Date [year_month_day]
[01.01] Assessment - CTCAE Rating
[01.02] When did the AE first occur?
The AE occurred for the first time
The AE existed before the activity and worsened
Don't know
[01.03] Assessment - Do you believe the AE is associated with the sport?
[02.02] Basics - What was the AE?
Pain
Nausea/vomiting
Superficial injuries
Circulatory problems
Bone injuries
Severe exhaustion
Coughing attack
Enuresis
Itching
Psychological stress reaction
Nosebleed
Soft tissue injury
Muscle soreness.
Other
[02.02] Basics - Other AE
[02.03] Basics - What caused the AE?
Tripping, slipping, falling
Physical exertion
Mental strain
Environmental conditions
Medical treatment
Coordination problems
Bump, jostle.
Other
[02.03] Basics - Other causes
[06.01] Basics - Detailed description of the occurrence, the trigger, and the nature of the AE.
[03.01] Consequences - Did pain occur?
[03.01.01] Consequences - Pain scale
[03.01.02] Consequences - How long did the pain last?
Pain on the same day
Pain until the next day
Pain lasting at least 3 days
Don't know
[03.02] Consequences - Did hospitalization or an extension of a hospital stay occur?
[03.02.01] Consequences - How soon after the AE was it decided to seek or extend hospitalization?
Within the first 30 minutes
Within the first 24 hours
After 24 hours
Don't know
[03.02.02] Consequences - How long did the (extended) hospitalization last?
At least 1 day
At least 3 days
At least 7 days
Don't know
[03.03] Consequences - Did medical follow-up care occur?
[03.03.01] Consequences - What did the medical follow-up care involve?
Manual examination
Invasive examination
Oral medication
Intravenous medication
Surgery
R.I.C.E. protocol
Observation
Life-saving intervention
Desinfection
Bandage, plaster
Cream and ointment
Massage
Other
Don't know
[03.03.01] Other: Consequences - What did the medical follow-up care involve?
[03.03.02] Consequences - When did the medical follow-up care take place after the AE?
Within the first 24 hours
Within the first week
After the first week
Don't know
[03.04] Consequences - Was there a significant delay in adhering to the medical treatment protocol?
[03.04.01] Other:Consequences - How was the treatment protocol delayed?
[03.04.02] Consequences - How long was the treatment protocol delayed?
Up to 24 hours
Up to 3 days
Up to 7 days
More than 7 days
Don't know
[03.05] Consequences - Were life-saving interventions (e.g., ventilation, CPR) necessary?
[03.05.01] Consequences - What life-saving interventions were carried out?
Cardiopulmonary resuscitation
Defibrillation
Emergency medications (e.g., adrenaline, nitroglycerin)
Blood transfusion(s)
Emergency surgery (e.g., trauma surgery)
Ventilation/oxygen therapy
Other
Don't know
[03.05.01] Other: Consequences - What life-saving interventions were carried out?
[03.05.01] Consequences - How often was the life-saving intervention repeated?
Once
Up to 5 times
More than 10 times
Don't know
[03.06] Consequences - Was there an increased need for care?
[03.06.01] Consequences - In which areas was the increased care required?
Mobility (e.g., assistance with dressing and movement, wheelchair use) Personal hygiene (e.g., help with washing, brushing teeth, dressing) Medical care (e.g., therapies and medication) Nutrition (e.g., tube feeding, special diets) Psychosocial support (e.g., emotional support, behavioral interventions) Other
[03.06.01] Other: Consequences - In which areas was the increased care required?
[03.06.02] Consequences - How long did the increased need for care last?
Up to 3 hours
Up to 24 hours
Up to 48 hours
Over 2 days
Over 1 week
Don't know
[03.07] Consequences - Were medications administered?
[03.07.01] Other: Consequences - What medications were administered?
[03.07.02] Consequences - How long were these medications administered?
Only once
Up to 3 days
Up to 7 days
Longer than 7 days
Don't know
[03.08] Consequences - Did anxiety or uncertainty arise?
[03.08.02] Consequences - How long did anxiety or uncertainty influence the situation?
Only on the same day
Until the end of the week
Until the end of the month
No longer
[03.09] Consequences - Were structural adjustments made?
[03.09.01] Other: Consequences - What structural adjustments were made?
[03.09.02] Consequences - How long did the structural adjustments last?
Only on the same day
Until the end of the week
Until the end of the month
No longer
[03.10] Consequences - Was the situation reviewed by an expert?
[03.10.01] Other: Consequences - Who reviewed the situation?
[03.10.02] Consequences - Was approval given to proceed?
[03.11] Consequences - Was the R.I.C.E. protocol applied?
[03.11.02] Consequences - How long was the R.I.C.E. protocol applied?
Up to 3 hours
Up to 24 hours
Up to 7 days
More than 7 days
Don't know
[03.12] Consequences - Was the child observed after the AE?
[03.12.01] Other: Consequences - How was the observation carried out?
[03.12.02] Consequences - How long was the child observed?
Up to 3 hours
Up to 24 hours
Up to 7 days
More than 7 days
Don't know
[03.13] Consequences - Was the exercise session stopped?
[03.13.01] Consequences - How was the session stopped?
[03.13.02] Consequences - How long was the pause?
Up to 1 minute
Up to 5 minutes
More than to 10 minutes
[03.14] Consequences - Was the content of the exercise session changed or adapted?
[03.14.02] Consequences - How long was the adaptation applied?
Only for this session
For the entire therapy phase
From now on, for all exercise sessions with all patients
[03.15] Consequences - Was active comforting provided?
[03.15.01] Consequences - Was the approach to handling the AE purely pedagogical?
[03.15.02] Consequences - How long was the comforting provided?
Up to 1 minute
Up to 10 minutes
More than 10 minutes
[03.16] Consequences - Did the AE result in death?
[03.17] Consequences - Are there any other relevant consequences?
[03] Consequences - comment
[05.01] Context - In which phase of therapy did the AE occur?
Acute therapy
Long-term therapy
Aftercare
Don't know
[05.02] Context - What was the group size during the exercise session in which the AE occurred?
Individual
Group of 2 to 5 participants
Group of 5 to 10 participants
Group of over 10 participants
[05.03] Context - How old was the affected individual at the time of the AE?
2 to 5 years
6 to 9 years
10 to 14 years
15 to 18 years
18+ years
[05.04] Context - Did the exercise program take place online?
[05.05] Context - Did the AE occur during a sports test?
[05.06] Context - In which setting did the AE occur?
Outdoors
Hospital corridor
Patient room
Swimming pool
Gym/sports room
At home
Other
[05.06] Other: Context - In which setting did the AE occur?
[05.07] Context - Which primary motor form dominated the exercise session?
Coordination
Endurance
Strength
Flexibility
Full body
Speed
Relaxation
[05.07] Other: Context - Which primary motor form dominated the exercise session?
[05.08] Context - During which phase of the planned exercise session did the AE occur?
1st half
2nd half
Don't know
[05.09] Context - What was the fitness level of the affected individual when the AE occurred?
1 Good
2 Average
3 Poor
4 Don't know
[06.11] Context - comment
[07.01] Report - At which NAOK location did the AE occur?
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