RTG Instruments¶
These instruments are from the Research Training Group (RTG) study, designed for specialized clinical and research applications.
study_participant_information¶
Study Participant Information
Basic demographic and study enrollment information.
Shape: 5 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| subject | text | Record ID |
| dob | text | Date of birth |
| sex | dropdown | Sex |
| study_participation | text | What studies have they participated in? |
| study_indication | radio | Study Indication |
Usage Example
fal_initial_questionnaire¶
FAL Initial Questionnaire
Initial assessment questionnaire for the FAL study.
Shape: 42 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| fal_date | text | Date completed |
| fal_age | calc | Age |
| fal_examiner | text | Name of examiner |
| fal_add_info | notes | Additional Information |
| fal_hand | radio | Are you: |
| fal_weight | text | Body weight |
| fal_height | text | Height |
| fal_school | radio | Highest level of school qualification: |
| fal_job | radio | What is your current profession? Please specify in the following question |
| fal_job_ex | text | Please specify current occupation (e.g. chemistry, engineer, retired/unemployed) |
| fal_train_years | text | How many years of training do you have in total? |
| fal_exercise | radio | How often do you exercise per week? |
| fal_avg_sleep | text | Average sleep duration (Hours) |
| fal_last_sleep | text | How many hours did you sleep last night? |
| fal_preg | yesno | Is there a possibility of pregnancy? |
| fal_smoke | radio | Are you: |
| fal_smoke_year | text | If yes, duration of smoking in years: |
| fal_smoke_quantity | text | If yes, how many cigarettes per day? |
| fal_alc | yesno | Did you drink alcohol yesterday? |
| fal_alc_quant | text | If yes, quantity: |
| fal_alc_tod | yesno | Did you drink alcohol today? |
| fal_alc_tod_quant | text | If yes, quantity: |
| fal_tea | yesno | Do you drink tea, coffee, or cola? |
| fal_tea_quant | radio | If yes, quantity: |
| fal_drug | yesno | Do you or have you taken recreational drugs? (Besides alcohol and cigarettes) |
| fal_drug_cont | text | If yes, please list: |
| fal_ill | checkbox | Do you suffer from any of the following illnesses? |
| fal_ment_ill | text | If mental illness selected, which one(s)? |
| fal_ill_other | text | If 'Other' selected, please describe: |
| fal_med | yesno | Are you currently taking any medications (including non-prescription medications)? |
| fal_med_cont | text | If yes, which ones? |
| fal_eat | text | How many hours ago did you last eat? |
| fal_hear | yesno | Do you wear a hearing aid or cochlear implant / are you hard of hearing? |
| fal_hear_cont | text | If yes, please describe |
| fal_eye | radio | Is your eyesight impaired? |
| fal_study | yesno | Have you ever participated in a scientific study? |
| fal_study_part | text | If yes, date of last participation: |
| fal_which_study | text | If yes, which study? |
| fal_gait | yesno | Do you suffer from gait problems or have you ever had any before? |
| fal_kick | radio | If you were kicking a ball at a target, which leg would you kick the ball with? |
| fal_stand | radio | If you were asked to stand on one leg, which leg would you choose? |
| fal_treadmill | radio | How much experience do you have walking on an electric treadmill? |
becks_depression_inventory_ii¶
Beck's Depression Inventory II
RTG version of the BDI-II for depression screening.
Shape: 25 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| bdi_date | text | Date of Assessment |
| bdi_age | calc | Age at Assessment |
| bdi_add_info | notes | Additional Information |
| bdi_sad | radio | 1. Sadness |
| bdi_pessimism | radio | 2. Pessimism |
| bdi_past_failure | radio | 3. Past Failure |
| bdi_loss_of_pleasure | radio | 4. Loss of Pleasure |
| bdi_guilty | radio | 5. Guilty Feelings |
| bdi_punishment | radio | 6. Feelings of Punishment |
| bdi_self_dislike | radio | 7. Self-rejection |
| bdi_self_critical | radio | 8. Self Critique |
| bdi_suicide | radio | 9. Suicidality** |
| bdi_cry | radio | 10. Crying |
| bdi_restless | radio | 11. Restlessness |
| bdi_loss_interest | radio | 12. Loss of Interest |
| bdi_indecisive | radio | 13. Indecisiveness |
| bdi_worthless | radio | 14. Worthlessness |
| bdi_loss_energy | radio | 15. Loss of Energy |
| bdi_sleep | radio | 16. Changes in Sleep Pattern |
| bdi_irritability | radio | 17. Irritability |
| bdi_appetite | radio | 18. Changes in Appetite |
| bdi_concentration | radio | 19. Concentration Difficulty |
| bdi_fatigue | radio | 20. Fatigue |
| bdi_sex | radio | 21. Loss of sexual Interest |
| bdi_total | calc | Total Score |
stroke_telephone_interview¶
Stroke Telephone Interview
Phone-based assessment for stroke patients.
Shape: 37 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| stroke_int_date | text | Date of initial interview |
| stroke_int_examiner | text | Name of researcher calling |
| stroke_int_age | calc | 4. Age |
| stroke_int_manual_age | text | 4. Age |
| stroke_int_type | text | 5. What kind of stroke(s) did you have? |
| stroke_int_count | text | 6. How many strokes have you had in your life? |
| stroke_int_last_inc | text | 7. When was the last incident? |
| stroke_int_larm | text | 8. On a scale of 1 (no movement) to 10 (full movement), how much mobility do you have in your left arm? |
| stroke_int_rarm | text | 9. ... in your right arm? |
| stroke_int_notes | notes | Additional notes |
| stroke_int_date_2 | text | Date of second interview 2 |
| stroke_int_examiner_2 | text | Name of researcher calling |
| stroke_int_studies | text | Are you participating in other studies? |
| stroke_int_time | text | Time since last stroke |
| stroke_int_amount | text | 2. Have you experiences any more strokes since the first stroke? |
| stroke_int_symp | text | 3. What symptoms did you have during your stroke? |
| stroke_int_trig | text | 4. Were there specific triggers or risk factors for your stroke? |
| stroke_int_measures | text | 5. What medical measures were taken after your stroke? |
| stroke_int_delay | text | 6. How much time passed between the first symptoms of your stroke and your diagnosis? |
| stroke_int_change | text | 7. Has your lifestyle changed after the stroke? |
| stroke_int_qol | text | 8. How do you rate the quality of your life since the stroke? |
| stroke_int_adl | text | 9. Have you had problems performing activities of daily living since the stroke? |
| stroke_int_rehab | text | 10. Have you participated in a stroke rehabilitation program? |
| stroke_int_indir_symp | text | 11. What symptoms do you currently have that are directly or indirectly caused by your stroke? |
| stroke_int_health | text | 12. Are you currently taking active steps to improve your health? |
| stroke_int_full_para | text | 13. Is there complete paralysis on one side of the body? |
| stroke_int_part_para | text | 14. Is there partial paralysis on one side of the body? |
| stroke_int_rhand | text | 15. Right-handedness? |
| stroke_int_impair | text | 16. Is there impairment of hearing or vision which could prevent participation? |
| stroke_int_german | text | 17. Are you at a language level of a German native speaker? |
| stroke_int_disease | text | 18. Other neurological or psychiatric diseases (e.g. Multiple Sclerosis, Epilepsy, Schizophrenia, Depression)? |
| stroke_int_meds | text | 19. Medications (e.g. antidepressants, neuroleptics, pain medications, antihypertensive medications, blood thinners, hormone/metabolic medications)? |
| stroke_int_metal | text | 20. Metal in the body (e.g. pacemakers, artificial heart valves, clips, clamps, etc.)? |
| stroke_int_preg | text | 21. Are you pregnant? |
| stroke_int_worker | text | 22. Are you a metal worker or welder? |
| stroke_int_claus | text | 23. Are you claustrophobic? |
| stroke_int_notes_2 | text | Additional notes part 2 |
frageboden_grk_p10¶
Frageboden GRK P10
Research Training Group P10 questionnaire.
Shape: 14 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| grk_10_date | text | Date of MRI |
| grk_10_mri | text | MRI Number |
| grk_10_task_order | radio | Which task was first? |
| grk_10_mritime | text | Time of MRI |
| grk_10_ta | text | Name of Technical Assistant |
| grk_10_researcher | text | Name of Researcher |
| grk_10_q1 | yesno | 1. The task was clear |
| grk_10_q2 | yesno | 2. I could see everything and the buttons/pedals were easy to use |
| grk_10_q3 | yesno | 3. It was clear which condition (cognitive, motor, or combined) should be used |
| grk_10_q4 | yesno | 4. I sometimes mixed up the tasks and did the wrong task |
| grk_10_q5 | radio | 5. How difficult did you find the cognitive task? |
| grk_10_q6 | radio | 6. How difficult did you find the motor task? |
| grk_10_q7 | radio | 7. How difficult did you find the combined tasks? |
| grk_10_q8 | notes | Further Comments |
sf12¶
SF-12 Health Survey
Short-form health survey measuring quality of life.
Shape: 14 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| sf12_date | text | Date Completed |
| sf12_add_info | notes | Additional Information |
| sf12_health | radio | 1. How would you describe your state of health in general? |
| sf12_mod_task | radio | 2. Moderately difficult tasks (e.g. moving a table, vacuuming, bowling) |
| sf12_climb | radio | 3. Climbing several flights of stairs |
| sf12_diff_phys_less_accomp | yesno | 4. Have you had any difficulties at work due to your PHYSICAL health? |
| I accomplished less than I wanted | ||
| sf12_diff_certain | yesno | 5. Have you had any difficulties at work due to your PHYSICAL health? |
| I could only do certain things | ||
| sf12_diff_ment_accomp | yesno | 6. Have you had any difficulties at work due to your MENTAL health? |
| I accomplished less than I wanted | ||
| sf12_diff_ment_care | yesno | 7. Have you had any difficulties at work due to your MENTAL health? |
| I couldn't work as carefully as usual | ||
| sf12_pain | radio | 8. To what extent have you experiences pain in the past 4 weeks while carrying out your everyday activities at home or on the job? |
| sf12_calm | radio | 9. Calm and composed? |
| sf12_energy | radio | 10. Full of energy? |
| sf12_sad | radio | 11. Discouraged and sad? |
| sf12_contact | radio | 12. How often have your physical or mental health problems affected your contact with other people? |
jebsen_taylor_hand_function_test¶
Jebsen-Taylor Hand Function Test
Assessment of hand function for daily activities.
Shape: 37 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| jthft_examiner | text | Name of Examiner |
| jthft_dominant_hand_pref | radio | Dominant Hand |
| jthft_study_ind | calc | Study Indication |
| jthft_stroke_hand | radio | If applicable, which hand is impacted by stroke? |
| jthft_add_info | notes | Additional Information |
| jthft_test1_date | text | Date of Test 1 |
| jthft_pt_age_test1 | calc | Age at Test 1 |
| jthft_write_test1_nondom | text | 1. Writing (seconds) |
| jthft_card_test1_nondom | text | 2. Card turning (seconds) |
| jthft_common_test1_nondom | text | 3. Small Common Object (seconds) |
| jthft_feed_test1_nondom | text | 4. Simulated Feeding (seconds) |
| jthft_check_test1_nondom | text | 5. Checkers (seconds) |
| jthft_light_test1_nondom | text | 6. Large Light Object (seconds) |
| jthft_heavy_test1_nondom | text | 7. Large Heavy Object (seconds) |
| jthft_write_test1_dom | text | 1. Writing (seconds) |
| jthft_card_test1_dom | text | 2. Card turning (seconds) |
| jthft_common_test1_dom | text | 3. Small Common Object (seconds) |
| jthft_feed_test1_dom | text | 4. Simulated Feeding (seconds) |
| jthft_check_test1_dom | text | 5. Checkers (seconds) |
| jthft_light_test1_dom | text | 6. Large Light Object (seconds) |
| jthft_heavy_test1_dom | text | 7. Large Heavy Object (seconds) |
| jthft_test2_date | text | Date of Test 2 |
| jthft_pt_age_test2 | calc | Age at Test 2 |
| jthft_write_test2_nondom | text | 1. Writing (seconds) |
| jthft_card_test2_nondom | text | 2. Card turning (seconds) |
| jthft_common_test2_nondom | text | 3. Small Common Object (seconds) |
| jthft_feed_test2_nondom | text | 4. Simulated Feeding (seconds) |
| jthft_check_test2_nondom | text | 5. Checkers (seconds) |
| jthft_light_test2_nondom | text | 6. Large Light Object (seconds) |
| jthft_heavy_test2_nondom | text | 7. Large Heavy Object (seconds) |
| jthft_write_test2_dom | text | 1. Writing (seconds) |
| jthft_card_test2_dom | text | 2. Card turning (seconds) |
| jthft_common_test2_dom | text | 3. Small Common Object (seconds) |
| jthft_feed_test2_dom | text | 4. Simulated Feeding (seconds) |
| jthft_check_test2_dom | text | 5. Checkers (seconds) |
| jthft_light_test2_dom | text | 6. Large Light Object (seconds) |
| jthft_heavy_test2_dom | text | 7. Large Heavy Object (seconds) |
functional_gait_assessment¶
Functional Gait Assessment
Assessment of gait and balance abilities.
Shape: 15 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| fga_date | text | Date of Assessment |
| fga_age | calc | Age at Assessment |
| fga_examiner | text | Name of Examiner |
| fga_add_info | notes | Additional Information |
| fga_level | radio | 1. Gait Level Surface |
| fga_speed | radio | 2. Change in Speed |
| fga_horizon_head | radio | 3. Gait with Horizontal Head Turns |
| fga_vert_head | radio | 4. Gait with Vertical Head Turns |
| fga_pivot | radio | 5. Gait and Pivot Turn |
| fga_obstacle | radio | 6. Step Over Obstacle |
| fga_narrow | radio | 7. Gait with Narrow Base of Support |
| fga_eye_closed | radio | 8. Gait with Eyes Closed |
| fga_backward | radio | 9. Walking backwards |
| fga_stair | radio | 10. Stairs |
| fga_total_score | calc | Total Score |
tapm_divided_attention_dual_task¶
TAPM Divided Attention Dual Task
Test of attentional performance measuring divided attention.
Shape: 44 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| d3_date | text | Date of Assessment |
| d3_time | text | Time of Assessment |
| d3_age | calc | Age at Assessment |
| d3_examiner | text | Name of Examiner |
| d3_edu | dropdown | Education Level |
| d3_edu_other | text | If other, please specify |
| d3_norms | radio | Norms |
| d3_add_info | notes | Additional Information |
| d3_react_omit | text | Reaction time and omissions: |
| d3_bold | text | Bold: |
| d3_normal | text | Normal: |
| d3_mea1 | text | Mean |
| d3_mdn1 | text | Median |
| d3_mdt1 | text | T-Score |
| d3_std1 | text | Standard Deviation |
| d3_stt1 | text | T-Score |
| d3_cor1 | text | Correct |
| d3_err1 | text | Errors |
| d3_ert1 | text | T-Score |
| d3_omi1 | text | Omissions |
| d3_omt1 | text | T-Score |
| d3_lap1 | text | Outliers |
| d3_mea2 | text | Mean |
| d3_mdn2 | text | Median |
| d3_mdt2 | text | T-Score |
| d3_std2 | text | Standard Deviation |
| d3_stt2 | text | T-Score |
| d3_cor2 | text | Correct |
| d3_err2 | text | Errors |
| d3_ert2 | text | T-Score |
| d3_omi2 | text | Omissions |
| d3_omt2 | text | T-Score |
| d3_lap2 | text | Outliers |
| d3_mea0 | text | Mean |
| d3_mdn0 | text | Median |
| d3_mdt0 | text | T-Score |
| d3_std0 | text | Standard Deviation |
| d3_stt0 | text | T-Score |
| d3_cor0 | text | Correct |
| d3_err0 | text | Errors |
| d3_ert0 | text | T-Score |
| d3_omi0 | text | Omissions |
| d3_omt0 | text | T-Score |
| d3_lap0 | text | Outliers |
tapm_executive_control¶
TAPM Executive Control
Test of attentional performance measuring executive control.
Shape: 65 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| ec_date | text | Date of Assessment |
| ec_time | text | Time of Assessment |
| ec_age | calc | Age at Assessment |
| ec_examiner | text | Name of Examiner |
| ec_edu | dropdown | Education Level |
| ec_edu_other | text | If other, please specify |
| ec_norms | radio | Norms |
| ec_add_info | notes | Additional Information |
| ec_bold | text | Bold: |
| ec_normal | text | Normal: |
| ec_mea1 | text | Mean |
| ec_mdn1 | text | Median |
| ec_mdt1 | text | T-Score |
| ec_std1 | text | Standard Deviation |
| ec_stt1 | text | T-Score |
| ec_cor1 | text | Correct |
| ec_err1 | text | Errors |
| ec_ert1 | text | T-Score |
| ec_omi1 | text | Omissions |
| ec_omt1 | text | T-Score |
| ec_lap1 | text | Outliers |
| ec_mea2 | text | Mean |
| ec_mdn2 | text | Median |
| ec_mdt2 | text | T-Score |
| ec_std2 | text | Standard Deviation |
| ec_stt2 | text | T-Score |
| ec_cor2 | text | Correct |
| ec_err2 | text | Errors |
| ec_ert2 | text | T-Score |
| ec_omi2 | text | Omissions |
| ec_omt2 | text | T-Score |
| ec_lap2 | text | Outliers |
| ec_mea3 | text | Mean |
| ec_mdn3 | text | Median |
| ec_mdt3 | text | T-Score |
| ec_std3 | text | Standard Deviation |
| ec_stt3 | text | T-Score |
| ec_cor3 | text | Correct |
| ec_err3 | text | Errors |
| ec_ert3 | text | T-Score |
| ec_omi3 | text | Omissions |
| ec_omt3 | text | T-Score |
| ec_lap3 | text | Outliers |
| ec_mea4 | text | Mean |
| ec_mdn4 | text | Median |
| ec_mdt4 | text | T-Score |
| ec_std4 | text | Standard Deviation |
| ec_stt4 | text | T-Score |
| ec_cor4 | text | Correct |
| ec_err4 | text | Errors |
| ec_ert4 | text | T-Score |
| ec_omi4 | text | Omissions |
| ec_omt4 | text | T-Score |
| ec_lap4 | text | Outliers |
| ec_mea0 | text | Mean |
| ec_mdn0 | text | Median |
| ec_mdt0 | text | T-Score |
| ec_std0 | text | Standard Deviation |
| ec_stt0 | text | T-Score |
| ec_cor0 | text | Correct |
| ec_err0 | text | Errors |
| ec_ert0 | text | T-Score |
| ec_omi0 | text | Omissions |
| ec_omt0 | text | T-Score |
| ec_lap0 | text | Outliers |
tapm_gonogo¶
TAPM Go/No-Go
Test of attentional performance measuring response inhibition.
Shape: 21 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| g1_date | text | Date of Assessment |
| g1_time | text | Time of Assessment |
| g1_age | calc | Age at Assessment |
| g1_examiner | text | Name of Examiner |
| g1_edu | dropdown | Education Level |
| g1_edu_other | text | If other, please specify |
| g1_norms | radio | Norms |
| g1_add_info | notes | Additional Information |
| g1_bold | text | Bold: |
| g1_normal | text | Normal: |
| g1_mea0 | text | Mean |
| g1_mdn0 | text | Median |
| g1_mdt0 | text | T-Score |
| g1_std0 | text | Standard Deviation |
| g1_stt0 | text | T-Score |
| g1_cor0 | text | Correct |
| g1_err0 | text | Errors |
| g1_ert0 | text | T-Score |
| g1_omi0 | text | Omissions |
| g1_omt0 | text | T-Score |
| g1_lap0 | text | Outliers |
tapm_distractibility¶
TAPM Distractibility
Test of attentional performance measuring distractibility.
Shape: 43 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| dis_date | text | Date of Assessment |
| dis_time | text | Time of Assessment |
| dis_age | calc | Age at Assessment |
| dis_examiner | text | Name of Examiner |
| dis_edu | dropdown | Education Level |
| dis_edu_other | text | If other, please specify |
| dis_norms | radio | Norms |
| dis_add_info | notes | Additional Information |
| dis_bold | text | Bold: |
| dis_normal | text | Normal: |
| dis_mea1 | text | Mean |
| dis_mdn1 | text | Median |
| dis_mdt1 | text | T-Score |
| dis_std1 | text | Standard Deviation |
| dis_stt1 | text | T-Score |
| dis_cor1 | text | Correct |
| dis_err1 | text | Errors |
| dis_ert1 | text | T-Score |
| dis_omi1 | text | Omissions |
| dis_omt1 | text | T-Score |
| dis_lap1 | text | Outliers |
| dis_mea2 | text | Mean |
| dis_mdn2 | text | Median |
| dis_mdt2 | text | T-Score |
| dis_std2 | text | Standard Deviation |
| dis_stt2 | text | T-Score |
| dis_cor2 | text | Correct |
| dis_err2 | text | Errors |
| dis_ert2 | text | T-Score |
| dis_omi2 | text | Omissions |
| dis_omt2 | text | T-Score |
| dis_lap2 | text | Outliers |
| dis_mea0 | text | Mean |
| dis_mdn0 | text | Median |
| dis_mdt0 | text | T-Score |
| dis_std0 | text | Standard Deviation |
| dis_stt0 | text | T-Score |
| dis_cor0 | text | Correct |
| dis_err0 | text | Errors |
| dis_ert0 | text | T-Score |
| dis_omi0 | text | Omissions |
| dis_omt0 | text | T-Score |
| dis_lap0 | text | Outliers |
moca¶
Montreal Cognitive Assessment (RTG version)
RTG-specific version of the MoCA cognitive screening.
Shape: 49 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| moca_date | text | Date of Asessment |
| moca_age | calc | Age |
| moca_examiner | text | Name of Examiner |
| moca_edu | text | Years of education |
| moca_version | radio | Which version of the MoCA was administered? |
| moca_administer | yesno | Was any part of the MoCA administered? |
| moca_lang | radio | Language of MoCA administration: |
| moca_lang_ex | text | Specify language of MoCA administration: |
| moca_add_info | notes | Additional Information |
| moca_visuo_trails | dropdown | Visuospatial/Executive - Trails: |
| moca_visuo_cube | dropdown | Visuospatial/Executive - Cube: |
| moca_visuo_contour | dropdown | Visuospatial/Executive - Clock contour: |
| moca_visuo_numbers | dropdown | Visuospatial/Executive - Clock numbers: |
| moca_visuo_hands | dropdown | Visuospatial/executive - Clock hands: |
| moca_visuo_total | calc | MoCA Visuospatial Sum |
| moca_mem_lion | dropdown | Naming - Lion/Snake/Horse: |
| moca_mem_rhino | dropdown | Naming - Rhino/Elephant/Tiger: |
| moca_mem_camel | dropdown | Naming - Camel/Alligator/Duck: |
| moca_name_total | calc | MoCA Naming Sum |
| moca_word1_body | dropdown | Words 1 - Face/Hand/Leg |
| moca_word1_fabric | dropdown | Words 1 - Velvet/Nylon/Cotton |
| moca_word1_place | dropdown | Words 1 - Church/Park/School |
| moca_word1_plant | dropdown | Words 1 - Tulip/Carrot/Tomato |
| moca_word1_color | dropdown | Words 1 - Red/Yellow/White |
| moca_word1_total | calc | Memory Words 1 Total |
| moca_word2_body | dropdown | Words 2 - Face/Hand/Leg |
| moca_word2_fabric | dropdown | Words 2 - Velvet/Nylon/Cotton |
| moca_word2_place | dropdown | Words 2 - Church/Park/School |
| moca_word2_plant | dropdown | Words 2 - Tulip/Carrot/Tomato |
| moca_word2_color | dropdown | Words 2 - Red/Yellow/White |
| moca_word2_total | calc | Words 2 Total |
| moca_digits | dropdown | Attention - Digits: |
| moca_letter_a | dropdown | Attention - Letter A: |
| moca_serial7s | dropdown | Attention - Serial 7s: |
| moca_repetition | dropdown | Language - Repetition: |
| moca_fluency | dropdown | Language - Fluency: |
| moca_abstraction | dropdown | Abstraction: |
| moca_nocue | dropdown | Delayed recall - No cue: |
| moca_category | dropdown | Delayed recall - Category cue: |
| moca_recognition | dropdown | Delayed recall - Recognition: |
| moca_recall_total | calc | Delayed Recall Total |
| moca_orient_date | dropdown | Orientation - Date: |
| moca_orient_month | dropdown | Orientation - Month: |
| moca_orient_year | dropdown | Orientation - Year: |
| moca_orient_day | dropdown | Orientation - Day: |
| moca_orient_place | dropdown | Orientation - Place: |
| moca_orient_city | dropdown | Orientation - City: |
| moca_raw | calc | MoCA Sum |
| moca_zscore | text | MoCA Z-score: |
aachener_aphasia_test¶
Aachener Aphasia Test
Assessment for language disorders (aphasia).
Shape: 27 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| aat_date | text | Date of Assessment |
| aat_age | calc | Age at Assessment |
| aat_examiner | text | Name of Examiner |
| aat_edu | dropdown | Education Level |
| aat_edu_other | text | If other, please specify |
| aat_add_info | notes | Additional Information |
| aat_tt_feas | dropdown | Exercise Examples: |
| aat_tt_pt1_total | text | Part 1. Total Errors |
| aat_tt_pt1_notes | notes | Part 1. Which directions/questions had errors? |
| aat_tt_pt2_total | text | Part 2. Total Errors |
| aat_tt_pt2_notes | notes | Part 2. Which directions/questions had errors? |
| aat_tt_pt3_total | text | Part 3. Total Errors |
| aat_tt_pt3_notes | notes | Part 3. Which directions/questions had errors? |
| aat_tt_pt4_total | text | Part 4. Total Errors |
| aat_tt_pt4_notes | notes | Part 4. Which directions/questions had errors? |
| aat_tt_pt5_total | text | Part 5. Total Errors |
| aat_tt_pt5_notes | notes | Part 5. Which directions/questions had errors? |
| aat_tt_corrected | calc | Age Corrected Error Points (Part 1-5) |
| aat_tt_total | calc | Token Test Total Error Points |
| aat_wl_read_total | text | 1. Read Aloud Total |
| aat_wl_assign_total | text | 2. Assign according to dictation |
| aat_wl_letter_feas | dropdown | 2. Assign Letters/Words |
| aat_wl_examp2_feas | dropdown | 2. Exercise example: A/L/T |
| aat_wl_write_total | text | 3. Write according to dictation |
| aat_wl_examp3_feas | dropdown | 3. Exercise example |
| aat_wl_total | calc | Total points from Written Language: Parts 1 - 3 |
| aat_wl_write_long | notes | 3. Writing from Dictation (write participant's response) |
modified_ashworth_scale¶
Modified Ashworth Scale
Scale for measuring muscle spasticity.
Shape: 7 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| mas_date | text | Date of Assessment |
| mas_age | calc | Age at Assessment |
| mas_examiner | text | Name of Examiner |
| mas_edu | dropdown | Education Level |
| mas_edu_other | text | If other, please specify |
| mas_add_info | notes | Additional Information |
| mas_evaluation | dropdown | 0, No increased tone |
| 1, Slight increase in tone recognizable by a tch and release or minimal resistance at the end of the range of motion when the affected limb is moved in flexion or extension | ||
| 1+, Slight increase in tone recognizable by a catch followed by minimal resistance through the rest of the range of motion (less than half) | ||
| 2, More pronounced increase in tone through most of the range of motion, but the affected limb is easily mobile | ||
| 3, Significant increase in muscle tone, passive movement is difficult | ||
| 4, Affected limb is rigid in flexion or extension |
upper_extremity_fuglmeyer_assessment¶
Upper Extremity Fugl-Meyer Assessment
Assessment of motor function in the upper extremity post-stroke.
Shape: 74 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| mfma_date | text | Date of Assessment |
| mfma_age | calc | Age at Assessment |
| mfma_examiner | text | Name of Examiner |
| mfma_edu | dropdown | Education Level |
| mfma_edu_other | text | If other, please specify |
| mfma_add_info | notes | Additional Information |
| mfma_a1_no_fsr | radio | Flexor: Shoulder: Retraction |
| mfma_a1_no_fse | radio | Flexor: Shoulder: Elevation |
| mfma_a1_no_fsa | radio | Flexor: Shoulder: Adduction |
| mfma_a1_no_fser | radio | Flexor: Shoulder: External Rotation |
| mfma_a1_no_fef | radio | Flexor: Elbow: Flexion |
| mfma_a1_no_ffs | radio | Flexor: Forearm: Supination |
| mfma_a1_no_esa | radio | Extensor: Shoulder: Adduction |
| mfma_a1_no_eee | radio | Extensor: Elbow: Extension |
| mfma_a1_no_efp | radio | Extensor: Forearm: Pronation |
| mfma_a1_no_subtotal | calc | AI. Less/not impaired subtotal |
| mfma_a2_no_1 | radio | 1. Hand to the lower lumbar spine |
| mfma_a2_no_2 | radio | 2. Shoulder flexion 0° - 90° |
| mfma_a2_no_3 | radio | 3. Pronation-supination |
| mfma_a2_no_subtotal | calc | AII. Less/not impaired subtotal |
| mfma_a3_no_4 | radio | 4. Shoulder adduction 0 - 90° |
| mfma_a3_no_5 | radio | 5. Shoulder flexion 90 - 180° |
| mfma_a3_no_6 | radio | 6. Pronation/supination |
| mfma_a3_no_subtotal | calc | AIII. Less/not impaired subtotal |
| mfma_a1_imp_fsr | radio | Flexor: Shoulder: Retraction |
| mfma_a1_imp_fse | radio | Flexor: Shoulder: Elevation |
| mfma_a1_imp_fsa | radio | Flexor: Shoulder: Adduction |
| mfma_a1_imp_fser | radio | Flexor: Shoulder: External Rotation |
| mfma_a1_imp_fef | radio | Flexor: Elbow: Flexion |
| mfma_a1_imp_ffs | radio | Flexor: Forearm: Supination |
| mfma_a1_imp_esa | radio | Extensor: Shoulder: Adduction |
| mfma_a1_imp_eee | radio | Extensor: Elbow: Extension |
| mfma_a1_imp_efp | radio | Extensor: Forearm: Pronation |
| mfma_a1_imp_subtotal | calc | AI. Impaired subtotal |
| mfma_a2_imp_1 | radio | 1. Hand to the lower lumbar spine |
| mfma_a2_imp_2 | radio | 2. Shoulder flexion 0° - 90° |
| mfma_a2_imp_3 | radio | 3. Pronation-supination |
| mfma_a2_imp_subtotal | calc | AII. Impaired subtotal |
| mfma_a3_imp_4 | radio | 4. Shoulder adduction 0 - 90° |
| mfma_a3_imp_5 | radio | 5. Shoulder flexion 90 - 180° |
| mfma_a3_imp_6 | radio | 6. Pronation/supination |
| mfma_a3_imp_subtotal | calc | AIII. Impaired subtotal |
| mfma_a_no_total | calc | A. Less/not impaired total |
| mfma_a_imp_total | calc | A. Impaired total |
| mfma_b_no_7 | radio | 7. Stability at 15° dorsiflexion: elbow at 90° |
| mfma_b_no_8 | radio | 8. Repeated dorsiflexion/voluntary flexion: elbow at 90° |
| mfma_b_no_9 | radio | 9. Stability at 15° dorsiflexion: elbow at 0° |
| mfma_b_no_10 | radio | 10. Repeated dorsiflexion/voluntary flexion: elbow at 0° |
| mfma_b_no_11 | radio | 11. Circumduction |
| mfma_b_imp_7 | radio | 7. Stability at 15° dorsiflexion: elbow at 90° |
| mfma_b_imp_8 | radio | 8. Repeated dorsiflexion/voluntary flexion: elbow at 90° |
| mfma_b_imp_9 | radio | 9. Stability at 15° dorsiflexion: elbow at 0° |
| mfma_b_imp_10 | radio | 10. Repeated dorsiflexion/voluntary flexion: elbow at 0° |
| mfma_b_imp_11 | radio | 11. Circumduction |
| mfma_b_no_total | calc | B. Less/not impaired total |
| mfma_b_imp_total | calc | B. Impaired total |
| mfma_c_no_12 | radio | 12. Mass diffraction |
| mfma_c_no_13 | radio | 13. Mass extension |
| mfma_c_no_14 | radio | 14. Hook handle |
| mfma_c_no_15 | radio | 15. Thumb adduction |
| mfma_c_no_16 | radio | 16. Scissor grip, opposition |
| mfma_c_no_17 | radio | 17. Cylinder handle |
| mfma_c_no_18 | radio | 18. Spherical handle |
| mfma_c_imp_12 | radio | 12. Mass diffraction |
| mfma_c_imp_13 | radio | 13. Mass extension |
| mfma_c_imp_14 | radio | 14. Hook handle |
| mfma_c_imp_15 | radio | 15. Thumb adduction |
| mfma_c_imp_16 | radio | 16. Scissor grip, opposition |
| mfma_c_imp_17 | radio | 17. Cylinder handle |
| mfma_c_imp_18 | radio | 18. Spherical handle |
| mfma_c_no_total | calc | C. Less/not impaired total |
| mfma_c_imp_total | calc | C. Impaired total |
| mfma_no_total | calc | Less/not impaired total score |
| mfma_imp_total | calc | Impaired total score |
action_research_arm_test¶
Action Research Arm Test
Assessment of upper limb function.
Shape: 54 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| arat_date | text | Date of Assessment |
| arat_age | calc | Age at Assessment |
| arat_examiner | text | Name of Examiner |
| arat_edu | dropdown | Education Level |
| arat_edu_other | text | If other, please specify |
| arat_add_info | notes | Additional Information |
| arat_grasp_left_block10 | radio | 1. Block, 10 cm2 |
| arat_grasp_left_block25 | radio | 2. Block, 2.5cm2 |
| arat_grasp_left_block5 | radio | 3. Block, 5cm2 |
| arat_grasp_left_block75 | radio | 4. Block, 7.5cm2 |
| arat_grasp_left_ball75 | radio | 5. Wooden ball, 7.5cm & 2 lids |
| arat_grasp_left_stone | radio | 6. Stone block, 10x2.5x1cm |
| arat_grasp_left_total | calc | Grasp- Left Side Total |
| arat_grip_left_glass | radio | 7. Water from glass to glass |
| arat_grip_left_thick | radio | 8. Thick tube from rod to rod |
| arat_grip_left_narrow | radio | 9. Narrow tube from rod to rod |
| arat_grip_left_disk | radio | 10. Disk from box to bar |
| arat_grip_left_total | calc | Grip- Left Side Total |
| arat_pinch_left_ball_ring | radio | 11. Ball, thumb and ring finger |
| arat_pinch_left_marble_index | radio | 12. Marble, thumb and index finger |
| arat_pinch_left_ball_middle | radio | 13. Ball, thumb and middle finger |
| arat_pinch_left_ball_index | radio | 14. Ball, thumb and index finger |
| arat_pinch_left_marble_ring | radio | 15. Marble, thumb and ring finger |
| arat_pinch_left_marble_middle | radio | 16. Marble, thumb and middle finger |
| arat_pinch_left_total | calc | Pinch- Left Side Total |
| arat_gross_left_back | radio | 17. Hand to back of head, then lap |
| arat_gross_left_head | radio | 18. Hand on head, then lap |
| arat_gross_left_mouth | radio | 19. Hand to mouth, then lap |
| arat_gross_left_total | calc | Gross Movement- Left Side Total |
| arat_grasp_right_block10 | radio | 1. Block, 10 cm2 |
| arat_grasp_right_block25 | radio | 2. Block, 2.5cm2 |
| arat_grasp_right_block5 | radio | 3. Block, 5cm2 |
| arat_grasp_right_block75 | radio | 4. Block, 7.5cm2 |
| arat_grasp_right_ball75 | radio | 5. Wooden ball, 7.5cm & 2 lids |
| arat_grasp_right_stone | radio | 6. Stone block, 10x2.5x1cm |
| arat_grasp_right_total | calc | Grasp- Right Side Total |
| arat_grip_right_glass | radio | 7. Water from glass to glass |
| arat_grip_right_thick | radio | 8. Thick tube from rod to rod |
| arat_grip_right_narrow | radio | 9. Narrow tube from rod to rod |
| arat_grip_right_disk | radio | 10. Disk from box to bar |
| arat_grip_right_total | calc | Grip- Right Side Total |
| arat_pinch_right_ball_ring | radio | 11. Ball, thumb and ring finger |
| arat_pinch_right_marble_index | radio | 12. Marble, thumb and index finger |
| arat_pinch_right_ball_middle | radio | 13. Ball, thumb and middle finger |
| arat_pinch_right_ball_index | radio | 14. Ball, thumb and index finger |
| arat_pinch_right_marble_ring | radio | 15. Marble, thumb and ring finger |
| arat_pinch_right_marble_middle | radio | 16. Marble, thumb and middle finger |
| arat_pinch_right_total | calc | Pinch- Right Side Total |
| arat_gross_right_back | radio | 17. Hand to back of head, then lap |
| arat_gross_right_head | radio | 18. Hand on head, then lap |
| arat_gross_right_mouth | radio | 19. Hand to mouth, then lap |
| arat_gross_right_total | calc | Gross Movement- Right Side Total |
| arat_left_total | calc | LEFT Side Total |
| arat_right_total | calc | RIGHT Side Total |
modified_frenchay_scale¶
Modified Frenchay Scale
Assessment of arm function in daily activities.
Shape: 17 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| mfs_date | text | Date of Assessment |
| mfs_age | calc | Age at Assessment |
| mfs_examiner | text | Name of Examiner |
| mfs_edu | dropdown | Education Level |
| mfs_edu_other | text | If other, please specify |
| mfs_add_info | notes | Additional Information |
| mfs_jar | radio | 1. Open and close the jam jar with both hands. Your impaired hand holds the jar. |
| mfs_big_bot | radio | 2. Reach for the large bottle with your impaired hand, lift it up and put it back down again. |
| mfs_smal_bot | radio | 3. Reach for the small bottle with your impaired hand, lift it up and put it back down again. |
| mfs_glass | radio | 4. Reach for the glass with your impaired hand, lift it, bring it to your mouth and put it back again. |
| mfs_ruler | radio | 5. Draw a straight line with the ruler and pencil. Use both hands, but hold the ruler firmly with your impaired hand. |
| mfs_pins | radio | 6. Clamp three clothespins to the notepad. Use both hands, but attach the clothespins with your impaired hand. |
| mfs_comb | radio | 7. Reach for the comb with your impaired hand, lift it up and simulate the movement of combing your hair. |
| mfs_teeth | radio | 8. Apply some toothpaste to the toothbrush. Use both hands, but hold and squeeze the toothpaste tube with your impaired hand. |
| mfs_fork | radio | 9. Grasp the cutlery with both hands and simulate a cutting movement. Your impaired hand holds the fork. |
| mfs_broom | radio | 10. Sweep the floor with the broom. Use both hands. |
| mfs_total | calc | Total Score |
stroke_impact_scale¶
Stroke Impact Scale
Comprehensive measure of stroke outcomes and quality of life.
Shape: 74 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| sis_date | text | Date of Assessment |
| sis_age | calc | Age at Assessment |
| sis_examiner | text | Name of Examiner |
| sis_edu | dropdown | Education Level |
| sis_edu_other | text | If other, please specify |
| sis_add_info | notes | Additional Information |
| sis_str_arm | radio | 1a. arm? |
| sis_str_grip | radio | 1b. grip of your hand? |
| sis_str_leg | radio | 1c. leg? |
| sis_str_foot | radio | 1d. foot/ankle? |
| sis_str_total | calc | Part 1 Total |
| sis_memory_things | radio | 2a. remember things that people just told you? |
| sis_memory_yesterday | radio | 2b. remember things that happened the day before? |
| sis_memory_dothings | radio | 2c. remember to do things (e.g., keep scheduled appointments or take medication)? |
| sis_memory_day | radio | 2d. remember the day of the week? |
| sis_concentrate | radio | 2e. concentrate? |
| sis_think | radio | 2f. think quickly? |
| sis_problems | radio | 2g. solve everyday problems? |
| sis_memory_total | calc | Part 2 Total |
| sis_mood_sad | radio | 3a. feel sad? |
| sis_mood_isolate | radio | 3b. feel that there is nobody you are close to? |
| sis_mood_burden | radio | 3c. that you are a burden to others? |
| sis_mood_hopeless | radio | 3d. that you have nothing to look forward to? |
| sis_mood_blame | radio | 3e. blame yourself for mistakes that you made? |
| sis_mood_joy | radio | 3f. enjoy things as much as ever? |
| sis_mood_nervous | radio | 3g. feel quite nervous? |
| sis_mood_live | radio | 3h. feel that life is worth living? |
| sis_mood_laugh | radio | 3i. smile and laugh at least once a day? |
| sis_mood_total | calc | Part 3 Total |
| sis_comm_name | radio | 4a. say the name of someone who was in front of you? |
| sis_comm_understand | radio | 4b. understand what was being said to you in a conversation? |
| sis_comm_reply | radio | 4c. reply to questions? |
| sis_comm_name_obj | radio | 4d. correctly name objects? |
| sis_comm_convo | radio | 4e. participate in a conversation with a group of people? |
| sis_comm_convo_phone | radio | 4f. have a conversation on the telephone? |
| sis_comm_call | radio | 4g. call another person on the telephone, including selecting the correct phone number and dialing? |
| sis_comm_total | calc | Part 4 Total |
| sis_typ_cut | radio | 5a. cut your food with a knife and fork? |
| sis_typ_dress | radio | 5b. dress the top part of your body? |
| sis_typ_bathe | radio | 5c. bathe yourself? |
| sis_typ_clip | radio | 5d. clip your toenails? |
| sis_typ_toilet | radio | 5e. get to the toilet on time? |
| sis_typ_bladder | radio | 5f. control your bladder (not have an accident)? |
| sis_typ_bowels | radio | 5g. control your bowels (not have an accident)? |
| sis_typ_tasks | radio | 5h. do light household tasks/chores (e.g., dust, make a bed, take out garbage, do the dishes)? |
| sis_typ_shop | radio | 5i. go shopping? |
| sis_typ_chores | radio | 5j. do heavy household chores (e.g., vacuum, laundry or yard work)? |
| sis_typ_total | calc | Part 5 Total |
| sis_mob_sit | radio | 6a. stay sitting without losing your balance? |
| sis_mob_stand | radio | 6b. stay standing without losing your balance? |
| sis_mob_walk | radio | 6c. walk without losing your balance? |
| sis_mob_bed | radio | 6d. move from a bed to a chair? |
| sis_mob_walk_short | radio | 6e. walk one block? |
| sis_mob_walk_fast | radio | 6f. walk fast? |
| sis_mob_stair_short | radio | 6g. climb one flight of stairs? |
| sis_mob_manystairs | radio | 6h. climb several flights of stairs? |
| sis_mob_car | radio | 6i. get in and out of a car? |
| sis_mob_total | calc | Part 6 Total |
| sis_hand_carry | radio | 7a. carry heavy objects (e.g., bag of groceries)? |
| sis_hand_doorknob | radio | 7b. turn a doorknob? |
| sis_hand_jar | radio | 7c. open a can or jar? |
| sis_hand_shoes | radio | 7d. tie a shoe lace? |
| sis_hand_dime | radio | 7e. pick up a dime? |
| sis_hand_total | calc | Part 7 Total |
| sis_lim_work | radio | 8a. in your work (paid, voluntary or other)? |
| sis_lim_social | radio | 8b. in your social activities? |
| sis_lim_recreation | radio | 8c. in quiet recreation (crafts, reading)? |
| sis_lim_active | radio | 8d. in active recreation (sports, outings, travel)? |
| sis_lim_role | radio | 8e. in your role as a family member and/or friend? |
| sis_lim_relig | radio | 8f. in your participation in spiritual or religious activities? |
| sis_lim_control | radio | 8g. in your ability to control your life as you wish? |
| sis_lim_help | radio | 8h. in your ability to help others? |
| sis_lim_total | calc | Part 8 Total |
| sis_stroke_recovery | text | 9. On a scale of 0 to 100, with 100 representing full recovery and 0 representing no recovery, how much have you recovered from your stroke? |
nasatlx¶
NASA Task Load Index
Subjective workload assessment tool.
Shape: 13 fields × 18 columns
| field_name | field_type | field_label |
|---|---|---|
| nasatlx_date | text | Date of Assessment |
| nasatlx_age | calc | Age at Assessment |
| nasatlx_examiner | text | Name of Examiner |
| nasatlx_edu | dropdown | Education Level |
| nasatlx_edu_other | text | If other, please specify |
| nasatlx_add_info | notes | Additional Information |
| nasatlx_intellect | slider | 1. Intellectual requirements |
| nasatlx_physical | slider | 2. Physical requirements |
| nasatlx_time | slider | 3. Time requirements |
| nasatlx_performance | slider | 4. Performance |
| nasatlx_effort | slider | 5. Effort |
| nasatlx_frustration | slider | 6. Frustration |
| nasatlx_requir_total | calc | Requirement total (intellectual, time, physical) |