Elements and Performance Criteria

Factors likely to have a negative impact on assessment may include:
Language difficulties
Disabilities
Emotional trauma
Lack of privacy or focus due to additional parties being present
Cultural or gender factors

Other health care professional may include:
Podiatrists
Osteopaths
Energy therapists
Physiotherapists
Chiropractors
Medical practitioners
Registered nurses
Social workers
Alternative health practitioners
Counsellors
Other allied health care professionals

Client history may include:
Date of presentation
Identifying personal details
Source of referral (if applicable)
Main presenting complaint or reason for massage
Presenting symptom picture
General state of health
Physical
Emotional
Allergies
Dietary picture
Sleep pattern
Exercise
Leisure activities
Childhood and adult illness
Accidents, injuries, operations
Hospitalisations
Occupational history and environment
Other current medical/alternative health care treatment
Medication, supplements and natural prescriptions - current and previous
Previous occurrence of presenting complaint
Social lifestyle including social drug usage
Family history

Potential sensitivities may include:
Gender
Ethnicity
Language
Religious beliefs
Cultural heritage
Sexuality
Ability
Presenting disease state and personal history

Physical assessment will include attention to:
Active movements
Passive movements
Resisted movements
Functional movements
Palpatory findings
Swelling
Instability
Parasthesia
Characteristics of pain

Established assessment procedures may include:
Observation
Discussion
Temperature
Pulse
Palpation
Percussion
Range of motion tests
Muscle strength tests
Orthopaedic tests
Observation of variations of posture
Any other method in which the practitioner has been trained to a competent standard
Procedure which is conducted according to legislative and regulatory requirements

Contra-indications to treatment may include:
Massage therapists are not expected to diagnose any conditions but must be able to recognise the indications and contra-indications of conditions
Massage is contra-indicated in all infectious diseases suggested by fever, nausea and lethargy until a diagnosis is received and recommended by a medical practitioner
Referral for diagnosis when symptoms do not have a logical explanation. Indications for referral include:
Pain-local, sharp, dull, achy, deep, surface
Fatigue
Inflammation
Lumps and tissue changes
Rashes and changes in the skin
Oedema
Mood alterations, eg depression, anxiety
Infection
Changes in habits such as appetite elimination or sleep
Bleeding and bruising
Nausea, vomiting or diarrhoea
Temperature - hot or cold
Endangerment sites are areas where nerves and blood vessels lie close to the skin and are not well protected
Anterior triangle of the neck
Posterior triangle of the neck
Axillary area
Medial epicondyle
Lateral epicondyle
Area of the sternal notch and anterior throat
Umbilicus area
Twelfth rib dorsal body
Sciatic notch
Inguinal triangle
Popliteal fossa

Critical aspects of assessment:
Knowledge of physical signs and symptoms of disease
Demonstrated observation skills
Ability to observe and identify variations of posture
Demonstrated record keeping skills
Demonstrated communication skills
Ability to perform testing and assessment procedures
Knowledge of and ability to use terminology correct to epidemiology and massage practice
Ability to recognise and adjust to contra-indications for treatment
Knowledge of further testing procedures
Ability to read medical test results or documents
Ability to discuss and observe treatment protocols

Concurrent assessment and relationship with other units:
Communicate effectively with clients/patients
Contribute to the control of infection
Work effectively in the health industry

Underpinning knowledge and skills:
Knowledge of advanced assessment procedures and options allowing complex regional assessments
Ability to gather and interpret information through the tactile senses
Awareness of critical information required for diagnosis and treatment according to massage therapy framework
Skills in applying advanced assessment techniques
Knowledge of history, philosophy and beliefs of massage therapy within a health framework
Knowledge of best practice massage therapy principles
Understanding of physiology and anatomy according to massage therapy
Knowledge of structure and function of anatomical systems appropriate to massage therapy and the scope of practice
Understanding of the fundamental principles of biomechanics and functional anatomy
Ability to identify prominent bones/structure and phasic and postural muscles
Ability to palpate prominent bones/structure and phasic and postural muscles
Knowledge of the structure and function of the articular system ie classification of joints and types and ranges of motion
Knowledge of the structure and function of the immune system
Knowledge of the situation and referral patterns of trigger points
Knowledge of the processes of biological maturation
Knowledge of pain and chronic pain syndromes
Knowledge of the processes of aging
Knowledge of symptomotology and pathology
Knowledge of disease causation, acute and chronic inflammatory processes, wound healing and haemorrhage processes
Knowledge of the pathological process of thrombosis and embolism
Knowledge of atheroma formation and oedema and their effects within the human body
Knowledge of normotensive and hypertensive characteristics
Knowledge of infectious and immunity process
Knowledge of neoplasms and pathological skin conditions
Knowledge of structure and function of cells, tissues, blood and organs
Knowledge of main paths of the human respiratory and cardiovascular systems and their physiology
Knowledge of digestive, integumentary, nervous, urinary, endocrine and reproductive systems
Knowledge of structure and function of anatomical systems
Knowledge of structure and function of skeletal, muscular, cardiovascular and lymphatic systems
Knowledge of the effects of hormones on the body
Knowledge of bioenergetic concepts and the cardio-respiratory concepts in relation to exercise
Knowledge of environmental physiology and the effects of drugs on the individual
Knowledge of technical and practical knowledge of treatment
Knowledge of indications, possible reactions and contra-indications to treatment
Knowledge of temperature control, homeostasis, feedback mechanisms, neurological, psychological and psychogenic foundations and issues
Ability to manage time throughout consultation and treatment
Ability to write referrals, appraisal letters for insurance companies and other documentation
Ability to use equipment and resources competently and safely
Ability to communicate effectively with client/patient/other health practitioners
Demonstrated ability to read medical reports
Knowledge of ethical and legal implications of enquiry
Demonstrated ability to comprehend common medical terminology
Ability to transcribe assessment findings and treatment in a patient history using accepted medical terminology

Resource implications:
Resource requirements may include:
An appropriately stocked and equipped clinic or simulated clinic environment
Relevant assessment instruments
Appropriate assessment environment
Skilled assessors

Method of assessment:
Assessment may include:
Observation of performance
Examples of assessment notes
Simulated assessments
Oral questioning on technique or assessment strategy
Case studies and scenarios as a basis for discussion of issues and strategies to contribute to best practice in the work environment

Context of assessment:
This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may be conducted on more than one occasion to cover a variety of circumstances.