Purpose: To assess balance and gait abilities and provide fall risk assessment.
Population: Older adults and individuals with balance or mobility impairments.
Time to Complete: 10-15 minutes
Scoring: Balance section (0-16 points) and Gait section (0-12 points), with a maximum total score of 28 points.
Also Known As: Performance Oriented Mobility Assessment (POMA)
| Item | Test | Scoring | Score |
|---|---|---|---|
| 1 | Sitting balance |
• Leans or slides in chair (0 points) • Steady, safe (1 point) |
|
| 2 | Rises from chair |
• Unable to without help (0 points) • Able, uses arms to help (1 point) • Able without use of arms (2 points) |
|
| 3 | Attempts to rise |
• Unable to without help (0 points) • Able, requires > 1 attempt (1 point) • Able to rise, 1 attempt (2 points) |
|
| 4 | Immediate standing balance (first 5 seconds) |
• Unsteady (staggers, moves feet, trunk sway) (0 points) • Steady but uses walker or other support (1 point) • Steady without walker or other support (2 points) |
|
| 5 | Standing balance |
• Unsteady (0 points) • Steady but wide stance and uses support (1 point) • Narrow stance without support (2 points) |
|
| 6 | Nudged |
• Begins to fall (0 points) • Staggers, grabs, catches self (1 point) • Steady (2 points) |
|
| 7 | Eyes closed |
• Unsteady (0 points) • Steady (1 point) |
|
| 8A | Turning 360 degrees - steps |
• Discontinuous steps (0 points) • Continuous (1 point) |
|
| 8B | Turning 360 degrees - steadiness |
• Unsteady (grabs, staggers) (0 points) • Steady (1 point) |
|
| 9 | Sitting down |
• Unsafe (misjudged distance, falls into chair) (0 points) • Uses arms or not a smooth motion (1 point) • Safe, smooth motion (2 points) |
|
| Balance Score Total: (Maximum = 16) | ____/16 | ||
| Item | Test | Scoring | Score |
|---|---|---|---|
| 10 | Indication of gait (Immediately after told to 'go') |
• Any hesitancy or multiple attempts (0 points) • No hesitancy (1 point) |
|
| 11A | Step length and height - Right |
• Step to (0 points) • Step through R (1 point) |
|
| 11B | Step length and height - Left |
• Step to (0 points) • Step through L (1 point) |
|
| 12A | Foot clearance - Right |
• Foot drop (0 points) • R foot clears floor (1 point) |
|
| 12B | Foot clearance - Left |
• Foot drop (0 points) • L foot clears floor (1 point) |
|
| 13 | Step symmetry |
• Right and left step lengths not equal (0 points) • Right and left step lengths appear equal (1 point) |
|
| 14 | Step continuity |
• Stopping or discontinuity between steps (0 points) • Steps appear continuous (1 point) |
|
| 15 | Path |
• Marked deviation (0 points) • Mild/moderate deviation or uses walking aid (1 point) • Straight without walking aid (2 points) |
|
| 16 | Trunk |
• Marked sway or uses walking aid (0 points) • No sway but flexes knees or back or uses arms for stability (1 point) • No sway, flex, use of arms or walking aid (2 points) |
|
| 17 | Walking time |
• Heels apart (0 points) • Heels almost touching while walking (1 point) |
|
| Gait Score Total: (Maximum = 12) | ____/12 | ||
Balance + Gait Score: ______ / 28
| Tinetti Score | Fall Risk Interpretation |
|---|---|
| Below 19 | High fall risk |
| 19 - 23 | Moderate fall risk |
| 24 and above | Low fall risk |
This test is performed with the patient wearing regular footwear, using a hard, armless chair.
Balance section: The subject is seated in a hard, armless chair, while performing different actions, as required by the assessor.
Gait assessment: The subject stands up and walks across the room or down the hallway, first at a "usual pace" then back at a more rapid pace.
Where there is hesitation and rising from chair in stages, the patient may have problems with proprioception or the cerebellar areas of balance.
In case walking assistance is required, the assessor will provide it and will also make a note of this. Examples of abnormalities during walking include abnormal knee extension, high stepping, toe dragging or shuffling gait.