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Interrater and Intrarater Reliability of the Tinetti Balance Test for Individuals with Amyotrophic Lateral Sclerosis

Kloos, Anne D. PhD, PT, NCS1; Bello-Haas, Vanina Dal PhD, PT2; Thome, Rachel MS, PT3; Cassidy, Jan PT4; Lewis, Lisa PT5; Cusma, Tricia PT6; Mitsumoto, Hiroshi MD, DSc7

Journal of Neurologic Physical Therapy:
doi: 10.1097/01.NPT.0000284773.87060.c8
Research Article
Abstract

Background and Purpose: Individuals with amyotrophic lateral sclerosis (ALS) develop balance problems. This study was conducted to determine the reliability of the Tinetti Balance Test for individuals with ALS.

Subjects and Methods: Subjects in Stages I - III volunteered for Parts 1 (n=21) and 2 (n=11). One physical therapist and 2 physical therapy students (Part 1) rated subjects' live performances of the Tinetti Balance Test. Two physical therapists and 4 physical therapy students (Part 2) rated videotaped performances twice.

Results: Excellent ICC values (± 0.90) were found for the total Tinetti Balance Test scores in Parts 1 and 2. In Part 1, substantial to almost perfect agreement among all 3 raters (kappa range 0.62 - 0.84) was found for 88% of individual maneuvers. In Part 2, fair to perfect agreement (kappa range 0.40 -1.00) was found on 93% of maneuver scores recorded 1 week apart for the 6 raters. Conclusion: The results suggest that the Tinetti Balance Test is reliable for examination of individuals with ALS in Stages I-III by physical therapists and physical therapy students.

Author Information

1Post-Doctoral Fellow and Lecturer, Division of Physical Therapy, The Ohio State University, Columbus, OH (akloos@amp.osu.edu)

2Associate Professor, School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Adjunct Associate Professor, Department of Health Sciences, Cleveland State University, Cleveland, OH

3Physical Therapist, Concorde Kids, Canton, OH (at time of study was a student in the Physical Therapy Program at Walsh University, North Canton, OH.)

4At time of study was a student in the Physical Therapy Program at Cleveland State University, Cleveland, OH

5Physical Therapist, Cleveland Clinic Foundation, Cleveland, OH (at time of study was a student in the Physical Therapy Program at Cleveland State University, Cleveland, OH)

6Physical Therapist, Great Lakes Harborside Healthcare, Beachwood, OH (at time of study was a student in the Physical Therapy Program at Cleveland State University, Cleveland, OH)

7Wesley J Howe Professor of Neurology, Director, Eleanor and Lou Gehrig MDA/ALS Center, Division Head Neuromuscular Disease, Columbia University (at time of study was Director of the Amyotrophic Lateral Sclerosis Association Center, Department of Neurology, Cleveland Clinic Foundation, Cleveland, OH)

© 2004 Neurology Section, APTA