NCBTMB Special Populations and Treatment Adaptations 4 — Questions and Answers
Question 1: A client with osteoporosis presents for massage. Which technique is most contraindicated for this population?
- Deep percussion over the spine (Correct answer)
- Gentle effleurage on the limbs
- Light petrissage on soft tissue
- Passive range-of-motion within comfort
Correct answer: Deep percussion over the spine
Deep percussion over the spine is contraindicated in osteoporosis due to the risk of vertebral fractures.
Question 2: When working with a client who has lymphedema in the right arm, the therapist should:
- Begin proximal and work toward the hand (Correct answer)
- Begin distal and work toward the axilla
- Apply deep compression over the affected limb
- Avoid all massage on the affected extremity
Correct answer: Begin proximal and work toward the hand
Manual lymphatic drainage begins proximally to clear lymph nodes before moving distally, facilitating fluid movement toward the trunk.
Question 3: A pregnant client in her third trimester reports shortness of breath when lying supine. The best position for massage is:
- Semi-reclined at 45 degrees on her left side (Correct answer)
- Prone with a pregnancy bolster
- Supine with knees elevated
- Seated upright only
Correct answer: Semi-reclined at 45 degrees on her left side
Left-lateral semi-reclined positioning reduces aortocaval compression and relieves shortness of breath in late pregnancy.
Question 4: A client receiving chemotherapy for breast cancer asks for a massage. Which consideration is MOST important before proceeding?
- Obtain oncologist clearance and assess current blood counts (Correct answer)
- Decline all massage until chemotherapy is complete
- Perform only deep tissue work to stimulate immunity
- Focus all work on the area surrounding the tumor site
Correct answer: Obtain oncologist clearance and assess current blood counts
Oncology clearance and knowledge of current blood counts guide safe pressure and technique selection for clients undergoing chemotherapy.
Question 5: When massaging an infant, the therapist should adjust technique by:
- Using very light pressure and slow, gentle strokes (Correct answer)
- Applying firm effleurage to stimulate muscle development
- Limiting sessions to no more than 60 minutes
- Avoiding all work on the abdomen
Correct answer: Using very light pressure and slow, gentle strokes
Infant massage requires very light pressure and gentle strokes because neonatal skin and musculoskeletal structures are delicate.
Question 6: A geriatric client reports taking warfarin. The massage therapist should:
- Use lighter pressure to reduce bruising risk (Correct answer)
- Avoid all massage due to blood-thinning medication
- Apply vigorous friction to improve circulation
- Work only on the extremities and avoid the torso
Correct answer: Use lighter pressure to reduce bruising risk
Warfarin increases bleeding and bruising risk, so lighter pressure helps prevent subcutaneous hemorrhage.
Question 7: A client with Type 1 diabetes arrives for massage and mentions they skipped their last meal. The therapist's FIRST action should be:
- Ask the client to eat a snack and recheck before starting (Correct answer)
- Proceed with a shorter session to avoid fatigue
- Focus the massage on the feet only
- Check the client's injection sites before beginning
Correct answer: Ask the client to eat a snack and recheck before starting
A missed meal in a Type 1 diabetic raises hypoglycemia risk, and ensuring the client has eaten is a safety priority before massage.
NCBTMB Special Populations and Treatment Adaptations 4
A client with osteoporosis presents for massage.
Which technique is most contraindicated for this population?