Treatment D. Flashcards
When should a therapist discuss home care options with their patient?
Home care is best prescribed at the end of the treatment and the therapist should not give too many home care suggestions at one time
When treating a patient with Parkinson’s disease, some treatment goals might include all of the following except:
Frictions to reduce scar tissue
A patient has been getting treatment for their biceps tendonitis and has also been experiencing weakness in their biceps brachii muscle. Which of the following would be the most ideal exercise to prescribe to this patient?
Preacher curls
Which technique should be avoided for a patient experiencing spasticity?
trigger point release using ischemic compressions to the affected tissue
What would be a local contraindication to tapotement?
Light hacking to the posterior thorax for a patient with asthma
A patient with scoliosis wishes to have a balanced back massage. Which of the following techniques could be reasonably performed on both the concave and convex sides of the scoliotic curve?
Myofascial Trigger Point Technique
A patient fractured their humerus and severed their radial nerve three-and-a-half months ago. On testing, they have sensation in their posterior arm, elbow, and proximal forearm, but none in their mid to distal posterior forearm and dorsum of their hand. They have strength in their triceps and supinator muscles but are unable to extend their wrist or fingers. Which technique would be contraindicated in a treatment for this person?
Muscle stripping to the forearm and wrist extensor muscles
According to evidence, what is the physiological purpose of superficial stroking?
to reduce pain
What can be efficiently used over clothes, over sheets, or directly on the skin?
Joint mobs
Soothing stroking is one of the lightest techniques used in massage. When would soothing stroking be contraindicated?
On a patient with open lesions
A hyperkyphotic patient complains of feeling tension and pain in their upper back. They demonstrate that the only thing that makes it feel better is when they ‘hug themselves’, stretching out the tight upper back muscles. They ask for further self-care recommendations. What would be appropriate to tell them?
They should stop the ‘self-hug’ as this will continue contributing to the already long and tight back muscles. Instead, they should perform shoulder retraction for strengthening and pectoralis major stretches to open up the chest.
What is an appropriate treatment goal for a patient with an extra cervical rib who is experiencing diffuse, aching pain in the shoulder, forearm & hand, and paresthesia on the ulnar side of the hand, especially in the fingers?
maintain function in the hand
Which of the following techniques can be used as both a passive movement technique and an assessment tool?
Rhythmic mobs
Which technique should be included in a treatment for a patient experiencing tension headaches involving aching pain traveling to the forehead and around the eye?
Full myofascial trigger point technique to the sternocleidomastoid muscle
Which condition would benefit the most from a therapist performing a friction technique?
Tendonitis
Which procedure best describes an appropriate protocol for manual lymphatic drainage?
Each manipulation is performed at least five times with unidirectional strokes
A patient with both lupus and fibromyalgia inquires about which type of massage they should get and for how long they should book the treatment. What would be the best response from a therapist to this patient?
A 45-minute relaxation massage with a focus on inflammation reduction would be recommended
What would benefit the most from gentle, progressive grades of joint play used carefully on the affected area?
A scleroderma patient not in flare up
Your new patient indicates on their health history form that they have never had a massage before and they occasionally experience tonic-clonic seizures. How might this affect your treatment plan?
The initial treatment might be shorter in duration and will focus on stress reduction. During subsequent treatments, you will introduce new and deeper techniques gradually and slowly
A patient has come in for a focused treatment on their left hip. They have signed off on special consent to treat the gluteal region. They indicate that imaging has not shown any arthritic degeneration and their doctor has suggested their joint pain is idiopathic in nature and should consider massage treatment. Their doctor also gave them a cortisone injection one week ago into the left gluteal region just posterior to their greater trochanter to see if it helps. What is the best treatment course for this patient?
Offer treatment for the low back and compensatory areas as performing a treatment directly over and around the left hip is contraindicated
Which lymph node region needs to be opened first before starting a manual lymphatic drainage treatment for swelling in the wrist?
Axillary region
Which of the following would be the best position for performing frictions to the infraspinatus tendon?
Prone with the shoulder in neutral
Which of the following is an important part of a treatment for a patient who has arrived with their neck bent towards the right side and complaining of stiffness and extreme pain on the right side of their neck after they slept poorly last night?
Deep diaphragmatic breathing
A patient who is seven months pregnant comes in for treatment for bilateral piriformis syndrome. Which passive stretch would be most appropriate and efficient at the very end of the treatment?
Bring the hip and knee to 90° of flexion, horizontally adduct the hip with slight external rotation of the femur
When should a therapist NOT employ a Golgi Tendon Organ technique?
The patient has acute acquired torticollis and received a cortisone shot for this condition two days ago
Which of the following would be the most appropriate and efficient order of techniques based on the principles of massage?
Soothing stroking, effleurage, petrissage, passive stretch
A therapist performs Deep Diaphragmatic Breathing (DDB) on a patient who is in a prone position. Which of the following is NOT an appropriate landmark to palpate during this technique for this patient?
abdomen
Which of the following steps should be followed when preparing to treat the lower leg and gluteals in a patient who is six months pregnant?
Obtain special consent, take up the linen uncovering the leg to mid-way up the thigh, lift the top leg slightly and feed the linen through by creating a fan, shimmy the linen up the leg to the gluteal region, continue to shimmy until you reach the lateral border of the sacrum, PSIS and iliac crest
Which hydrotherapy application is best for subacute adhesive capsulitis?
Deep moist heat
Which of the following conditions should prompt a therapist to prescribe isometric exercises to a patient?
A joint with a three-week-old cast on
Which home care exercise would be ideal for a patient with rib fixation to perform on their own?
Active thoracic rotation and extension
When treating a healthy pregnant patient, at what time is the prone position considered appropriate?
first trimester only
A therapist prescribes pull-ups to a patient who is a professional athlete. What is the benefit of prescribing this type of exercise?
This exercise will help improve the stability of the shoulder complex
Which of the following is an example of a clinical indication for treatment of the gluteal region?
A patient who is experiencing “pseudo-sciatica” due to a trigger point in gluteus minimus
Which technique falls under both petrissage and myofascial techniques?
skin rolling
Which technique would be contraindicated for the treatment of chronic intercostal neuralgia for a patient who has osteoporosis?
Rib Springing
Which technique would be considered to have a reflexive effect?
GTO
What would be something specific that a therapist should be highly cognizant of before making a treatment plan for postoperative patients in a hospital setting?
Potential of DVT
A patient with a blood pressure of 175/108 is requesting a relaxation massage, which of the following modifications would the therapist need to consider?
Treatment should begin with a hand and/or foot massage, techniques should move from distal to proximal, and abdominal pillowing should not be used
Which technique does not require a warm-up and has a reflexive effect to relax the muscle and will also mobilize the joint capsule?
Rocking
A patient states they have general tightness in their upper back but no specific pain at the moment. When palpating a nodule in the right rhomboids, the patient remarks that they suddenly feel aching along the medial border of their scapula. This patient most likely has which type of trigger point?
Latent
A patient comes in for a massage treatment. They suffered a severe burn to the left side of their torso and arm seven months ago. They are in the late subacute stage of healing and wish to get treatment for their condition. Which of the following would be most appropriate and effective for this patient?
Proprioceptive Neuromuscular Facilitation stretching to stress the scar tissue and reduce the restrictions in movement
When treating a patient with pes planus which of the following treatments would be most effective?
From the prone position, utilize effleurage and petrissage to decrease hypertonicity in the low back, gluteals, and gastrocnemius, followed by a Proprioceptive Neuromuscular Facilitation stretch to peroneus longus
A patient with long-standing moderate spastic hemiplegia on their right-hand side requests treatment to address their quadriceps, low to mid back, and right pectoralis major. What would be the best positioning plan for this patient’s treatment goals?
Side lying on left side
A therapist performs a 90-minute relaxation massage treatment on an HIV-positive patient to reduce their stress and anxiety. What type of effect of massage is being targeted for this particular patient?
Psychological effect
Which of the following best describes the appropriate procedure for preparing a patient for an abdominal massage?
Place a towel over the chest region before bringing the top blanket and sheet to the ASISs of the patient
What is a contraindication to manual lymphatic drainage (MLD)?
edema from chronic heart failure
A patient who had permanent metal pins placed throughout their vertebral column 16 months ago comes in for a massage treatment on their back. Which technique can be used over the repaired area but must be modified and used with caution?
Hydrotherapy
A patient spends a great deal of time working with their head in a flexed position, looking down, and reports that their doctor told them they have degenerative disc disease at C3, C4, and C5 but no evidence of disc herniation. Which of the following techniques are most applicable to treating this condition?
Fascial work to the pectoral region, grade III sustained glide to hypomobile thoracic vertebrae, GTO technique to suboccipitals, and tapotement to rhomboids
Which of the following statements regarding the Contract-Relax technique is true?
Uses autogenic inhibition, an isotonic, concentric contraction, and can be used to increase range of motion in a patient who is not experiencing pain
When treating a patient for true carpal tunnel syndrome, which muscle should be addressed in the treatment?
Flexor pollicis longus
A patient is in the postoperative maximum protection phase from a hip surgery. Which Range of Motion (ROM) exercise would be most appropriate to prescribe for this patient?
Active assisted ROM to the hip
Which condition would indicate a paraffin wax application to the affected area?
Chronic hamstring strain
Which technique application would be most beneficial for a patient with lumbar degenerative disc disease and pronounced hyperlordosis
Fascial techniques over rectus femoris to release hip flexors
A patient has osteophyte formation as a result of osteoarthritis. Which technique can be used but may need to be modified?
Joint play techniques to the affected joint capsule
Which of the following exercises would be an example of a closed-chain exercise?
Pull-ups for the latissimus dorsi
what is an open chain exercise?
the distal segment (the hand or foot) is free to move in space and is not anchored.
What is a closed chain exercise?
the distal segment is fixed, and the body (torso) moves.
Which massage technique can be used as an assessment AND assigned as home care for a patient?
Passive Range of Motion (PR ROM) to the talocrural joint
A regular patient comes in for their monthly massage, and the therapist notices that they are not smiling as usual and seem to have trouble closing their eye on one side. When the therapist inquires, the patient tells them that they were diagnosed with Bell’s Palsy three weeks ago, and that it is a little bit better now, but they are still experiencing some symptoms. What would be an appropriate treatment approach?
Provide them with a treatment in the context of a general relaxation massage. Starting with the unaffected side using techniques such as fingertip kneading, compression, stroking, and vibrations, working from the lateral side of the face towards the midline. Moving to the affected side next, using the same techniques and working from the midline of the face to the lateral side.
Which of the following techniques is indicated for a patient experiencing numbness and tingling in the median nerve distribution and pain that wakes them up in the night?
Stretch the forearm flexors
Which of the following techniques would be categorized as a Passive Movement Technique?
Rocking
Why should a therapist avoid the use of cold hydrotherapy over an inflamed gout-affected joint?
Extreme cold can increase the crystallization of the urate crystals and exacerbate the condition
When considering incorporating hydrotherapy into a treatment, in which situation would both hot and cold hydrotherapy be contraindicated?
A patient with very high blood pressure
Which of the following hydrotherapy applications would be stimulating for a patient?
Very short, very hot
