Assessment of Manual Abilities Using the Box and Block Test in Children with Bilateral Cerebral Palsy.

Vanessa Zapata-Figueroa,Fernando Ortiz-Corredor,Kuan Lin Chen

doi:10.1155/2022/9980523

Abstract

Objective The aim of this study was to determine the correlation between manual dexterity evaluated with the Box and Block Test (BBT) and the performance of daily activities in children with bilateral cerebral palsy (CP). Methods The BBT was applied to 162 children with cerebral palsy of bilateral distribution aged 6 to 13 years. The level of performance was evaluated according to the Manual Ability Classification System (MACS), Gross Motor Function Classification System (GMFCS), and Pediatric Evaluation of Disability Inventory (PEDI) in the domains of self-care, mobility, and social function. Correlations between the findings of the BBT and the PEDI were determined, and additionally, some specific toileting tasks of the PEDI were evaluated. Results The results of the BBT were lower in the lowest functional levels of the MACS (p ≤ 0.001). The BBT showed a strong correlation with the domains' self-care (r = 0.8), mobility (r = 0.7), and social function (r = 0.6) of the PEDI. The BBT was different between children who were able and children who were not able to perform the toileting tasks that were evaluated. A lower capacity in the BBT obtained in children with functional status GMFCS III, IV, and V was associated with poor performance in toileting tasks evaluated in the PEDI. Conclusion The results of the BBT are correlated with the activities of daily living of children with bilateral CP. The data obtained from this test is used to predict the performance of daily activities of these patients in settings such as school and home and helps to identify contextual factors that influence the level of independence in children with bilateral CP.

Highlights

The functional independence of children with cerebral palsy (CP) is determined by multiple factors, such as cognitive ability, gross motor function, and manual dexterity
The Box and Block Test (BBT) showed a very strong correlation with self-care domain (r = 0:83; 95% CI = 0:77 − 0:87; p ≤ 0:001), a strong correlation with mobility domain (r = 0:70; 95% CI = 0:61 − 0:77; p ≤ 0:001), and a strong correlation with social function domain (r = 0:66; 95% CI = 0:57 − 0:74; p ≤ 0:001) of the Pediatric Evaluation of Disability Inventory (PEDI) (Figure 1)
A significant lower capacity in the BBT obtained in children with functional status Gross Motor Function Classification System (GMFCS) III, IV, and V was associated with poor performance in toileting tasks evaluated in the PEDI

Summary

Introduction

The functional independence of children with cerebral palsy (CP) is determined by multiple factors, such as cognitive ability, gross motor function, and manual dexterity. Manual dexterity involves complex abilities that allow for rapid and coordinated hand movements and that require proper integration of the upper limb with the central nervous system. Gross manual dexterity is strongly related to manual abilities required for a child’s functional independence [1]. Manual ability in children with bilateral CP is affected to different degrees, compromising their independence. Therapeutic activities for the upper limb are an important part of the rehabilitation program and serve to define treatment goals. Therapeutic goals are defined based on a consensus between health professionals, patients, and their families. Goals are established according to the family’s priorities, children’s performance in activities of daily living, and their abilities in standardized settings

Methods

Results

Discussion

Conclusion