Reliability of Box and Block Test for manual dexterity in patients with rheumatoid arthritis: a pilot study.
01 Dec 2016-International Journal of Rheumatic Diseases (Int J Rheum Dis)-Vol. 19, Iss: 12, pp 1272-1277
TL;DR: The reliability of the Box and Block Test for manual dexterity of upper extremity function in patients with rheumatoid arthritis is determined and the results with age‐ and sex‐matched healthy controls, and also with available normative data are compared.
Abstract: Objective
This study is aimed to determine the reliability of the Box and Block (B&B) Test for manual dexterity of upper extremity function in patients with rheumatoid arthritis (RA) and to compare the results with age- and sex-matched healthy controls, and also with available normative data.
Methods
The reliability of B&B Test was assessed within and between testers using the intraclass correlation coefficient (ICC) in patients with RA attending rheumatology clinics of Christian Medical College Hospital, India. The dexterity scores of patients were then compared with age- and sex-matched controls and the Mathiowetz's population-based normative data by Student's independent t-test.
Results
The interrater and intrarater reliability of the BB contralateral hand 52.65 vs. 65.6, P < 0.001) and population-based normative score (dominant hand 54.87 vs. 80.02, P < 0.001; contralateral hand 52.65 vs. 77.23; P < 0.001). The control group scores were also lower than the normative data. Higher age of patient, longer disease duration and higher disease activity reflected by Disease Activity Score of 28 joints (DAS-28) also correlated well with lower dexterity score.
Conclusions
The B&B Test is a reliable tool for assessing upper extremity function in patients with RA and the dexterity scores are lower for RA patients. The scores had correlation with age, disease duration and disease activity.
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TL;DR: The results of this investigation suggest that programs designed to prevent the decline, as well as improve, handgrip strength and manual dexterity might improve the oral hygiene of older adults.
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References
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TL;DR: Hand function deteriorated during a 5-year period in female RA patients and hand disability (GAT) improved in the male RA group, although hand impairment (grip strength, KFT) was unchanged.
Abstract: Objective
To follow hand function and activity of daily living (ADL) capacity prospectively during a 5-year period in a cohort of outpatients with rheumatoid arthritis (RA).
Methods
Forty-three patients (28 women, 15 men), mean age 53.7 years and mean disease duration 7.5 years, were included. The Grip Ability Test (GAT), grip strength, the Keitel Function Test (KFT), the Health Assessment Questionnaire (HAQ), self-estimated hand function, and pain scales were used. Need of personal assistance in the HAQ components was recorded as ADL dependence.
Results
After 5 years, the GAT, the KFT, and 3 HAQ components were significantly worse in women. Improved GAT was the only significant change in men. An additional 12 patients needed personal ADL assistance, bringing the total to 21 patients (49%).
Conclusions
Hand function deteriorated during a 5-year period in female RA patients. Hand disability (GAT) improved in the male RA group, although hand impairment (grip strength, KFT) was unchanged. Over one-fourth of each gender group had developed a new handicap (dependence).
66 citations
TL;DR: The tested instruments can all be used to evaluate hand function in people with Charcot Marie Tooth, and certain factors, however, like limited time aspects for the Nine-Hole Peg Test and the number of trials used, should be taken into consideration.
Abstract: OBJECTIVE: To evaluate the reliability of some measurements of hand function in people with Charcot Marie Tooth disease.
DESIGN: Test retest study. SETTING: University, hospitals/clinics in norther ...
57 citations
TL;DR: The ABILHAND questionnaire is a clinically valid person-centred measure of manual ability that could be useful in longitudinal RA studies and stable across demographic and clinical subgroups and over time.
Abstract: OBJECTIVE: Hand and upper limb involvement is common in patients with rheumatoid arthritis (RA). However, its impact on manual activities of daily life has not been fully evaluated. A measure of manual ability was developed, through the Rasch measurement model, by adapting and validating the ABILHAND questionnaire, which measures the patient's perceived difficulty in performing everyday manual activities. METHODS: 112 patients with RA were evaluated. The following tests were performed: the ABILHAND questionnaire, the Health Assessment Questionnaire (HAQ), the Jamar grip and key pinch strength tests, the Box and Block dexterity test and the Purdue pegboard dexterity test. In total, 35 patients were reassessed to determine the test-retest reliability of the ABILHAND, and 6 patients were studied before and after therapy with tumour necrosis factor (TNF) blockers to address sensitivity to change. RESULTS: The Rasch refinement of the ABILHAND led to a selection of 27 items rated on a 3-point scale. The resulting ability scale was targeted to the ability of the patients. The item-difficulty hierarchy was stable across demographic and clinical subgroups and over time. Grip and key pinch strength and manual and digital dexterity on both hands were significantly, though moderately, correlated with the ABILHAND measures. Manual ability was also significantly related to the number of affected hands, disease duration, tender and swollen joint counts on upper limbs, disease activity and the HAQ. Sensitivity to change was demonstrated in patients treated with TNF blockers, commensurate with their clinical improvement. CONCLUSION: The ABILHAND questionnaire is a clinically valid person-centred measure of manual ability that could be useful in longitudinal RA studies.
55 citations
TL;DR: The box and block test of manual dexterity in normal subjects and relapsing-remitting MS patients is applied and as this test is easily applied and is sensitive in detecting upper extremity functionalability, it is recommended for use in clinical trials to evaluate new drugs in MS patients.
Abstract: Recently new disease-modifying treatments for multiple sclerosis (MS) were introduced which can change the natural course of the disease. In clinical trials with these new agents the Expanded Disability Status Scale (EDSS) is often used as a primary outcome instrument to measure neurological impairment and disability. A number of limitations have been identified when using the EDSS, some of wich are because the EDSS is an ordinal scale that is heavily biased to locomotor function. In this study we applied the box and block test of manual dexterity in normal subjects and relapsing-remitting MS patients. The results were that 64.8% of the female and 80.7% of the male patients had significant changes on this task compared with normal subjects, and as this test is easily applied and is sensitive in detecting upper extremity functional ability, we recommend its use in clinical trials to evaluate new drugs in MS patients.
40 citations
TL;DR: The results of this pilot study demonstrate the importance of defining dexterity, of considering work strategies and of analyzing the work station before planning a hand rehabilitation program and a return to work.
Abstract: The evaluation of dexterity as a measure of hand function requires caution. The results of this pilot study demonstrate the importance of defining dexterity, of considering work strategies and of analyzing the work station before planning a hand rehabilitation program and a return to work.
35 citations