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Test-retest Reliability, Interrater Reliability, and Convergent Validity of the Targeted Box and Block Test in an
Kimberly Kontson1, Bin Wang2, Nicole Leung1
1Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD.
Archives of Rehabilitation Research and Clinical Translation
|September 22, 2025
Summary
The targeted Box and Block Test (tBBT) demonstrates excellent reliability for upper limb prosthesis users. This valid measure efficiently assesses functional performance with speed and accuracy.
Area of Science:
- Rehabilitation Medicine
- Prosthetics and Orthotics
- Biomedical Engineering
Background:
- Upper limb prosthesis users require reliable functional assessment tools.
- The targeted Box and Block Test (tBBT) is a novel outcome measure designed for this population.
- Evaluating the psychometric properties of the tBBT is crucial for its clinical adoption.
Purpose of the Study:
- To establish the test-retest reliability of the tBBT.
- To determine the interrater reliability of the tBBT.
- To assess the convergent validity of the tBBT against established measures.
Main Methods:
- An observational study involving 20 upper limb prosthesis users.
- Participants completed the tBBT across two sessions to assess test-retest reliability.
- Multiple raters evaluated the tBBT to assess interrater reliability and convergent validity with the Capacity Assessment of Prosthesis Performance for the Upper Limb (CAPPFUL).
Main Results:
- The tBBT exhibited excellent interrater reliability (ICC: 0.97-0.99) for completion time and unsuccessful transports.
- Good to excellent test-retest reliability was observed (ICC >0.84).
- Strong correlations (r >0.75) were found between repeated tBBT sessions and between different raters, with moderate to strong correlations between tBBT, Box and Block Test (BBT), and CAPPFUL subtasks.
Conclusions:
- The tBBT is a valid and reliable measure for assessing functional performance in upper limb prosthesis users.
- The tBBT offers advantages in ease of implementation and speed.
- It effectively assesses repetitive, ecologically representative movements, quantifying performance through speed and accuracy.
