Tinetti Balance and Gait Assessment Calculator
The Tinetti Assessment Tool (also called the Performance-Oriented Mobility Assessment or POMA) is a widely used clinical test that evaluates balance and gait to predict fall risk in older adults. Score each item based on your observation of the patient to get the total score and fall risk category.
The Tinetti Assessment has two sections:
Balance section (0-16 points): 10 items covering sitting balance, rising from a chair, standing balance (immediate and prolonged), response to a nudge, eyes closed standing, turning 360 degrees, and sitting back down.
Gait section (0-12 points): 8 items covering gait initiation, step length and height for each foot, step symmetry, step continuity, path deviation, trunk sway, and walking stance width.
Scoring interpretation:
- 25-28: Low fall risk
- 19-24: Moderate fall risk
- <= 18: High fall risk
The test was developed by Dr. Mary Tinetti at Yale in 1986 and remains one of the most validated tools for fall risk assessment in geriatric medicine. It takes about 10-15 minutes to administer and requires only a hard armless chair and a flat walking surface.
Clinical use:
The Tinetti is used in hospitals, rehabilitation facilities, nursing homes, and outpatient geriatric clinics. It helps guide decisions about physical therapy referrals, assistive device prescriptions (cane vs. walker), home safety modifications, and the need for supervision during ambulation. Serial assessments can track improvement after interventions or decline over time.
A score drop of 5 or more points between assessments is clinically meaningful and warrants investigation into possible causes (new medications, deconditioning, neurological changes, or other medical issues).