
2 | Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed ) |
3 | Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed ) |
4 | Severe Incoordination/Ataxia ( Unable to perform test ) |
7 | Not Testable |
9 | Unknown |
ID 3643
For Form: [Form 2]
For Variables: [CoordLLEF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Normal Coordination |
2 | Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed ) |
3 | Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed ) |
4 | Severe Incoordination/Ataxia ( Unable to perform test ) |
7 | Not Testable |
8 | Not Applicable: Not first year follow-up |
9 | Unknown: No evaluation performed |
ID 3644
For Form: [Form 2]
For Variables: [CoordLUEF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Normal Coordination |
2 | Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed ) |
3 | Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed ) |
4 | Severe Incoordination/Ataxia ( Unable to perform test ) |
7 | Not Testable |
8 | Not Applicable: Not first year follow-up |
9 | Unknown: No evaluation performed |
ID 3645
For Form: [Form 2]
For Variables: [CoordRLEF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Normal Coordination |
2 | Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed ) |
3 | Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed ) |
4 | Severe Incoordination/Ataxia ( Unable to perform test ) |
7 | Not Testable |
8 | Not Applicable: Not first year follow-up |
9 | Unknown: No evaluation performed |
ID 3646
For Form: [Form 2]
For Variables: [CoordRUEF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Normal Coordination |
2 | Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed ) |
3 | Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed ) |
4 | Severe Incoordination/Ataxia ( Unable to perform test ) |
7 | Not Testable |
8 | Not Applicable: Not first year follow-up |
9 | Unknown: No evaluation performed |
History
No history found for the Domain.
MUSCLE STRENGTH - ARCHIVE
Definition
This variable describes the patient’s amount of voluntary muscle strength. Record overall average strength of extremity measured at time of the physiatric physical evaluation performed within 72 hours following admission to rehabilitation (Form 1) and first annual follow-up evaluation only (Form 2).
Form
[X] Form 1
[X] Form 2
Source
- Form 1 - Physical exam completed by designated staff (physician, physical therapist, etc.)
- Form 2 - In-person physical exam completed by data collector.
Details
Although classical manual muscle examination is often difficult in persons with spasticity/rigidity, functionally the patient must be able to demonstrate this strength (movement) despite the increased muscle tone.
Data are collected for the right and left, upper and lower extremities.
Variables
Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 1 | StrngthLLE | 3534 | Voluntary Muscle Strength - Left Lower Extremity | 1989-10-01 - Variable Added |
Form 1 | StrngthLUE | 3535 | Voluntary Muscle Strength - Left Upper Extremity | 1989-10-01 - Variable Added |
Form 1 | StrngthRLE | 3536 | Voluntary Muscle Strength - Right Lower Extremity | 1989-10-01 - Variable Added |
Form 1 | StrngthRUE | 3537 | Voluntary Muscle Strength - Right Upper Extremity | 1989-10-01 - Variable Added |
Form 2 | StrngthLLEF | 3951 | PE - Voluntary Muscle Strength Left LE | 1989-10-01 - Variable Added |
Form 2 | StrngthLUEF | 3952 | PE - Voluntary Muscle Strength Left UE | 1989-10-01 - Variable Added |
Form 2 | StrngthRLEF | 3953 | PE - Voluntary Muscle Strength Right LE | 1989-10-01 - Variable Added |
Form 2 | StrngthRUEF | 3954 | PE - Voluntary Muscle Strength Right UE | 1989-10-01 - Variable Added |
Codes and Values
ID 3534
For Form: [Form 1]
For Variables: [StrngthLLE]
Code | Description |
|---|---|
0 | 0/5 - None |
1 | 1/5 |
2 | 2/5 |
3 | 3/5 |
4 | 4/5 |
5 | 5/5 - Full Strength |
7 | Not Testable |
9 | Unknown |
ID 3535
For Form: [Form 1]
For Variables: [StrngthLUE]
Code | Description |
|---|---|
0 | 0/5 - None |
1 | 1/5 |
2 | 2/5 |
3 | 3/5 |
4 | 4/5 |
5 | 5/5 - Full Strength |
7 | Not Testable |
9 | Unknown |
ID 3536
For Form: [Form 1]
For Variables: [StrngthRLE]
Code | Description |
|---|---|
0 | 0/5 - None |
1 | 1/5 |
2 | 2/5 |
3 | 3/5 |
4 | 4/5 |
5 | 5/5 - Full Strength |
7 | Not Testable |
9 | Unknown |
ID 3537
For Form: [Form 1]
For Variables: [StrngthRUE]
Code | Description |
|---|---|
0 | 0/5 - None |
1 | 1/5 |
2 | 2/5 |
3 | 3/5 |
4 | 4/5 |
5 | 5/5 - Full Strength |
7 | Not Testable |
9 | Unknown |
ID 3951
For Form: [Form 2]
For Variables: [StrngthLLEF]
Code | Description |
|---|---|
0 | 0/5 - None |
1 | 1/5 |
2 | 2/5 |
3 | 3/5 |
4 | 4/5 |
5 | 5/5 - Full strength |
6 | Variable Did Not Exist |
7 | Not Testable |
8 | Not Applicable: Not first year follow-up |
9 | Unknown: No evaluation performed |
ID 3952
For Form: [Form 2]
For Variables: [StrngthLUEF]
Code | Description |
|---|---|
0 | 0/5 - None |
1 | 1/5 |
2 | 2/5 |
3 | 3/5 |
4 | 4/5 |
5 | 5/5 - Full strength |
6 | Variable Did Not Exist |
7 | Not Testable |
8 | Not Applicable: Not first year follow-up |
9 | Unknown: No evaluation performed |
ID 3953
For Form: [Form 2]
For Variables: [StrngthRLEF]
Code | Description |
|---|---|
0 | 0/5 - None |
1 | 1/5 |
2 | 2/5 |
3 | 3/5 |
4 | 4/5 |
5 | 5/5 - Full strength |
6 | Variable Did Not Exist |
7 | Not Testable |
8 | Not Applicable: Not first year follow-up |
9 | Unknown: No evaluation performed |
ID 3954
For Form: [Form 2]
For Variables: [StrngthRUEF]
Code | Description |
|---|---|
0 | 0/5 - None |
1 | 1/5 |
2 | 2/5 |
3 | 3/5 |
4 | 4/5 |
5 | 5/5 - Full Strength |
6 | Variable Did Not Exist |
7 | Not Testable |
8 | Not Applicable: Not first year follow-up |
9 | Unknown: No evaluation performed ( No evaluation performed ) |
History
No history found for the Domain.
MUSCLE TONE - ARCHIVE
Definition
This variable documents the patient’s muscle tone measured at time of the physiatric physical evaluation performed within 72 hours following admission to rehabilitation (Form 1) and first annual follow-up evaluation only (Form 2).
Form
[X] Form 1
[X] Form 2
Source
- Form 1 - Physical exam completed by designated staff (physician, physical therapist, etc.)
- Form 2 - In-person physical exam completed by data collector.
Details
Data are collected for the right and left, upper and lower extremities.
Variables
Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 1 | ToneLLE | 3559 | Muscle Tone - Left Lower Extremity | 1989-10-01 - Variable Added |
Form 1 | ToneLUE | 3560 | Muscle Tone - Left Upper Extremity | 1989-10-01 - Variable Added |
Form 1 | ToneRLE | 3561 | Muscle Tone - Right Lower Extremity | 1989-10-01 - Variable Added |
Form 1 | ToneRUE | 3562 | Muscle Tone - Right Upper Extremity | 1989-10-01 - Variable Added |
Form 2 | ToneLLEF | 3967 | PE - Muscle Tone Left LE | 1989-10-01 - Variable Added |
Form 2 | ToneLUEF | 3968 | PE - Muscle Tone Left UE | 1989-10-01 - Variable Added |
Form 2 | ToneRLEF | 3969 | PE - Muscle Tone Right LE | 1989-10-01 - Variable Added |
Form 2 | ToneRUEF | 3970 | PE - Muscle Tone Right UE | 1989-10-01 - Variable Added |
Codes and Values
ID 3559
For Form: [Form 1]
For Variables: [ToneLLE]
Code | Description |
|---|---|
1 | Normal ( No deficits ) |
2 | Hypotonia ( Decreased muscle tone ) |
3 | Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) ) |
7 | Not Testable ( Limb missing, unable to be ranged ) |
9 | Unknown |
ID 3560
For Form: [Form 1]
For Variables: [ToneLUE]
Code | Description |
|---|---|
1 | Normal ( No deficits ) |
2 | Hypotonia ( Decreased muscle tone ) |
3 | Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) ) |
7 | Not Testable ( Limb missing, unable to be ranged ) |
9 | Unknown |
ID 3561
For Form: [Form 1]
For Variables: [ToneRLE]
Code | Description |
|---|---|
1 | Normal ( No deficits ) |
2 | Hypotonia ( Decreased muscle tone ) |
3 | Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) ) |
7 | Not Testable ( Limb missing, unable to be ranged ) |
9 | Unknown |
ID 3562
For Form: [Form 1]
For Variables: [ToneRUE]
Code | Description |
|---|---|
1 | Normal ( No deficits ) |
2 | Hypotonia ( Decreased muscle tone ) |
3 | Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) ) |
7 | Not Testable ( Limb missing, unable to be ranged ) |
9 | Unknown |
ID 3967
For Form: [Form 2]
For Variables: [ToneLLEF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Normal ( No deficits ) |
2 | Hypotonia ( Decreased muscle tone ) |
3 | Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) ) |
7 | Not Testable ( Limb missing, unable to be ranged ) |
8 | Not Applicable: Not first year follow-up |
9 | Unknown ( No evaluation performed ) |
ID 3968
For Form: [Form 2]
For Variables: [ToneLUEF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Normal ( No deficits ) |
2 | Hypotonia ( Decreased muscle tone ) |
3 | Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) ) |
7 | Not Testable ( Limb missing, unable to be ranged ) |
8 | Not Applicable: Not first year follow-up |
9 | Unknown ( No evaluation performed ) |
ID 3969
For Form: [Form 2]
For Variables: [ToneRLEF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Normal ( No deficits ) |
2 | Hypotonia ( Decreased muscle tone ) |
3 | Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) ) |
7 | Not Testable ( Limb missing, unable to be ranged ) |
8 | Not Applicable: Not first year follow-up |
9 | Unknown ( No evaluation performed ) |
ID 3970
For Form: [Form 2]
For Variables: [ToneRUEF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Normal ( No deficits ) |
2 | Hypotonia ( Decreased muscle tone ) |
3 | Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) ) |
7 | Not Testable ( Limb missing, unable to be ranged ) |
8 | Not Applicable: Not first year follow-up |
9 | Unknown ( No evaluation performed ) |
History
No history found for the Domain.
SWALLOWING - ARCHIVE
Definition
Measured at time of the physiatric physical evaluation performed within 72 hours following admission to rehabilitation, and at the time of first annual follow-up evaluation (Form 2).
Form
[X] Form 1
[X] Form 2
Source
- Form 1 - Physical exam completed by designated staff (physician, physical therapist, etc.)
- Form 2 - In-person physical exam completed by data collector.
Variables
Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 1 | Swallowing | 3552 | Swallowing | 1989-10-01 - Variable Added |
Form 2 | SwallowingF | 3957 | PE - Swallowing | 1989-10-01 - Variable Added |
Codes and Values
ID 3552
For Form: [Form 1]
For Variables: [Swallowing]
Code | Description |
|---|---|
1 | Grossly Normal |
2 | Impaired |
3 | Absent |
7 | Not Testable |
9 | Unknown |
ID 3957
For Form: [Form 2]
For Variables: [SwallowingF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Grossly Normal |
2 | Impaired |
3 | Absent |
7 | Not Testable |
8 | Not Applicable: Not first year follow-up |
9 | Unknown ( No evaluation performed ) |
History
No history found for the Domain.
VISION - ARCHIVE
Definition
This variable describes the patient’s visual function, based on best corrected vision measured at time of the physiatric physical evaluation performed within 72 hours following admission to rehabilitation (Form 1) and at time of the first annual follow-up evaluation (Form 2).
Form
[X] Form 1
[X] Form 2
Source
- Form 1 - Physical exam completed by designated staff (physician, physical therapist, etc.)
- Form 2 - In-person physical exam completed by data collector.
Details
Examining clinician must use judgement in determining whether inability to count fingers is due to vision vs. cognitive problems. If not testable code as such.
Legally blind = maximal visual acuity of the better eye, after correction, of 20/200 or less, or a total diameter of the visual field in that eye of 20 degrees or less.
If more than one code applies, the physician should determine which is the most severe and code that one.
Variables
Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 1 | Vision | 3575 | Vision | 1989-10-01 - Variable Added |
Form 2 | VisionF | 3977 | PE - Vision | 1989-10-01 - Variable Added |
Codes and Values
ID 3575
For Form: [Form 1]
For Variables: [Vision]
Code | Description |
|---|---|
1 | Grossly Normal ( No deficits (glasses may be worn) ) |
2 | Hemianopsia ( Blindness for half the visual field in both eyes unless blind in one eye (unless there is something additional wrong in one eye) ) |
3 | Impaired Monocular Visual Acuity ( Inability to count fingers (glasses on if appropriate), either eye, and/or monocular field cut ) |
4 | Hemianopsia and Impaired Monocular Visual Acuity |
5 | Legally Bind |
6 | Diplopia ( Double vision ) |
7 | Not Testable |
9 | Unknown |
ID 3977
For Form: [Form 2]
For Variables: [VisionF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Grossly Normal ( No deficits (glasses may be worn) ) |
2 | Hemianopsia ( Blindness for half the visual field in both eyes unless blind in one eye (unless there is something additional wrong in one eye) ) |
3 | Impaired Monocular Visual Acuity ( Inability to count fingers (glasses on if appropriate), either eye, and/or monocular field cut ) |
4 | Hemianopsia and Impaired Monocular Visual Acuity |
5 | Legally Blind |
6 | Diplopia ( Double vision ) |
7 | Not Testable |
8 | Not Applicable: Not first year follow-up |
9 | Unknown ( No evaluation performed ) |
History
No history found for the Domain.