Tinetti Test: Difference between revisions

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== Objective<br>  ==
== Objective<br>  ==
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The&nbsp;'''Tinetti Falls Efficacy Scale''' is used to assess perception of balance and stability during activities of daily living and fear of falling in the elderly population, along with those diagnosed with Multiple Sclerosis  
The&nbsp;'''Tinetti Falls Efficacy Scale''' is used to assess perception of balance and stability during activities of daily living and fear of falling in the elderly population, along with those diagnosed with Multiple Sclerosis  


== Intended Population<br>  ==


 
Community and hospital inpatients with acquired brain injury, multiple sclerosis, spinal cord injury, stroke and the elderly population.  
[[Category:Outcome_Measures]]
 
== Intended Population<br> ==
 
Community and hospital inpatients with acquired brain injury, multiple sclerosis, spinal cord injury, stroke and the elderly population.


== Method of Use  ==
== Method of Use  ==


*The Tinetti Falls Efficacy Scale is a&nbsp;10-item questionnaire designed to assess confidence in patients' ability to perform 10 daily tasks without falling as an indicator of how one's fear of falling impacts physical performance
*The Tinetti Falls Efficacy Scale is a&nbsp;10-item questionnaire designed to assess confidence in patients' ability to perform 10 daily tasks without falling as an indicator of how one's fear of falling impacts physical performance  
*Each item is rated from 1 ("very confident") to 10 ("not confidenent at all"), and the per item ratings are added to generate a summary total score
*Each item is rated from 1 ("very confident") to 10 ("not confidenent at all"), and the per item ratings are added to generate a summary total score  
*Total scores can range from 10 (best possible) to 100 (worst possible). Thus, lower scores indicate more confidence and higher scores indicate lack of confidence and greater fear of falling
*Total scores can range from 10 (best possible) to 100 (worst possible). Thus, lower scores indicate more confidence and higher scores indicate lack of confidence and greater fear of falling


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=== Reliability  ===
=== Reliability  ===


<u>Test-retest Reliability:</u>
<u>Test-retest Reliability:</u>  


<u></u>''Geriatric:&nbsp;''(Tinetti et al, 1990)&nbsp;<ref name="Tinetti et al">Tinetti, M., Richman, D., et al. "Falls efficacy as a measure of fear of falling." Journal of gerontology 1990 45(6): P239</ref>
<u></u>''Geriatric:&nbsp;''(Tinetti et al, 1990)&nbsp;<ref name="Tinetti et al">Tinetti, M., Richman, D., et al. "Falls efficacy as a measure of fear of falling." Journal of gerontology 1990 45(6): P239</ref>  


*Adequate test-retest reliability (r = 0.71)
*Adequate test-retest reliability (r = 0.71)


''Chronic Stroke:&nbsp;''(Hellstrom &amp; Lindmark, 1999; n = 30; mean age = 65 (11) years; stroke onset between 5 and 84 months prior to assessment)&nbsp;<ref name="Hellstrom and Lindmark">Hellstrom, K. and Lindmark, B. "Fear of falling in patients with stroke: a reliability study." Clinical rehabilitation 1999 13(6): 509</ref>
''Chronic Stroke:&nbsp;''(Hellstrom &amp; Lindmark, 1999; n = 30; mean age = 65 (11) years; stroke onset between 5 and 84 months prior to assessment)&nbsp;<ref name="Hellstrom and Lindmark">Hellstrom, K. and Lindmark, B. "Fear of falling in patients with stroke: a reliability study." Clinical rehabilitation 1999 13(6): 509</ref>  


*Excellent test-retest reliability (ICC = 0.97)
*Excellent test-retest reliability (ICC = 0.97)
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=== Validity  ===
=== Validity  ===


<u>Criterion Validity:</u>
<u>Criterion Validity:</u>  


<u></u>''Geriatric:&nbsp;''(Huang &amp; Wang, 2009)&nbsp;<ref name="Huang and Wang">Huang, T. T. and Wang, W. S. "Comparison of three established measures of fear of falling in community-dwelling older adults: psychometric testing." International Journal of Nursing Studies 2009 46(10): 1313-1319</ref>
<u></u>''Geriatric:&nbsp;''(Huang &amp; Wang, 2009)&nbsp;<ref name="Huang and Wang">Huang, T. T. and Wang, W. S. "Comparison of three established measures of fear of falling in community-dwelling older adults: psychometric testing." International Journal of Nursing Studies 2009 46(10): 1313-1319</ref>  


*Adequate concurrent validity with the ABC Scale (r = -0.55)
*Adequate concurrent validity with the ABC Scale (r = -0.55)  
*Adequate concurrent validity with the Geriatric Fear of Falling Measurement (r = -0.57)
*Adequate concurrent validity with the Geriatric Fear of Falling Measurement (r = -0.57)


''Geriatric:&nbsp;''(Powell and Myers, 1995; n = 60 community dwelling seniors aged 65-95; self-classified as either high or low in mobility confidence)&nbsp;<ref name="Powell and Myers">Powell, L. and Myers, A. "The activities-specific balance confidence (ABC) scale." The Journals of Gerontology: Series A 1995 50(1): M28</ref>
''Geriatric:&nbsp;''(Powell and Myers, 1995; n = 60 community dwelling seniors aged 65-95; self-classified as either high or low in mobility confidence)&nbsp;<ref name="Powell and Myers">Powell, L. and Myers, A. "The activities-specific balance confidence (ABC) scale." The Journals of Gerontology: Series A 1995 50(1): M28</ref>  


*Excellent correlation with the Activities Specific Balance Confidence Scale (ABC) (r = 0.84)
*Excellent correlation with the Activities Specific Balance Confidence Scale (ABC) (r = 0.84)


''Spinal Cord Injury:&nbsp;''(Wirz et al, 2010)&nbsp;<ref name="Wirz et al">Wirz, M., Muller, R., et al. "Falls in persons with spinal cord injury: validity and reliability of the Berg Balance Scale." Neurorehabil Neural Repair 2010 24(1): 70-77</ref>
''Spinal Cord Injury:&nbsp;''(Wirz et al, 2010)&nbsp;<ref name="Wirz et al">Wirz, M., Muller, R., et al. "Falls in persons with spinal cord injury: validity and reliability of the Berg Balance Scale." Neurorehabil Neural Repair 2010 24(1): 70-77</ref>  


*Excellent concurrent validity with the Berg Balance Scale and the 16-item FES-I (r = -0.81)
*Excellent concurrent validity with the Berg Balance Scale and the 16-item FES-I (r = -0.81)


<u>Construct Validity:</u>
<u>Construct Validity:</u>  


<u></u>''Geriatric:&nbsp;''(Huang &amp; Wang, 2009)&nbsp;<ref name="Huang and Wang">Huang, T. T. and Wang, W. S. "Comparison of three established measures of fear of falling in community-dwelling older adults: psychometric testing." International Journal of Nursing Studies 2009 46(10): 1313-1319</ref>
<u></u>''Geriatric:&nbsp;''(Huang &amp; Wang, 2009)&nbsp;<ref name="Huang and Wang">Huang, T. T. and Wang, W. S. "Comparison of three established measures of fear of falling in community-dwelling older adults: psychometric testing." International Journal of Nursing Studies 2009 46(10): 1313-1319</ref>  


*Poor correlation with age (r = -0.23)
*Poor correlation with age (r = -0.23)  
*Excellent correlation with balance (r = 0.66)
*Excellent correlation with balance (r = 0.66)  
*Excellent correlation with gait (r = 0.67)
*Excellent correlation with gait (r = 0.67)  
*Excellent correlation with mobility (r = 0.71)
*Excellent correlation with mobility (r = 0.71)  
*Adequate correlation with fall history (r = -0.47)
*Adequate correlation with fall history (r = -0.47)  
*Poor correlation with medical conditions (r = -0.18)
*Poor correlation with medical conditions (r = -0.18)  
*Adequate correlation with self-rated health status (r = 0.36)
*Adequate correlation with self-rated health status (r = 0.36)


=== Responsiveness  ===
=== Responsiveness  ===


''Elderly:&nbsp;''(Powell &amp; Myers, 1995)&nbsp;<ref name="Powell and Myers">Powell, L. and Myers, A. "The activities-specific balance confidence (ABC) scale." The Journals of Gerontology: Series A 1995 50(1): M28</ref>
''Elderly:&nbsp;''(Powell &amp; Myers, 1995)&nbsp;<ref name="Powell and Myers">Powell, L. and Myers, A. "The activities-specific balance confidence (ABC) scale." The Journals of Gerontology: Series A 1995 50(1): M28</ref>  


*Large responsiveness between low and high mobility groups (Effect size = 1.20)
*Large responsiveness between low and high mobility groups (Effect size = 1.20)


''Elderly:&nbsp;''(Harada et al, 1995; n = 53 individuals living in two residential care facilities for the elderly)&nbsp;<ref name="Harada et al">Harada, N., Chiu, V., et al. "Screening for balance and mobility impairment in elderly individuals living in residential care facilities." Physical Therapy 1995 75(6): 462</ref>
''Elderly:&nbsp;''(Harada et al, 1995; n = 53 individuals living in two residential care facilities for the elderly)&nbsp;<ref name="Harada et al">Harada, N., Chiu, V., et al. "Screening for balance and mobility impairment in elderly individuals living in residential care facilities." Physical Therapy 1995 75(6): 462</ref>  


*Sensitivity (59%)
*Sensitivity (59%)  
*Specificity (82%)
*Specificity (82%)


''Parkinson Disease:&nbsp;''(Cakit et al 2007)&nbsp;<ref name="Cakt et al">Cakt, B. D., Nacir, B., et al. "Cycling progressive resistance training for people with multiple sclerosis: a randomized controlled study." American Journal of Physical Medicine and Rehabilitation 2010 89(6): 446-457</ref>
''Parkinson Disease:&nbsp;''(Cakit et al 2007)&nbsp;<ref name="Cakt et al">Cakt, B. D., Nacir, B., et al. "Cycling progressive resistance training for people with multiple sclerosis: a randomized controlled study." American Journal of Physical Medicine and Rehabilitation 2010 89(6): 446-457</ref>  


*FES scores improved significantly (p &lt; 0.01) in treadmill group but not in control group. (Also significant score change for BBS and DGI). However, FES did not differentiate “fallers” and “non-fallers” at baseline nor after treadmill training
*FES scores improved significantly (p &lt; 0.01) in treadmill group but not in control group. (Also significant score change for BBS and DGI). However, FES did not differentiate “fallers” and “non-fallers” at baseline nor after treadmill training


=== Miscellaneous<span style="font-size: 20px; font-weight: normal;" class="Apple-style-span"></span><br>  ===
=== Miscellaneous<br>  ===


== Links  ==
== Links  ==


[http://www.rehabmeasures.org/PDF%20Library/Falls%20Efficacy%20Scale.pdf Tinetti Falls Efficacy Scale]
[http://www.rehabmeasures.org/PDF%20Library/Falls%20Efficacy%20Scale.pdf Tinetti Falls Efficacy Scale]  


== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
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References will automatically be added here, see [[Adding References|adding references tutorial]].  
References will automatically be added here, see [[Adding References|adding references tutorial]].  


<references />
<references />  
 
[[Category:Outcome_Measures]]

Revision as of 12:19, 4 September 2014

 

Original Editor - Sinead Greenan

Top Contributors - Kim Jackson, Sinead Greenan, Lucinda hampton, Oyemi Sillo, Scott Buxton, WikiSysop, Vidya Acharya, Lauren Lopez, 127.0.0.1, Evan Thomas, Naomi O'Reilly, Uchechukwu Chukwuemeka, Amrita Patro and Aminat Abolade  

Objective
[edit | edit source]

The Tinetti Falls Efficacy Scale is used to assess perception of balance and stability during activities of daily living and fear of falling in the elderly population, along with those diagnosed with Multiple Sclerosis

Intended Population
[edit | edit source]

Community and hospital inpatients with acquired brain injury, multiple sclerosis, spinal cord injury, stroke and the elderly population.

Method of Use[edit | edit source]

  • The Tinetti Falls Efficacy Scale is a 10-item questionnaire designed to assess confidence in patients' ability to perform 10 daily tasks without falling as an indicator of how one's fear of falling impacts physical performance
  • Each item is rated from 1 ("very confident") to 10 ("not confidenent at all"), and the per item ratings are added to generate a summary total score
  • Total scores can range from 10 (best possible) to 100 (worst possible). Thus, lower scores indicate more confidence and higher scores indicate lack of confidence and greater fear of falling

Reference
[edit | edit source]

Evidence[edit | edit source]

Reliability[edit | edit source]

Test-retest Reliability:

Geriatric: (Tinetti et al, 1990) [1]

  • Adequate test-retest reliability (r = 0.71)

Chronic Stroke: (Hellstrom & Lindmark, 1999; n = 30; mean age = 65 (11) years; stroke onset between 5 and 84 months prior to assessment) [2]

  • Excellent test-retest reliability (ICC = 0.97)

Validity[edit | edit source]

Criterion Validity:

Geriatric: (Huang & Wang, 2009) [3]

  • Adequate concurrent validity with the ABC Scale (r = -0.55)
  • Adequate concurrent validity with the Geriatric Fear of Falling Measurement (r = -0.57)

Geriatric: (Powell and Myers, 1995; n = 60 community dwelling seniors aged 65-95; self-classified as either high or low in mobility confidence) [4]

  • Excellent correlation with the Activities Specific Balance Confidence Scale (ABC) (r = 0.84)

Spinal Cord Injury: (Wirz et al, 2010) [5]

  • Excellent concurrent validity with the Berg Balance Scale and the 16-item FES-I (r = -0.81)

Construct Validity:

Geriatric: (Huang & Wang, 2009) [3]

  • Poor correlation with age (r = -0.23)
  • Excellent correlation with balance (r = 0.66)
  • Excellent correlation with gait (r = 0.67)
  • Excellent correlation with mobility (r = 0.71)
  • Adequate correlation with fall history (r = -0.47)
  • Poor correlation with medical conditions (r = -0.18)
  • Adequate correlation with self-rated health status (r = 0.36)

Responsiveness[edit | edit source]

Elderly: (Powell & Myers, 1995) [4]

  • Large responsiveness between low and high mobility groups (Effect size = 1.20)

Elderly: (Harada et al, 1995; n = 53 individuals living in two residential care facilities for the elderly) [6]

  • Sensitivity (59%)
  • Specificity (82%)

Parkinson Disease: (Cakit et al 2007) [7]

  • FES scores improved significantly (p < 0.01) in treadmill group but not in control group. (Also significant score change for BBS and DGI). However, FES did not differentiate “fallers” and “non-fallers” at baseline nor after treadmill training

Miscellaneous
[edit | edit source]

Links[edit | edit source]

Tinetti Falls Efficacy Scale

Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

References will automatically be added here, see adding references tutorial.

  1. ↑ Tinetti, M., Richman, D., et al. "Falls efficacy as a measure of fear of falling." Journal of gerontology 1990 45(6): P239
  2. ↑ Hellstrom, K. and Lindmark, B. "Fear of falling in patients with stroke: a reliability study." Clinical rehabilitation 1999 13(6): 509
  3. ↑ 3.0 3.1 Huang, T. T. and Wang, W. S. "Comparison of three established measures of fear of falling in community-dwelling older adults: psychometric testing." International Journal of Nursing Studies 2009 46(10): 1313-1319
  4. ↑ 4.0 4.1 Powell, L. and Myers, A. "The activities-specific balance confidence (ABC) scale." The Journals of Gerontology: Series A 1995 50(1): M28
  5. ↑ Wirz, M., Muller, R., et al. "Falls in persons with spinal cord injury: validity and reliability of the Berg Balance Scale." Neurorehabil Neural Repair 2010 24(1): 70-77
  6. ↑ Harada, N., Chiu, V., et al. "Screening for balance and mobility impairment in elderly individuals living in residential care facilities." Physical Therapy 1995 75(6): 462
  7. ↑ Cakt, B. D., Nacir, B., et al. "Cycling progressive resistance training for people with multiple sclerosis: a randomized controlled study." American Journal of Physical Medicine and Rehabilitation 2010 89(6): 446-457
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