NCBTMB exam Format | Course Contents | Course Outline | exam Syllabus | exam Objectives
Exam Type: Computer-based multiple-choice exam.
Number of Questions: 100 scored questions + 20 un-scored pretest questions (total of 120 questions).
Time Limit: 2 hours (120 minutes).
Question Types: Multiple-choice questions with four answer options.
Language: English.
Scoring System: The exam uses a scaled scoring system, with scores ranging from 300 to 700.
Passing Score: A scaled score of 500 or higher is required to pass.
1. Anatomy and Physiology (25%)
- Skeletal System: Bones, joints, and their functions.
- Muscular System: Muscle groups, origins, insertions, actions, and types of muscle contractions.
- Nervous System: Central and peripheral nervous systems, reflexes, and sensory receptors.
- Circulatory System: Heart, blood vessels, and circulation pathways.
- Lymphatic System: Lymph nodes, vessels, and immune function.
- Respiratory System: Lungs, diaphragm, and breathing mechanics.
- Digestive System: Organs and processes of digestion.
- Endocrine System: Hormones and glands.
- Integumentary System: Skin, hair, and nails.
- Reproductive System: Male and female reproductive anatomy.
2. Kinesiology (20%)
- Muscle Function: Agonists, antagonists, synergists, and stabilizers.
- Range of Motion (ROM): Active, passive, and resisted movements.
- Posture and Alignment: Common postural deviations (e.g., lordosis, kyphosis, scoliosis).
- Gait Analysis: Walking patterns and their impact on the body.
- Biomechanics: Lever systems, force, and torque in movement.
3. Pathology (15%)
- Contraindications: Absolute (e.g., deep vein thrombosis) and local (e.g., open wounds).
- Common Pathologies: Arthritis, fibromyalgia, carpal tunnel syndrome, tendonitis, etc.
- Infectious Diseases: HIV/AIDS, hepatitis, and universal precautions.
- Chronic Pain Conditions: Understanding pain pathways and management.
- Medications: How medications may affect massage therapy.
4. Massage and Bodywork Assessment (15%)
- Client Intake: Health history forms, informed consent, and SOAP notes (Subjective, Objective, Assessment, Plan).
- Palpation Skills: Identifying tissue texture, temperature, and tension.
- Range of Motion Testing: Assessing joint mobility.
- Postural Assessment: Identifying imbalances and compensations.
- Special Populations: Adapting techniques for pregnant women, elderly clients, athletes, etc.
5. Massage and Bodywork Techniques (25%)
- Swedish Massage: Effleurage, petrissage, tapotement, friction, and vibration.
- Deep Tissue Massage: Techniques for addressing chronic tension and adhesions.
- Myofascial Release: Releasing fascial restrictions.
- Trigger Point Therapy: Identifying and releasing trigger points.
- Sports Massage: Pre-event, post-event, and maintenance techniques.
- Seated Massage: Techniques for chair massage.
- Energy-Based Modalities: Basics of Reiki, craniosacral therapy, etc.
- Hydrotherapy: Use of hot/cold therapies.
- Stretching Techniques: Active, passive, and PNF stretching.
6. Professional Practices, Ethics, and Legalities (10%)
- Scope of Practice: Understanding what is within and outside a massage therapist's scope.
- Ethical Standards: Confidentiality, boundaries, and client-therapist relationships.
- Laws and Regulations: State licensing requirements, HIPAA compliance, and business laws.
- Professional Communication: Effective communication with clients and healthcare providers.
- Business Practices: Marketing, record-keeping, and insurance billing.
7. Research and Evidence-Based Practice (5%)
- Research Literacy: Understanding peer-reviewed studies and evidence-based practices.
- Outcome Measures: Evaluating the effectiveness of massage techniques.
- Continuing Education: Importance of staying updated with current research and trends.
- Effleurage: A gliding stroke used in Swedish massage.
- Petrissage: Kneading techniques to lift and squeeze muscles.
- Tapotement: Rhythmic tapping or percussion movements.
- Myofascial: Relating to the fascia surrounding muscles.
- Trigger Point: A hyperirritable spot in a muscle associated with pain.
- Contraindication: A condition or factor that makes a particular treatment inadvisable.
- SOAP Notes: A method of documentation (Subjective, Objective, Assessment, Plan).
- PNF Stretching: Proprioceptive Neuromuscular Facilitation, a stretching technique.
- Endangerment Sites: Areas of the body where nerves or blood vessels are close to the surface and require caution during massage.
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Question: 885
Which cranial nerve is primarily responsible for the movement of the sternocleidomastoid and trapezius muscles?
1. Trigeminal nerve (V)
2. Facial nerve (VII)
3. Vagus nerve (X)
er: D
nation: The accessory nerve (XI) innervates the sternocleidomastoid and trapezius muscles, ating head and shoulder movement.
ion: 886
a gait analysis, a therapist observes that the patient's foot excessively pronates during the st Which of the following muscle groups is likely weak, contributing to this biomechanical on?
eus oneals
strocnemius ialis posterior
er: D
nation: Weakness in the tibialis posterior muscle can lead to excessive foot pronation, as it is sible for controlling the medial arch and stabilizing the foot during the stance phase.
Accessory nerve (XI) Answ
Expla facilit
Quest
During ance
phase. deviati
1. Sol
2. Per
3. Ga
4. Tib Answ
Expla respon
Question: 887
A therapist is utilizing hydrotherapy techniques for a client with muscle soreness after a workout. Which combination of hot and cold therapies would be most effective for facilitating recovery?
1. Alternating between hot packs and ice baths
2. A long soak in hot water followed by a cold shower
3. Continuous application of cold compresses
4. Steaming followed by an ice massage
Answer: B
Explanation: A long soak in hot water followed by a cold shower can enhance circulation and reduce inflammation, promoting recovery effectively.
Question: 888
king exaggerated claims about treatment effectiveness viding testimonials from satisfied clients with their consent
moting services through unsolicited emails to potential clients ering discounts without clearly stating the conditions
er: B
nation: Providing testimonials with client consent reflects ethical advertising practices, as it b ithout resorting to exaggeration or misleading claims.
ion: 889
a massage session, a therapist notices that the client's biceps brachii is more developed on one hich muscle action is primarily responsible for the shortening of the biceps during elbow fl
centric contraction metric contraction kinetic contraction ncentric contraction
er: D
A massage therapist is developing a marketing strategy for their practice. Which of the following methods would best comply with ethical advertising practices while attracting new clients?
1. Ma
2. Pro
3. Pro
4. Off Answ
Expla uilds
trust w
Quest
During
side. W exion?
1. Ec
2. Iso
3. Iso
4. Co
Answ
Explanation: Concentric contraction occurs when a muscle shortens while generating force, such as when the biceps brachii flexes the elbow.
Question: 890
When considering the circulatory system, which of the following parameters is essential for calculating cardiac output, and what is the formula used?
1. Stroke volume and blood pressure; CO = SV/BP
2. Blood pressure and heart rate; CO = BP/HR
3. Blood volume and heart rate; CO = BV HR
4. Stroke volume and heart rate; CO = SV HR Answer: D
Explanation: Cardiac output (CO) is calculated using the formula CO = SV HR, where SV is stroke volume and HR is heart rate.
ion: 891
nt with a history of severe chronic pain is taking multiple medications, including opioids and relaxants. Which of the following is a potential side effect of these medications that the the consider?
owsiness and decreased alertness ghtened awareness of body sensations reased pain sensitivity
hanced muscle strength er: A
nation: Opioids and muscle relaxants can cause drowsiness and decreased alertness, which th ist should consider when planning the session.
ion: 892
rm "active range of motion" refers to: movement achieved by an external force
measurement of joint laxity
total movement available in a joint
Quest
A clie
muscle rapist
should
1. Dr
2. Hei
3. Inc
4. En
Answ
Expla e
therap
Quest
The te
1. The
2. The
3. The
4. The movement performed by the client without assistance Answer: D
Explanation: Active range of motion refers to the movement a client can achieve independently without assistance, reflecting their muscle strength and control.
Question: 893
A client with a history of tendonitis in the shoulder area wishes to receive massage therapy. Which of the following techniques would be most beneficial for this condition, focusing on the surrounding musculature?
1. Trigger point release on the affected tendon
2. Myofascial release to the surrounding muscles
3. Deep friction on the tendon itself
nation: Myofascial release to the surrounding muscles can help alleviate tension and Boost ty without directly stressing the inflamed tendon.
ion: 894
a posture assessment, the therapist observes that the client's shoulders are uneven, with one er appearing higher than the other. This condition may indicate an imbalance in which musc
per trapezius wer trapezius ratus anterior omboids
er: A
nation: An imbalance in the upper trapezius can lead to uneven shoulder height, as it is respo vating the scapula.
ion: 895
Direct pressure on the joint capsule Answer: B
Expla mobili
Quest
During
should le
group?
1. Up
2. Lo
3. Ser
4. Rh
Answ
Expla nsible
for ele
Quest
A patient with a history of cardiovascular disease presents with chest pain during exercise. An exercise stress test reveals ST-segment depression. What does this finding indicate about the patient's coronary circulation during exercise?
1. Normal coronary perfusion
2. Left ventricular hypertrophy
3. Myocardial ischemia
4. Arrhythmia Answer: C
Explanation: ST-segment depression during an exercise stress test indicates myocardial ischemia, suggesting that the coronary circulation is inadequate to meet the heart's demands during exertion.
Question: 896
A client is experiencing symptoms of carpal tunnel syndrome. Which area should the therapist be particularly cautious about during treatment?
forearm upper back shoulder
wrist and hand er: D
nation: The wrist and hand are critical areas affected by carpal tunnel syndrome, and caution ary to avoid exacerbating symptoms.
ion: 897
apist assesses a patient with limited hip extension during walking. Which of the following m might be tight, potentially limiting this movement?
uteus maximus mstrings ductors
flexors er: D
nation: Tight hip flexors can limit hip extension during walking, as they oppose the extensio
The
The
The
The Answ
Expla is
necess
Quest
A ther uscle
groups
1. Gl
2. Ha
3. Ad
4. Hip Answ
Expla n
movement that requires the gluteus maximus to function effectively.
Question: 898
During a reproductive health assessment, a female client reports irregular menstrual cycles and weight gain. Which hormone imbalance might primarily contribute to these symptoms?
1. Insulin
2. Progesterone
3. Luteinizing hormone
4. Estrogen Answer: A
Explanation: An imbalance in insulin can lead to weight gain and irregular menstrual cycles, often associated with conditions like polycystic ovary syndrome (PCOS).
ion: 899
of the following is the primary purpose of administering a cross-fiber friction technique? ncrease muscle length
nhance lymphatic drainage reak down adhesions mprove circulation
er: C
nation: Cross-fiber friction is primarily used to break down adhesions and scar tissue within es and connective tissues, promoting flexibility and healing.
ion: 900
onducting a postural assessment, you observe a client has a flat back posture. This type of p associated with which of the following muscular imbalances?
ortened hip flexors and lengthened hamstrings
ortened rectus abdominis and lengthened erector spinae ortened gluteus maximus and lengthened quadriceps ortened latissimus dorsi and lengthened rhomboids
Quest
Which
1. To i
2. To e
3. To b
4. To i Answ
Expla muscl
Quest
Upon c osture
can be
1. Sh
2. Sh
3. Sh
4. Sh
Answer: B
Explanation: A flat back posture is often associated with shortened rectus abdominis and lengthened erector spinae, leading to specific muscular imbalances.
Question: 901
A therapist is assessing a clients mental status following a head injury. Which part of the nervous system is primarily responsible for higher cognitive functions?
1. Brainstem
2. Cerebral cortex
3. Cerebellum
4. Spinal cord Answer: B
ing, and decision-making processes.
ion: 902
sage therapist is preparing to treat a patient with a exact upper respiratory infection. Which ing actions represents a local contraindication for massage therapy in this case?
plying pressure directly over congested sinuses ssaging the upper back and shoulders
ating areas of the body not affected by infection lizing gentle effleurage on the arms
er: A
nation: Applying pressure directly over congested sinuses is a local contraindication, as it ca bate discomfort and spread the infection.
ion: 903
apist observes that a client exhibits excessive pronation during their gait cycle. Which of the ing structures is primarily responsible for controlling this motion?
Explanation: The cerebral cortex is responsible for higher cognitive functions, including thought, reason
Quest
A mas of the
follow
1. Ap
2. Ma
3. Tre
4. Uti Answ
Expla n
exacer
Quest A ther follow
1. Soleus
2. Gastrocnemius
3. Peroneus longus
4. Tibialis posterior Answer: D
Explanation: The tibialis posterior plays a crucial role in controlling pronation during the gait cycle by providing support to the arch of the foot.
Question: 904
A patient with chronic pain syndrome expresses frustration with their current pain management regimen. Which of the following multidisciplinary approaches is most effective for managing chronic pain?
1. Physical therapy combined with cognitive-behavioral therapy
2. Exclusive reliance on pharmacological interventions
mplete rest and immobilization of affected areas er: A
nation: Combining physical therapy with cognitive-behavioral therapy is an effective isciplinary approach for managing chronic pain, addressing both physical and psychological
aspects.
ion: 905
a biomechanical analysis of a client's squat, the therapist notes that the client's knees exten their toes. This could indicate which of the following issues?
ufficient hip flexion ak quadriceps
ht hamstrings
Poor ankle dorsiflexion er: D
nation: Poor ankle dorsiflexion can lead to compensatory movements, causing the knees to e the toes during a squat.
Surgical intervention as a primary treatment
3. Co
Answ Expla
multid
Quest
During d
beyond
1. Ins
2. We
3. Tig D.
Answ
Expla xtend
beyond
Question: 906
The "anterior drawer test" is primarily used to assess instability in which joint?
1. Shoulder
2. Ankle
3. Knee
4. Hip
Answer: C
Explanation: The anterior drawer test is used to assess anterior cruciate ligament (ACL) stability in the knee joint by evaluating the forward movement of the tibia.
Question: 907
leurage with a focus on the cervical spine ep petrissage on the upper trapezius ration applied to the thoracic spine
ction applied along the latissimus dorsi er: B
nation: Deep petrissage on the upper trapezius addresses tension in the thoracic region and ca vely alleviate discomfort in the neck.
ion: 908
btaining a client's health history, the therapist discovers that the client is currently taking agulants. How should this medication impact the therapist's approach to the massage session
lighter pressure and avoid techniques that may cause bruising oid any work on the lower extremities altogether
deeper pressure to Boost circulation
cus solely on the upper body to minimize risk er: A
nation: Clients on anticoagulants are at increased risk for bleeding and bruising, so using ligh
A client reports discomfort in their neck that seems to originate from their upper back. While performing Swedish massage, which technique would best facilitate the release of tension in the thoracic region?
1. Eff
2. De
3. Vib
4. Fri Answ
Expla n
effecti
Quest
While o
antico ?
1. Use
2. Av
3. Use
4. Fo
Answ
Expla ter
pressure and avoiding aggressive techniques is crucial for safety.
Question: 909
Which of the following best describes the "tonic" muscle fibers?
1. Fast-twitch fibers that produce explosive strength
2. Slow-twitch fibers that resist fatigue and maintain posture
3. Hybrid fibers that adapt based on training
4. Fibers that primarily generate heat Answer: B
Explanation: Tonic muscle fibers are slow-twitch fibers that resist fatigue and are primarily involved in maintaining posture and endurance activities.
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