Use of relative motion orthoses from the perspective of hand-injured patients: A qualitative study
Management of patients with hand injuries often involves the decision to use an orthosis to protect healing tissues, correct deformity, improve function or to control pain.1,2 However, the purpose of the orthosis cannot be realized if it is not worn. During the process of fabrication, other factors aside from the purpose should be considered, such as the patient's life roles, physical and psychosocial needs.3 Patient adherence to orthotic wear may be positively affected if the therapist involves the patient in the design process such as in choosing the color of strapping and orthotic material. (Source: Journal of Hand Therapy)
Source: Journal of Hand Therapy - April 8, 2023 Category: Rehabilitation Authors: Özge Buket Arslan, Yeşim Şahin, İlkem Ceren Sığırtmaç, Büşra Yildiz, Egemen Ayhan, Çiğdem Öksüz Source Type: research
“Around the global hand table”: Hand surgeon and therapist perspectives on overcoming barriers to relative motion orthotic intervention in the management of zones V-VI finger extensor tendon repairs
Our 2021 international survey1 inquiring about hand therapists preferred postoperative management approach of zones V-VI extensor tendon repairs resulted in several unexpected findings. The popularity of the relative motion extension (RME) orthosis/early active motion (EAM) approach (43%), referred to throughout this manuscript as the RME/EAM approach, was not anticipated when compared to the available alternate approaches of: palmar resting interphalangeal joints (IPJs) free/EAM (25%), resting hand orthosis/EAM (15%) dynamic/early passive motion (8%), and resting hand orthosis/immobilization (7%). (Source: Journal of Hand Therapy)
Source: Journal of Hand Therapy - April 8, 2023 Category: Rehabilitation Authors: Julianne W. Howell, Melissa J. Hirth Source Type: research
Use of a relative motion flexion orthosis after epitendinous zone II flexor tendon repair: A case report
Flexor tendon injuries are one of the most common injuries sustained in the hand and occur from a variety of different mechanisms.1 An array of hand therapy approaches have been described in the literature for management of patients after flexor tendon repair.2,3 There is wide acceptance that controlled active mobilization of repaired tendons is essential to improve the quality of the healing tendon and to optimize patient outcomes.4-6 Initiation of early mobilization of tendons after surgery decreases the formation of scar adhesions, promotes strength of the repair, and minimizes the risk of joint stiffness and contractur...
Source: Journal of Hand Therapy - April 8, 2023 Category: Rehabilitation Authors: Megan Blakeway, Julianne Wright Howell Source Type: research
Relative motion orthoses for early active motion after finger extensor and flexor tendon repairs: A systematic review
Tendon injuries are the second most common injury of the hand after fractures, with extensor tendons more frequently injured than flexors.1 They frequently occur in the working-age population, predominantly males.2 In tendon injuries where operative management is indicated, the British Society for Surgery of the Hand (BSSH) standards recommend early surgical repair, within four days of injury3,4. Early rehabilitation is also advised; initiated three to five days post-surgery.5 Tendon repair and rehabilitation must avoid rupture and adhesions, by balancing a strong repair with sufficient tendon glide. (Source: Journal of Hand Therapy)
Source: Journal of Hand Therapy - April 8, 2023 Category: Rehabilitation Authors: Abigail V Shaw, Yash Verma, Sarah Tucker, Abhilash Jain, Dominic Furniss Source Type: research
Systematic review: Zone IV extensor tendon early active mobilization programs
Traditional management of extensor tendon injuries involved a period of immobilization for 4-6 weeks following repair in order to prevent rupture.1 However, early mobilization of tendon repairs has become the standard of care in current times due to the understanding that early mobilization after tendon repair reduces tendon adhesion and supports healing.2 Systematic reviews of rehabilitation after extensor tendon repair have shown that early mobilization provides superior short-term outcomes to immobilization. (Source: Journal of Hand Therapy)
Source: Journal of Hand Therapy - April 7, 2023 Category: Rehabilitation Authors: Shirley Collocott, Amy Wang, Melissa J. Hirth Tags: Research paper Source Type: research
Relative motion orthoses: fabrication tips
Relative Motion (RM) orthoses are an extremely important and beneficial intervention in hand rehabilitation.1 They can be used for a variety of hand conditions such as to protect finger extensor zone IV - VII repairs,1,2 to manage acute and chronic boutonniere deformity,1,3-5 as a tool to relieve pain or other symptoms from trauma or strain about the structures at the metacarpophalangeal (MCP) joint,1 to encourage more flexion or extension in a stiff proximal interphalangeal (PIP) joint1,6,7 and to improve alignment of the MCP joints of people living with rheumatoid arthritis. (Source: Journal of Hand Therapy)
Source: Journal of Hand Therapy - April 7, 2023 Category: Rehabilitation Authors: Deborah A Schwartz Source Type: research
A commentary from the pioneers on the innovation of the relative motion concept: History, biologic considerations, and anatomic rationale
Relative motion is not an orthosis. It is a concept about the normal functional anatomy that may be harnessed and controlled to a beneficial degree by orthoses. Simply stated, the relative motion (RM) concept is recognition that the normal powerful extensor digitorum communis (EDC) and flexor digitorum profundus (FDP) extrinsic muscle forces on the metacarpophalangeal joints (MCPJs), proximal interphalangeal joints (PIPJs) and distal interphalangeal joints (DIPJs) in finger digits significantly vary between digits when there are relative differences in position between their adjacent MCPJs, whether held by an orthosis or n...
Source: Journal of Hand Therapy - April 7, 2023 Category: Rehabilitation Authors: Wyndell Merritt, Sandra Robinson, Maureen Hardy Source Type: research
The use of exercise relative motion orthoses to improve proximal interphalangeal joint motion: A survey of Australian hand therapy practice
Reduced range of motion at the proximal interphalangeal joint (PIPJ) is common and can be difficult to manage following finger injury or surgery.1,2 Yang and colleagues outlined four categories to classify causes of restricted finger movement following hand injury or surgery; including skin and fascia related problems (such as scar tissue), muscle and tendon limitations (such as adhesions or tightness), contractures of joint capsule and ligament, and damage of articular bone.3 Regardless of diagnosis, patients seeking hand therapy may present with one or more of these underlying limitations, which can negatively influence ...
Source: Journal of Hand Therapy - April 6, 2023 Category: Rehabilitation Authors: Sally E. Yates, Joanne V. Glinsky, Melissa J. Hirth, Joel T. Fuller Source Type: research
Relative motion flexion following zone I-III flexor tendon repair: Concepts, evidence and practice.
The concept of relative motion has gained wide acceptance and popularity, particularly through the use of the relative motion extension (RME) orthosis for the management of extensor tendon injuries.1-7 More recently, relative motion flexion (RMF) orthoses have been reported as a potential rehabilitation strategy for patients following zone I-III flexor tendon repair.8-10 (Source: Journal of Hand Therapy)
Source: Journal of Hand Therapy - April 5, 2023 Category: Rehabilitation Authors: Lisa Newington, Emma Bamford, Steven L Henry Source Type: research
How controlled motion alters the biophysical properties of musculoskeletal tissue architecture
Much of what is done in hand therapy relates to the benefits of controlled motion after a whole variety of injury patterns. Mason and Allen's1 historic paper on flexor tendon repair and motion, while recognizing that “function stimulates repair”, still advocated for three weeks of immobilization to protect the repair until sufficient healing had occurred. Following these scholarly works was a contemporary commentary by Harvey2 who recognized that the introduction of active functional pull upon the tissues ac celerates fiber realignment, and in effect remodels “tendon with the function of a tendon”. (Source: Journal of Hand Therapy)
Source: Journal of Hand Therapy - April 5, 2023 Category: Rehabilitation Authors: Maureen Hardy, Lynne Feehan, Georgia Savvides, Jason Wong Source Type: research
The ongoing evolution of a clinical innovation: Relative motion concept and orthoses
In their aim to improve patient outcomes following zones V-VI extensor tendon repair, Merritt, Robinson, and Hardy write about their collaborative innovation in the 1980s of the relative motion (RM) concept and RM extension (RME) orthosis (see Fig. 1). The approach has taken several decades to be widely accepted, which is often true for most innovations.1 At a similar time, Evans and Burkhalter2 were also experiencing the downside of immobilization and were concurrently developing a mathematical formula explanation for controlled motion delivered by a dynamic orthosis. (Source: Journal of Hand Therapy)
Source: Journal of Hand Therapy - April 1, 2023 Category: Rehabilitation Authors: Julianne W. Howell, Melissa J. Hirth Tags: Editorial Source Type: research
JHT 2023 special issue reviewer acknowledgment
The quality and content of this 2023 JHT special issue have been improved by the following dedicated reviewers. Their intellectual and practice expertise accounts for hours of volunteer time and adds to the quality of the 23 manuscripts in this issue. (Source: Journal of Hand Therapy)
Source: Journal of Hand Therapy - April 1, 2023 Category: Rehabilitation Authors: Julianne W. Howell, Melissa J. Hirth Source Type: research
Table of Contents
(Source: Journal of Hand Therapy)
Source: Journal of Hand Therapy - April 1, 2023 Category: Rehabilitation Source Type: research
Editorial Board / Masthead / ASHT Officers
(Source: Journal of Hand Therapy)
Source: Journal of Hand Therapy - April 1, 2023 Category: Rehabilitation Source Type: research
Instructions for authors
(Source: Journal of Hand Therapy)
Source: Journal of Hand Therapy - April 1, 2023 Category: Rehabilitation Source Type: research
