Fine motor & dexterity
Box and Block Test
Unilateral gross manual dexterity, scored as the number of 2.5 cm blocks transferred over a partition in 60 seconds. Normed on 628 adults ages 20 to 94.
Administration
- Standard box: 53.7 cm long, partitioned at the center by a 15.2 cm divider into two equal compartments, with 150 wooden blocks, 2.5 cm per side.
- Blocks start in the compartment on the side of the hand being tested. Participant moves blocks one at a time over the partition; fingertips must cross the partition for a block to count.
- 15-second practice trial, then one 60-second timed trial per hand. Test the dominant hand first.
- Score is the number of blocks transferred in 60 seconds; blocks that drop outside the box after crossing the partition still count, and multiple blocks carried at once count as one.
Normative data
| Age group | Male right | Male left | Female right | Female left |
|---|---|---|---|---|
| 20-24 | 88.2 | 86.4 | 88.0 | 83.4 |
| 25-29 | 85.0 | 84.1 | 86.0 | 80.9 |
| 30-34 | 81.9 | 81.3 | 85.2 | 80.2 |
| 35-39 | 81.9 | 79.8 | 84.8 | 83.5 |
Blocks per 60 seconds, mean values. Verify against the published table before clinical use; full norms cover 12 age groups from 20 to 94 with SD, SE, and low/high scores.
Source: Mathiowetz et al., 1985 (AJOT)
Interpretation
Compare blocks per minute to the age- and sex-matched norm for each hand. Scores decline with age. In clinical populations, the affected-hand score is often compared both to norms and to the less-affected hand.
References
- Mathiowetz V, Volland G, Kashman N, Weber K. Adult norms for the Box and Block Test of manual dexterity. Am J Occup Ther. 1985;39(6):386-391. doi:10.5014/ajot.39.6.386 PubMed
- Shirley Ryan AbilityLab Rehabilitation Measures Database: Box and Block Test. Instrument summary, psychometrics, and normative references. PubMed