About the Tinetti Performance-Oriented Mobility Assessment
The Tinetti test (Tinetti Performance-Oriented Mobility Assessment, or POMA) is a bedside balance and gait test developed by Mary Tinetti to help identify older adults at higher risk of falling. An observer watches the person perform a series of balance maneuvers (sitting, standing up, standing still, being nudged, standing with eyes closed, turning, and sitting back down) and a series of gait maneuvers (starting to walk, step length and foot clearance, step symmetry and continuity, path, trunk control, and walking stance) and scores each one using fixed criteria.
How the score is built
The tool sums two subscales:
- Balance subscale (0-16): ten scored items - sitting balance, arising, attempts to arise, immediate standing balance, standing balance, response to a nudge, standing with eyes closed, and turning 360 degrees (scored for steps and steadiness), and sitting down. Most items are scored 0-2; a few are scored 0-1.
- Gait subscale (0-12): ten scored items - gait initiation, right step length, right foot floor clearance, left step length, left foot floor clearance, step symmetry, step continuity, path deviation, trunk stability, and walking stance. Most items are scored 0-1; path and trunk are scored 0-2.
Adding the balance subscore and the gait subscore gives the total Tinetti POMA score, from 0 to 28. A lower score reflects more balance and gait impairment.
Interpreting the result
Widely used clinical cutoffs classify a total score of 24-28 as low fall risk, 19-23 as moderate fall risk, and below 19 as high fall risk. These bands summarize a single observed assessment; they describe typical risk for people who score similarly, not a guarantee for any one person, and some institutions use slightly different thresholds.
When to consult a professional
This tool performs the standard Tinetti POMA arithmetic once you have scored each item; it does not observe the patient and is not a diagnosis. A physical therapist, physician, or other trained clinician should perform the actual assessment and use the score alongside a fuller fall-risk history, medication review, and home-safety evaluation before making care decisions.