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Tinetti Mobility Scale

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As a Physical Therapist assistant our main goal is to help the patient get better. But in order to help the patient get better we must be able to assess the conditions they have, this is done with Test and Measurements. With a set of tests and measurements the therapist can accurately find out what the patient’s limitations are and set a goal for the patient to achieve. It is typically done in the beginning of the session with a series of questions asked in order to get an idea of what the patient is struggling with. These tests can include: The Timed up and go test (TUG), the Functional reach test, the Berg balance scale, the Romberg test, and the one that I will speak to you about, the Tinetti mobility scale.

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What is the Tinetti mobility scale?

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The Tinetti Mobility Scale is a task performance test used to assess gait, and balance. According to O’Sullivan, Schmitz, and Fulk the tinetti efficiency scale was developed by Tinetti et al as a self-report measure that examines how confident an individual feels to perform ten activities of daily living without falling (219). It is also known as Performance-Oriented Mobility Assessment (POMA), it can indicate the risk of fall for an individual. The Tinetti mobility scale can also target patients who have a diagnosis of Spinal cord injury, CVA, Parkinson’s, Multiple Sclerosis, and our geriatric community. In order to find out if the patient is at risk for falls, we must find out the overall score of the Tinetti scale. The score is done on a three-point scale that ranges from 0-2 with zero representing the most impairment, and two representing the most independent. The individual scores for gait, and balance are combined giving the overall result if the patient is at risk for falls or independent. If the patient scores under 18 then they are at high risk for falls, if the patient scores between 19-23 then they are at moderate risk for falls, and if the patient is over a score of 24 then they are at low risk for falls.

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How to Perform the Tinetti Mobility Scale

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In order to perform the tinetti mobility scale test it requires an armless chair, a stopwatch, and a typical fifthteen feet walkway for the patient to walk. The test has two sections: the first section measures the balance abilities in either a chair or standing position, and the second section assesses balance through gait exercises. In the balance test the patient would be required to get up from the chair and back, it can also include the patient performing a 360 degree rotation while standing up and then sitting down. It would test the patient’s balance in how well they were able to perform the exercise, getting up the chair with a good posture and back down without any stumbling, or if the patient can stand upright while standing up and holding on to nothing. It can provide information to the therapist on how well the patient’s balance is. The second section is assessing balance through gait training. This test will be done using the fifthteen feet walkway. The test would require the patient to get up from the chair, walk fifthteen feet at normal speed, turn around, and walk back at normal speed to sit back on the chair.The therapist would observe the walk and there can determine if the patient is losing balance or is compensating. The Tinetti test usually takes about ten to fifteen minutes to complete. From there the therapist can assess the scores and determine if the patient is at high risk of falls or at low risk of falls. According to the O’Sullivan, Schmitz, and Fulk The tinetti mobility scale is an excellent test-retest reliability is excellent, good interrater reliability , and good concurrent validity (216). The Tinetti mobility scale is very effective and it is one of the oldest clinical balance assessment tools that is used for the elderly patients.

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Evaluating Patients with Tinetti Mobility Scale

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Geriatric Patients

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The Tinetti mobility scale can be used to help patients with diagnoses such as Parkinson’s, Multiple sclerosis, Spinal cord injury, Traumatic brain injury, and our geriatric community. The Tinetti scale is most effective to the geriatric community because as we age our body weakens and provides a challenge everyday to just complete daily tasks. As people age and get old, everything in their system starts to slow down from muscle mass, balance, coordination, reflexes, and etc. This makes it more difficult to avoid trips and falls, according to the article “Tinetti mobility test is related to muscle mass and strength in noninstitutionalized elderly people” 30 percent of the community-dwelling people aged sixty-five or older fall each year, and among people aged eighty-five or older, the percentage increases (2016). Falls can have severe consequences, it can cause an injury that can then limit the person long term. The Tinetti mobility scale helps measure balance and gait in the elderly by doing a series of tests. The test alone is short but reliable as a clinical measure tool.

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CVA Patients and the Tinetti Mobility Scale

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The Tinetti mobility scale not only helps patients in the geriatric community it can also help patients that had a CVA. A CVA is also known as cerebrovascular accident or strokecan create damage to the brain from a block in the blood supply. Having a CVA is a serious matter, once recovering from it can create certain limitations that were not there before such as trouble with balance, delayed cognitive skills, and etc. The Tinetti mobility scale is an important factor because patients with a stroke are able to assess the test and provide information such as if the patient has a slow gait, losing balance, are they at risk for falling The test retest for CVA patients can provide an idea of how much they have improved in a set amount of time. The Tinetti mobility scale is considered an essential tool because the reliability and validity of the assessment has had very successful outcomes.

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Conclusion

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According to the Health Jade team the Tinetti Mobility Scale was published by Mary Tinetti in order to assess gait and balance in older adults, and to also assess perception of balance and activities of daily living and fear of falling (2019). It has been a great indicator of the fall risk of an individual. Over time the Tinetti scale has been used for other diagnoses such as CVA, SCI, MS, and TBI. It is an easy to use assessment test that takes less than thirty minutes with great feedback to determine if the patient is at low risk if falls or at high risk of falls.The reliability of the test is proven to be good that it is chosen specifically to determine the risk of falls for the patient, and the validity is also good because it can provide a consistent score to whether or not the patient really is at low risk for falls or at high risk for falls. The Tinetti mobility scale has become consistent over time and I believe that it will stay consistent because it is easy to use, but provides so much information about the patient whether or not they are able to walk with no risk of falls, or if they are having difficulty in walking that are in high risk for falls.