Abstract
This study aimed to examine the reliabilities (test–retest reliability and measurement error), construct validity, and the interpretability (minimal clinically important difference) of the Box and Block Test (BBT) to interpret test scores precisely for children with UCP. A total of 100 children with UCP were recruited and 50 children from the whole sample assessed the BBT twice within 2-week interval. The BBT, the Melbourne Assessment 2, the Bruininks–Oseretsky Test of Motor Proficiency, 2nd Edition, and the Pediatric Motor Activity Log Revised were measured before and immediately after a 36-h intensive neurorehabilitation intervention. Measurement properties of the BBT were performed according to the COnsensus-based Standards for the selection of health Measurement INstruments checklist. The test–retest reliability of the BBT was high (intraclass correlation coefficient = 0.98). The measurement error estimated by the MDC95 value was 5.95. Construct validity was considered good that 4 of 4 (100%) hypotheses were confirmed. The interpretability estimated by the MCID ranged from 5.29 to 6.46. The BBT is a reliable and valid tool for children with UCP. For research and clinical applications, an improvement of seven blocks on the BBT is recommended as an indicator of statistically significant and clinically important change.
Highlights
This study aimed to examine the reliabilities, construct validity, and the interpretability of the Box and Block Test (BBT) to interpret test scores precisely for children with unilateral cerebral palsy (UCP)
The results indicate that the BBT demonstrates acceptable reliabilities and is significantly correlated (r = 0.40–0.72 and 0.25–0.48 for age bands 1 and 2, respectively) with the manual dexterity subtest of the Movement Assessment Battery for Children–2 (MABC-2)[15]
The score of the BBT had moderate to strong correlations with the four subtests of the Melbourne Assessment 2 (MA2), moderate correlations with the subtest 3 of the BOT-2, and moderate correlations with the AOU/QOM of the Pediatric Motor Activity Log Revised (PMAL-R)
Summary
This study aimed to examine the reliabilities (test–retest reliability and measurement error), construct validity, and the interpretability (minimal clinically important difference) of the Box and Block Test (BBT) to interpret test scores precisely for children with UCP. Abbreviations AOU Amount of use BBT Box and block test BOT-2 Bruininks–Oseretsky test of motor proficiency, 2nd edition ICC Intraclass correlation coefficient MACS The manual ability classification system MA2 Melbourne assessment 2 MDC Minimal detectable change MCID Minimal clinically important difference PMAL-R Pediatric motor activity log-revised QOM Quality of movement UCP Unilateral cerebral palsy. Upper limb functional impairment is one of the most common problems in children with unilateral cerebral palsy (UCP)[1] Such children tend to use their less-affected hand much more frequently than the more-affected hand, which can negatively affect the children’s motor development and further interfere with their participation in daily routines[2,3]. Outcome measures BBT MA2 Range of movement Accuracy Dexterity Fluency Subtest 3 of the BOT-2 PMAL-R AOU QOM
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