What is the Tinetti Balance Test?


Various conditions can affect gait, balance, mobility, fall risk, and other issues related to walking, sitting down, or standing up. In such cases, there are some tests that your medical provider may perform to diagnose your condition and come up with a treatment plan to address any symptoms you’re experiencing. Let’s delve into some of these conditions and their associated tests.

How the Tinetti Balance Test Came to be

The Tinetti test is named after its creator, Mary Tinetti, a Yale physician who developed it in 1986. It’s a test designed to assess the gait and balance of older adults. It can also be used with patients of all ages if they have gait or balance issues that put them at risk of falling. It’s also designed to test patients’ perception of their balance and stability and fear of falling during typical daily living activities. It’s also known as POMA, which stands for Performance-Oriented Mobility Assessment. It’s beneficial in determining an individual’s fall risk.

What Is Gait?

man in blue shoes performing a balance test

Image via Flickr by University of Salford

Gait is a person’s walking pattern, which involves muscle coordination and balance. These function together to propel your body forward in a rhythm known as the stride. If any of these bodily systems are affected, it can cause an abnormal gait. There is a host of reasons for gait disorders, some of which are:

  • A stroke.
  • A condition that affects the feet.
  • A neurological condition.
  • A degenerative disease (such as arthritis.)
  • An inner ear disorder.
  • Wearing ill-fitting shoes.

There are also several different ways to describe abnormal gaits, including:

  • Propulsive gait. People with this gait may be experiencing Parkinson’s disease. Its characteristics include a rigid, stooping posture. This gait disorder also involves the head and neck, which will be bent forward. Due to this imbalance in gait, someone suffering from propulsive gait will have shorter and faster steps.
  • Scissors gait. This gait disorder derives its name from the walking motion of the person suffering from it. Someone with a scissors gait will have thighs and knees which cross or hit, resulting in a scissor-like pattern when walking. There’s prominent flexing of the hips, pelvis, and legs, making a person appear to be crouched down as they walk. This gait is often observed in patients with spastic cerebral palsy.
  • Spastic gait. This gait is commonly seen in patients with multiple sclerosis or cerebral palsy. When walking, a patient with spastic gait disorder will have one stiff leg and tend to drag that leg in a semicircular motion. This drag usually occurs in the leg on the side of the body most affected by long-term muscle contractions.
  • Steppage gait. This type of gait is high stepping. When walking, the patient’s leg will be lifted high while the foot drops. The foot will appear floppy, with the toes pointing downward, making the toes scrape the ground while walking. This type of gait issue can be caused by peroneal nerve injuries or peroneal muscle atrophy, such as spinal problems of a herniated disc or spinal stenosis.
  • Waddling gait. This type of gait results from an exaggerated movement of the body’s trunk, which results in a waddling walk, that’s duck-like. Conditions that can produce this gait can be progressive muscular dystrophy or congenital hip dislocation.

What Is the Romberg Test?

The Romberg test, also known as the Romberg’s sign or Romberg’s maneuver, is designed to measure your sense of balance. A Romberg test is used to diagnose balance problems. Your balance system involves a couple of parts: your vision and sense of position. This test will be performed as part of a neurological exam.

A Romberg test is specifically designed to assess your dorsal column, which is part of your spinal cord. The dorsal column’s function is responsible for your sense of movement and position, known as proprioception. Your doctor will perform a Romberg test if you’ve been experiencing falls or dizziness and imbalance in the course of everyday life activities.

Who Would Get a Tinetti Balance Test?

The Tinetti balance test is administered to patients with Parkinson’s Disease, Multiple Sclerosis, stroke, spinal cord injury, acquired brain injury, and older adults. These groups of people are at higher risk for falls, and the Tinetti Balance Test helps assess the level and severity of that risk.

How Is the Tinetti Balance Test Performed?

The essential elements of the test are a hard, armless chair, a stopwatch, and a 15-foot flat, open walkway. The test has two parts. The first section is designed to assess balance abilities while seated in the chair and the ability to stand up from a seated position in the chair. The second section of the test is designed to assess the dynamic balance of the patient’s gait while they walk the fifteen feet of the test area. During the test, assistive devices the patient uses will typically be permitted, such as a cane, crutches, or walkers.

The patient will be seated in an armless chair and asked to rise out of the chair and remain standing. The patient will then be instructed to turn 360 degrees and return to a seated position in the chair. During this part of the test, the evaluating doctor will be checking several key points, such as how the patient rises from the chair and how they sit back down into the chair.

The doctor will also be checking whether the patient can stay upright while seated and standing. They’ll also evaluate what occurs when the patients’ eyes are closed and the reaction when they receive a slight push against their sternum.

Next, the patient will be instructed to walk a few feet at a normal, regular speed, turn around, and return to the beginning, walking back at a fast but safe speed. Then the patient will be asked to sit back down. The point of this part of the test is for the doctor to evaluate the patient’s gait — the length and height of their steps, whether their steps have symmetry and continuity, and if their trunk is straight while they’re walking.

If you’d like more information on gait disorders, the Romberg test, or the Tinetti balance test, reach out to the knowledgeable team at Scheck & Siress. We’d be happy to answer any questions you may have or get you set up for a consultation. You can reach us by phone at 866-299-6205 or via our secure online messaging system.