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Exam Number : NCBTMB
Exam Name : National Certification Board for Therapeutic Massage & Bodywork
Vendor Name : Medical
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BOARD CERTIFICATION IN THERAPEUTIC MASSAGE & BODYWORK (BCTMB)
Board Certification in Therapeutic Massage and Bodywork represents the highest attainable credential within the massage therapy and bodywork profession. Board Certification is a separate credential above and beyond entry-level massage therapy licensure.

As Board Certification is voluntary- its achievement represents the highest level of commitment to clients and to the advancement of the massage therapy and bodywork profession. Board Certificants must meet higher standards of education and experience- as well as pass a rigorous exam that tests massage therapy and bodywork technique and application- critical thinking- communication- law- ethics- evaluation- documentation- and planning.

NCBTMB is the only certifying body for the massage therapy and bodywork profession. For that reason- NCBTMBs certification processes are founded upon a superior Code of Ethics and Standards of Practice- which all Board Certificants must adhere to. Like their Certificants- the advancement of the profession and the improvement of client care is their focus.

Board Certification in Therapeutic Massage and Bodywork (BCTMB) is the highest attainable credential within the massage therapy and bodywork profession. It is a separate credential above and beyond entry-level- mandatory state licensure.
Board Certificants must meet stringent requirements- clear a recurring criminal background check- and pass the Board Certification Exam.
Board Certification is so much more than having an entry-level massage license. By achieving the profession's highest attainable credential- you represent advanced standards of education- experience- critical thinking- and assessment skills to provide clients and patients positive outcomes.

In the past- massage therapists have not made Board Certification a priority as it is voluntarybut that is changing rapidly in both clinical and staff positions. As massage therapy gains traction as a reimbursable- non-pharmaceutical method for pain relief- insurance companies and other approval entities will look for- or may even require- Board Certification to make this possible.

Course Outline | Syllabus | Objectives
I. Massage Modalities- Techniques- And Manual Forces (20%)
Knowledge
General massage protocols
Compression
Tension/decompression
Friction/shearing
Bending
PNF- MFR- pin and stretch- etc.
Torsion
Range of motion
Muscle Energy Techniques
Stretching
Hydrotherapy
Indications and contraindications
Vibration (jostling- shaking)
Tapotement
Client/patient positioning
Special population (pregnancy massage- oncology massage- etc.)
Appropriate tools and appropriate use
Efficient body mechanics
Benefits and effects of modalities (forms)- and techniques
Modality literacy Skills
Determine applicable massage techniques when working with clients
Apply massage techniques safely
Perform massage on special populations
(athletes- geriatric- prenatal- etc.)
Identify contraindications and apply affective techniques
Identify fundamental characteristics of bodywork modalities
Perform proper body mechanics while working with different populations
Position clients for comfort and safety
II. Applied Science: Anatomy- Physiology- Kinesiology- Pathology/ Injury- and Pharmacology (25%)
Knowledge
Anatomy (structure of the human body including joints- tissues- muscles- functions- origins- insertions- and actions- nerve structure- etc.)
Physiology systems of the body with:
i. in-depth knowledge in muscle- skeletal- and nervous systems
ii. intermediate knowledge in integumentary- cardiovascular- lymphatic and digestive systems iii. basic knowledge in respiratory- endocrine- reproductive and urinary systems
Kinesiology (mechanics of body movement including levers- agonists- antagonists- synergist- etc.)
Pharmacology (contraindications of prescription and non-prescription medication- implications for massage- etc.)
Standard precautions
Endangerment sites
Skills
Identify structures and functions of all body systems
Identify muscle and joint physiology
Recognize mechanics of body movement
agonists- antagonists and synergists
Identify and apply range of motion techniques
passive- active- active assisted and resistive range of motion
Identify endangerment/cautionary sites
Recognize muscle and orthopedic testing
Identify indications and contraindications of common prescription drugs
Determine proper stretching techniques and end feels
III. Professional Communication (15%)
Knowledge
Medical terminology
How to communicate with client/patient in understandable terms
Reporting formats (appropriate language in medical history- treatment plan- SOAP notes- EMR etc.)
HIPAA
Communication with clients/patients (asking questions to clarify information)
Client/patient sensitivity and vulnerabilities (how to make clients comfortable during treatment)
Verbal and non-verbal cues
Informed consent
Skills
Effectively communicate with clients when explaining treatment plans
Describe techniques- anatomy- physiology and kinesiology in understandable terms
Identify HIPAA procedures
Work within client comfort levels
Adapt to verbal and non-verbal cues when working with clients
Document sessions appropriate to the work setting SOAP- EMR- spa etc.
Uphold all HIPAA confidentiality standards
Effectively communicate in proper medical terminology when working with other healthcare professionals
IV. Professionalism & Ethics (10%)
Knowledge
Current standard of care for safe and effective massage
Professional boundaries
Draping laws and techniques
When to refer clients to other health professionals
When- why and how to refuse treatment
How to report misconduct and who to report to
Transference and countertransference
Skills
Maintain proper physical and emotional boundaries
Respect clients right to say no
Identify when to refer out and whom to refer clients with pathologies
Identify transference and countertransference situations
Identify when to refuse to treat clients
Identify correct entities to report client or fellow massage therapists misconduct
V. Laws & Business Practices (5%)
Knowledge
Appropriate draping
Continuing education requirements
Scope of practice and applicable licensing laws
Record keeping (business and client/patient)
Skills
Maintain client confidentiality
Perform only within the massage therapy scope of practice
Maintain appropriate draping for client protection and privacy
Represent educational and professional
qualifications honestly
Demonstrate proper business and client record keeping
Abide by national organizations code of conduct and policies
Comply with all federal state and local laws
VI. Assessment (25%)
Knowledge
Comprehensive intake
Interview and data collection techniques
Observation techniques (posture deviation- etc.)
Range of motion (normal and abnormal body motions)
Treatment session planning techniques in collaboration with client/patient and other healthcare professionals when necessary
Indications and contraindications
Functional assessments and reassessments
Customized treatments
Pain scale and pain management
Medical terminology (SOAP charting- etc.)
Clinical reasoning (analyzing information from client/patient)
Research associated with massage therapy
Skills
Conduct an effective and thorough intake interview to gather information
Interpret client health history information
Customize treatment plans to fit the needs of each client
Discuss treatment plan and alternate plans if requested by the client
Determine common pain scale descriptions
Utilize palpatory skills to assess soft tissue
Perform and interpret active and passive range of motion assessments
Perform and interpret postural analysis
Perform and interpret gait assessment
Perform and interpret manual resistance tests
Perform and interpret special orthopedic tests
Reassess client movement- strength and range of motion post treatment
Document all findings properly pre and post treatment and change treatment plans accordingly
Collaborate with other healthcare professionals as needed
Communicate using appropriate medical terminology when speaking with other medical professionals and in official documentation
Work effectively as part of an integrated healthcare team
Recognize and analyze research
Identify different areas of research



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Medical Therapeutic guide

Assays might also book SGLT2 Inhibitor Use in high CV-chance Diabetes | NCBTMB real questions and PDF Download

heart failure (HF) instructions and follow had been short to include the sodium-glucose cotransporter 2 (SGLT2) inhibitor drug type after DAPA-HF, EMPEROR-decreased, and other trials recommended that, apparently as a category, they reduce cardiovascular (CV) possibility in sufferers with coronary heart failure and decreased ejection fraction (HFrEF) both with and devoid of diabetes. but how they achieve that's poorly understood, and such excessive-possibility patients don't all seem to improvement to the identical extent.

Now, a brand new analysis according to the CANVAS trial means that such sufferers undoubtedly to reply to SGLT2-inhibitor therapy can probably be identified by means of their profiles on a various assay panel focused on circulating biomarkers of myocardial harm and reworking.

The extra biomarkers that were elevated, the poorer the sufferers' results in a post-hoc feasibility analyze according to the trial, which validated canagliflozin (Invokana, Janssen pharmaceuticals) in patients with poorly controlled class 2 diabetes and a heritage of CV activities or dissimilar different chance components.

however additionally, the SGLT2 inhibitor's clinical improvement went up enormously with the number of multiplied markers in the panel of three, every reflecting diverse mechanisms underlying the drug's outcomes. patients with an increase in all three confirmed a fifty six% discount in chance for primary hostile cardiac pursuits (MACE). those and not using a biomarker elevations or just one showed no scientific benefit from canagliflozin.

The findings imply that the biomarker responses can predict results "even during this high scientific-possibility inhabitants," Muthiah Vaduganathan, MD, MPH, Brigham and ladies's health center and Harvard clinical faculty, Boston, Massachusetts, instructed theheart.org | Medscape Cardiology. these with no assay abnormalities "face markedly decrease risk in comparison with people who've multiple abnormalities in these biomarkers."

The SGLT2 inhibitors have not frequently been viewed to reduce the chance of myocardial infarction (MI), stroke, or CV dying, he cited. but the biomarkers seem to predict which excessive CV-risk patients will display fewer of those activities, and "determine those that may additionally stand to advantage essentially the most" from the drug category.

Vaduganathan offered the evaluation this week at HFA 2021, the annual meeting of the heart Failure association of the european Society of Cardiology (ESC-HFA), conducted each practically and live in Florence, Italy.

The analyze is an early seem into the feasibility of the biomarker-panel approach to guiding SGLT2 inhibitor therapy, "but when this had been to grasp up," stated Mark H. Drazner, MD, perhaps one may "establish people that are at greater possibility and simply tailor your remedy, thereby sparing the americans who potentially would not improvement the extra can charge and knowledge possibility."

It continues to be uncertain how SGLT2 inhibitors advantage sufferers, Drazner, of the tuition of Texas Southwestern scientific middle, Dallas, told theheart.org | Medscape Cardiology. "may these kinds of biomarker reports supply some insights into competencies mechanisms? it truly is a possible offshoot of this kind of work, probably a greater understanding of the mechanism of those drugs."

further possibility stratification equipment are mostly unneeded for most sufferers with diagnosed coronary coronary heart ailment or kidney sickness or with HF, Vaduganathan noted. "We know that such people are high possibility and should be correctly treated with risk-reducing recommendations corresponding to an SGLT2 inhibitor."

but for decrease-possibility patients, reminiscent of these with type 2 diabetes, "or not it's harder to make that scientific determination," he talked about. "or not it's really harder to no longer only persuade the affected person, however also convince your self that the particular person is going to improvement from a given remedy. And so, the use of these biomarkers can assist inform that decision."

having said that, Drazner counseled, the SGLT2 inhibitors may enhance results in ways that aren't yet identified and aren't picked up by means of a panel of chosen biomarkers. "You want to be sure that the community to whom you might be no longer giving the treatment doesn't miss out on different expertise merits," he said. "this is a neighborhood that needs extra exploration."

The preference of particular person accessories of the assay panel, Vaduganathan agreed, "is still open for debate. I feel the subsequent step is to be mindful what is the most effective mixture of biomarkers."

The CANVAS trial, carried out in 30 countries, randomly assigned 4330 sufferers with diabetes for at the least 10 years with a history of CV ailment or other CV risk components, reminiscent of multiplied systolic blood pressure or lipids, to acquire canagliflozin at both 300 mg/day or one hundred mg/day or placebo.

The biomarker panel, comprising assays for cardiac troponin T through high-sensitivity assay (hs-cTnT), soluble suppression of tumorigenesis-2 (sST2), and insulin-like boom factor–binding protein 7 (IGFBP7) become created according to 3040 CANVAS participants, Vaduganathan mentioned. patients have been assigned one element for each improved biomarker. Elevations have been defined as:

  • ≥ 14 pg/mL for hs-cTnT

  • > 35 ng/mL for sST2

  • > ninety six.5 ng/mL for IGFBP7

  • "we have selected three biomarkers that each evaluate the diverse events that SGLT2 inhibitors really keep away from, and are hoping that once combined into a single panel, they can consider varied outcomes across these systems," Vaduganathan said. tiers of hs-cTnT reflect myocardial injury; sST2 is a marker of vascular congestion and myocardial fibrosis; and IGFBP7 elevations point to acute kidney harm.

    "they may be all rather prognostic of those routine when evaluated alone, and really, they have additive value after they mix them." Of the three biomarkers, hs-cTnT provides the strongest indication and looks to pressure the panel's interplay with SGLT2 inhibitor remedy, Vaduganathan observed. "but the sign is actually more suitable once they evaluate diverse markers in combination."

    The risks of distinctive CV and renal endpoints each and every climbed tremendously with increasing number of biomarker elevations. The four assessed movements were MACE (CV dying, nonfatal MI, nonfatal stroke, or HF); hospitalization for HF; CV death; and a renal composite endpoint that included a sustained 40% reduce in eGFR, need for dialysis or kidney transplantation, or death from renal reasons.

    desk 1. Hazard Ratio (HR)* for MACE on Canagliflozin via variety of Biomarker Panel Elevations in CANVAS

    variety of Biomarker Elevations (% of cohort) HR (ninety five% CI) 0 of three (36) 0.ninety four (0.sixty three - 1.39) 1 of 3 (35) 1.36 (0.96 - 1.92) 2 of three (27) 0.sixty two (0.forty six - 0.83) three of 3 (2) 0.forty four (0.19 - 1.01)

    *interplay P for style = .009

    because the variety of increased biomarkers on the panel went up, from none to 3, the possibility of MACE for patients on canagliflozin vs placebo ceaselessly declined (desk 1).

    Whereas an assay panel can also neatly be successful in guiding SGLT2 inhibitor remedy, Vaduganathan mentioned, "the costs and value-effectiveness of extensive implementation of this biomarker-primarily based allocation strategy will need to be formally evaluated."

    CANVAS and the current analysis have been funded with the aid of Janssen analysis & development. Vaduganathan has disclosed relationships with Amgen, American Regent, AstraZeneca, Baxter Healthcare, Bayer AG, Boehringer Ingelheim, Cytokinetics, Lexicon prescribed drugs, Novartis, Relypsa, and Roche Diagnostics. Drazner has said no central fiscal relationships.

    coronary heart Failure association of the eu Society of Cardiology, 2021. offered June 29 on the session: risk factors and Prevention, Rehabilitation and sports Cardiology, cardiovascular disease in special Populations.

    observe Steve Stiles on Twitter: @SteveStiles2. For more from theheart.org | Medscape Cardiology, follow us on Twitter and facebook.

    For greater from theheart.org | Medscape Cardiology, comply with us on Twitter and facebook.


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