File Name: tinetti balance and gait evaluation .zip
The Tinetti test
Metrics details. After translation into Turkish, the Turkish version of the scale was applied on the participants at 2-week intervals. The Turkish version was evaluated with respect to inter- and intrarater reliability and test—retest reliability intraclass correlation coefficient ICC.
Eighty participants enrolled in the study with a mean age of ICCs were detected above 0. According to the results of this study, the Turkish version of the POMA-I scale has been found to be a reliable and a valid scale for elderly Turkish people. Age-related impairments in balance and postural control affect the safe performance of daily activities, and they are the primary reasons responsible for falls [ 1 , 2 ].
In many studies, risk factors for falls have been determined. These are classified as intrinsic and extrinsic factors. Besides, a decrease in the ability to perform daily living activities and usage of walking aids contribute to the frequency of falls [ 3 , 5 , 7 ]. Tests and functional scales used in proportion to variations in risk factors for falls, and excess numbers of components of postural control are also numerous [ 8 ].
Within a few years — , Tinetti made some modifications in the components of POMA to be used as an outcome measure in her research population, developed, tested, and released its various versions [ 1 , 9 — 14 ]. Some maneuvers were included or excluded in compliance with the conditions of the population under investigation. These inclusions and exclusions were agreed upon in consideration of consensus among raters. It is composed of two separate categories as balance and gait tests [ 15 — 19 ].
Balance and gait are evaluated with nine and eight items, respectively. As a result, the total score of the scale amounts to 28 points. The highest score indicates the best performance [ 10 ]. The aims of this study are both to translate the original English version POMA-I scale into Turkish and also ensure its cross-cultural adaptation by the Turkish population in order to establish its validity and reliability.
Written informed consent was obtained from all participants. Ambulatory status of the patients was evaluated using functional ambulation classification FAC. FAC classifies ambulation in six separate levels as: level 0—nonfunctional ambulation and level 5—ambulator-independent ambulation [ 20 ]. Self-assessment scale of well-being evaluated health status of individuals on a five-item scale as: 1 I feel myself very well, 2 my general health status is fine, 3 my health state is of moderate degree, 4 I feel myself sick, and 5 I feel myself very sick.
BBS has been developed to be used for the evaluation of functional balance in older people, and it is efficiently employed in many fields of rehabilitation [ 15 , 21 , 22 ].
The BBS scale has been developed with the consideration of its fundamental role in the maintenance of different bodily postures during activities of daily life, self-driven spontaneous response to voluntary movements of the trunk and extremities, and postural control.
It consists of 14 items. Scores range from 0 inability to perform the task to 4 points ability to achieve the task independently within specifed time interval , and total score varies between 0 and 56 points [ 15 , 16 , 18 — 19 , 21 — 23 ].
The validity and reliability of the Turkish version of this scale which has received a global acceptance in the field of rehabilitation have been already established [ 23 ]. TUGT is an easy-to-use balance and gait scale not requiring professional expertise and training. The time passed during this maneuver is recorded [ 25 — 27 ]. Translation and cultural adaptation phases of the Turkish version of the scale were utilized according to previously published articles of Guillemin et al.
Differences between these two Turkish translations were eliminated by a native speaker Turkish physiatrist with a good command of English, and a common Turkish version was formulated. At the second step, the Turkish version was retranslated into English by two native English speakers with a good command of Turkish.
Differences between two translated texts were eliminated, and a satisfactory concordance between the Turkish and the original English version was ensured. After completion of the translation process, the Turkish version was evaluated by eight physiatrists, and ineligible guidelines were pinpointed and reported by each physiatrist individually.
Two experienced physiatrists with a good command of English reevaluated ineligible guidelines and made appropriate modifications. The resultant translation was accepted as the final format of the Turkish version. To establish its interrater reliability, 20 participants were randomized out of 80 and were tested the same day at 15—min intervals by two separate assessors. To determine intrarater reliability, 20 participants were randomized out of 80 and were evaluated by the same assessor two times in the morning and afternoon in the same day.
Data obtained from this study were analyzed using SPSS For the evaluation of demographic characteristics of the participants, descriptive statistical methods means, standard deviation were used. ICC was calculated for the evaluation of test—retest reliability of the scale.
Eighty participants 64 women, 16 men were enrolled in the study. Mean age of the participants including 43 housewives and 27 pensioners was A medical problem was not encountered in seven participants. The remaining 73 participants had at least one and at most five concomitant diseases.
Nine subjects The remaining seven individuals 8. Of the participants Total score was found to be 0. Since balance is a multifactorial function, a single test cannot be sufficient for its evaluation.
Different types of tests measure diverse aspects of postural control. Balance tests can be grouped based on their types. Static standing balance tests evaluate maintenance of balanced state while standing on different support platforms. However dynamic standing balance tests evaluate continuity of balanced state during movements requiring weight transfer [ 16 , 29 ]. Sensorial manipulation tests assess various positions of the trunk and head, eye movements, and also limitations imposed on visual, vestibular, and somatosensorial functions.
However tests evaluating functional balance are related to the scales of mobility and gait, sitting and standing, walking, and stepping over objects which involve ability to perform tasks requiring mobility of the body as a whole [ 16 ]. POMA is one of the functional scales used to assess fall risk and functions of postural balance which had been developed firstly in a study where falls had been evaluated prospectively [ 9 ].
Before the development of POMA, conventional approaches for the evaluation of mobility disorders were focused on either standard neuromuscular assessment methods i. As is the case in other fields of rehabilitation, to obtain accurate and objective measurements from functional scales used in the evaluation of fall risks and balance impairments, these scales should have certain clinometric properties [ 8 , 15 , 31 ].
Reliability, validity, and sensitivity to change lead the way among these required characteristics. Implementation of the scales for diverse population groups requires, in addition to accurate translation cross-cultural validity, interpretation of the original scale in easily comprehensible terms for the target population and culture [ 8 , 15 , 31 , 32 ]. During the process of cultural adaptation phase implemented after the Turkish translation of POMA, appropriateness of the terms used was examined.
At item 6 standing balance against a slight nudging is tested, and testing of the item 7 is required in case the subject has obtained the best score from testing in item 6. When these units are converted to centimeters and meters used in our country, whole numbers cannot be obtained. Therefore complying with the recommendations of the translation committee, values were expressed in both measurement units, and included in the relevant items in order to be faithful to the original version and render the scale more comprehensible.
Interrelated items of the scale assessing the same functional parameters i. These estimates demonstrate improved internal consistency of the POMA scale. In the literature any study estimating the internal consistency of POMA scale has not been encountered. With prolongation of life expectancies, individuals are living longer senescent periods. Since during this relatively longer duration of time the elder people will be probably monitored by different physicians at various time spans, intra- and interrater reliabilities of the scales used should be established.
POMA was firstly developed in , and it was then applied on 15 ambulatory participants by two separate assessors and interrater reliability was evaluated. Besides, the POMA scores assigned to the patients were found to be correlated with parameters of musculoskeletal system and neurologic variables muscular strength of the lower extremities, lumbar extension, neck examination findings, and self-reported mobility status of the patients.
In our study, we calculated intraclass correlation coefficient for the study of inter- and intrarater reliability studies, and determined intrarater ICC values for subscale scores of balance 0. In three separate studies involving old population where interrater reliability was tested, higher interrater ICC values of 0. The Test—retest reliability method means testing the scale used at short or long intervals depending on the components of the scale. For test—retest correlation, usage of intraclass correlation method is advised.
The test—retest correlation coefficient should be at least 0. Some authors reported that a reliability coefficient of 0. In our study ICC values for test—retest reliability were above 0.
To demonstrate the validity of POMA scale, the BBS scale developed for the assessment of balance impairment in the elderly with its proven validity and reliability of the Turkish version was used [ 21 — 23 ]. Previous studies conducted by Berg et al. TUGT is used widely in the assessment and monitorization of functional mobility in the elderly.
In our study, as an another indicator of validity, the correlation between POMA and TUGT scale which is an important tool in the evaluation of risks of fall and can be used in the assessment and monitorization of functional mobility, was investigated. A very significant negative correlation was found between total score, and also balance and gait subscales of POMA with the corresponding parameters of TUGT.
This negative correlation means that in case of improvement of postural balance of the individual, higher POMA scores are obtained together with decreased time intervals required for the performance of TUGT tasks.
Similarly, in a study conducted by Faber et al. Also, in a study conducted by Cho et al. In conclusion, in this study, POMA-I scale which is used widely in the prediction of postural balance and risk of fall in the elderly was translated into Turkish, and appropriateness of the Turksih version for the Turkish population was demonstrated.
Based on the results of this study, the Turkish version of POMA-I scale was shown as a reproducible, reliable, and a valid scale. N Engl J Med — Arch Neurol — J Am Geriatr Soc — J Gerontol 49 3 :M—M WHO Spine — Am J Med — Tinetti ME Performance-oriented assessment of mobility problems in elderly patients.
TINETTI BALANCE ASSESSMENT TOOL
Our whole person wellness programming is committed to helping individuals of all ages and abilities maintain a lifestyle that is of the highest quality attainable. Multidisciplinary teams of University faculty and students work with community partners to implement these goals. Programming at the Center for Successful Aging is developed around the principles of whole-person wellness to help our clients maintain a lifestyle that is of the highest quality. Whole-person wellness embodies a comprehensive approach to wellness, which respects our complexity by acknowledging that we are multidimensional beings. It is through attention to and the development of each dimension of wellness that we can be successful in achieving whole-person wellness.
Falls are an increasing problem as people age. The emotional, physical, and personal costs to the individual are even higher. Most falls could be prevented by a vigilant physician anticipating, assessing, and correcting fall risks, which may be medical, mechanical, or environmental. The impact of chronic disease and medication, balance and gait, and home risks should be assessed routinely. The test results will indicate areas of further investigation.
Gait, Balance, and Fall Prevention
Trunk Marked sway or uses w. Forget about scanning and printing out forms. Use our detailed instructions to fill out and e-sign your documents online. SignNow's web-based service is specially created to simplify the management of workflow and optimize the entire process of qualified document management. Use this step-by-step instruction to fill out the Tinetti balance assessment tool - BHPS - hdcs fullerton form quickly and with ideal precision.
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