Modified Box and Block Test to Assess the Roles of Vision and Somatosensation

Reaching and grasping require a combination of visual and somatosensory feedback, both of which can be impaired in neurologic conditions. We examined the effect of removing vision on individuals' ability to perform the Box and Block Test, and compared the effect between younger and older adults and in a small pilot sample of individuals with chronic hemiparetic stroke. Thirty young adults, 16 older adults, and 4 individuals with chronic stroke completed the Box and Block Test with each hand with vision and then with vision occluded. Both younger and older adults had reductions in performance when vision was removed of approximately 27%, with no differences found between age groups or hands. Preliminary data from adults with stroke demonstrated variable performance with the reduction in performance for the less affected hand ranging from 22%-44.4% and for the more affected hand from 42.9%-73.2%. We did not detect any age-related differences in the reliance on vision in our sample. We found that it is feasible to use a modified Box and Block test to assess visual reliance versus somatosensory feedback, and it may be used as a clinically feasible tool for clinical populations, including stroke.