Towards objective evaluation of balance in the elderly: validity and reliability of a measurement instrument applied to the Tinetti test

Abstract

The aim of the present study was the validation of an instrument for evaluating balance, applied to the Tinetti test. Trunk inclination was measured by inclinometers during the Tinetti test in 163 healthy participants scoring 28/28 in the Tinetti scale (controls: 92 women, 71 men; age 19-85 years), and 111 residents in old people's homes, able to autonomously perform the test, but scoring less than 28/28 (test group: 78 women, 33 men; age 55-96 years). Trunk inclination was quantified by 20 parameters, whose standardized values were summed and provided an overall performance index (PTOT). PTOT reliability was evaluated by Cronbach's alpha, and its validity by item scale correlation, discriminant validity and concurrent validity. Influence of age and sex was assessed by a logistic regression model. Repeatable and consistent measurements were obtained (Cronbach's alpha=0.88). Parameter distribution was significantly different in controls and patients (P<0.001). Optimal PTOT threshold for discriminating between normal and abnormal performance (153.9/200) corresponded to sensitivity of 88.3%, specificity of 84.7% and area under the receiver operating characteristics curve of 0.93. PTOT correlated with the Tinetti scale score, its partial, balance-related score and Barthel's Index, but not with the Mini Mental State score. PTOT correlated with age and level of performance but not with sex; correlation with age did not prevent the possibility of discriminating between different levels of performance and between normal and abnormal performance. The instrument provided objective discrimination between different performance levels, in particular, between normal and altered performance.

Effects of 12-Week Proprioception Training Program on Postural Stability, Gait, and Balance in Older Adults

“…Pérennou et al (29) concluded that Tinetti test is a valid and reliable tool to evaluate the mobility and the risk of falling in older adults, and it is more effective than other tests, such as Berg scale test, but according to our results, both tests can be used to assess balance and gait, supporting evidences from Panella et al (28) who determined that these scales provide a very good reliability about the risk of falling, balance, and gait. The scores obtained with the Berg balance scale seem to be appropriate, as a score of ,45 was shown to be predictive of multiple falls in older adults (4).…”

Increased Brain Sensorimotor Network Activation after Incomplete Spinal Cord Injury

“…The Tinetti Performance Oriented Mobility Assessment (POMA) scoring scale is broken down into two parts: a gait portion (maximum score 12) consisting of initiation of gait, step length, step height, step symmetry, step continuity, path, trunk stability, and walking stance; and a balance portion (maximum score 16) consisting of sitting balance, rising, attempting to rise, immediate standing balance, nudging response, eyes closed balance, and turning 360 degrees while sitting down. 30,31 Higher POMA scores correspond to better motor function.…”

A wearable system for measuring limb movements and balance control abilities based on a modular and low-cost inertial unit

“…Typically, balance control is assessed by means of clinical balance scales, that consist in the scoring of a set of simple, everyday-life movements executed in sequence by the patient. The most common scales are: the Tinetti test [4,5], the Berg balance scale [6], and the BEST test [7]. The subject's performance is currently evaluated by the physiatrist or the physiotherapist, who give his/her judgment by means of a numerical score on a predefined scale.…”