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Test-Retest Reliability and Construct Validity of the Tinetti Performance-Oriented Mobility Assessment in People With Stroke

Canbek, Jennifer PT, PhD, NCS; Fulk, George PT, PhD; Nof, Leah PT, MS, PhD; Echternach, John DPT, EdD, ECS, FAPTA

Journal of Neurologic Physical Therapy: March 2013 - Volume 37 - Issue 1 - p 14–19
doi: 10.1097/NPT.0b013e318283ffcc
Research Articles
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Background and Purpose: The Tinetti Performance-Oriented Mobility Assessment (POMA) is commonly used to measure balance ability in older adults. The purpose of this study was to determine the test-retest reliability and minimal detectable change (MDC) of the POMA and explore its cross-sectional and longitudinal construct validity for use in people early after stroke.

Methods: Participants were recruited if they had a first documented stroke and were receiving physical therapy during inpatient rehabilitation. The POMA, gait speed, and motor Functional Independence Measure (FIM) scores were collected at admission and at discharge from inpatient rehabilitation. A second trial of the POMA was conducted 1 day after the first trial for reliability analysis. Correlations (Spearman ρ) between raw scores of admission and discharge outcome measures, as well as change in scores between admission and discharge, were used to explore the construct validity of the POMA.

Results: Fifty-five people, with average age of 75 ± 11 years, who had experienced first documented stroke participated in the study and began inpatient physical therapy at a mean of 8 ± 5 days poststroke. Test-retest reliability intraclass correlation coefficient (ICC2,1) was 0.84 and MDC was 6 points. The POMA scores were moderately correlated to motor FIM and gait speed scores at admission (rs = 0.55 and 0.70) and discharge (rs = 0.55 and 0.82.) Change scores of all 3 measures had a fair correlation (rs = 0.28–0.51).

Discussion and Conclusions: Test-retest reliability and MDC of the POMA in people with stroke is similar to previous research in older adult long-term care residents. Results support cross-sectional and longitudinal construct validity of the POMA in persons early after stroke and demonstrate validity and reliability to measure balance ability in this population.

Video Abstract available (see Video, Supplemental Digital Content 1, for more insights from the authors.

Nova Southeastern University, Physical Therapy Program, Fort Lauderdale, Florida (J.C., G.F., L.N., J.E.); Clarkson University, Physical Therapy Department, Potsdam, New York (G.F.); and Old Dominion University, Physical Therapy Program, Norfolk, Virginia (J.E.).

Correspondence: Jennifer Canbek, PT, PhD, NCS, Nova Southeastern University, Ft Lauderdale, FL 33328 (

This research was presented in a poster format at the American Physical Therapy Association's annual conference in National Harbor, Maryland, on June 10, 2011.

The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

© 2013 Neurology Section, APTA