NCBTMB Client Assessment and Treatment 5 — Questions and Answers
Question 1: A client with osteoporosis is seeking massage. Which technique should be avoided to prevent pathological fracture?
- Effleurage over the back
- Deep compression over the vertebral column (Correct answer)
- Light petrissage on the shoulders
- Gentle passive range of motion of the arms
Correct answer: Deep compression over the vertebral column
Osteoporosis weakens bone density, making the vertebral column vulnerable to fracture under direct deep pressure or compression.
Question 2: A client presents with a herniated disc at L4-L5 with radiating pain down the left leg. This pattern of nerve root compression is called:
- Brachialgia
- Sciatica (Correct answer)
- Meralgia paresthetica
- Thoracic outlet syndrome
Correct answer: Sciatica
Sciatica describes pain radiating along the sciatic nerve distribution from the lumbar spine into the leg, commonly caused by L4-L5 or L5-S1 disc herniation.
Question 3: During gait assessment, a client demonstrates excessive hip drop on the left side during right stance phase. This indicates weakness in:
- Right hip flexors
- Left hip abductors (gluteus medius) (Correct answer)
- Right quadriceps
- Left hamstrings
Correct answer: Left hip abductors (gluteus medius)
The Trendelenburg sign occurs when the stance-side hip abductors (gluteus medius) are weak and cannot stabilize the pelvis, causing the opposite hip to drop.
Question 4: A client asks about the difference between a sprain and a strain. The therapist correctly explains that a sprain involves:
- Overstretching or tearing of a muscle or its tendon
- Overstretching or tearing of a ligament at a joint (Correct answer)
- Inflammation of a bursa
- Nerve entrapment within a joint capsule
Correct answer: Overstretching or tearing of a ligament at a joint
Sprains affect ligaments (bone-to-bone), while strains affect muscles or tendons (muscle-to-bone).
Question 5: Which of the following best defines 'myofascial trigger point'?
- A bony prominence used as a landmark for palpation
- A hyperirritable spot in skeletal muscle that refers pain to a distant site when compressed (Correct answer)
- An area of localized skin redness caused by dermal stimulation
- A joint space where synovial fluid accumulates
Correct answer: A hyperirritable spot in skeletal muscle that refers pain to a distant site when compressed
A myofascial trigger point is a hyperirritable nodule in a taut band of muscle that produces referred pain, local tenderness, and autonomic phenomena when stimulated.
Question 6: A client has been diagnosed with fibromyalgia. Which approach is most appropriate for initial massage treatment?
- Deep tissue massage targeting all major muscle groups
- Short sessions with light pressure, progressing gradually based on tolerance (Correct answer)
- Vigorous tapotement to stimulate the nervous system
- Avoid massage entirely as it is contraindicated
Correct answer: Short sessions with light pressure, progressing gradually based on tolerance
Fibromyalgia clients are highly sensitive to pressure and can experience post-massage flare-ups, so starting with light, brief sessions and adjusting based on response is essential.
Question 7: In the context of treatment planning, what is the primary purpose of establishing measurable short-term goals with a client?
- To increase the number of sessions billed to insurance
- To provide objective benchmarks for tracking treatment progress and effectiveness (Correct answer)
- To limit the therapist's liability if outcomes are not achieved
- To ensure the client follows a standardized protocol regardless of response
Correct answer: To provide objective benchmarks for tracking treatment progress and effectiveness
Measurable short-term goals create observable checkpoints that allow both the therapist and client to evaluate whether treatment is producing meaningful functional improvement.
NCBTMB Client Assessment and Treatment 5
A client with osteoporosis is seeking massage.
Which technique should be avoided to prevent pathological fracture?