Reliability and responsiveness of the Jebsen-Taylor Test of Hand Function and the Box and Block Test for children with cerebral palsy.
Rodrigo Araneda, Daniela Ebner-Karestinos, Julie Paradis and 4 others
PMID 30761528WHAT IT FOUND
The Box and Block Test and Jebsen-Taylor Test gave stable scores over 2 weeks, except the Box and Block Test on the more affected hand.
They changed after 90 hours of intensive bimanual therapy. Over 120 days without therapy, scores were not stable.
Key findings
01When tested again within 2 weeks without intensive therapy, both tests gave stable scores on both hands, except the Box and Block Test on the more affected hand.
02After 90 hours of either hand and arm bimanual intensive therapy or hand and arm bimanual intensive therapy including lower extremity, the Box and Block Test changed significantly on both hands, and the Jebsen-Taylor Test changed significantly on the more affected hand.
03When tested again after a mean of 120 days without therapy, scores were not stable, and changes exceeded the minimal clinically important difference.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The reliability analysis used 67 children and the responsiveness analysis used 87 children, not all 154 participants. Most children had unilateral cerebral palsy, 108 of 154, and the responsiveness sample was over-represented for Manual Ability Classification System level II, 52 of 87. The minimal clinically important difference was calculated from a numerical method, not from patient or therapist judgment. The responsiveness analyses combined two different intensive therapies, so the study cannot separate the effect of any single therapy. The longer interval without therapy had a mean of 120 days, and developmental change may explain score changes.
Declared interests
The supplied text does not include a conflicts-of-interest declaration. The publication types list research support from N.I.H. extramural and non-U.S. government sources.
The easy way to misread this
Do not treat a score change over 120 days as proof of treatment benefit. The same tests changed significantly over a mean of 120 days without therapy, so developmental change can look like improvement.