How To: Make a Relative Motion Orthosis (RMO)

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In this video I'm demo-ing how to make a relative motion orthosis for the middle finger (for PIP flexion, or to keep the MCP extended farther than the other digits). There are LOADS of options for making RMO splints, so let me know if you want to see something specific! The principles remains the same, just the position of the fingers will change.
Updated May 2021: This article may be helpful for more information: handsurgery.org/multimedia/fi...
I used orficast samples for this video, here is the orficast website if you want to know more about that material: www.orfit.com/physical-rehabi...
This video is not sponsored by orficast, by the way, I just really like this material. You can also use lots of other types of thermoplastics, too. I used to use tailor or NCM preferred for my RMOs! What material is your favorite?
Here is the handy BraceLab guide for positioning the fingers (I almost always sneak a peek at this before I bring my patient back because I need that reminder sometimes, heehee): bracelab.com/clinicians-class...
*Disclaimer: This video is not sponsored, all opinions are my own. While I am a Certified Hand Therapist, I can't diagnose you via the internet. Please seek the advice of a medical or rehabilitation professional prior to starting an exercise program.

Опубликовано:

25 мар 2021

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Комментарии : 40

@Digitalnomad267 Год назад

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

@amyhiggs7020 9 месяцев назад

Thank you for the link! Super helpful!!

@mjhprofessional Год назад

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

@tommiejack 3 года назад

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 3 года назад

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.

@godschild5824 3 года назад

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

@ForwardTherapy 3 года назад

Thanks Tracey!!

@kellywavrin7861 2 года назад

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

@TheAtul7788 2 года назад

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

@xrei. 2 года назад

thank you so much

@AYA-Art17 2 года назад

Thanks!

@courtneyflagg7026 2 года назад

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 2 года назад

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 3 года назад

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 3 года назад

Sounds correct!!

@newellzelarayan9117 3 года назад

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

@tommiejack 3 года назад

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 3 года назад

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.

@myscreen2urs 2 года назад

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

@ForwardTherapy 2 года назад

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

@TheMorningGlory91 Год назад

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 Год назад

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 3 месяца назад

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 3 месяца назад

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.

@youssefounaha Год назад

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 Год назад

hooksplint.com this is a great option!

@sevchyk Год назад

What kind of material is it?

@ForwardTherapy Год назад

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

@sevchyk Год назад

@@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 Год назад

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 Год назад

@@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 Год назад

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 Год назад

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

@tommiejack 3 года назад

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 3 года назад

Thank you - this is great feedback!

@ForwardTherapy 3 года назад

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 Год назад

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 Год назад

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

@tommiejack 3 года назад

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

@ForwardTherapy 3 года назад

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