Balance
Sitting balance
Steady, safe
Rise from chair
Able, uses arms to help
Attempts
Able, requires > 1 attempt
Standing balance (5s)
Steady but with support
Standing balance
Steady, wide stance/support
Nudged
Staggers, grabs, catches self
Eyes closed
Steady
Turning steps
Continuous
Turning steadiness
Steady
Sitting down
Uses arms/no smooth motion
Gait
Indication
No hesitancy
Step (right)
Step through R
Step (left)
Step through L
Foot (right)
R foot clears floor
Foot (left)
L foot clears floor
Symmetry
R and L step length are equal
Continuity
Steps appear continuous
Path
Mild/moderate deviation/aid
Trunk
No sway but flex. etc for stability
Walking
Heels almost touching
Results
Balance section
/16
Gait section
/12
Total
/28
✴️ Moderate fall risk.

The Tinetti calculator is a fall risk assessment tool, based on a scheme used by physicians during overall assessment of the elderly.

Tinetti balance and gait assessment is a short and efficient score, evaluated in two separate stages.

Keep on reading to find the details of the POMA balance test, discover other popular elements of the fall risk assessment, and our recommendations for different check-ups.

How to use the Tinetti calculator?

The Tinetti assessment test is based on a careful evaluation of the patient's behavior during a series of tasks. Before using the tool, carefully read the Tinetti test instruction presented below.

The patient is kindly asked to follow the commands enumerated below:

  1. Sit down
    • Does the patient keep a steady balance when sitting?
  2. Stand up
    • Are they able to stand up? Do they need to use arms as support?
    • How many attempts do they need?
  3. Standing
    • Assess the patient's balance during first 5 seconds after standing up.
    • Assess their general stability when standing for a more extended period of time.
  4. Nudging - lightly push on a patient sternum. Repeat 3 times.
    • Is the patient steady? Are they stagging, trying to catch their balance, or falling?
  5. Close your eyes
    • Once again assess the patient's balance.
  6. Turn around 360 degrees
    • Are the steps continuous?
    • Is the patient steady when turning around?
  7. Sit down
    • Does the patient sit down without any help, or using their arms?
  8. Take a walk
    • Evaluate the initiation of the movement. Is it delayed? Hesitant?
  9. Walking in a straight line
    • Assess the step length and height, for both legs separately.
    • Assess the movement of the feet, for both feet separately.
    • Assess whether the right and left steps are of similar length.
    • Is the walk continuous? Did the patient have to stop for a while?
    • Are they walking straight? Observe any excursion of 1 foot either side over about 10 feet of the course.
    • Observe the trunk - is there any deviation from the norm? Back, knees, flexion? Sway or the use of a walking aid?
    • Are the patients' heels away or close to each other?

Write down your observations and choose the correct option in all the fields of our Tinetti online calculator.

Check out our other calculators that are useful for elderly group of patients:

Elements of the fall risk assessment

Our Tinetti balance assessment online is only one of many parts of a general risk assessment. Here we enumerate its other crucial parts:

  1. Timed up go test - sitting, getting up, walking, sitting down.
  2. ADL and ADL-i - assessment of a person's independence.
  3. 30-s chair stand test - standing up and sitting down.
  4. Arm strength score.
  5. Postural hypotension test.
  6. Blood pressure.
  7. Calf & arm circumference.
  8. Malnutrition & frailty evaluation.

Liver insufficiency may cause a worse Tinetti POMA test score - remember to always rule out and treat all reversible states and diseases. Use these diagnostic tools to make sure your patient doesn't suffer from one of them:

Tinetti score table

The Tinetti calculator is divided into two parts:

  • Balance - maximum 16 points; and
  • Gait - maximum 12 points. For a total of:
  • Total: 28 points

The more points your patient scores in the Tinetti balance test, the better is the result is.

<19 points - High risk of falls

✴️ 19-23 points - Moderate risk of falls

❇️ >23 - Low risk of falls

You can find detailed instruction in the section above. Here we present the Tinetti balance assessment points chart:

ElementPoints
Balance section
Sitting BalanceLeans or slides in chair = 0
Steady, safe = 1
Rises from chairUnable to without help = 0
Able, uses arms to help = 1
Able without use of arms = 2
Attempts to riseUnable to without help = 0
Able, requires > 1 attempt = 1
Able to rise, 1 attempt = 2
Immediate standing Balance (first 5 seconds)Unsteady (staggers, moves feet, trunk sway) = 0
Steady but uses walker or other support = 1
Steady without walker or other support = 2
Standing balanceUnsteady = 0
Steady but wide stance and uses support = 1
Narrow stance without support = 2
NudgedBegins to fall = 0
Staggers, grabs, catches self = 1
Steady = 2
Eyes closedUnsteady = 0
Steady = 1
Turning 360 degrees (steps)Discontinuous steps = 0
Continuous = 1
Turning 360 degrees (steadiness)Unsteady (grabs, staggers) = 0
Steady = 1
Sitting downUnsafe (misjudged distance, falls into chair) = 0
Uses arms or not a smooth motion = 1
Safe, smooth motion = 2
Gait section
Indication of gaitAny hesitancy or multiple attempts = 0
No hesitancy = 1
Step length and height (right)Step to = 0
Step through = 1
Step length and height (left)Step to = 0
Step through = 1
Foot clearance (right)Foot drop = 0
Foot clears floor = 1
Foot clearance (left)Foot drop = 0
Foot clears floor = 1
Step symmetryRight and left step length not equal = 0
Right and left step length appear equal = 1
Step continuityStopping or discontinuity between steps = 0
Steps appear continuous = 1
PathMarked deviation = 0
Mild/moderate deviation or uses w. aid = 1
Straight without w. aid = 2
TrunkMarked sway or uses w. aid = 0
No sway but flex. knees or back or uses arms for stability = 1
No sway, flex., use of arms or w. aid = 2
Walking timeHeels apart = 0
Heels almost touching while walking = 1

You may also take a look at our essential emergency calculators:

Łucja Zaborowska