Tinetti Balance Test Calculator

How does this Tinetti balance test calculator work?

This health tool assesses static and dynamic balance in a two section clinical evaluation. This version is named after the person devising it, Mary Tinetti. The test is also known in clinical trials as the Performance Oriented Mobility Assessment (POMA) and other times used as Tinetti’s Mobility Test.

While the two sections are designed to be working together, they can also be used separately as they target different functionalities. It can also be used in addition to other balance or mobility tools such as the Berg balance scale. The Elderly mobility scale offers similar evaluation but focuses on interpreting the results in association with activities of daily living instead of falling risk.

The Tinetti balance test calculator provides a quick result interpretation while the performing of the test usually takes about 10 to 15 minutes.

Compared to other fall risk predictors, such as the Up and Go test (TUG), it established better test-retest and discriminative validity.

The instruction for the balance section has the subject seated in a hard, armless chair while the instruction for the gain assessment has the subject stand by the examiner and then walk across the room or down the hallway, first at a “usual pace” then back at a more rapid pace. In case the subject requires it, they will be allowed walking assistance.

Most of the research studies around this balance test have been performed on older populations but also on subjects suffering from the following conditions:

■ Amyotrophic Lateral Sclerosis;

■ Normal Pressure Hydrocephalus;

■ Parkinson's Disease;

■ Stroke.

Tinetti test score interpretation

There are 9 items in the balance section and 8 items in the gait section of the Tinetti test. Most items comprise of answers weighed on an ordinal scale from 0 to 2 while others comprise of answers weighed 0 and 1, depending on the severity of the impairment (0 points) and the ability to perform said tasks independently (2 points).

The maximum score attainable in the balance section is 16 while in the gait section the max score is 12. Therefore the highest score possible in the Tinetti balance test is 28, usually consistent with best functional independence. The results are contained in three ranges:

■ Scores equal to or less than 18 – consistent with high fall risk;

■ Scores between 19 and 23 – consistent with moderate fall risk;

■ Scores of 24 and above – consistent with low fall risk.

There are some other interpretation recommendations beside the overall test result, as follows:

■ The subject rising from the chair in stages might indicate problems with proprioception or cerebellar areas of balance.

■ Examples of abnormalities during walking include abnormal knee extension, high stepping, toe dragging or a shuffling gait.

■ The subject being unable to perform sitting down and falling in the chair after the tasks might indicate poor knee or hip flexion.

References

1) Tinetti ME, Williams TF, Mayewski R. (1986) Fall risk index for elderly patients based on number of chronic disabilities. Am J Med; 80(3):429-34.

2) Mancini M, Horak FB. (2010) The relevance of clinical balance assessment tools to differentiate balance deficits. Eur J Phys Rehabil Med; 46(2): 239–248.

3) Kopke S, Meyer G. (2006) The Tinetti test, Babylon in geriatric assessment. Z Gerontol Geriat 39:288–291

4) Lin MR, Hwang HF, Hu MH, Wu HD, Wang YW, Huang FC. (2004) Psychometric comparisons of the timed up and go, one-leg stand, functional reach, and Tinetti balance measures in community-dwelling older people. J Am Geriatr Soc; 52(8):1343-8.

5) Mitchell KD, Newton RA. (2006) Performance-oriented mobility assessment (POMA) balance score indicates need for assistive device. Disabil Rehabil Assist Technol; 1(3):183-9.