Item
1. Measured walk A. Is the participant able to walk 15 feet?
text
C0559964 (UMLS CUI [1])
Code List
1. Measured walk A. Is the participant able to walk 15 feet?
CL Item
Not able (Not able)
CL Item
Not assessed (Not assessed)
time to walk 15 feet
Item
B. Time, in seconds, to walk 15 feet
float
C0080331 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
pain in hands due to arthritis or tendonitis
Item
*2. Do you have any pain in your wrists or hands, for example, due to arthritis or tendonitis?
boolean
C0221785 (UMLS CUI [1,1])
C0003864 (UMLS CUI [1,2])
C0039503 (UMLS CUI [1,3])
C0239833 (UMLS CUI [2,1])
C0003864 (UMLS CUI [2,2])
C0039503 (UMLS CUI [2,3])
surgery on hands or arms
Item
3. Have you had any surgery on your hands or arms during the last 13 weeks?
boolean
C0543467 (UMLS CUI [1,1])
C0018563 (UMLS CUI [1,2])
C0543467 (UMLS CUI [2,1])
C1140618 (UMLS CUI [2,2])
Item
4. Code which hand is being tested.
text
C1140618 (UMLS CUI [1])
Code List
4. Code which hand is being tested.
position of dynamometer
Item
5. Position of dynamometer
text
C0180572 (UMLS CUI [1,1])
C0733755 (UMLS CUI [1,2])
first try
Item
6. 1st try
float
C0180572 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
second try
Item
7. 2nd try
float
C0180572 (UMLS CUI [1,1])
C0205436 (UMLS CUI [1,2])
third try
Item
8. 3rd try
float
C0180572 (UMLS CUI [1,1])
C0205437 (UMLS CUI [1,2])
Item
9. Code which hand is being tested.
text
C1140618 (UMLS CUI [1])
Code List
9. Code which hand is being tested.
position of dynamometer opposite hand
Item
10. Position of dynamometer
text
C0180572 (UMLS CUI [1,1])
C0733755 (UMLS CUI [1,2])
first try opposite hand
Item
11. 1st try
float
C0180572 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
second try opposite hand
Item
12. 2nd try
float
C0180572 (UMLS CUI [1,1])
C0205436 (UMLS CUI [1,2])
third try opposite hand
Item
13. 3rd try
integer
C0180572 (UMLS CUI [1,1])
C0205437 (UMLS CUI [1,2])
Item
Chest, lungs *14. Bilateral rales that do not clear with coughing
text
C0034642 (UMLS CUI [1,1])
C0238767 (UMLS CUI [1,2])
Code List
Chest, lungs *14. Bilateral rales that do not clear with coughing
CL Item
Don`t know (Don`t know)
Item
15. Systolic murmur
text
C0232257 (UMLS CUI [1])
Code List
15. Systolic murmur
CL Item
Don`t know (Don`t know)
Item
16. Diastolic murmur
text
C0232262 (UMLS CUI [1])
Code List
16. Diastolic murmur
CL Item
Don`t know (Don`t know)
Item
17. a. Right - Supraclavicular Fossa
text
C0241305 (UMLS CUI [1,1])
C0205090 (UMLS CUI [1,2])
Code List
17. a. Right - Supraclavicular Fossa
CL Item
Don`t know (Don`t know)
Item
b. Right - Angle of jaw
text
C0007280 (UMLS CUI [1,1])
C1305724 (UMLS CUI [1,2])
C0205090 (UMLS CUI [1,3])
Code List
b. Right - Angle of jaw
CL Item
Don`t know (Don`t know)
Item
c. Intensity
text
C0007280 (UMLS CUI [1,1])
C0522510 (UMLS CUI [1,2])
CL Item
Supraclavicular fossa louder (Supraclavicular fossa louder)
CL Item
angle of jaw louder (angle of jaw louder)
Item
18. a. Left - Supraclavicular Fossa
text
C0241305 (UMLS CUI [1,1])
C0205091 (UMLS CUI [1,2])
Code List
18. a. Left - Supraclavicular Fossa
CL Item
Don`t know (Don`t know)
Item
b. Left- Angle of jaw
text
C0007280 (UMLS CUI [1,1])
C1305724 (UMLS CUI [1,2])
C0205091 (UMLS CUI [1,3])
Code List
b. Left- Angle of jaw
CL Item
Don`t know (Don`t know)
Item
c. Intensity
text
C0007280 (UMLS CUI [1,1])
C0522510 (UMLS CUI [1,2])
CL Item
Supraclavicular fossa louder (Supraclavicular fossa louder)
CL Item
angle of jaw louder (angle of jaw louder)
Item
19. Pitting ankle edema
text
C0333243 (UMLS CUI [1,1])
C0003086 (UMLS CUI [1,2])
Code List
19. Pitting ankle edema
CL Item
Don`t know (Don`t know)
stand up from chair without arms
Item
20. Do you think it would be safe for you to try to stand up from a chair without using your arms?
boolean
C0555088 (UMLS CUI [1])
try to stand up from a chair
Item
21. Do you think you could try to stand up from a chair without using your arms?
boolean
C0555088 (UMLS CUI [1])
Item
*22. Code the reason task was not performed:
text
C0445106 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
Code List
*22. Code the reason task was not performed:
CL Item
Not attempted, safety reasons (Not attempted, safety reasons)
CL Item
Not attempted, other (Not attempted, other)
CL Item
Not attempted, chair bound (Not attempted, chair bound)
other reason
Item
If, other specify:
text
C3840932 (UMLS CUI [1])
number of attempts to rise
Item
*23. Number of attempts to rise
integer
C3163850 (UMLS CUI [1,1])
C4055533 (UMLS CUI [1,2])
CL Item
Rises without using arms (Rises without using arms)
CL Item
Rises using arms (Rises using arms)
CL Item
Attempted, but unable (Attempted, but unable)
rise several times
Item
25. Do you think it would be safe for you to try to stand up from a chair, without using your arms, five times quickly?
boolean
C4055533 (UMLS CUI [1])
Item
26. Reason task not attempted:
text
C0445106 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
Code List
26. Reason task not attempted:
CL Item
Not attempted, safety reasons (Not attempted, safety reasons)
CL Item
Not attempted, other (Not attempted, other)
CL Item
Not attempted, chair bound (Not attempted, chair bound)
other reason
Item
If other, specify
text
C3840932 (UMLS CUI [1])
heart rate
Item
*27. Heart rate (30 second) prior to chair stands:
integer
C0018810 (UMLS CUI [1])
chair rises
Item
28. Number of completed chair rises:
integer
C4055533 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
heart rate after
Item
29. Heart rate (30 second) immediately following chair stands:
integer
C0018810 (UMLS CUI [1,1])
C1548614 (UMLS CUI [1,2])
number of seconds
Item
30. Number of seconds
integer
C0457385 (UMLS CUI [1])
chair height
Item
31. Chair height (Centimeters from floor to lowest point)
integer
C0489786 (UMLS CUI [1,1])
C0179847 (UMLS CUI [1,2])
comments
Item
*32. Do you have comments to enter?
boolean
C0947611 (UMLS CUI [1])
comments specify
Item
If yes, specify:
text
C0947611 (UMLS CUI [1])