1. Have you ever had unpleasant or uncomfortable feelings in your legs that occurred mainly while you were either sitting or lying down?
Item
1. Have you ever had unpleasant or uncomfortable feelings in your legs that occurred mainly while you were either sitting or lying down?
boolean
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C4062607 (UMLS CUI [1,3])
C0277814 (UMLS CUI [1,4])
C1140621 (UMLS CUI [2,1])
C1527305 (UMLS CUI [2,2])
C4062607 (UMLS CUI [2,3])
C0444334 (UMLS CUI [2,4])
2. Are these feelings painful rather than just uncomfortable?
Item
2. Are these feelings painful rather than just uncomfortable?
boolean
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C0030193 (UMLS CUI [1,3])
2a. How would you describe these feelings or sensations?
Item
2a. How would you describe these feelings or sensations?
text
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C0678257 (UMLS CUI [1,3])
3. Have you ever felt the need or urge to move your legs that occurred mainly while you were either sitting or lying down?
Item
3. Have you ever felt the need or urge to move your legs that occurred mainly while you were either sitting or lying down?
boolean
C1863322 (UMLS CUI [1,1])
C0277814 (UMLS CUI [1,2])
C1863322 (UMLS CUI [2,1])
C0444334 (UMLS CUI [2,2])
3a. Do these feelings in your legs ever become overwhelming to the point that you cannot resist moving your legs?
Item
3a. Do these feelings in your legs ever become overwhelming to the point that you cannot resist moving your legs?
boolean
C1863322 (UMLS CUI [1])
Item
3b. If you developed these feelings in your legs and you could not move your legs, or if someone were to hold your legs down, how would this effect the feelings in your legs?:
integer
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C0558185 (UMLS CUI [1,3])
C1280500 (UMLS CUI [1,4])
C1140621 (UMLS CUI [2,1])
C1527305 (UMLS CUI [2,2])
C1948035 (UMLS CUI [2,3])
C1280500 (UMLS CUI [2,4])
Code List
3b. If you developed these feelings in your legs and you could not move your legs, or if someone were to hold your legs down, how would this effect the feelings in your legs?:
CL Item
No Difference (3)
4. Do you think these feelings in your legs are due to a Charlie-horse or muscle cramp?
Item
4. Do you think these feelings in your legs are due to a Charlie-horse or muscle cramp?
boolean
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C0277823 (UMLS CUI [1,3])
C1140621 (UMLS CUI [2,1])
C1527305 (UMLS CUI [2,2])
C0026821 (UMLS CUI [2,3])
4a. Are these feelings always due to a Charlie-horse or muscle cramp?
Item
4a. Are these feelings always due to a Charlie-horse or muscle cramp?
boolean
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C0277823 (UMLS CUI [1,3])
C2003902 (UMLS CUI [1,4])
C1140621 (UMLS CUI [2,1])
C1527305 (UMLS CUI [2,2])
C0026821 (UMLS CUI [2,3])
C2003902 (UMLS CUI [2,4])
Item
5. While you are actually walking around, do you get any relief from these feelings?
integer
C0080331 (UMLS CUI [1,1])
C0564405 (UMLS CUI [1,2])
C1140621 (UMLS CUI [1,3])
C1527305 (UMLS CUI [1,4])
Code List
5. While you are actually walking around, do you get any relief from these feelings?
Item
5a. How quickly do you get relief from walking?
integer
C0080331 (UMLS CUI [1,1])
C0564405 (UMLS CUI [1,2])
C1140621 (UMLS CUI [1,3])
C1527305 (UMLS CUI [1,4])
C0456962 (UMLS CUI [1,5])
Code List
5a. How quickly do you get relief from walking?
CL Item
Almost immediately (1)
CL Item
Soon after walking (2)
CL Item
Only after awhile (3)
Item
5b. Will these feeling return if you continue to walk?
integer
C0080331 (UMLS CUI [1,1])
C0549178 (UMLS CUI [1,2])
C1140621 (UMLS CUI [1,3])
C1527305 (UMLS CUI [1,4])
C0034897 (UMLS CUI [1,5])
Code List
5b. Will these feeling return if you continue to walk?
Item
5c. If you move your legs, do you get any relief from these feelings, even temporarily?
integer
C0561995 (UMLS CUI [1,1])
C0564405 (UMLS CUI [1,2])
C1140621 (UMLS CUI [1,3])
C1527305 (UMLS CUI [1,4])
Code List
5c. If you move your legs, do you get any relief from these feelings, even temporarily?
5d. What do you do to get relief from these feelings?
Item
5d. What do you do to get relief from these feelings?
text
C0564405 (UMLS CUI [1,1])
C1140621 (UMLS CUI [1,2])
C1527305 (UMLS CUI [1,3])
6. Are these feelings in your legs more likely to occur while you are resting then when you are physically active?
Item
6. Are these feelings in your legs more likely to occur while you are resting then when you are physically active?
boolean
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C2745955 (UMLS CUI [1,3])
C0035253 (UMLS CUI [1,4])
C1140621 (UMLS CUI [2,1])
C1527305 (UMLS CUI [2,2])
C2745955 (UMLS CUI [2,3])
C0556453 (UMLS CUI [2,4])
7. Are these feelings in your legs a lot worse while you are sitting compared to when you are lying down?
Item
7. Are these feelings in your legs a lot worse while you are sitting compared to when you are lying down?
boolean
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C0277814 (UMLS CUI [1,3])
C1457868 (UMLS CUI [1,4])
C1140621 (UMLS CUI [2,1])
C1527305 (UMLS CUI [2,2])
C0444334 (UMLS CUI [2,3])
C1457868 (UMLS CUI [2,4])
7a. Would it be true to say that you have these feelings almost exclusively when you are sitting and only rarely, if ever, when lying down.
Item
7a. Would it be true to say that you have these feelings almost exclusively when you are sitting and only rarely, if ever, when lying down.
boolean
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C1548966 (UMLS CUI [1,3])
C0277814 (UMLS CUI [1,4])
C1140621 (UMLS CUI [2,1])
C1527305 (UMLS CUI [2,2])
C0522498 (UMLS CUI [2,3])
C0444334 (UMLS CUI [2,4])
8. Are these feelings in your legs worse at night or in the evening than other times of the day?
Item
8. Are these feelings in your legs worse at night or in the evening than other times of the day?
boolean
C3176727 (UMLS CUI [1,1])
C1140621 (UMLS CUI [1,2])
C1527305 (UMLS CUI [1,3])
C1457868 (UMLS CUI [2,1])
C0587117 (UMLS CUI [2,2])
C1140621 (UMLS CUI [2,3])
C1527305 (UMLS CUI [2,4])
9. Approximately, how old were you when you first noticed these feelings in your legs?
Item
9. Approximately, how old were you when you first noticed these feelings in your legs?
integer
C2745955 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C1140621 (UMLS CUI [1,3])
C1527305 (UMLS CUI [1,4])
10. Do you still have these feelings in your legs?
Item
10. Do you still have these feelings in your legs?
boolean
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C0549178 (UMLS CUI [1,3])
10a.Did the feelings stop because you are currently on treatment?
Item
10a.Did the feelings stop because you are currently on treatment?
boolean
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C2746065 (UMLS CUI [1,3])
C0087111 (UMLS CUI [1,4])
C0678226 (UMLS CUI [1,5])
10b.How long ago did these feelings stop?
Item
10b.How long ago did these feelings stop?
integer
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C2746065 (UMLS CUI [1,3])
C0449238 (UMLS CUI [1,4])
Item
10c.When you had these feelings in your legs, did they bother you for?
integer
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C4036195 (UMLS CUI [1,3])
C0449238 (UMLS CUI [1,4])
Code List
10c.When you had these feelings in your legs, did they bother you for?
10d.About how many (weeks, months or years) did these feelings bother you?
Item
10d.About how many (weeks, months or years) did these feelings bother you?
integer
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C4036195 (UMLS CUI [1,3])
C0449238 (UMLS CUI [1,4])
11. Are you presently on medication for these feelings?
Item
11. Are you presently on medication for these feelings?
boolean
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C0013227 (UMLS CUI [1,3])
Item
12. How many days in the month do (did) you have these feelings?
integer
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C0556971 (UMLS CUI [1,3])
Code List
12. How many days in the month do (did) you have these feelings?
CL Item
2-4 X per month (3)
CL Item
5-15 X per month (4)
CL Item
16-25 X per month (5)
12. If < 1 per month, then how many times a year?
Item
12. If < 1 per month, then how many times a year?
integer
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C0556970 (UMLS CUI [1,3])
12a.For how many years has it been occurring (did it occur) at least this frequently?
Item
12a.For how many years has it been occurring (did it occur) at least this frequently?
integer
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C0449238 (UMLS CUI [1,3])
C0439234 (UMLS CUI [1,4])
12b.Did you ever have these feelings at least once a month for three consecutive months?
Item
12b.Did you ever have these feelings at least once a month for three consecutive months?
boolean
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C3845349 (UMLS CUI [1,3])
C1707491 (UMLS CUI [1,4])
Item
12c.At what time of day do (did) these feelings usually start?
integer
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C0439548 (UMLS CUI [1,3])
C1301880 (UMLS CUI [1,4])
Code List
12c.At what time of day do (did) these feelings usually start?
CL Item
after 6 p.m., but before bedtime (3)
CL Item
before 6 p.m. (4)
13. Are you aware of any medications or medical problems which might be causing (have caused) these feelings or making (made) these feelings worse?
Item
13. Are you aware of any medications or medical problems which might be causing (have caused) these feelings or making (made) these feelings worse?
boolean
C0013227 (UMLS CUI [1,1])
C0085978 (UMLS CUI [1,2])
C1140621 (UMLS CUI [1,3])
C1527305 (UMLS CUI [1,4])
C1254481 (UMLS CUI [2,1])
C0085978 (UMLS CUI [2,2])
C1140621 (UMLS CUI [2,3])
C1527305 (UMLS CUI [2,4])
13a.(If yes) What is the medication or medical problem?
Item
13a.(If yes) What is the medication or medical problem?
text
C0013227 (UMLS CUI [1])
C1254481 (UMLS CUI [2])
14. At the time you first developed these feelings did you have any problems with anemia, iron deficiency, nerve damage in your legs or feet, or pregnancy?
Item
14. At the time you first developed these feelings did you have any problems with anemia, iron deficiency, nerve damage in your legs or feet, or pregnancy?
boolean
C1140621 (UMLS CUI [1,1])
C1527305 (UMLS CUI [1,2])
C0002871 (UMLS CUI [2])
C0240066 (UMLS CUI [3])
C0161479 (UMLS CUI [4,1])
C1140621 (UMLS CUI [4,2])
C0016504 (UMLS CUI [4,3])
C0032961 (UMLS CUI [5])
14a.(If yes) Which problem(s)?
Item
14a.(If yes) Which problem(s)?
text
C1254481 (UMLS CUI [1])
15. Do you have any difficulty getting to sleep?
Item
15. Do you have any difficulty getting to sleep?
boolean
C0393760 (UMLS CUI [1])
Item
15a.How often?
integer
C0393760 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
15b.Is this because your legs are bothering you and you must move them?
Item
15b.Is this because your legs are bothering you and you must move them?
boolean
C1140621 (UMLS CUI [1,1])
C4036195 (UMLS CUI [1,2])
C0560560 (UMLS CUI [2,1])
C1140621 (UMLS CUI [2,2])
15c. Why are th elegs bothering and why do you have to move them?
Item
15c.Can you tell me anything more about why your legs are bothering you and why you must move them? (Enter the comments on the line).
text
C1140621 (UMLS CUI [1,1])
C4036195 (UMLS CUI [1,2])
C0085978 (UMLS CUI [1,3])
C0560560 (UMLS CUI [2,1])
C1140621 (UMLS CUI [2,2])
C0392360 (UMLS CUI [2,3])
16. If you wake up at night, do you have trouble getting back to sleep?
Item
16. If you wake up at night, do you have trouble getting back to sleep?
boolean
C1170730 (UMLS CUI [1,1])
C4086382 (UMLS CUI [1,2])
Item
16a.How often?
integer
C0439603 (UMLS CUI [1])
16b.Is this because your legs are bothering you and you must move them?
Item
16b.Is this because your legs are bothering you and you must move them?
boolean
C1140621 (UMLS CUI [1,1])
C4036195 (UMLS CUI [1,2])
C0560560 (UMLS CUI [2,1])
C1140621 (UMLS CUI [2,2])
16c.Why are th elegs bothering and why do you have to move them?
Item
16c.Can you tell me anything more about why your legs are bothering you and why you must move them?
text
C1140621 (UMLS CUI [1,1])
C4036195 (UMLS CUI [1,2])
C0085978 (UMLS CUI [1,3])
C0560560 (UMLS CUI [2,1])
C1140621 (UMLS CUI [2,2])
C0392360 (UMLS CUI [2,3])
17. While you were pregnant, did you have unpleasant or uncomfortable feelings in your legs that occurred while you were either sitting or lying down?
Item
17. While you were pregnant, did you have unpleasant or uncomfortable feelings in your legs that occurred while you were either sitting or lying down?
boolean
C0032961 (UMLS CUI [1,1])
C1140621 (UMLS CUI [1,2])
C1527305 (UMLS CUI [1,3])
C0277814 (UMLS CUI [1,4])
C0032961 (UMLS CUI [2,1])
C1140621 (UMLS CUI [2,2])
C1527305 (UMLS CUI [2,3])
C0444334 (UMLS CUI [2,4])
17a.While you were pregnant, did you have the need or urge to move your legs while you were either sitting or lying down?
Item
17a.While you were pregnant, did you have the need or urge to move your legs while you were either sitting or lying down?
boolean
C0032961 (UMLS CUI [1,1])
C1863322 (UMLS CUI [1,2])
C0277814 (UMLS CUI [1,3])
C0032961 (UMLS CUI [2,1])
C1863322 (UMLS CUI [2,2])
C0444334 (UMLS CUI [2,3])