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Published on: February 12, 2018
Characterizing upper extremity kinematics in typically developing children during box and blocks test
Robyn M Hansen1, Sara L Arena1, Robin M Queen1
1Kevin P. Granata Biomechanics Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA.
Insights
The Box and Blocks test (BBT) alone does not fully represent upper extremity (UE) kinematics in children. Collecting both BBT scores and kinematic data provides a comprehensive understanding of movement mechanics.
Area of Science:
- Biomechanics
- Pediatric Motor Development
- Rehabilitation Science
Background:
- Upper extremity (UE) kinematics are crucial for assessing functional ability and performance.
- The Box and Blocks test (BBT) is a common measure of manual dexterity but does not capture kinematic details.
- Understanding movement patterns is vital for evaluating children's functional performance.
Purpose of the Study:
- To investigate the correlation between UE kinematics and cycle time per block movement during the BBT in 7-, 9-, and 11-year-old children.
- To determine if BBT scores alone adequately represent UE movement mechanics in a pediatric population.
Main Methods:
- Three-dimensional motion capture was used to record hand velocity, position, and joint angles (shoulder, elbow, wrist) during the BBT.
- Kinematic data were analyzed for block movements, focusing on cycle time and peak joint angles.
- A mixed-effects model and Pearson's Correlation Coefficients were employed to analyze group differences and correlations.
Main Results:
- Significant differences in BBT scores and peak shoulder flexion/abduction were observed between 7- and 11-year-olds.
- Peak elbow flexion differed between 9- and 11-year-olds.
- Correlations between cycle time and kinematic measures were weak, indicating limited representativeness of BBT scores alone.
Conclusions:
- BBT scores alone are insufficient to represent UE kinematics in children.
- Comprehensive assessment requires collecting both BBT performance scores and detailed kinematic data.
- This approach offers deeper insights into pediatric movement mechanics during functional tasks.
Abstract:
Upper extremity kinematics are important for understanding functional ability and performance improvements. The Box and Blocks test (BBT) is a standardized functional test used to measure manual dexterity when evaluating children or patients following a stroke. The BBT measures the number of blocks moved in one minute and therefore, kinematic measures and compensatory strategies cannot be assessed. This study examined the correlation between upper extremity kinematics and cycle time per block movement during the BBT in three age groups (7-, 9-, and 11-year-olds). Participants completed one BBT session while test scores and kinematic measures (hand velocity and position and shoulder, elbow, and wrist range of motion and peak joint angles) were captured using standard three-dimensional motion capture techniques. Kinematic measures were determined for block movements during the middle of each BBT trial. A mixed-effects model was used to identify group differences (α = 0.05). BBT score was different (p = 0.005) between the 7- (44.88 ± 6.03) and the 11-year-old age group (56.95 ± 8.37) along with peak shoulder flexion (p = 0.024) and abduction (p = 0.022). Peak elbow flexion was different (p = 0.049) between the 9- and 11-year-old age groups. No differences were seen between the 7- and 9-year-old age groups. Pearson's Correlation Coefficients were determined between cycle time and each significant kinematic measure, where the cycle time is specific to each block movement (BBT score) and is correlated to the BBT score. This resulted in weak correlations for all the comparisons. Therefore, using BBT score alone is not representative of UE kinematics and both should be collected during this task to provide insight into movement mechanics in a pediatric population.
