Use of the Box and Block Test for the evaluation of manual dexterity in individuals with central nervous system disorders: A systematic review

Abstract

Introduction: Therapies designed to improve the functional capacity of the upper limb have become a vast field of research. Current clinical methods for upper extremity evaluations address function, motor control, sensory deficiency, dexterity, muscle tone and range of motion. The quality and performance in relation to activities related to the work of daily living and recreational activities are largely determined by hand functions and manual dexterity. Abnormal dexterity and the loss of motor coordination are among the main adverse conditions stemming from neurological disorders. Objective: The aim of the present study was to perform a systematic review of the literature on the use of the Box and Block Test (BBT) for the evaluation of manual dexterity in patients with central nervous system disorders. Methods: Searches were performed the Medline, PEDro, Lilacs, Scielo and PubMed databases. The articles retrieved during the initial search were analyzed independently by two blinded reviewers based on the following inclusion criteria: (1) controlled clinical trial; (2) population with neurological disorders; (3) evaluation involving the BBT; (4) outcome: evaluation of manual dexterity; (5) year of publication: 2005 and 2016. Preselected articles were evaluated for methodological quality using the Physiotherapy Evidence Database (PEDro) scale (minimum score for inclusion: 5 points). Results: The search resulted in the retrieval of 51 articles, 42 of which did not meet the inclusion criteria. Nine articles addressed the use of the BBT as one of the methods for the evaluation of manual dexterity in patients with central nervous system disorders, were considered methodologically adequate and were included in the present systematic review. Conclusion: The studies analyzed suggest that the BBT is a fast, easy, safe measure of manual dexterity with good applicability for adults and children with neurofunctional diseases.