title: Relative motion orthoses in the management of various hand conditions: A scoping review.
abstract: METHODS
  Scoping review.
  
  
  BACKGROUND
  The relative motion (RM) concept and immediate controlled active motion (ICAM) program, originally applied after zones IV-VII extensor tendon repairs, have been modified and extended to a variety of hand conditions, such as sagittal band injury, boutonniere deformity, and extensor lag.
  
  
  OBJECTIVE
  To scope the published and unpublished literature to review ICAM modifications, hand conditions for which the RM concept is used, and describe the preferred degree of relative metacarpophalangeal joint extension/flexion reported and spectrum of orthosis design.
  
  
  METHODS
  Electronic and manual searches of scientific and gray literature and expert consultation were conducted. Documents with quantitative data were assessed with Oxford Levels of Evidence and the Structured Effectiveness Quality Evaluation Scale.
  
  
  RESULTS
  Fifteen references met the inclusion criteria; 1 was level III evidence, and others were level IV evidence. RM-ICAM modifications, preferred degree of relative extension/flexion, orthotic design, management of other hand conditions and knowledge gaps were identified.
  
  
  CONCLUSIONS
  RM orthoses may improve outcomes in a variety of hand conditions; however, high-quality studies that contribute to the evidence base for its use are needed.
  
  
  METHODS
  Not applicable.
authors: Occupational Therapy Department, Austin Health, Melbourne, Australia; Department of Occupational Therapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Australia; Malvern Hand Therapy, Malvern, Melbourne, Victoria, Australia. Electronic address: melissa.hirth@austin.org.au.
authors: Melissa J
authors: MJ
authors: Hirth
authors: Samaritan Health Services, Samaritan Orthopaedics, Corvallis, OR, USA.
authors: Julianne W
authors: JW
authors: Howell
authors: Department of Occupational Therapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Australia.
authors: Lisa
authors: L
authors: O'Brien
mesh_terms: D004185:Disability Evaluation; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D006227:Hand Deformities, Acquired / Q000175:diagnosis / Q000534:rehabilitation*; D006230:Hand Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D009989:Orthotic Devices / Q000706:statistics & numerical data*; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology*; D013708:Tendon Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D016896:Treatment Outcome
keywords: Boutonniere; Extensor tendon; ICAM; Merritt splint; Relative motion; Sagittal band