Identifying Mobility Dysfunctions in Elderly Patients

Tinetti, Mary E.; Ginter, Sandra

doi:10.1001/jama.1988.03720080024022

Cited by 239 publications

(47 citation statements)

References 18 publications

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“…However, the results presented here are based on reasonably healthy, elderly women living at home. In hip fracture cases other factors, such as poor general health, immobility, medication and cognitive impairment, may explain a propensity to fall [20][21][22]. If less healthy individuals, such as those in nursing homes had …”

Section: Discussionmentioning

confidence: 99%

Is there a relationship between balance, gait performance and muscular strength in 75-year-old women?

Ringsberg¹

1999

Age and Ageing

134

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Objective: to see if there is a relationship between clinical and laboratory tests of balance, muscular strength and gait in elderly women. Design: a randomized population-based study. Settings: Malmö, Sweden. Methods: we investigated balance with a simple test of standing on one leg, as well as a computerized balance platform. Muscular strength was tested by computerized dynamometer. Extension and flexion of the knee and dorsiflexion of the ankle were tested. We measured the time and number of steps taken to walk a certain distance and the subjects' height and weight. Participants: 418 randomly selected 75-year-old women, of whom 230 took part. Results: there was no relation between the computerized balance tests and any of the other tests. The noncomputerized balance test was correlated with gait time and number of steps ( r = ¹0.50, P < 0.001 and r = ¹0.40, P < 0.001, respectively). Tests of extension and flexion, strength of the knee and ankle dorsiflexion were related to gait, speed and number of steps. Heavy women had poorer balance when assessed by the non-computerized test ( r = ¹0.32, P < 0.001) and with the computerized, stable platform, eyes-open test ( r = 0.27, P < 0.001) and eyesclosed test ( r = 0.44, P < 0.001). The heavier an individual was, the slower her gait and the shorter her steps, despite having stronger knee muscles. Conclusion: there is no relationship between the simple balance tests and computerized platform tests. Muscle strength of the leg is not necessarily linked to balance, but rather to gait performance.

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Section: Discussionmentioning

confidence: 99%

Is there a relationship between balance, gait performance and muscular strength in 75-year-old women?

Ringsberg¹

1999

Age and Ageing

134

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“…Other grades include poor, trace, poor minus, etc. Measurements of gait and balance were performed based on methods recommended by Tinetti and Ginter [26]. Mobility skills were measured using a 1 (total assist) to 7 (complete independence) system to rate each participant's level of ability to transfer, turn, sit, stand, walk, and climb stairs [27].…”

Section: Assessmentsmentioning

confidence: 99%

Physical Performance Effects of Low-Intensity Exercise among Clinically Defined High-Risk Elders

et al. 2003

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Background: Falls are among the leading causes of injuries and deaths. Results from a number of studies have suggested that a community-based exercise program may be effective in improving lower body strength, although some have shown only limited improvements. However, the impact of these programs on gait and balance are equivocal. Further, studies that have specifically targeted deconditioned elderly individuals, rather than individuals drawn from the general community, either showed limited or no improvements in gait and balance. Objective: This study examined the effectiveness of a community-based, short-term, low-intensity exercise intervention strategy on measures of mobility skills, gait and balance, and muscle strength for a clinically targeted group of elderly individuals at high risk of falls. Methods: 245 men and women aged 60 years or older were randomized into either an intervention or control group and received a baseline (T1) assessment. Subjects in the intervention group received up to 24 sessions (45 min long) of low-intensity standard exercise modalities tailored to the individual patient over an 8- to 10-week period. At the conclusion of the program, the participants in the intervention group were instructed to continue performing the exercises at home until 1 year after T1. Measures of physical function and performance were collected for all subjects at three different points of study enrollment. Results: Of the subjects assessed at baseline, 138 (56%) also had a postintervention assessment (T2), 128 (52%) had a 6-month follow-up assessment (T3), and 105 subjects had assessments at all time points. Primary analyses were based on the 105 subjects who had assessments at all time points. Intervention and control subjects did not differ in any of the physical function or performance measures at baseline. Between T1 and T2, the intervention subjects showed significantly greater improvement than the control subjects on all outcomes, with improvements plateauing for most measures between T2 and T3. Gait and balance scores continued to improve throughout the study period for both groups of subjects. Conclusions: This easily implemented, low-intensity exercise program may lead to improvements in physical functioning that are retained over the long term and effectively targets a clinically defined population of deconditioned elders at high risk of falling and sustaining serious injury.

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“…One of these scales [Performance-Oriented Mobility Assessment (POMA)-I, see Appendix 1] was developed by Tinetti in 1986 so as to determine the risk of falls [9]. Within a few years (1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994), Tinetti made some modifications in the components of POMA to be used as an outcome measure in her research population, developed, tested, and released its various versions [1,[9][10][11][12][13][14]. Some maneuvers were included or excluded in compliance with the conditions of the population under investigation.…”

Section: Introductionmentioning

confidence: 99%

Reliability and validity of the Turkish version of the Performance-Oriented Mobility Assessment I

Yücel¹,

Şahin

Doğu

et al. 2012

Eur Rev Aging Phys Act

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The Performance-Oriented Mobility Assessment (POMA)-I is widely used assessment tool for evaluation of balance and gait properties. The aim of this study was to translate POMA-I to Turkish and to assess its reliability and validity. People with amputated lower extremities using prosthetics, those who underwent orthopedic surgery within the last 6 months, those dependent on wheel chairs and also bed-ridden patients, subjects with dementia and Alzheimer's disease, and illiterate people were excluded. After translation into Turkish, the Turkish version of the scale was applied on the participants at 2-week intervals. Volunteers ≥65 years of age were enrolled in the study. Internal consistencies of POMA subscale scores of postural balance and gait, and total score were calculated using Cronbach's α coefficient. The Turkish version was evaluated with respect to inter-and intrarater reliability and test-retest reliability intraclass correlation coefficient (ICC). For validation, Pearson's correlation coefficient between POMA and Berg Balance Scale (BBS) and Timed Up and Go Test (TUGT) was estimated. Eighty participants enrolled in the study with a mean age of 76.5± 6.75 years. In the reliability evaluation of the scale, considering postural balance, gait, and total score, Cronbach's α coefficients were found to be 0.72, 0.83, and 0.88, respectively. ICCs were detected above 0.70 for test-retest reliability and also for interrater and intrarater reliability. In validation study POMA total score had a strong positive correlation with BBS total score (r00.86, p<0.0001), and also a negative correlation with TUGT (r0−0.75, p<0.0001). According to the results of this study, the Turkish version of the POMA-I scale has been found to be a reliable and a valid scale for elderly Turkish people.

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Identifying Mobility Dysfunctions in Elderly Patients

Cited by 239 publications

References 18 publications

Is there a relationship between balance, gait performance and muscular strength in 75-year-old women?

Is there a relationship between balance, gait performance and muscular strength in 75-year-old women?

Physical Performance Effects of Low-Intensity Exercise among Clinically Defined High-Risk Elders

Reliability and validity of the Turkish version of the Performance-Oriented Mobility Assessment I

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