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Subject of the scale: Impairment: dynamic balance

Tinetti Mobility Test


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The Tinetti Performance-Oriented Mobility Assessment (POMA), also called the Tinetti Mobility Test (TMT), is a clinical test to assess mobility, balance and gait, and predict falls in elderly people and some patient populations.

The original test was developed and used in an institutionalized population of intermediate care residents with chronic diseases, who were independent or required minimal assistance in activities of daily living.

In the literature, it has been studied: in the Huntington Disease [13] [16] [17], after stroke [15], in patients with Parkinson disease [10] [14], in patients with Demencia [12], in geriatric assessment [9], in community-dwelling older people [7] [8] [11], in individuals with amyotrophic lateral sclerosis [4][6]

Different versions can be found. Wide variations were found concerning the name of the instrument, test items, scoring, and cut-off values [9].
The balance and gait subscales that form the TMT have been studied individually or combined.

The TMT predicts falls among elderly individuals ; those scoring 19 to 24 out of 28 on the TMT have a “moderate” risk for falling, and individuals scoring less than 19 have a “high” risk for falling.

The TMT is easily administered and provides information about an individual’s ability to ambulate and transfer safely.

The TMT can be administered in less than 5 minutes.
The POMA items require the ability to perform executive functions.

There is balance portion in this tool, called BPOMA. It has eight activities. The tasks range from sitting and standing balance in a comfortable position to narrowing the base of support in standing and maintenance of balance during an external force applied to the sternum.

> Access to the scale is free.

Psychometric properties:


Psychometric properties



Face validity


Content validity


Criterion validity

Concurrent validity

[4] [10] [11] [13] [14] [17]

Predictive validity

[4] [9] [10] [12] [14]

Construct validity

Convergent validity

[4] [7] [15]

Divergent validity

[4] [7] [15]

Discriminant validity
(sensitivity and distinctiveness)

[4] [7] [15]


Intra-rater reliability

[6] [10]

Inter-rater reliability

[3] [6] [10]


[7] [12] [15] [16] [17]

Internal consistency (alpha)




General comment on reliability:

The Tinetti Mobility Test (TMT) and FSST were highly correlated with most spatiotemporal measures [17].

When studied in Parkinson disease, it was also correlated with UPDRS motor scores and gait speed. The sensitivity and specificity of the TMT to identify fallers were 76% and 66%, respectively [10].

The criterion-related validity of the Dynamic Parkinson Gait Scale (DYPAGS) was demonstrated by strong correlations with the gait subscales of the Tinetti Mobility Test [14]<.

The POMA scores were moderately correlated to motor FIM and gait speed scores [15].

The predictive validity was acceptable, with a sensitivity of 70–85% and a specificity of 51–61% for the POMA and its subtests [12].

PTOT instrument was correlated with the balance-related score of the Tinetti scale score [11].

Fair to good reliability of BPOMA scores occurred across many raters of varied experience with a small amount of training [3].
The TMT total showed good to excellent test-retest reliability [16] [17].
Inter-rater and intra-rater reliability was good to excellent [10].
The minimal detectable change (MDC) was 6 points [15].
The inter-rater reliability of the instrument was good when used in patients with dementia [12].

Poor responsiveness to fall status [7].


The high test-retest reliability over a six week period and concurrent validity between the TMT, FSST, and spatiotemporal gait measures suggest that the TMT and FSST may be useful outcome measures for future intervention studies in ambulatory individuals with Huntington Disease [17].

The TMT had a sensitivity of 74% and a specificity of 60% to identify fallers. Lower TMT scores and younger age were significant predictors of falls. The TMT is a valid tool for assessing balance and gait status and fall risk of individuals with HD [13].

The POMA is a valid and reliable measure balance in a population of persons early after stoke [15].

According to psychometric properties, the most suitable performance measure for evaluating balance in community-dwelling older people is the Tinetti Mobility Test [7].

The Tinetti test (TT) and the Time Up and Go test (TUG) are the most suited to assess postural capacities in very elderly people, in whom the predictive validity of the postural assessment of falls is still modest [8].

The Tinetti Balance Test is reliable for examination of individuals with Amyotrophic Lateral Sclerosis in Stages I-III by physical therapists and physical therapy students [6].

Tasks that reportedly most often lead to falls and that predict balance confidence in individuals with PD (ie, turning, initiating gait, slowing to sit down) are assessed with the TMT [10].

However, application of the POMA in populations with moderate to severe dementia is hampered by feasibility problems [12].

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For more details of the scale, the comments or the psychometric properties presented here, please contact Dr. Thibaud HONORE :


Inaugural references:

1. Tinetti, M. E. Performance-oriented assessment of mobility problems in elderly patients. Journal of the American Geriatrics Society 34, 119–126 (1986).

Psychometric references:

2. Tinetti, M. E. et al. Yale FICSIT: risk factor abatement strategy for fall prevention. Journal of the American Geriatrics Society 41, 315–320 (1993).

3. Cipriany-Dacko, L. M., Innerst, D., Johannsen, J. & Rude, V. Interrater reliability of the Tinetti Balance Scores in novice and experienced physical therapy clinicians. Arch Phys Med Rehabil 78, 1160–1164 (1997).

4. Kloos, A. D., Dal Bello-Haas, V., Burton, K., Proch, C. & Mitsumoto, H. Validity of the Tinetti Balance Assessment in individuals with amyotrophic lateral sclerosis. in 16–18 (1998).

5. Whitney, S. L., Poole, J. L. & Cass, S. P. A review of balance instruments for older adults. Am J Occup Ther 52, 666–671 (1998).

6. Kloos, A. D. et al. Interrater and intrarater reliability of the Tinetti Balance Test for individuals with amyotrophic lateral sclerosis. Journal of Neurologic Physical Therapy 28, 12–19 (2004).

7. Lin, M.-R. et al. 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, 1343–1348 (2004).

8. Pérennou, D. et al. [Evaluation of balance in neurologic and geriatric disorders]. Ann Readapt Med Phys 48, 317–335 (2005).

9. Köpke, S. & Meyer, G. The Tinetti test: Babylon in geriatric assessment. Z Gerontol Geriatr 39, 288–291 (2006).

10. Kegelmeyer, D. A., Kloos, A. D., Thomas, K. M. & Kostyk, S. K. Reliability and validity of the Tinetti Mobility Test for individuals with Parkinson disease. Phys Ther 87, 1369–1378 (2007).

11. Panella, L., Tinelli, C., Buizza, A., Lombardi, R. & Gandolfi, R. Towards objective evaluation of balance in the elderly: validity and reliability of a measurement instrument applied to the Tinetti test. Int J Rehabil Res 31, 65–72 (2008).

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