Validity and reliability of modified box and block test and targeted box and block test in patients with stroke.

The Box and Block Test (BBT) is commonly used to evaluate unilateral manual dexterity in patients with stroke. While the BBT is quick and simple to use, it causes large measurement variability because the administration is not standardized. In this study, we evaluated the validity and reliability of the modified BBT (mBBT) and a targeted BBT (tBBT) in patients with stroke. Our participants were 50 patients with stroke. We evaluated the criterion validity of the mBBT and tBBT through its correlations with scores on the 9-Hole Peg Test (9-HPT), the Fugl-Meyer Assessment-Upper Extremity test (FMA-UE) and BBT. We analyzed the reliability with test-retest reliability. The mBBT was strongly and positively correlated with the 9 HPT (r = 0.823), and strongly negatively correlated the BBT (r = -0.870) for the more-affected hand (p < 0.001). The tBBT was also strongly positively correlated with the 9 HPT (r = 0.913), and the BBT (r = -0.889) for the more-affected hand (p < 0.001). The mBBT was moderately positively correlated with the FMA-UE (r = -0.574), and the tBBT was moderately correlated with (r = -0.604) for the more-affected hand (p < 0.001). The ICCs for the mBBT and the tBBT ranged from 0.86 to 0.97 for the more-affected hand. In this sample, the mBBT and tBBT appeared to be valid and reliable for patients with stroke.