I've been refining my approach to MA in RM, I am planning on moving Nerve Strikes to Combat Maneuvers and making it a Restricted skill. Then use the lower ranked skill, either Nerve Strike or the attack paired with it. This would allow someone grappling to apply a nerve strike, or someone with a suitable weapon (staff, club, etc.). I may end up treating it like paired weapon, where you have to develop nerve strike with specific attacks. Note, I do not use the MA Combat Maneuvers category, I've placed those skills in Combat Maneuvers and made mosr of them restricted.