Sensitivity of the Tinetti Gait Assessment for detecting change in individuals with Parkinson’s disease

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Abstract
Objective: To determine the Tinetti Gait Assessment’s sensitivity for detecting changes in verbally instructed gait in patients with Parkinson’s disease. Design: Two-group comparison study with sample of convenience. Setting: Motor Behavior Lab, Department of Physical Therapy, University of Florida. Subjects: Twenty community-dwelling, elderly adults: 10 with moderately disabling Parkinson’s disease (PD) recruited from local Parkinson Support Groups and 10 gender and age-matched adults without PD recruited from the local community. Main outcome measures: Tinetti Gait Assessment (TGA) overall scores. All subjects were assessed while walking under ”ve verbally instructed conditions: (1) usual walking, (2) swing arms, (3) take large steps, (4) walk fast, (5) count aloud. Results: A 2 x 5 analysis of variance (group x instructional set) was performed. The PD group scored less than the control group on the TGA regardless of the instructed walking conditions ( p < 0.05), however, there was no signi”cant difference in the TGA scores across conditions. The effect size of the instructional set measured by the TGA was greatest for the swing arms condition, though small at 0.25. Conclusion: The TGA is not sensitive for detecting change in the gait impairments observed in moderately disabling PD and, therefore, is not adequate as an assessment to establish short-term goals, guide treatment, or assess the effects of intervention for clients with PD.

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