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Therapeutic Massage & Bodywork Practice Test

NCBTMB test Format | Course Contents | Course Outline | test Syllabus | test 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 test 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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NCBTMB
National Certification Board for Therapeutic Massage
& Bodywork
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Question: 885
Which cranial nerve is primarily responsible for the movement of the sternocleidomastoid and trapezius
muscles?
A. Trigeminal nerve (V)
B. Facial nerve (VII)
C. Vagus nerve (X)
D. Accessory nerve (XI)
Answer: D
Explanation: The accessory nerve (XI) innervates the sternocleidomastoid and trapezius muscles,
facilitating head and shoulder movement.
Question: 886
During a gait analysis, a therapist observes that the patient's foot excessively pronates during the stance
phase. Which of the following muscle groups is likely weak, contributing to this biomechanical
deviation?
A. Soleus
B. Peroneals
C. Gastrocnemius
D. Tibialis posterior
Answer: D
Explanation: Weakness in the tibialis posterior muscle can lead to excessive foot pronation, as it is
responsible for controlling the medial arch and stabilizing the foot during the stance phase.
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?
A. Alternating between hot packs and ice baths
B. A long soak in hot water followed by a cold shower
C. Continuous application of cold compresses
D. 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
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?
A. Making exaggerated claims about treatment effectiveness
B. Providing testimonials from satisfied clients with their consent
C. Promoting services through unsolicited emails to potential clients
D. Offering discounts without clearly stating the conditions
Answer: B
Explanation: Providing testimonials with client consent reflects ethical advertising practices, as it builds
trust without resorting to exaggeration or misleading claims.
Question: 889
During a massage session, a therapist notices that the client's biceps brachii is more developed on one
side. Which muscle action is primarily responsible for the shortening of the biceps during elbow flexion?
A. Eccentric contraction
B. Isometric contraction
C. Isokinetic contraction
D. Concentric contraction
Answer: D
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?
A. Stroke volume and blood pressure; CO = SV/BP
B. Blood pressure and heart rate; CO = BP/HR
C. Blood volume and heart rate; CO = BV � HR
D. 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.
Question: 891
A client with a history of severe chronic pain is taking multiple medications, including opioids and
muscle relaxants. Which of the following is a potential side effect of these medications that the therapist
should consider?
A. Drowsiness and decreased alertness
B. Heightened awareness of body sensations
C. Increased pain sensitivity
D. Enhanced muscle strength
Answer: A
Explanation: Opioids and muscle relaxants can cause drowsiness and decreased alertness, which the
therapist should consider when planning the session.
Question: 892
The term "active range of motion" refers to:
A. The movement achieved by an external force
B. The measurement of joint laxity
C. The total movement available in a joint
D. 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?
A. Trigger point release on the affected tendon
B. Myofascial release to the surrounding muscles
C. Deep friction on the tendon itself
D. Direct pressure on the joint capsule
Answer: B
Explanation: Myofascial release to the surrounding muscles can help alleviate tension and improve
mobility without directly stressing the inflamed tendon.
Question: 894
During a posture assessment, the therapist observes that the client's shoulders are uneven, with one
shoulder appearing higher than the other. This condition may indicate an imbalance in which muscle
group?
A. Upper trapezius
B. Lower trapezius
C. Serratus anterior
D. Rhomboids
Answer: A
Explanation: An imbalance in the upper trapezius can lead to uneven shoulder height, as it is responsible
for elevating the scapula.
Question: 895
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?
A. Normal coronary perfusion
B. Left ventricular hypertrophy
C. Myocardial ischemia
D. 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?
A. The forearm
B. The upper back
C. The shoulder
D. The wrist and hand
Answer: D
Explanation: The wrist and hand are critical areas affected by carpal tunnel syndrome, and caution is
necessary to avoid exacerbating symptoms.
Question: 897
A therapist assesses a patient with limited hip extension during walking. Which of the following muscle
groups might be tight, potentially limiting this movement?
A. Gluteus maximus
B. Hamstrings
C. Adductors
D. Hip flexors
Answer: D
Explanation: Tight hip flexors can limit hip extension during walking, as they oppose the extension
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?
A. Insulin
B. Progesterone
C. Luteinizing hormone
D. 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).
Question: 899
Which of the following is the primary purpose of administering a cross-fiber friction technique?
A. To increase muscle length
B. To enhance lymphatic drainage
C. To break down adhesions
D. To Boost circulation
Answer: C
Explanation: Cross-fiber friction is primarily used to break down adhesions and scar tissue within
muscles and connective tissues, promoting flexibility and healing.
Question: 900
Upon conducting a postural assessment, you observe a client has a flat back posture. This type of posture
can be associated with which of the following muscular imbalances?
A. Shortened hip flexors and lengthened hamstrings
B. Shortened rectus abdominis and lengthened erector spinae
C. Shortened gluteus maximus and lengthened quadriceps
D. Shortened latissimus dorsi and lengthened rhomboids
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 client�s mental status following a head injury. Which part of the nervous system
is primarily responsible for higher cognitive functions?
A. Brainstem
B. Cerebral cortex
C. Cerebellum
D. Spinal cord
Answer: B
Explanation: The cerebral cortex is responsible for higher cognitive functions, including thought,
reasoning, and decision-making processes.
Question: 902
A massage therapist is preparing to treat a patient with a exact upper respiratory infection. Which of the
following actions represents a local contraindication for massage therapy in this case?
A. Applying pressure directly over congested sinuses
B. Massaging the upper back and shoulders
C. Treating areas of the body not affected by infection
D. Utilizing gentle effleurage on the arms
Answer: A
Explanation: Applying pressure directly over congested sinuses is a local contraindication, as it can
exacerbate discomfort and spread the infection.
Question: 903
A therapist observes that a client exhibits excessive pronation during their gait cycle. Which of the
following structures is primarily responsible for controlling this motion?
A. Soleus
B. Gastrocnemius
C. Peroneus longus
D. 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?
A. Physical therapy combined with cognitive-behavioral therapy
B. Exclusive reliance on pharmacological interventions
C. Surgical intervention as a primary treatment
D. Complete rest and immobilization of affected areas
Answer: A
Explanation: Combining physical therapy with cognitive-behavioral therapy is an effective
multidisciplinary approach for managing chronic pain, addressing both physical and psychological
aspects.
Question: 905
During a biomechanical analysis of a client's squat, the therapist notes that the client's knees extend
beyond their toes. This could indicate which of the following issues?
A. Insufficient hip flexion
B. Weak quadriceps
C. Tight hamstrings
D. Poor ankle dorsiflexion
Answer: D
Explanation: Poor ankle dorsiflexion can lead to compensatory movements, causing the knees to extend
beyond the toes during a squat.
Question: 906
The "anterior drawer test" is primarily used to assess instability in which joint?
A. Shoulder
B. Ankle
C. Knee
D. 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
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?
A. Effleurage with a focus on the cervical spine
B. Deep petrissage on the upper trapezius
C. Vibration applied to the thoracic spine
D. Friction applied along the latissimus dorsi
Answer: B
Explanation: Deep petrissage on the upper trapezius addresses tension in the thoracic region and can
effectively alleviate discomfort in the neck.
Question: 908
While obtaining a client's health history, the therapist discovers that the client is currently taking
anticoagulants. How should this medication impact the therapist's approach to the massage session?
A. Use lighter pressure and avoid techniques that may cause bruising
B. Avoid any work on the lower extremities altogether
C. Use deeper pressure to Boost circulation
D. Focus solely on the upper body to minimize risk
Answer: A
Explanation: Clients on anticoagulants are at increased risk for bleeding and bruising, so using lighter
pressure and avoiding aggressive techniques is crucial for safety.
Question: 909
Which of the following best describes the "tonic" muscle fibers?
A. Fast-twitch fibers that produce explosive strength
B. Slow-twitch fibers that resist fatigue and maintain posture
C. Hybrid fibers that adapt based on training
D. 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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