Tinetti Calculator

Tinetti Calculator

Estimate fall risk from observed balance and gait performance with the 28-point Tinetti assessment.

Balance16 Gait12 Total28
Balance10 observations · 16 points

Begin with the patient seated in a hard, armless chair.

Patient is initially seated in a hard, armless chair. Observe whether sitting balance is steady and safe.
Ask the patient to rise from a hard, armless chair and observe the amount of help or arm support required.
Count the attempts required to rise from the chair.
Assess the first 5 seconds after standing. Unsteady includes staggering, moving the feet, or trunk sway.
Assess sustained standing balance after the first 5 seconds.
With the patient's feet as close together as possible, lightly push the sternum three times while guarding the patient.
With the feet as close together as possible, ask the patient to close the eyes and assess balance.
Ask the patient to turn 360 degrees and observe whether the steps are continuous.
During the 360-degree turn, observe whether the patient remains steady.
Unsafe includes misjudging the distance or falling into the chair.
Gait10 observations · 12 points

Observe the usual pace first, then a rapid but safe pace.

Assess initiation of gait immediately after the patient is told to “go”.
Assess right step length: whether the right foot passes the left stance foot.
Assess left step length: whether the left foot passes the right stance foot.
Assess whether the right foot completely clears the floor.
Assess whether the left foot completely clears the floor.
Estimate whether right and left step lengths appear equal.
Observe whether there is stopping or discontinuity between steps.
Observe the path over about 10 feet and note deviation or use of a walking aid.
Observe trunk sway, knee or back flexion, use of the arms for stability, and use of a walking aid.
Observe whether the heels remain apart or almost touch while walking.

What is the Tinetti test?

The Tinetti test, also known as the Tinetti Performance-Oriented Mobility Assessment (POMA), is a clinical assessment used to evaluate balance, gait, and the risk of falling, particularly in older adults.

The 28-point version of the test has two components:

Assessment Maximum score What it evaluates
Balance 16 points Sitting, standing up, maintaining balance, responding to a nudge, turning, and sitting down
Gait 12 points Gait initiation, step length, foot clearance, symmetry, continuity, path, trunk stability, and walking stance
Total Tinetti score 28 points Overall balance and gait performance

Higher scores indicate better mobility performance and generally correspond to a lower risk of falling. The Tinetti score should nevertheless be considered a screening result rather than a diagnosis or a complete fall-risk assessment.

Important: The Tinetti assessment involves standing, turning, and walking. A person who may be at risk of falling should be assessed with appropriate supervision and support.

How to use the Tinetti calculator?

The Tinetti Calculator converts observations from the balance and gait assessment into a total score out of 28. Select the option that most closely describes the person's actual performance during each task.

Step What to do What to observe
1. Prepare Use a stable, hard, armless chair and provide a safe walking area. Make sure the person can perform the assessment safely.
2. Assess balance Observe the person while sitting, standing up, remaining standing, closing their eyes, responding to a gentle nudge, turning 360°, and sitting down again. Stability, use of the arms or support, number of attempts, staggering, and control of movement.
3. Assess gait Ask the person to begin walking and observe their steps while they walk along a clear path. Gait initiation, step length, foot clearance, symmetry, continuity, deviation, trunk movement, and stance.
4. Select the observations Choose the matching response for every item in the calculator. Each response is automatically assigned 0, 1, or 2 points, depending on the item.
5. Read the result The calculator adds the balance and gait subscores. Balance /16 + Gait /12 = Total /28.
6. Interpret the score Compare the total with the fall-risk ranges below. Lower scores indicate greater mobility impairment and a higher fall risk.

A standard Tinetti assessment generally takes around 10–15 minutes. Commonly described equipment includes a hard armless chair, a stopwatch or watch, and approximately 15 ft (4.6 m) of clear walking space. During gait testing, the examiner should remain close enough to assist if the person becomes unstable.

Quick assessment checklist

Balance — 16 points Gait — 12 points
Sitting balance Gait initiation
Rise from chair Right and left step length
Attempts to rise Right and left foot clearance
Immediate standing balance Step symmetry
Standing balance Step continuity
Response to a nudge Walking path
Standing with eyes closed Trunk stability
360° turn Walking stance
Sitting down

These categories reflect the scoring structure used by this calculator.

Understanding the Tinetti balance and gait scores

The total score is useful, but the two subscores can also show where mobility difficulties are concentrated.

Balance score Gait score
Range 0–16 0–12
Higher score suggests Better postural stability and transfers More stable and coordinated walking
Lower score may reflect problems with Rising, standing, turning, or maintaining balance Gait initiation, step quality, symmetry, foot clearance, or trunk control
Maximum score 16 12

The scoring items used in the calculator are:

Balance scoring items

Item Possible points
Sitting balance 0–1
Rise from chair 0–2
Attempts to rise 0–2
Immediate standing balance 0–2
Standing balance 0–2
Nudged 0–2
Eyes closed 0–1
Turning 360° — steps 0–1
Turning 360° — steadiness 0–1
Sitting down 0–2
Maximum balance score 16

Gait scoring items

Item Possible points
Gait initiation 0–1
Right step length 0–1
Left step length 0–1
Right foot clearance 0–1
Left foot clearance 0–1
Step symmetry 0–1
Step continuity 0–1
Path 0–2
Trunk stability 0–2
Walking stance 0–1
Maximum gait score 12

The individual observations matter as well as the final number. For example, a relatively good total score can still coexist with a noticeable deficit in either balance or gait. Clinical interpretation should therefore consider both subscores and the person's individual difficulties.

Tinetti score table

The Tinetti total score ranges from 0 to 28 points:

Tinetti score = Balance score + Gait score

Tinetti score Fall risk Interpretation
0–18 🔴 High risk Significant balance and/or gait impairment may be present. A comprehensive fall-risk evaluation is appropriate.
19–23 🟠 Moderate risk Some mobility impairment is present and additional risk factors should be considered.
24–28 🟢 Low risk Better balance and gait performance, although the score does not mean that fall risk is absent.

In other words:

🔴 0–18 🟠 19–23 🟢 24–28
High fall risk Moderate fall risk Low fall risk
Lower mobility performance Intermediate mobility performance Higher mobility performance

These thresholds are the ones used by this 28-point Tinetti Calculator and are also reported in contemporary clinical references. Different versions of the POMA and different research populations have produced other proposed cut-off values. For that reason, the result should be interpreted using the scoring system of the specific Tinetti version being administered rather than treating a single threshold as universally diagnostic.

Tinetti calculator FAQ

What is a good Tinetti score?

In the 28-point version used by this calculator, a score of 24–28 points is generally classified as low fall risk. Scores of 19–23 indicate moderate risk, while scores of 18 or below indicate high risk. A high score does not guarantee that a person will not fall.

What does a Tinetti score of 18 mean?

A total score of 18 points falls within the high-risk category. The balance and gait subscores should also be reviewed to identify which part of mobility contributed most to the lower result.

What is the maximum Tinetti score?

The maximum score is 28 points:

  • 16 points for balance;
  • 12 points for gait.

A perfect score therefore equals 16 + 12 = 28 points.

Is the Tinetti test the same as POMA?

Yes. POMA stands for Performance-Oriented Mobility Assessment, and the assessment is commonly referred to as the Tinetti test, Tinetti POMA, or Tinetti Mobility Test. Several versions have appeared in clinical practice and research, so the maximum score and exact item structure should always be checked.

Can a walker or cane be used during the Tinetti test?

An assistive walking device may be used when appropriate. However, the need for an assistive device affects the scoring of some gait and balance observations, including path deviation and trunk stability. The goal is to score the person's observed performance, not to remove an aid that they normally need.

How long does the Tinetti assessment take?

A complete balance and gait assessment typically takes approximately 10–15 minutes to administer.

Can the Tinetti calculator diagnose the cause of falls?

No. The Tinetti Calculator is a screening and assessment aid, not a diagnostic test. Falls are often multifactorial, and a complete evaluation can include medical history, medications, vision, cardiovascular factors, muscle strength, cognition, environmental hazards, and other mobility tests. A concerning Tinetti result should be interpreted together with the broader clinical picture.