NCBTMB Special Populations and Treatment Adaptations 2 — Questions and Answers
Question 1: A client taking antihypertensive medication is finishing a massage session. What should the therapist advise?
- Stand up quickly to get blood flowing again
- Drink cold water immediately after sitting up
- Rise slowly from the table to prevent orthostatic hypotension (Correct answer)
- Resume vigorous activity immediately to maintain the blood pressure benefits
Correct answer: Rise slowly from the table to prevent orthostatic hypotension
Antihypertensive medications combined with massage's vasodilatory effects can cause a sudden drop in blood pressure upon standing, known as orthostatic hypotension.
Question 2: Which precaution is most important when working near a total hip replacement?
- Avoid all massage above the waist
- Apply deep pressure directly over the surgical scar to prevent fibrosis
- Use vigorous joint mobilization to prevent adhesions
- Avoid extreme ranges of motion to prevent joint dislocation (Correct answer)
Correct answer: Avoid extreme ranges of motion to prevent joint dislocation
After hip replacement, surgical protocols restrict motion to prevent dislocation of the prosthetic joint, and massage therapists must respect these movement limitations.
Question 3: A client with multiple sclerosis experiences Uhthoff's phenomenon. What does this mean for the treatment plan?
- Vigorous tapotement can trigger a relapse
- Heat applications should be used to relax spastic muscles
- Avoid elevating the client's body temperature during the session (Correct answer)
- The client needs extra blankets to stay warm throughout the session
Correct answer: Avoid elevating the client's body temperature during the session
Uhthoff's phenomenon is the temporary worsening of MS symptoms with elevated body temperature, so heat applications or overheating must be avoided.
Question 4: A client has peripheral neuropathy in both feet. What is the primary massage concern?
- Applying extra pressure to stimulate nerve regeneration
- The client may not accurately perceive pain or pressure in the affected areas (Correct answer)
- Massage will permanently worsen the neuropathy
- The client will experience excessive ticklishness due to hypersensitivity
Correct answer: The client may not accurately perceive pain or pressure in the affected areas
Peripheral neuropathy reduces or distorts sensation, so the client cannot reliably report if pressure is too intense, increasing the risk of undetected injury.
Question 5: A client who is 6 weeks post-mastectomy asks for a full-body massage. What is the most important consideration for the arm on the affected side?
- Apply vigorous tapotement to stimulate remaining lymph nodes
- Completely avoid the arm for at least one year post-surgery
- Check for signs of lymphedema and use only very light strokes on the arm (Correct answer)
- Deep tissue massage is preferred to prevent fibrosis in the axilla
Correct answer: Check for signs of lymphedema and use only very light strokes on the arm
Removal of axillary lymph nodes during mastectomy impairs lymph drainage and creates risk for lymphedema; the arm must be treated with minimal pressure.
Question 6: How does regular massage therapy primarily benefit clients with anxiety disorders?
- It permanently corrects neurotransmitter imbalances associated with anxiety
- It activates the parasympathetic nervous system, reducing physiological stress responses (Correct answer)
- It primarily resolves the cognitive distortions associated with anxiety
- It is contraindicated because touch can trigger anxiety responses
Correct answer: It activates the parasympathetic nervous system, reducing physiological stress responses
Massage stimulates the vagus nerve and promotes parasympathetic dominance, reducing cortisol and promoting relaxation that is beneficial for managing anxiety.
Question 7: A client with significant obesity schedules a massage. Which adaptation is most appropriate?
- No adaptation is needed; standard protocols apply to all body types
- Double the depth of pressure to effectively reach underlying muscles
- Refuse treatment due to heightened cardiovascular risk
- Use additional bolsters and adjust table height for proper body mechanics (Correct answer)
Correct answer: Use additional bolsters and adjust table height for proper body mechanics
Additional bolsters support body contours for client comfort and safety, while proper table height protects the therapist's postural mechanics throughout the session.
NCBTMB Special Populations and Treatment Adaptations 2
A client taking antihypertensive medication is finishing a massage session.
What should the therapist advise?