Use of the Box and Block Test for the evaluation of manual dexterity in individuals with central nervous system disorders: A systematic review

Abstract

Objective: The aim of the present study was to perform a systematic review of the literature on the use of the Box and Block Test (BBT) for the evaluation of manual dexterity in patients with central nervous system disorders. Methods: Searches were performed the Medline, PEDro, Lilacs, Scielo and PubMed databases. The articles retrieved during the initial search were analyzed independently by two blinded reviewers based on the following inclusion criteria: (1) controlled clinical trial; (2) population with neurological disorders; (3) evaluation involving the BBT; (4) outcome: evaluation of manual dexterity; (5) year of publication: 2005 and 2016. Preselected articles were evaluated for methodological quality using the Physiotherapy Evidence Database (PEDro) scale (minimum score for inclusion: 5 points). Results: The search resulted in the retrieval of 51 articles, 42 of which did not meet the inclusion criteria. Nine articles addressed the use of the BBT as one of the methods for the evaluation of manual dexterity in patients with central nervous system disorders, were considered methodologically adequate and were included in the present systematic review. Conclusion: The studies analyzed suggest that the BBT is a fast, easy, safe measure of manual dexterity with good applicability for adults and children with neurofunctional diseases.

Assessment of Upper Extremity Function in People With Stroke Based on the Framework of the ICF: A Narrative Review

“…The time to administer the BBT is less than 5 minutes, and training to administer the BBT is not mandatory. The test-retest reliability and construct validity of the BBT have been verified in diverse populations, including older adults, children, and patients with stroke [ 44 45 46 47 ]. Because a previous study found that the score of the BBT was not sensitive to the change of UE function until 5 weeks after onset for stroke patients in the acute phase [ 48 ], the BBT is an effective tool to identify patterns of change in the hand dexterity of stroke patients in at least the subacute stage.…”

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

“…This study has a high potential application taking into account the clinical experiences published by using the real BBT as a tool for the assessment of manual dexterity in several neurological pathologies such as cerebral palsy, and more frequently stroke [1]. Previous studies that have also presented a virtualization of BBT, were mostly focused on stroke pathology [6] [7] [12] and have not shown a dispersion analysis with the actual test.…”

“…Affectation on manipulative dexterity and loss of motor coordination are some of the consequences of neurological diseases, greatly conditioning the autonomy and level of independence and social participation of people who suffer from them. Thus, the quality of movement and performance of daily life activities is heavily influenced by hand function and manipulative dexterity [1].…”

“…There is evidence from several studies that have applied BBT as one of the methods to evaluate manual dexterity in patients with central nervous system disorders. These studies have been analyzed suggesting that BBT is a fast, simple and safe method for measuring manual dexterity with good applicability in adults and children with neurofunctional disorders [1].…”

Measures of Maximal Tactile Pressures during a Sustained Grasp Task Using a TactArray Device Have Satisfactory Reliability and Concurrent Validity in People with Stroke

“…The characteristics of the participants with stroke were based on the following standard clinical measures: the Wolf Motor Function Test (WMFT) [ 72 ], Action Research Arm Test (ARAT) [ 73 ], Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Box and Block Test (BBT) [ 74 , 75 ], grip strength (Jamar dynamometer, Patterson Medical, Pemulwuy, Australia) [ 76 , 77 ], pulp-to-pulp pinch strength (B & L Engineering, Santa Ana, Canada) [ 78 ], Modified Tardieu Scale (MTS) [ 79 ], Tactile Discrimination Test (TDT) [ 80 ], Stroke Impact Scale (SIS) [ 81 ], the Motor Activity Log (MAL) [ 82 , 83 ], and a pain visual analogue scale (PVAS) [ 84 ]. Standard objective performance-based neuropsychological tests were also performed: the Montreal Cognitive Assessment (general indicator of cognitive performance) [ 85 , 86 ], the Star Cancellation Test (neglect) [ 87 , 88 ], and the Rey-Osterrieth Complex Figure Test-copy condition (indicator for visuospatial perception) [ 89 ].…”