Assessment of Manual Abilities Using the Box and Block Test in Children with Bilateral Cerebral Palsy.
Vanessa Zapata-Figueroa, Fernando Ortiz-Corredor
PMID 35281716WHAT IT FOUND
In children with bilateral cerebral palsy, Box and Block Test scores strongly predicted daily living performance.
Scores of 28 to 40 blocks indicated a high probability of managing independent wiping. Low scores suggest looking for environmental barriers or cognitive factors rather than just motor limits.
Key findings
01Box and Block Test scores showed a very strong correlation with PEDI self-care domain scores and strong correlations with mobility and social function.
02Children with an average Box and Block Test score between 28 and 40 had a high probability of independently wiping after bowel movements.
03Most children in GMFCS levels IV and V failed to achieve independence in toileting tasks, with significant differences in performance compared to lower levels.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study did not assess intelligence quotient (IQ), so cognitive factors influencing toileting independence were not controlled for. Most participants were in GMFCS levels III, IV, and V, so the findings may not apply to children with milder motor impairments. The study was conducted at a single center in Colombia, so results may not generalize to other populations or settings. Test-retest reliability of the Box and Block Test was not established in this specific population.
Declared interests
No specific funding sources or conflicts of interest were reported in the provided text.
The easy way to misread this
Do not assume that a low Box and Block Test score alone explains poor toileting independence. The study found that children with good manual dexterity scores sometimes still depended on caregivers, suggesting that environmental barriers or cognitive factors may be the limiting cause.