Concurrent Validity of a Virtual Version of Box and Block Test for Patients with Neurological Disorders

Abstract

Background: The Box and Block clinical test is a validated and standardized scale for use in the clinical environment that allows the assessment of rough manipulative dexterity. Proposing virtual methods to carry out these assessments is an attempt to eliminate some of the subjectivity that the test may entail depending on the observer and the way in which the patient gives instructions. Applied to the assessment of skills after neurological pathologies, previous experiences in stroke patients have been found. So, this work was centered on the Spinal Cord Injury. Objective: To present the virtual application of the Box and Block scale, as well as details about its design and development for its manipulation based on Leap Motion Controller. Methodology: The relationship between the results obtained in the actual test and in the virtual application in healthy subjects and, mostly, patients with cervical spinal cord injury is analyzed, obtaining a high correlation index between both tests' performance. Results: A high correlation index was obtained between both tests performance, the real and virtual version of the Box and Block Test. Conclusion: This virtual test can serve as an element to evaluate in the future the effectiveness of the RehabHand prototype based on virtual reality applications with a therapeutic and a rehabilitative sense that, manipulated from Leap Motion Controller, allow the improvement of the manipulative dexterity in patients with neurological diseases such as spinal cord injury.

Ηand dexterities assessment in stroke patients based on augmented reality and machine learning through a box and block test

“…The use of such technologies for Virtual patients' assessment through BBT is a relatively new, but highly intriguing and promising approach in rehabilitation, and only a small number of studies have been published. Their primary goal is to provide an objective assessment of hand dexterity, the automation of the procedure, and the correlation of the virtual setting to the traditional BBT test in Parkinson's disease 22 , spinal cord injury 23 , and post-stroke patients 21 , 31 . Other studies explored the feasibility of measuring additional clinical data (hand kinematic parameters) via VR-BBT 19 or investigated the limitations of computer-based BBTs 20 , 32 .…”

“…In 2020 Ona et al proposed a comparable immersive VR implementation on BBT, utilizing controllers, such as the leap motion controller 22 , to evaluate the hand dexterity of Parkinson's disease patients, demonstrating excellent reliability of the measurements. The same year, Rodríguez et al 23 assessed hand dexterity in spinal cord injury (SCI) patients and showed a Leap Motion Controller-based virtual version of the BBT. A significant correlation was also found between the actual and virtual versions of the test.…”

The Use of Leap Motion in Manual Dexterity Testing by the Box and Blocks Test: A Review Study

“…In another study by [27], they developed a form of application of the VBBT using the LMC. The sample in the research consisted of 24 individuals, divided into two groups: the typical group (n = 12) and the group with neurological diseases (n = 12) and, consequently, impairment of upper limb motor function.…”

“…From the studies discussed, it can be noticed some of the advantages and disadvantages of using the LMC [27], which can be a device dependent on the conditions presented by the computer to which it will be connected. Some results [11] showed that participants with less knowledge of video games and VR performed in a slower time than those with more experience, who reported greater enjoyment than those who did not have VR contact.…”