How To: Make a Relative Motion Orthosis (RMO)

[@Digitalnomad267]

Lady, you just made my life way more comfortable, thanks a lot for this video!

[@tommiejack]

excellent to add the little "tunnel" as this is actually really important with saggittal band injuries that need to be centered carefully for healing in correct position

[@ForwardTherapy]

Thank you - totally agree. I did see a video the other day where a therapist put a velcro strap across the top and I thought that also looked like it could work.

[@TheAtul7788]

Dr, Pls make video on claw hand, ape hand, drop wrist rehabilitation exercises and strength training...

[@mjhprofessional]

Nice video, and yes, this video has been helpful. You made it a fun and comprehendible video to watch.

[@camgiannetti9614]

Great tutorial. Thank you!

[@Emilieajm]

Hello, I have a relative motion orthosis on my ringer finger because of a extensor tendon repair. But my finger rests way higher than what's shown on your video. Could this be problematic for the healing? Thank you

[@ForwardTherapy]

For a tendon repair the finger should be up much higher than what’s shown in the video!!

[@youssefounaha]

Please help me. I've had the same problem with my middle finger for over two years. I also suffer from ring finger on my left hand. Where can I find this splint? I am from Morocco and unfortunately there is no such treatment here. Most doctors only order surgery Help me, sister, please

[@ForwardTherapy]

hooksplint.com this is a great option!

[@TheMorningGlory91]

I injured my sagittal band on my middle knuckle. What is the size that I would need that you are using in this video?

[@ForwardTherapy]

So this isn’t something you’d want to make yourself, but have a hand therapist make for you! The other option that is a prefabricated version is called Hook Splint

[@martinwright1575]

Should this be used 24/7 for a sagittal band tear? How can be wash our hands, take a shower etc while using the splint?

[@ForwardTherapy]

you should definitely discuss with your doctor or the therapist that has made the splint for a specific wearing schedule! but typically yes you should use it 24/7 for a period of 6-8 weeks usually (I usually tell people they can remove for hand washing or showering but can't use the hand to grip while in the shower). the splint CAN actually get wet, (no hot tubs tho, it'll start to get misshapen with hot water) but it will stay wet for a while.

[@godschild5824]

Not awkward at all :-) you do what you got to do!!! Thanks Kelly

[@ForwardTherapy]

Thanks Tracey!!

[@amyhiggs7020]

Thank you for the link! Super helpful!!

[@myscreen2urs]

Can this work for the pinky finger? I need mine to get back full extension

[@ForwardTherapy]

every case is different! I'd talk with your doctor and see if they recommend hand therapy for help regaining full extension if possible.

[@courtneyflagg7026]

Would one of these be suitable to help with ROM on a flexor tendon surgery of the pinky? I'm 6 weeks post op with no movement in the dip and pip joints. Wondering if one of these would help? My therapist is very old school and doesn't utilize many tools for therapy. Also I've read that blocking joints is not recommended for the fifth finger. What's your opinion on this? Not sure how one would work on ROM without blocking. I'm just desperate to get at least some ROM back at this point.

[@ForwardTherapy]

Sometimes they can help - depends on the timeline and the exact post op details. Agree - wouldn’t recommend joint blocking at the pinky!! Now that you’re 6 weeks the exercises should advance (:

[@newellzelarayan9117]

Great video! Very informative! I want to make a RMO for a pt who currently cannot extend at the index finger PIP joint. What fingers would I include to make the RMO and what position should the fingers be in? I am guessing maybe the index finger and small finger should be in MCP flexion? With the Orficast below the proximal phalanxes of the ring and middle finger?

[@ForwardTherapy]

Sounds correct!!

[@newellzelarayan9117]

@@ForwardTherapy Thank you! Looking forward to more of your videos.

[@tommiejack]

actually that is incorrect.... if you want to EXTEND at the PIP joint you have to put the index down in flexion, the next two finger is extension and the small finger in flexion again for a balanced type RMF or you can also put the small finger in extension also for an unbalanced type RMF

[@ForwardTherapy]

I think that’s what the comment was suggesting, at least that’s the way I read it...index and small in flexion in comparison to the middle and ring. Maybe I misunderstood the comment.

[@kellywavrin7861]

Awesome video! I need to find an OT to make this for me. Thank you!

[@sevchyk]

What kind of material is it?

[@ForwardTherapy]

It’s made with thermoplastic. Specifically I used orficast for this video

[@sevchyk]

@@ForwardTherapy Hey, could you please tell me, what other material or option (maybe much cheaper) can help reach the same positive result? (Orficast is very expensive and rare in my country)? What about plaster (that is, gypsum) bandages? If you tape the fourth finger with the third damaged saggital band finger by that bandage, from your practice, what can you say? Does that stabilise the extensor tendon?

[@ForwardTherapy]

You need to get the affected finger in relative extension compared to the adjacent finger, so I don’t think that buddy taping would work. I haven’t tried plaster, not sure if it would be easy to make a relative motion splint for that! But you could also make a splint that is hand based, volarly in the palm, that has a piece that extends the mcp joint of the affected finger!

[@sevchyk]

@@ForwardTherapy From your experience, did this splint (relative motion splint, “yoke” splint) help to reattach the saggital band fibers? Say, after wearing this splint for three weeks, the patients came to you, and what have you seen? Did the tendon cease to slip sideways? Say, out of 10 patients with acute cases of tendon slipping, how many of them came to you and you realised, "Wow, for this patient the tendon surprisingly remains in the center at flexion, but previously it slipped ulnarly'?

[@ForwardTherapy]

Most of the patients I’ve done this for haven’t come back for therapy after the course of immobilization. Here’s a research article about the yoke orthosis for sagittal band: handsurgery.org/multimedia/files/preCourse/relative%20motion%20splint%20Merritt.pdf

[@sevchyk]

Has anybody tried it for a month? Did it work?

[@xrei.]

thank you so much

[@tommiejack]

actually if it is for a sagittal band injury the finger should be in more than the 15 to 20 degree position. That position is for extensor tendon repiar en for sagittal band injury it should be up more like 25 / 35 degrees

[@ForwardTherapy]

Thank you - this is great feedback!

[@ForwardTherapy]

I think what I’ve seen referenced most often is that the MCP is allowed full flexion minus 15-20 degrees, think that’s what I got mixed up on when talking in this video: handsurgery.org/multimedia/files/preCourse/relative%20motion%20splint%20Merritt.pdf

[@franallas3649]

The splint allows MCP flexion, doesn't this affect the healing of the sagittal band ? I thought the idea was to keep the MCP extended to prevent subluxation.

[@ForwardTherapy]

Here is a good article detailing more: handsurgery.org/multimedia/files/preCourse/relative%20motion%20splint%20Merritt.pdf

[@AYA-Art17]

Thanks!

[@tommiejack]

youcan have the patient hold the digit up for you, then you have more fingers free to work with the material

[@ForwardTherapy]

Yes! love this. also could put a pencil in there!