Tinetti Falls Efficacy Scale

Geriatrics:

(Tinetti et al, 1990; n = 74 community dwelling elderly persons)

• > 80 increased risk of falling
• > 70 indicates a fear of falling

Geriatrics: 

(Harada 1995; n = 53; residents in two residential care facilities; mean age = 83.3 (7.7) years)

• Mean = 18.3 (9.9) 
• Median = 12 (range = 10 - 40)  

(Huang & Wang, 2009; n = 174 community-dwelling adults aged 60 and older; Taiwanese sample)

Geriatric:

(Tinetti et al, 1990)

• Adequate test-retest reliability (r = 0.71)

Geriatric:

(Tinetti et al, 1990)

• Excellent internal consistency (Cronbach’s alpha = 0.91)

Geriatric:

(Huang & Wang, 2009)

• 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)

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

Geriatric: 

(Hotchkiss et al, 2004; n = 118 community dwelling individuals 60 years and older; mean age = 75.8(60-99) years)

• Excellent correlation with Activities Specific Balance Scale (ABC) in individuals 60 years or older (r = 0.86)
• Excellent correlation with Survey and Fear of Falling in the Elderly (SAFE) in individuals 60 years or older (r = 0.67)
• FES cannot identify individuals who restrict their activity
  • Scores on the FES explained 28% of the variance
• FES cannot identify individuals with a history of falling
  • Scores on the FES explained 4% of the variance

Geriatric:

(Huang &  Wang, 2009)

• 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)

Elderly: 

(Powell & Myers, 1995)

• 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)

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

Geriatric Hip Fracture:

(Petrella et al, 2000; n = 56; enrolled in daily rehab (~80 min/session) for 3-6 weeks) 

• Mean change in score over time: 14–72/365, Moderate effect size (0.78), SRM = 0.75.

SCI:

(Wirz et al, 2010; n = 42; mean age = 49.3 (11.5) years; ASIA A = 2, B = 2, C = 35, D = 3; injured within one year of assessment, Swiss sample)

Spinal Cord Injury:

(Wirz et al, 2010)

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

Parkinson disease:

(Rahman et al, 2011. n =110 with PD – all completed questionnaire (out of 130 respondents); mean age 66.7 (8.52); mean duration of disease = 12.1 (7.94); mean self-rated HY stage 2.63 (1.19). Measured Fear of Falling using: FES, SAFFE activity avoidance, and perceived consequence of falling (CoF))

• Mean Tinetti FES = 38.9% (24.8) 

(Thomas et al, 2010; Retrospective survey. n = 102 with idiopathic PD; mean age 70.8 (11.5); Disease duration 7.6 (8.2); MMSE mean 27.3 (2.4); H& Y median 2.5. Excluded 2 subjects as outliers for extremely high fall rate; 59% were non-fallers. Of the fallers, mean fall rate over 3 months was 1.22 (2.5) falls)

• Mean Tinetti FES score: 24.96% (16.99)

Parkinson Disease:

(Rahman et al, 2011; Measured Fear of Falling using: FES, SAFFE activity avoidance, and perceived consequence of falling (CoF))

• Fallers had greater fear than non-fallers (p < 0.05), longer disease duration (p = 0.001), higher HY stage (p < 0.05)
• Tinetti FES variance (41.2%) explained by disability (HY stage), previous falls, and specific mobility indicators but only HY stage was significant predictor of FES (B = -0.41, t = -4.97, p < 0.0005)
• Fear of falling measures collectively explained 65% of variance in PDQ-39 with FES and SAFFE the primary predictors (FES: B = 0.24, t = 2.51, p = 0.015). (SAFFE B = 0.399, t = 3.44, p = 0.001)

(Thomas et al, 2010) 

Parkinson's Disease:

(Cakit et al, 2007; n = 31 with diagnosis of idiopathic PD; mean age = 71.8 (6.4); duration of PD diagnosis = 5.58 (2.9) years; UPDRS motor subscale mean = 18.14 (9.32); MMSE > 20/30; tested in "on" state of medications. RCT with random assignment to treadmill walking or control group)

• FES did not differentiate "fallers" and "non-fallers" at baseline nor after treadmill training

(Rahman et al, 2011)

• FES demonstrated confidence was significantly lower in those with higher falls frequency (p > 0.01)
  • FES non-fallers = 30.8 (25.1) and FES fallers = 40.4 (23.4)

Parkinson Disease:

(Thomas et al 2010)

• In PD with some history of falls (from rare to very frequent) and representing HY stages 1-4, most reported ranges of scores for that did not demonstrate floor effect. The 2 subjects with very high falls frequency rated confidence higher than expected and could represent ceiling effect - median rating = 12.5% (0.71)

Parkinson Disease:

(Cakit et al 2007)

• 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

Chronic Stroke:

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

• Excellent test-retest reliability (ICC = 0.97)

Multiple Sclerosis: 

(Cakt et al, 2010; n = 45 patients with multiple sclerosis; mean age = 37.9 (10.43) years)

• Excellent correlation with 10 meter walk test (r = 0.826)
• Excellent correlation with Dynamic Gait Index (r = -0.601)
• Adequate correlation with Times Up and Go (r = 0.535)
• Excellent correlation with Functional Reach (r = -0.612)
• Excellent correlation with the Beck Depression Inventory (r = 0.811)

Brain Injury (traumatic and anoxic):

(Medley et al., 2006; n = 26, mean = 41.9 (12.4); mean time since injury = 9 years (10); community-dwelling participants; 15 subjects did not use assistive device) 

Spearman Correlation Coefficients: 

P < 0.05

Brain Injury (traumatic and anoxic brain injury): (Medley et al., 2006; n = 26, mean = 41.9 (12.4); mean time since injury = 9 years (10); community-dwelling participants; 15 subjects did not use assistive device) 

• With cutoff score of 80: sensitivity was 54% and specificity was 92% (cut off score based on literature: Tinetti et al, 1990)