Block Building Task Identifies Distinct Groups of Left/Right-hand Choice Patterns After Unilateral Peripheral Nerve...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomechanics

Background:

• Assessing hand function after unilateral peripheral nerve injury is challenging due to the lack of methods capturing asymmetric limb use.
• Traditional self-report surveys may not accurately reflect actual hand choices in daily activities.

Purpose of the Study:

• To introduce the Block Building Task (BBT) as a novel, quantitative method for assessing left/right-hand choices in individuals with unilateral upper extremity impairment.
• To identify distinct patterns of hand usage following peripheral nerve injury.

Main Methods:

• The Block Building Task (BBT) involves participants building abstract shapes with interlocking bricks without instruction on hand preference.
• The primary outcome measured is the fraction of brick pickups initiated by each hand, quantifying hand usage.
• Patient hand usage patterns were clustered to identify distinct groups based on dominant/non-dominant hand use.

Main Results:

• Three distinct hand usage clusters were identified: typical use (44%), consistent dominant hand use (44%), and non-dominant hand preference (13%).
• A significant portion of patients (36%) with an injured dominant hand exhibited atypically increased use of that hand.
• Hand usage patterns were not predictable from clinical characteristics, highlighting the BBT's objective measurement capability.

Conclusions:

• The Block Building Task (BBT) offers a rapid, objective, and inexpensive assessment of hand choices in unconstrained environments for individuals with unilateral upper limb conditions.
• The BBT can identify maladaptive hand use patterns following peripheral nerve injury that are not apparent through clinical assessment alone.