NCBTMB Special Populations and Treatment Adaptations 5 — Questions and Answers
Question 1: When performing massage on a client with a pacemaker, the therapist should:
- Avoid strong vibration or percussion near the device site (Correct answer)
- Refuse treatment as pacemakers are an absolute contraindication
- Apply deep pressure directly over the pacemaker to improve circulation
- Use only hot stone therapy as it is safe for pacemaker patients
Correct answer: Avoid strong vibration or percussion near the device site
Strong vibration or percussion near an implanted pacemaker can potentially interfere with the device's function.
Question 2: A client with fibromyalgia reports widespread pain rated 7/10. Which approach is MOST appropriate?
- Light-to-moderate pressure with client feedback throughout (Correct answer)
- Deep tissue work to break up trigger points
- Vigorous tapotement to stimulate blood flow
- No massage until pain resolves below 5/10
Correct answer: Light-to-moderate pressure with client feedback throughout
Fibromyalgia clients are hypersensitive to pain, so light-to-moderate pressure with ongoing feedback prevents post-massage flare-ups.
Question 3: A client with multiple sclerosis (MS) reports heat sensitivity. The therapist should:
- Keep the room cool and avoid hot packs or hydrotherapy (Correct answer)
- Use hot packs to relax spastic muscles
- Recommend saunas between sessions for muscle relief
- Perform deep friction to generate warmth in tissues
Correct answer: Keep the room cool and avoid hot packs or hydrotherapy
Heat can temporarily worsen MS symptoms by slowing nerve conduction, so a cool environment and avoiding thermotherapy is essential.
Question 4: When working with a client who has a known latex allergy, the massage therapist must:
- Use latex-free gloves and ensure all equipment is latex-free (Correct answer)
- Avoid using any gloves during the session
- Wear double latex gloves to prevent contact
- Limit the session to areas not in contact with any linens
Correct answer: Use latex-free gloves and ensure all equipment is latex-free
Using latex-free gloves and equipment prevents allergic reactions ranging from contact dermatitis to anaphylaxis.
Question 5: A postpartum client 3 weeks after cesarean section requests abdominal massage. The therapist should:
- Obtain medical clearance before working near the incision site (Correct answer)
- Perform deep abdominal work to prevent adhesions immediately
- Decline all abdominal work until 6 months postpartum
- Apply friction directly over the scar to promote healing
Correct answer: Obtain medical clearance before working near the incision site
A healing cesarean incision requires medical clearance before any local abdominal massage to avoid disrupting tissue repair.
Question 6: A client with peripheral neuropathy in both feet has reduced sensation. The therapist's PRIMARY concern during foot massage is:
- Risk of injury due to the client's inability to accurately report pain or pressure (Correct answer)
- Increased risk of triggering reflexes that could cause falls
- Potential for spreading neuropathy to adjacent tissues
- Contraindication to all massage due to nerve damage
Correct answer: Risk of injury due to the client's inability to accurately report pain or pressure
Reduced sensation impairs protective pain feedback, so the therapist must rely on objective tissue assessment rather than client pain reports.
Question 7: When adapting massage for a client with severe rheumatoid arthritis during a flare-up, the therapist should:
- Avoid the inflamed joints and focus on surrounding musculature with gentle techniques (Correct answer)
- Apply deep friction directly to inflamed joints to reduce stiffness
- Postpone all treatment until inflammation completely subsides
- Use passive joint mobilization to maintain range of motion
Correct answer: Avoid the inflamed joints and focus on surrounding musculature with gentle techniques
During a flare-up, inflamed joints are contraindicated for direct massage, but gentle work on surrounding muscles can provide comfort.
NCBTMB Special Populations and Treatment Adaptations 5
When performing massage on a client with a pacemaker, the therapist should: