Lejeune, ThierryEverard, GauthierBurton, QuentinQuentinBurton2025-05-142025-05-142025-05-142023https://hdl.handle.net/2078.2/34216Background: Comprehensive upper limb assessments are crucial for effective stroke rehabilitation. Virtual reality (VR) and mixed reality (MR) has emerged as an innovative tool, offering immersive experience and the capacity to provide kinematics data. This cross-sectional study addresses a gap in the literature by comparing the content and concurrent validity of different Box and Block Test (BBT) versions using hand tracking (BBT-VR-HT) and controllers (BBT-VR-C) in VR, and mixed reality (BBT-MR) among individuals with stroke (IWS). Hypotheses include strong correlations between XR and traditional BBT versions and potential differences in block displacement. Secondary objectives involve assessing usability and reliability in IWS and healthy control subjects (HCS). Methods: Seventeen IWS, 21 HCS and 5 healthcare professionals in rehabilitation took part to the study. For the content validity, healthcare professionals were asked to perform the BBT, the BBT-VR-C, the BBT-VR-HT and the BBT-MR. They had to answer a questionnaire assessing the differences between the technological tests and the traditional BBT. HCS and IWS were asked to perform the BBT, the BBT-VR-C, the BBT-VR-HT and the BBT-MR three times with the dominant hand for HCS and with the paretic hand for IWS. Statistical analyses comprised Pearson and Spearman correlations, repeated measure ANOVA test, and Friedman test. Short-term test-retest reliability was calculated using intraclass correlation coefficient (ICC) between the second and the third trial. Usability of the three technological tests were also evaluated by HCS and IWS with the System Usability Scale. Results: Regarding content validity, healthcare professionals rated the BBT-VR-C as more difficult (1 [0 – 2]), and both BBT-VR-HT (0 [0 – 1]) and BBT-MR (0 [0 – 1]) as equally difficult to the traditional BBT. For concurrent validity, there were large correlations between the third score of BBT and the third score of BBT-VR-C (r = 0.741; p < 0.001), BBT-VR-HT (r = 0.944; p < 0.001), and BBT-MR (r = 0.953; p < 0.001) among IWS. IWS rated the usability of BBT-VR-C as good (70 [42.2 – 80]). This of BBT-VR-HT (80 [53.75 – 93.75]) and this of BBT-MR (77.5 [46.25 – 92.5]) were rated as excellent. HCS rated the usability of all tests as excellent. Short-term test-retest reliability for BBT-VR-C (ICC = 0.928; p < 0.001), BBT-VR-HT (ICC = 0.976; p < 0.001) and BBT-MR (ICC = 0.989; p < 0.001) were rated as excellent for IWS. The same results were observed for HCS. Conclusion: The BBT-VR-C, the BBT-VR-HT and the BBT-MR are valid, usable, and short-term reliable tools to assess post-stroke gross manual dexterity. Those tests hold potential to be used both in research and clinical practice.BBTVRXRStroke patientStrokevalidityMRvirtual realitymixed realityextended realitycontrollershand-trackingtext::thesis::master thesisthesis:41919