Tinetti Performance Oriented Mobility Assessment

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Observe the patient seated in a hard, armless chair.
Ask the patient to stand up from the chair without using their arms.
If the patient cannot rise on the first attempt, score the number of attempts needed.
Observe balance for the first 5 seconds after standing.
Ask the patient to stand still. Observe for at least 30 seconds.
Push lightly on the sternum three times with palm of hand. Safety: stand close to catch the patient.
Ask patient to close their eyes while standing. Observe for 3 seconds.
Ask the patient to turn 360 degrees. Observe the continuity of the steps.
Observe steadiness during and immediately after the 360-degree turn.
Ask the patient to sit back down. Observe for safety and smoothness.
Ask the patient to walk to a mark 10 feet away, turn, and return. Observe initiation.
Step length: right foot step should pass the left standing foot (step-through vs. step-to).
Step length: left foot step should pass the right standing foot.
Observe whether the right foot fully clears the floor during the swing phase.
Observe whether the left foot fully clears the floor during the swing phase.
Compare left and right step lengths. Asymmetry may indicate pain, weakness, or neurological deficit.
Observe whether the patient stops or pauses between individual steps.
Observe over about 10 feet. Mark a straight line on the floor if possible.
Observe trunk movement during walking. Excessive sway indicates poor core stability.
Observe the distance between the heels while walking. A wide base suggests instability.
Total POMA ScoreModerate fall risk
20/ 28

Combined balance and gait score (max 28)

Balance Subscore10/ 16
Gait Subscore10/ 12
Fall RiskModerate fall risk
20 points
High fall risk<19Moderate risk19-24Low fall risk24+

POMA total: 20/28 - Moderate fall risk.

  • Balance subscore is 10/16 and gait subscore is 10/12.
  • The balance subscore is notably low. Static balance training, chair exercises, and vestibular assessment should be considered.
  • Gait quality is relatively preserved. Continue weight-bearing activity and re-evaluate after any acute illness or medication change.

Next stepModerate fall risk: individualized exercise prescription (balance and strength training), review of medications affecting gait, and reassessment in 3-6 months are recommended.

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