Box and Block Test: Difference between revisions
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'''Original Editor '''- | '''Original Editor '''- [[User:Sinead Greenan|Sinead Greenan]] | ||
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | ||
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== Objective<br> == | == Objective<br> == | ||
The '''Box and Block Test''' is an objective measure of assessing unilateral gross manual dexterity | The '''Box and Block Test''' is an objective measure of assessing unilateral gross manual dexterity | ||
== Intended Population<br> == | == Intended Population<br> == | ||
Those with a range of neurological diagnoses including: | Those with a range of neurological diagnoses including: | ||
*Stroke | *Stroke | ||
*Multiple Sclerosis | *Multiple Sclerosis | ||
*Traumatic Brain Injury (TBI) | *Traumatic Brain Injury (TBI) | ||
*Neuromuscular Disorders | *Neuromuscular Disorders | ||
*Geriatric | *Geriatric | ||
*Spinal Cord Injury (SCI) | *Spinal Cord Injury (SCI) | ||
*Fibromyalgia | *Fibromyalgia | ||
== Method of Use == | == Method of Use == | ||
'''Equipment Required:''' | '''Equipment Required:''' | ||
*Stopwatch | *Stopwatch | ||
*Wooden box dimensioned in 53.7 cm x 25.4 cm x 8.5 cm | *Wooden box dimensioned in 53.7 cm x 25.4 cm x 8.5 cm | ||
*Partition (should be placed at the middle of the box, dividing it in two containers of 25.4 cm each) | *Partition (should be placed at the middle of the box, dividing it in two containers of 25.4 cm each) | ||
*150 wooden cubes (2.5 cm in size) | *150 wooden cubes (2.5 cm in size) | ||
'''Set-Up:''' | '''Set-Up:''' | ||
*A test box with 150 blocks and a partition in the middle is placed lengthwise along the edge of a standard-height table | *A test box with 150 blocks and a partition in the middle is placed lengthwise along the edge of a standard-height table | ||
*The patient should be seated on a standard height chair facing the box 150 blocks should be in the compartment of the test box on the side of the patient’s dominant hand | *The patient should be seated on a standard height chair facing the box 150 blocks should be in the compartment of the test box on the side of the patient’s dominant hand | ||
*The examiner should face the patient so she or he could view the blocks being transported | *The examiner should face the patient so she or he could view the blocks being transported | ||
'''Description:''' | '''Description:''' | ||
The patient is allowed a 15-second trial period prior to testing | |||
*Individuals are seated at a table, facing a rectangular box that is divided into two square compartments of equal dimension by means of a partition. | |||
*Individuals are seated at a table, facing a rectangular box that is divided into two square compartments of equal dimension by means of a partition. | *One hundred and fifty, 2.5 cm, colored, wooden cubes or blocks are placed in one compartment or the other. | ||
*One hundred and fifty, 2.5 cm, colored, wooden cubes or blocks are placed in one compartment or the other. | *The individual is instructed to move as many blocks as possible, one at a time, from one compartment to the other for a period of 60 seconds. | ||
*The individual is instructed to move as many blocks as possible, one at a time, from one compartment to the other for a period of 60 seconds. | *Standardized dimensions for the test materials and procedures for test administration and scoring have been provided by Mathiowetz et al, 1985. | ||
*Standardized dimensions for the test materials and procedures for test administration and scoring have been provided by Mathiowetz et al, 1985. | *To administer the test, the examiner is seated opposite the individual in order to observe test performance. | ||
*To administer the test, the examiner is seated opposite the individual in order to observe test performance. | *The BBT is scored by counting the number of blocks carried over the partition from one compartment to the other during the one-minute trial period. | ||
*The BBT is scored by counting the number of blocks carried over the partition from one compartment to the other during the one-minute trial period. | *Patient’s hand must cross over the partition in order for a point to be given, and blocks that drop or bounce out of the second compartment onto the floor are still rewarded with a point. | ||
*Patient’s hand must cross over the partition in order for a point to be given, and blocks that drop or bounce out of the second compartment onto the floor are still rewarded with a point. | *Multiple blocks carried over at the same time count as a single point. | ||
*Multiple blocks carried over at the same time count as a single point. | |||
*Higher scores on the test indicate better gross manual dexterity | *Higher scores on the test indicate better gross manual dexterity | ||
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(ARAT = Action Research Arm Test, BBT = Box and Block Test, CI = confidence interval, FMA = Fugl-Meyer Assessment, MAL-AOU = Motor Activity Log-Amount of Use, MAL-QOM = Motor Activity Log-Quality of Movement, NHPT = Nine-Hole Peg Test, SIS = Stroke Impact Scale) | (ARAT = Action Research Arm Test, BBT = Box and Block Test, CI = confidence interval, FMA = Fugl-Meyer Assessment, MAL-AOU = Motor Activity Log-Amount of Use, MAL-QOM = Motor Activity Log-Quality of Movement, NHPT = Nine-Hole Peg Test, SIS = Stroke Impact Scale) | ||
<u>Construct Validity (Convergent/Discriminant)</u> | <u>Construct Validity (Convergent/Discriminant)</u> | ||
<u></u>Upper Limb Impairment: (Desrosiers et al, 1994) <ref name="Desrosiers et al">Desrosiers, J., Bravo, G., et al. "Validation of the Box and Block Test as a measure of dexterity of elderly people: reliability, validity, and norms studies." Arch Phys Med Rehabil 1994 75: 751-755</ref> | <u></u>Upper Limb Impairment: (Desrosiers et al, 1994) <ref name="Desrosiers et al">Desrosiers, J., Bravo, G., et al. "Validation of the Box and Block Test as a measure of dexterity of elderly people: reliability, validity, and norms studies." Arch Phys Med Rehabil 1994 75: 751-755</ref> | ||
*Excellent convergent validity with the Action Research Arm Test (r = 0.80) | *Excellent convergent validity with the Action Research Arm Test (r = 0.80) | ||
*Adequate convergent validity with Functional Autonomy Measurement System (r (right hand) = 0.47; r (left hand) = 0.51) | *Adequate convergent validity with Functional Autonomy Measurement System (r (right hand) = 0.47; r (left hand) = 0.51) | ||
Upper Extremity Paresis: (Platz et al, 2005) <ref name="Platz et al">Platz, T., Pinkowski, C., et al. "Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Block Test: a multicentre study." Clin Rehabil 2005 19(4): 404-411</ref> | Upper Extremity Paresis: (Platz et al, 2005) <ref name="Platz et al">Platz, T., Pinkowski, C., et al. "Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Block Test: a multicentre study." Clin Rehabil 2005 19(4): 404-411</ref> | ||
*Excellent convergent validity with the Action Research Arm Test (r = 0.95) | *Excellent convergent validity with the Action Research Arm Test (r = 0.95) | ||
*Excellent convergent validity with the Fugl-Meyer Test (r = 0.92) | *Excellent convergent validity with the Fugl-Meyer Test (r = 0.92) | ||
*Excellent convergent validity with the Hemispheric Stroke Scale (r = -0.67) | *Excellent convergent validity with the Hemispheric Stroke Scale (r = -0.67) | ||
*Adequate convergent validity with the Passive Joint motion/Joint pain sub-scale of Fugl-Meyer Test (r = 0.43) | *Adequate convergent validity with the Passive Joint motion/Joint pain sub-scale of Fugl-Meyer Test (r = 0.43) | ||
*Poor convergent validity with the Modified Barthel Index (r = 0.04) | *Poor convergent validity with the Modified Barthel Index (r = 0.04) | ||
Central Paresis: (Platz et al, 2008; n = 33 neurological patients with central paresis due to stroke, ischemic/anoxic brain damage, traumatic brain injury, or spinal cord injury; n=3 patients with SCI(C3,C4,T8), 6 patients with TBI, and 23 patients with stroke; sex = 20 males, 13 females; mean duration of disease = 19.4 months; mean age = 49.7(17.3) years) <ref name="Platz et al">Platz, T., Vuadens, P., et al. "REPAS, a summary rating scale for resistance to passive movement: item selection, reliability and validity." Disabil Rehabil 2008 30(1): 44-53</ref> | Central Paresis: (Platz et al, 2008; n = 33 neurological patients with central paresis due to stroke, ischemic/anoxic brain damage, traumatic brain injury, or spinal cord injury; n=3 patients with SCI(C3,C4,T8), 6 patients with TBI, and 23 patients with stroke; sex = 20 males, 13 females; mean duration of disease = 19.4 months; mean age = 49.7(17.3) years) <ref name="Platz et al">Platz, T., Vuadens, P., et al. "REPAS, a summary rating scale for resistance to passive movement: item selection, reliability and validity." Disabil Rehabil 2008 30(1): 44-53</ref> | ||
*Excellent convergent validity with Resistance to Passive Movement (r = -0.680) | *Excellent convergent validity with Resistance to Passive Movement (r = -0.680) | ||
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=== Responsiveness === | === Responsiveness === | ||
Not established | Not established | ||
=== Miscellaneous<br> === | === Miscellaneous<br> === | ||
== Links == | == Links == | ||
[http://www.rehabmeasures.org/PDF%20Library/Box%20and%20Blocks%20Test%20Instructions.pdf Box and Block Test] | [http://www.rehabmeasures.org/PDF%20Library/Box%20and%20Blocks%20Test%20Instructions.pdf Box and Block Test] | ||
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | == Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | ||
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References will automatically be added here, see [[Adding References|adding references tutorial]]. | References will automatically be added here, see [[Adding References|adding references tutorial]]. | ||
<references /><br> | <references /><br> | ||
[[Category:Outcome_Measures]] |
Revision as of 12:16, 4 September 2014
Original Editor - Sinead Greenan
Top Contributors - Sinead Greenan, Kim Jackson, Scott Buxton, Oyemi Sillo, Evan Thomas, WikiSysop, Adam Vallely Farrell, 127.0.0.1, Admin and Candace Goh
Objective
[edit | edit source]
The Box and Block Test is an objective measure of assessing unilateral gross manual dexterity
Intended Population
[edit | edit source]
Those with a range of neurological diagnoses including:
- Stroke
- Multiple Sclerosis
- Traumatic Brain Injury (TBI)
- Neuromuscular Disorders
- Geriatric
- Spinal Cord Injury (SCI)
- Fibromyalgia
Method of Use[edit | edit source]
Equipment Required:
- Stopwatch
- Wooden box dimensioned in 53.7 cm x 25.4 cm x 8.5 cm
- Partition (should be placed at the middle of the box, dividing it in two containers of 25.4 cm each)
- 150 wooden cubes (2.5 cm in size)
Set-Up:
- A test box with 150 blocks and a partition in the middle is placed lengthwise along the edge of a standard-height table
- The patient should be seated on a standard height chair facing the box 150 blocks should be in the compartment of the test box on the side of the patient’s dominant hand
- The examiner should face the patient so she or he could view the blocks being transported
Description:
The patient is allowed a 15-second trial period prior to testing
- Individuals are seated at a table, facing a rectangular box that is divided into two square compartments of equal dimension by means of a partition.
- One hundred and fifty, 2.5 cm, colored, wooden cubes or blocks are placed in one compartment or the other.
- The individual is instructed to move as many blocks as possible, one at a time, from one compartment to the other for a period of 60 seconds.
- Standardized dimensions for the test materials and procedures for test administration and scoring have been provided by Mathiowetz et al, 1985.
- To administer the test, the examiner is seated opposite the individual in order to observe test performance.
- The BBT is scored by counting the number of blocks carried over the partition from one compartment to the other during the one-minute trial period.
- Patient’s hand must cross over the partition in order for a point to be given, and blocks that drop or bounce out of the second compartment onto the floor are still rewarded with a point.
- Multiple blocks carried over at the same time count as a single point.
- Higher scores on the test indicate better gross manual dexterity
Reference
[edit | edit source]
Evidence[edit | edit source]
Reliability[edit | edit source]
Test-retest Reliability:
Acute and Chronic Stroke: (Chen et al, 2009) [1]
- Excellent test-retest reliability when tested on more affected (r = 0.98) and less affected hand (r = 0.93)
Upper Limb Impairment: (Desrosiers et al, 1994; n = 35 able bodied subjects; mean age = 71.7(60-89) years; n = 34 subjects with impairment; mean age = 74.5(65-87) years) [2]
- Excellent test-retest reliability of the right hand for able bodied subjects (ICC= 0.97)
- Excellent test-retest reliability of the left hand for able bodied subjects (ICC= 0.96)
- Excellent test-retest reliability of the right hand for subjects with impairment (ICC= 0.90)
- Excellent test-retest reliability of the left hand for subjects with impairment (ICC= 0.89)
Upper Extremity Paresis: (Platz et al, 2005; n = 56 people with upper limb paresis as a result of stroke, Multiple Sclerosis (MS), and traumatic brain injury (TBI); median age = 54(13-92) years; n = 37 for stroke; median age = 62(22-92) years; n = 14 for MS; median age = 43(28-60) years; n = 5 for TBI; median age = 34(13-50) years) [3]
- Excellent test-retest reliability (ICC = 0.96)
Spastic Hemiplegia: (Siebers et al, 2010) [4]
- Excellent test-retest reliability (ICC = 0.95)
Interrater/Intrarater Reliability:
Normal Adults: (Mathiowetz et al, 1985) [5]
- Excellent interrater reliability for the right hand (r = 1.00)
- Excellent interrater reliability for the left hand (r = 0.99)
Upper Extremity Paresis: (Platz et al, 2005) [3]
- Excellent interrater reliability (ICC = 0.99)
Spastic Hemiplegia: (Siebers et al, 2010) [4]
- Excellent interrater reliability (r = 0.95)
Fibromyalgia: (Canny et al, 2009; n = 30 participants with fibromyalgia; mean age = 46.9(range 20-68) years; n = 30 healthy participants; mean age= 41.2(29-52) years) [6]
- Excellent intrarater reliability for participants with fibromyalgia (ICC = 0.90)
- Excellent intrarater reliability for healthy participants (ICC = 0.98)
- Excellent interrater reliability for participants with fibromyalgia (ICC = 0.85)
- Excellent interrater reliability for healthy participants (ICC = 0.80)
Validity[edit | edit source]
Criterion Validity (Predictive/Concurrent):
Stroke:
(Lin et al, 2010; n = 59 patients with stroke; sex = 47 males, 12 females; mean age = 55.5(11.66) years)
Concurrent Validity Pre- and Post- Treatment
Measure | Pretreatment (r) | Posttreatment (r) |
NHPT | -0.80 (Excellent) | -0.71 (Excellent) |
ARAT | 0.63 (Excellent) | 0.64 (Excellent) |
FMA | 0.44 (Adequate) | 0.35 (Adequate) |
MAL-AOU | -0.37 (Adequate) | 0.49 (Adequate) |
MAL-QOM | 0.52 (Adequate) | 0.52 (Adequate) |
SIS | 0.59 (Adequate) | 0.52 (Adequate) |
(ARAT = Action Research Arm Test, BBT = Box and Block Test, CI = confidence interval, FMA = Fugl-Meyer Assessment, MAL-AOU = Motor Activity Log-Amount of Use, MAL-QOM = Motor Activity Log-Quality of Movement, NHPT = Nine-Hole Peg Test, SIS = Stroke Impact Scale)
Construct Validity (Convergent/Discriminant)
Upper Limb Impairment: (Desrosiers et al, 1994) [2]
- Excellent convergent validity with the Action Research Arm Test (r = 0.80)
- Adequate convergent validity with Functional Autonomy Measurement System (r (right hand) = 0.47; r (left hand) = 0.51)
Upper Extremity Paresis: (Platz et al, 2005) [3]
- Excellent convergent validity with the Action Research Arm Test (r = 0.95)
- Excellent convergent validity with the Fugl-Meyer Test (r = 0.92)
- Excellent convergent validity with the Hemispheric Stroke Scale (r = -0.67)
- Adequate convergent validity with the Passive Joint motion/Joint pain sub-scale of Fugl-Meyer Test (r = 0.43)
- Poor convergent validity with the Modified Barthel Index (r = 0.04)
Central Paresis: (Platz et al, 2008; n = 33 neurological patients with central paresis due to stroke, ischemic/anoxic brain damage, traumatic brain injury, or spinal cord injury; n=3 patients with SCI(C3,C4,T8), 6 patients with TBI, and 23 patients with stroke; sex = 20 males, 13 females; mean duration of disease = 19.4 months; mean age = 49.7(17.3) years) [3]
- Excellent convergent validity with Resistance to Passive Movement (r = -0.680)
Responsiveness[edit | edit source]
Not established
Miscellaneous
[edit | edit source]
Links[edit | edit source]
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ Chen, H. M., Chen, C. C., et al. "Test-retest reproducibility and smallest real difference of 5 hand function tests in patients with stroke." Neurorehabil Neural Repair 2009 23(5): 435-440
- ↑ 2.0 2.1 Desrosiers, J., Bravo, G., et al. "Validation of the Box and Block Test as a measure of dexterity of elderly people: reliability, validity, and norms studies." Arch Phys Med Rehabil 1994 75: 751-755
- ↑ 3.0 3.1 3.2 3.3 Platz, T., Pinkowski, C., et al. "Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Block Test: a multicentre study." Clin Rehabil 2005 19(4): 404-411 Cite error: Invalid
<ref>
tag; name "Platz et al" defined multiple times with different content - ↑ 4.0 4.1 Siebers, A., Oberg, U., et al. "The effect of modified constraint-induced movement therapy on spasticity and motor function of the affected arm in patients with chronic stroke." Physiother Can 2010 62(4): 388-396
- ↑ Mathiowetz, V., Volland, G., et al. "Adult norms for the Box and Block Test of manual dexterity." Am J Occup Ther 1985 39(3160243): 386-391
- ↑ Canny, M. L., Thompson, J. M., et al. "Reliability of the box and block test of manual dexterity for use with patients with fibromyalgia." Am J Occup Ther 2009 63(4): 506-510