Extended reality to assess post-stroke manual dexterity: contrasts between the classic box and block test, immersive virtual reality with controllers, with hand-tracking, and mixed-reality tests.
Gauthier Everard, Quentin Burton, Vincent Van de Sype and 5 others
PMID 38491540WHAT IT FOUND
Virtual and mixed-reality box-and-block tests correlate strongly with the traditional test in stroke survivors, but score lower.
Hand-tracking and mixed-reality versions were rated as more usable and similar in difficulty to the classic test than the controller-based version.
Key findings
01Scores from the hand-tracking immersive VR and mixed-reality tests showed large correlations with the traditional Box and Block Test in people with stroke, while the controller-based VR test showed a moderate correlation.
02Participants with stroke scored significantly lower on all three extended reality tests than on the traditional physical Box and Block Test.
03Healthcare professionals rated the lack of tactile feedback in both immersive VR versions as a major complication, whereas the mixed-reality test, which uses real blocks, did not have this issue.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The mixed-reality test required bidirectional movement and precise placement, unlike the traditional BBT's unidirectional toss, which may explain lower scores. Familiarization periods were longer for iVR tests than for the traditional or MR tests, which could influence performance. Reliability was only assessed within a single session (short-term), so stability over days or weeks is unknown. The study did not assess sensitivity to change, so it is unclear how well these tools detect improvement during rehabilitation. There was an age difference between the stroke group (mean 65.7 years) and the healthy controls (mean 56 years), which may have influenced kinematic comparisons.
Declared interests
The study was supported by non-U.S. government funding. The mixed-reality test used in the study (REAtouch) was developed by AXINESIS, a company mentioned in the paper. The authors state that the supporting data is available in additional files.
The easy way to misread this
Do not compare a patient's score on a virtual or mixed-reality dexterity test directly to their score on the traditional physical Box and Block Test. The XR tests consistently yield lower scores, so a drop in score may reflect the change in assessment method rather than a loss of function.