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Box and Block Test (BBT)

The Box and Block Test (BBT) is an outcome measure used to assess and monitor unilateral upper extremity manual dexterity. It has been found to be a valid and reliable outcome measure in a variety of populations including people with Cerebral Palsy1(CP), Fibromyalgia, Charcot-Marie-Tooth (CMT), Multiple Sclerosis (MS), Stroke, Traumatic Brain Injury (TBI), traumatic upper extremity injury, children, and community-dwelling adults. Box and Block set-up includes: a wooden box with dimensions 21.5” by 10.1” divided into two equal compartments by a wooden partition with a height of 6.0”. The box should be opened and placed on a table top in a horizontal orientation in front of the patient, who is seated in a chair. All cubes of 1” are placed on one side of the partition and the patient is asked to transfer as many blocks as they can in 60 seconds to the other side of the box1. The blocks must be transferred one at a time, the patient must only use one hand and the hand should cross the partition in the transfer. The score is indicated by the number of blocks that can be transferred in 60 seconds. The patient should be given a minimum of 15 seconds to practice prior to beginning the test and should start with the dominant hand. At least two trials should be done for each hand and the score averaged.