title: Reliability of Box and Block Test for manual dexterity in patients with rheumatoid arthritis: a pilot study.
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 B&B Test in patients with RA (n = 60) ranged from 0.92 to 0.97 and 0.91 to 0.95, respectively. The dexterity scores in patients with RA were lower as compared to the control group (dominant hand 54.87 vs. 68.18, P < 0.001; 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.
authors.affiliation: School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India.
authors.forename: Alok
authors.initials: A
authors.lastname: Ranjan
authors.affiliation: Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, India.
authors.forename: Lydia Edward
authors.initials: LE
authors.lastname: Raj
authors.affiliation: Department of Community Health and Development, Christian Medical College, Vellore, India.
authors.forename: Dilesh
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Department of Clinical Immunology & Rheumatology, Christian Medical College, Vellore, India.
authors.forename: Pulukool
authors.initials: P
authors.lastname: Sandhya
authors.affiliation: Department of Clinical Immunology & Rheumatology, Christian Medical College, Vellore, India.
authors.forename: Debashish
authors.initials: D
authors.lastname: Danda
mesh_terms: D000328:Adult; D000367:Age Factors; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000503:physiopathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D015588:Observer Variation; D010865:Pilot Projects; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012219:Rheumatology / Q000379:methods*; D012720:Severity of Illness Index; D013647:Task Performance and Analysis; D013997:Time Factors
keywords: Box and Block Test; DAS 28; hand functions; manual dexterity; rheumatoid arthritis