MBLEx Flashcards

Client Assessment and Treatment Planning

The Client Assessment and Treatment Planning section of the massage exam determines the MBLEx candidate’s understanding of this component of the massage therapist’s skill set. Professional massage therapists should be able to perform a competent client assessment, and then establish a safe and effective treatment plan and client goals based on these findings. The initial assessment includes written data collection, as well as visual assessment for things like posture and gait analysis. The hands-on evaluation uses palpation assessment skills and range of motion assessment skills to gather more information needed to establish the treatment plan. The MBLEx exam candidate must demonstrate good clinical reasoning and knowledge of the basic organization and flow of the evaluation and treatment process. Our MBLEx flashcards are a great addition to a comprehensive massage exam preparation. 

Organization and Flow

What is a good general guideline for setting massage table height? (for basic Swedish techniques with moderate pressure)
knuckle (MCP) height when standing beside the table
What activity should be completed after every treatment to record assessment findings, treatment provided, progress towards goals, and response to therapy?
write a daily note
If a client pays for a 1-hour treatment, how long should the treatment be?
60 minutes
What special accommodation may be needed for some geriatric clients that could effect treatment timing?
geriatric clients may need additional time changing or assistance getting off the table
What should be done before treating a return client?
Review treatment notes and response to previous treatment(s)
What should a massage practitioner do upon finding out that a client's problem or treatment goals are out of the practitioner's scope of practice or beyond their current training?
refer the client to an appropriate health professional

Client consultation and evaluation

Name a method to quantify pain in order to document and track it:
Numeric Pain Rating Scale (NPRS); Visual Analog Scale (VAS); McGill Pain Questionnaire (MPQ); Oswestry Disability Index (ODI); Wong-Baker FACES scale
What should a massage therapist do with the health history form once the client completes it?
go over it with the client
What must a therapist establish with the client in order to build trust, and mutual understanding needed for a healthy therapeutic relationship?
rapport
What form should every client complete prior to initial evaluation?
health history (also consent for treatment)
What form of question requires a more detailed answer then "yes" or "no"?
open-ended question
Why should the plan of treatment be explained to the client before every treatment?
to enable the client to consent (or not) to the planned treatment

Written data collection

Name 3 characteristics of client-reported pain that a therapist should find out.
Onset. Location. Quality (sharp, dull, throbbing...). Any radiation or referral patterns? What makes it better? What makes it worse?
On which form should your personal opinions about a client be documented?
none
What type of data is: feel of a pulse, temperature or color of skin, texture, and smell?
objective
What section would the client statement: "my neck hurts today" go in a SOAP note?
Subjective
What does the "A" stand for in SOAP notes?
Assessment or Application
Where should an abnormal response to a heat treatment be documented?
"Assessment" section of SOAP note, and potentially an incident report

Visual assessment

Unilateral decreased foot arch typically results in what positioning of the ipsilateral leg?
internal (medial) rotation
Internal rotation of the upper extremities can result in the dorsal surface of the hand facing which direction during relaxed standing posture?
anteriorly
What are two characteristics of skin included in a thorough visual assessment?
color and discolorations, presence of hair,
Weakness of the dorsiflexors can result in what gait abnormality observed during gait assessment?
foot drop
The T8 spinous processes is approximately level with what boney landmark observed during posture assessment?
inferior angle of the scapula
What is a symptom of upper cross posture that may be observed during posture analysis from a side view?
forward head posture

Palpation assessment

What part of the hand is best to use during palpation assessment?
fingertips
Name 2 general qualities of soft tissue that are determined during a palpation assessment.
soft tissue movement or restrictions; temperature; texture; tone
A massage practitioner has palpated a tight band of muscle the causes increased pain at another area when pushed. What has the therapist likely found?
trigger point
A focused palpation assessment can occur during an evaluation, and an more thorough palpation assessment occurs:
during the massage treatment itself
What are 2 bony landmarks of the pelvis that can be palpated during a physical assessment?
anterior superior iliac spine (ASIS); posterior superior iliac spine (PSIS); iliac crest; sacroiliac joint
A massage therapist palpates a trigger point at the supraspinatus. Where would the client likely feel pain based on normal referral patterns?
lateral deltoid region

Range of motion assessment

What is normal flexion PROM of the shoulder complex?
180 degrees (includes glenohumeral and scapulothoracic movement)
Which type of range of motion assessment is not affected the client's strength?
passive range of motion (PROM)
How is a bony block end feel typically described when documenting ROM assessment findings?
hard end feel
What is normal ROM of wrist supination and pronation?
80 degrees supination, and 80 degrees pronation
If correcting ROM restrictions is a primary treatment goal, when should measurements be taken?
before and after treatment
How should you document assessing ROM at a joint when the client stops you before reaching end range due to pain?
empty end feel, stopped d/t pain

Clinical reasoning

Name a primary consideration behind deciding on a treatment plan?
client goals
If massage is not only safe for a client but likely to produce real benefits, then massage is:
indicated
What kind of special test attempts to reproduce the client's pain to identify the source?
provocation test
When is the best time for the client to provide feedback?
at any time; before, during or after treatment
What should the massage therapist do if a client reports pain that keeps him up at night and is not affected by movement or position?
this is a red flag, refer to physician prior to treatment
A 60 year old client presents with left leg swelling, warmth, redness, and pain and fatigue at the thigh. What is the best action for the massage therapist to take?
refer the client to a physician before providing any treatment (signs and symptoms of possible DVT)
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