Tinetti Balance and Gait Assessment
Assess fall risk using the Tinetti Balance and Gait Assessment
For healthcare professional use only. This assessment should be administered by trained clinical staff. Not a substitute for comprehensive medical evaluation.
Table of Contents
How to Use
- Conduct the balance assessment (9 items)
- Conduct the gait assessment (7 items)
- Score each item from 0-4 based on performance
- Click calculate to see total score and fall risk level
What is the Tinetti Assessment?
The Tinetti Performance-Oriented Mobility Assessment (POMA) is a standardized clinical assessment tool used to evaluate balance and gait in elderly individuals. Developed by Dr. Mary Tinetti, it's widely used to identify patients at risk for falls.
The assessment consists of two sections: Balance (9 items, maximum 16 points) and Gait (7 items, maximum 12 points), for a total possible score of 28 points.
Scoring and Interpretation
| Total Score | Fall Risk Level | Interpretation |
|---|---|---|
| 24-28 | Low Risk | Patient has good balance and gait |
| 19-23 | Moderate Risk | Increased fall risk, monitor closely |
| < 19 | High Risk | High fall risk, intervention needed |
Lower scores indicate greater impairment and higher fall risk. Patients scoring below 24 should receive comprehensive fall risk assessment and intervention.
Balance Assessment Items
- Sitting balance: Ability to maintain sitting position
- Arising from chair: Ability to stand from seated position
- Immediate standing balance: Balance in first 5 seconds of standing
- Standing balance: Ability to maintain standing position
- Balance with eyes closed: Standing balance without visual input
- Turning 360 degrees: Ability to turn in complete circle
- Sitting down: Ability to sit from standing position
- Nudge test: Response to gentle push on sternum
- Neck turning: Balance while turning head
Gait Assessment Items
- Gait initiation: Hesitation and smoothness of gait start
- Step length and height: Foot clearance and step size
- Step symmetry: Equality of step length between sides
- Step continuity: Flow and rhythm of walking
- Path deviation: Straightness of walking path
- Trunk stability: Sway and stability of trunk during gait
- Walking stance: Width of base during ambulation
Clinical Applications
The Tinetti Assessment is used in various healthcare settings:
- Fall risk screening in elderly populations
- Baseline assessment before rehabilitation
- Progress monitoring during physical therapy
- Post-surgical mobility evaluation
- Long-term care facility assessments
- Research on aging and mobility
Fall Prevention Strategies
For patients identified as at-risk:
- Refer to physical therapy for strength and balance training
- Conduct medication review (some medications increase fall risk)
- Assess and modify home environment for safety
- Ensure proper footwear and assistive devices
- Address vision and hearing problems
- Manage chronic conditions affecting balance
- Implement exercise programs focusing on balance and strength
- Consider vitamin D supplementation if deficient
Frequently Asked Questions
- Who should use the Tinetti Assessment?
- The Tinetti Assessment should be administered by trained healthcare professionals including physicians, nurses, and physical therapists. It's designed for evaluating elderly patients, particularly those aged 65 and older or those with known mobility issues.
- How long does the Tinetti Assessment take?
- The complete assessment typically takes 10-15 minutes to administer when performed by an experienced clinician. This includes both the balance and gait sections.
- What score indicates a need for intervention?
- Patients scoring below 24 points (out of 28) are considered at increased risk for falls and should receive intervention. Those scoring below 19 are at high risk and require immediate attention and comprehensive fall prevention strategies.
- Can this assessment be used to track progress?
- Yes, the Tinetti Assessment can be repeated periodically to monitor changes in balance and gait over time, assess response to interventions, or track decline in mobility. It's commonly used to measure progress during rehabilitation programs.
- Are there limitations to the Tinetti Assessment?
- While valuable, the Tinetti has limitations. It requires patient cooperation and ability to perform tasks, may be affected by acute illness or pain, and should be part of a comprehensive fall risk assessment rather than used in isolation. Cultural and environmental factors may also influence performance.
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