Introduction
The Council of Massage Therapy Educators has
agreed on the following position with regard to the licensing
of massage and bodywork therapists, the testing of candidates,
and the eligibility of candidates for licensing:
To be licensed as a massage therapist in the
state of Arizona, an individual must pass an Arizona State
Board approved licensing examination addressing the following
competencies.
This examination will include but not necessarily be
limited to a written test. To be eligible to sit
for the examination the individual must be a graduate of a
school of massage or bodywork therapy that is licensed in the
state in which it is located and approved by Arizona
State Board. To
be approved, a school must be known to the Arizona State Board
to provide a curriculum of a minimum of 700 clock hours that
adequately (in the opinion of the Arizona State Board)
addresses these competencies.
These competencies are set forth for the purpose
of licensing of entry level massage therapy and bodywork
practitioners, and are intended to establish a recognized
minimum standard of training that will serve to protect the
public from physical, mental, emotional, psychological, or
other harm associated with the practice of massage therapy and
bodywork. The
Council of Massage Therapy Educators recognizes that
fulfillment of this objective also requires that the minimum
standard of training must serve to assist members of the
public who seek to undertake the practice of massage therapy
and bodywork as a career to be able to do so without physical
self-injury, with a reasonable possibility of success, and in
adherence to the rule of law governing such
practice.
1. The practice of massage and bodywork therapy
involves the application of forces to the body that result in
the compression, stretch, vibration, and mobilization of the
organs and tissues beneath the dermis; movements of the
joints; and applications of water, heat, cold, and various
products to the skin. It is, therefore, important that
licensed massage therapy and bodywork practitioners be
sufficiently well trained in
-
the anatomy, physiology, and pathology of the
human body;
-
the physiological effects, contraindications and
precautions of the various techniques and modalities within
their scope of practice; and
-
the necessary assessment and evaluation
methodology
to be able to select and apply forms of
treatment that are appropriate, and to modify these as
necessary to avoid causing pain or physical injury to
individuals of various ages, health conditions, and
disability. These
issues are addressed in Unit 1 of these
competencies.
2. The practice of massage therapy and bodywork
also involves the touching of parts of the body other than the
hands, feet and head of clients who are unclothed and are
otherwise physically, psychologically and emotionally
vulnerable. It is, therefore, similarly important that
licensed massage therapy and bodywork practitioners are
sufficiently well trained in
-
communication
skills;
-
the
ability to establish and maintain safe and respectful
boundaries with clients; and
-
the
implementation of ethical principles in the practice of
massage therapy and bodywork
to practice massage therapy without causing
mental, emotional, or psychological harm to clients. These issues are
addressed in Unit 2 of these competencies.
3. The practice of massage therapy and bodywork
constitutes a form of employment or business enterprise that
requires particular skills and abilities to be performed
successfully, involves specific types of record keeping and
professional communication skills, and is governed by certain
local and state laws. It is, therefore, also necessary in the
public interest to assure that licensed massage therapy and
bodywork practitioners are trained to be able
to
-
develop
and implement an appropriate self-care
strategy;
-
develop
or function within a successful practice, business or
employment situation; and
-
have
an understanding of jurisprudence relevant to the practice of
massage therapy/bodywork.
These
issues are addressed in Units 3 and 4 of these
competencies.
These competencies are not intended to
identify or define specific techniques or modalities within
the scope of practice of massage and bodywork therapists that
must be included in their training, nor are they intended to
address levels of proficiency in the application of these
techniques and modalities. It is the belief of the Council of
Massage Therapy Educators that these matters are the primary
responsibility of massage therapy and bodywork schools, that
they are more appropriately addressed through educational
program accreditation, practitioner certification, and
competitive market factors, and that they are not properly
within the scope of licensing legislation that is intended
primarily for protection of the
public.
Entry Level Competencies for Licensed Massage
Therapy and Bodywork Practice in
Arizona
Unit 1
Select and apply forms of treatment that are safe and
appropriate for individuals of various ages, health
conditions, and
disability.
Element 1.1: Knowledge of the structure and
function of the human body and its systems in health and
disease.
Performance
Criteria
The candidate for licensing will be able
to:
I. Identify, locate, and describe the components
and function of the systems of the body: Anatomy and
Physiology
A. Anatomical organization and physiological
principles.
1. Describe anatomical position and organization
of the human body using appropriate
terminology.
2.
Identify the cavities of the human body.
3. Identify the major organ systems of the human
body.
4. Define and explain the concept of
homeostasis.
5. Identity and differentiate between
intracellular fluid and extracellular
fluid.
6. Identify and describe the systems that
support homeostasis and their functional
organization.
7. Identify the major structures involved in and
describe the functional organization of the following body
systems:
•
extracellular fluid transport
systems
•
support and movement
•
nutrient intake, storage, and distribution
systems
•
gas exchange systems
•
extracellular fluid composition and excretion of
metabolic wastes
•
reproductive systems
•
integration and coordination
systems
8. Identify the different types of tissues of
the human body and describe the structure and function of the
major tissue types.
9. Describe the physiology of excitable
cells.
10. Identify and describe the structure and
function of the integumentary system
B. Anatomy & physiology of the
cardiovascular and lymphatic
systems
1. Describe the characteristics of vascular
tissue and lymph vessels.
2. Describe the anatomy of the heart and
pericardium.
3. Identify and describe the location of the
major branches of the arterial system.
4. Identify and describe the location of the
major branches of the venous
system.
5. Describe the hepatic portal
system.
6. Describe the pulmonary
circulation.
7.
Describe the anatomy and function of the lymphatic
system
8. Describe the physiology of cardiac
function.
9. Describe the general functions of the
circulation and its functional
parts.
10. Identify and describe features of the
systemic circulation.
11. Identify the arterial pressures: systolic
pressure, diastolic pressure, pulse pressure and mean arterial
pressure.
12. Describe the effects of hydrostatic pressure
and variations in venous tone on venous
pressure.
13.
Identify and indicate the significance of the venous blood
reservoirs.
14. Describe the effects of muscle pumping on
venous return
15. Describe the functions of arterioles,
metarterioles and precapillary
sphincters.
16. Describe the relationship of arteriolar
resistance and venous pressure to capillary
flow.
17. Discuss the effects of massage on venous
pressure, venous flow and capillary flow.
18. Describe the acute and long-term regulation
of blood flow by the tissues.
19. Describe the role of the kidneys in
long-term regulation of arterial pressure and in
hypertension.
20. Describe the regulation of regional systemic
blood flows
21. Describe capillary fluid exchange and the
factors, which affect fluid distribution between plasma and
ECF.
22. Describe the physiology of lymph
flow.
23. Identify and describe the body fluid
compartments and indicate their approximate
volumes.
24. Describe the pathophysiology of
edema.
C. Histology & physiology of the blood and
immune system.
1. Identify
and describe the composition of blood and the histology of
blood cells.
2. Describe the mechanisms which preserve
haemostasis.
3. Define thrombus and
thrombosis.
4. Describe the cellular and vascular response
to inflammation and the outcomes of
inflammation.
5. Define and distinguish between innate and
acquired immunity.
6. Describe the functions of antibodies and
T-cells.
D. Anatomy & physiology of the urinary
system.
1. Identify and describe the anatomy of the
urinary system.
2. Describe the physiology of urine
formation
3. Discuss the role of the kidney in the
regulation of body fluid volume, and regulation of acid/base
balance of body fluids.
4. Describe the process of
micturition.
E. Anatomy & physiology of the respiratory
system.
1. Identify
and describe the anatomy of the respiratory
system.
2. Identify and describe the physiology of the
respiratory system including the mechanisms of pulmonary
ventilation, and alveolar gas
exchange.
3. Identify and describe the functions of the
muscles of inspiration and
expiration.
4. Define respiratory
work.
5. Describe the transport of O2 in
the blood by hemoglobin.
6. Describe the transport of CO2 in
the blood and explain how CO2 contributes to the
regulation of blood pH.
7. Define and describe the process of internal
respiration.
8. Describe the nervous and chemical control of
respiration.
9. Discuss the effects of exercise and movement
on respiration.
F. Anatomy & physiology of the digestive
system.
1. Identify and describe the anatomy of the
digestive system, including the digestive tract, liver, gall
bladder and pancreas.
2. Identify and describe the peritoneum, the
mesenteries and omenta.
3. Identify and describe the physiology of the
digestive system including the movement of food through the
alimentary tract, sources and functions of GI secretions,
processes of mechanical and chemical digestion, and mechanisms
of intestinal absorption.
4. Describe the function of the liver in
detoxification and bacterial decontamination of portal blood
and in the detoxification and excretion of drugs and
hormones.
G. Metabolism
1. Define metabolic rate and discuss how it
influences energetics and the regulation of body
temperature.
2. Describe the physiological changes associated
with exercise.
H. Anatomy & physiology of the endocrine
system.
1. Define endocrine and hormone and describe the
functions of hormones.
2. Locate the pituitary gland and identify and
describe the functions of the pituitary
hormones.
3. Locate the thyroid gland and identify and
describe the functions of the thyroid
hormones.
4. Locate the parathyroid glands and identify
and describe the functions of the parathyroid
hormones.
5. Locate the adrenal glands and identify and
describe the functions of the adrenal
hormones.
6. Locate the pancreas and identify and describe
the functions of the pancreatic
hormones.
7. Identify and describe the function of the
testicular hormones.
8. Identify and describe the function and
regulation of the ovarian
hormones.
9. Identify and describe the function of the
placental hormones.
I. Anatomy & physiology of the reproductive
system
1. Describe the physiology of pregnancy
including the process of fertilization and implantation, the
structure and function of the placenta, and the physiological
responses of the mother to
pregnancy.
2. Describe the process of
parturition.
3. Describe the process and hormonal regulation
of lactation.
J. Exercise
physiology.
1. Describe the physiology of exercise and the
effects of physical training.
2. Describe the energy sources available for
exercise and recovery from
exercise.
3.
Describe the effects of exercise on respiration, heart rate
and blood flow.
4. Describe the effects of exercise on acid-base
balance and the endocrine system.
5. Describe the effects of physical training on
the development of strength, endurance and
flexibility.
6. Describe the cardiorespiratory effects of
physical training.
7. Describe factors that influence the effects
of physical training.
8. Describe the relationships of exercise and
training for health and fitness.
K. Anatomy of the musculoskeletal
system
1. Describe the functions of bony
tissue
2. Identify and describe the composition and
structure of dense and spongy
bone.
3. Identify and describe the composition and
types of cartilage and their
functions.
4. Describe the processes of bone growth,
remodeling and repair of
fractures.
5. Identify the appropriate division (i.e. axial
or appendicular skeleton) to which individual bones belong and
identify left or right designation when
applicable.
6. Describe the functional and structural
classifications of the joints and describe the portions of the
bones that articulate at each
joint.
7. Identify the accessory ligaments associated
with each joint and the functions of each
ligament.
8. Identify and describe the movements possible
and normal range of motion at each
joint.
9. Identify each of the muscles of the axial and
appendicular skeleton by name, position of the muscle bellies,
origin, insertion, innervation and
action.
10. Demonstrate the orientation of the fasiculi
of the muscles.
11.
Identify the location, characteristics and functions of
fascial connective tissues.
12. Describe the fascial layers found in
muscles.
13. Identify bony landmarks on a human subject
and discuss the significance of
each.
L. Kinesiology
1. Identify and describe the planes and
movements of the body.
2. Describe human movement in terms of open and
closed kinetic chains.
3. Identify and describe lever systems relative
to kinetics, fulcrums, weights and
torques.
4. Identify and describe the principles of
arthrokinematics in clinical and practical
applications.
5. Identify and describe the types of muscle
contraction.
6. Identify and describe the principles of
muscular interaction.
7. Identify and describe length-tension
relationships and relate them to active and passive
weakness.
8. Identify valgus and varus angles and their
significance.
9. Determine Q
angle.
10. Describe weight-bearing and
non-weight-baring phases of gait.
M. Anatomy and physiology of the nervous
system.
1. Describe the anatomical and functional
organization of the nervous
system.
2. Describe synapses, neurotransmitters and the
mechanism of synaptic
transmission.
3. Describe the anatomy of the spinal cord, and
major branches of the spinal
nerves.
4. Describe the coverings of spinal cord and
their function.
5. Describe the components and functions of
spinal reflexes.
6. Identify and describe the gross anatomy of
the brain.
7. Identify and describe the coverings of the
brain and their functions.
8. Describe the components of the sensory
nervous system and the physiology of
perception.
9. Define referred pain, radiating pain, and
projected pain and discuss the clinical significance of
each.
10. Identify the two physiological types of pain
and describe their clinical manifestations, characteristics
and anatomical origins within the
body.
11. Define and compare chronic and acute
pain.
12. Define and compare pain threshold and pain
tolerance.
13. Describe how the transmission of pain can be
modulated within the central nervous
system.
14. Discuss tone and movement as two distinct
aspects of somatic motor
activity.
15. Distinguish between firmness to palpation,
resistance to stretch, and sustained contractile activity as
different meanings of the term muscle
tone.
16. Identify multiple levels of control of motor
activities by the nervous system.
17. Identify upper motor neurons and lower motor
neurons.
18. Describe how muscle spindles contribute to
muscle tone and motor control and their role in reflex
loops.
19. Describe the role of the Golgi tendon organs
in the regulation of motor
activity.
20. Describe the role of reciprocal inhibition
during activation of muscle
contraction.
21. Describe the effect of pain on spinal cord
motor activity.
22. Identify and describe the anatomical and
functional organization of the autonomic nervous
system.
23. Identify and differentiate between the
sympathetic and parasympathetic divisions of the
ANS.
24.
Describe the specific effects of sympathetic and
parasympathetic stimulation and autonomic
reflexes.
25. Describe the anatomy of the peripheral
nervous system
26. Define and describe the dermatomes of the
body.
II. Define and/or identify and describe the
pathologies of the human body that are commonly encountered in
massage therapy and bodywork practice.
A. General
pathology
1. Define and distinguish between signs and
symptoms.
2. Differentiate between congenital and
inherited diseases.
3.
Define and distinguish
between genetic disease and genetic
predisposition.
4.
Define
lesion and distinguish between structural and biochemical
lesions.
5. Identify and differentiate between internal
and external causes of cell and tissue
damage.
6. Describe how genetic error, hypoxia and
ischemia, and inappropriate immune responses lead to cell
damage.
7. Define ischemia, necrosis, and
infarction.
8. Identify and describe the changes in
extracellular fibers involved in fibrosis, and in solar
elastosis.
9. Describe the characteristics, vascular
responses to, and cellular exudate associated with acute
inflammation.
10. Identify and describe the sequelae of acute
inflammation.
11. Define chronic inflammation and describe the
mechanisms through which it leads
to:
• fibrosis and
cicatrization
• loss of normal
function
• endarteritis
obliterans
• ulceration.
12. Identify the causes of chronic
inflammation.
13. Distinguish between tissue repair and
regeneration.
14. Describe the mechanisms of tissue
repair.
15. Explain how the following influence wound
healing:
• infection
• foreign bodies and other
irritants
• movement
• age
• nutrition and nutritional
status
• stress and
glucocorticoids
• temperature.
16. Describe the mechanisms of immunoglobin
(antibody) action.
17. Define the process of complement formation
and describe its consequences.
18. Describe the T cell immune response and the
process of cell mediated
immunity.
19. Differentiate between primary and secondary
immune responses and describe the roles of memory cells and
vaccines in each.
20. Describe the consequences of
immunodeficiencies resulting from chemotherapy, immune
suppression, of ionizing
radiation.
21. Describe the relationship between human
immunodeficiency virus (HIV) infection, AIDS related complex
(ARC) and acquired immunodeficiency syndrome
(AIDS).
22.
Define
hypersensitivity, and describe and differentiate between the
five different types of hypersensitivity
reactions.
23. Define autoimmune disease and describe how
Type III immune hypersensitivity (IgG-mediated immune complex
reactions) contributes to autoimmune (collagen vascular)
diseases.
24. Define infection and differentiate between
infection and intoxication
25. Define and distinguish between endogenous
and exogenous sources of
infection.
26. Describe the body’s defenses against
infection.
27. Describe the mechanisms of spread of
infection within a host.
28. Describe how virulence, dose, site of
infection and synergism between different pathogens affect the
occurrence and spread of
infection.
29. Describe how resistance, immune competency,
leukocyte count, and necrosis and ischemia of tissue can
affect the occurrence and spread of
infection.
30. Define opportunistic
infection.
31.
Describe the
pathogenesis of bacterial disease, including local, widespread, and immune
responses to bacterial
infections.
32.
Describe the
pathogenesis of viral disease, including local, widespread, and immune
responses to viral
infections.
33.
Describe the
pathogenesis of fungal
infections.
34. Define
neoplasia.
35. Identify and describe the characteristics of
malignant neoplasms.
36. Differentiate between benign and malignant
neoplasms.
37. Define and describe
metastasis.
B. Cardiovascular system
pathology
1. Describe the kinds and consequences of
disturbances in fluid balance.
2. Define circulatory shock.
3. Describe the mechanisms leading to exudate
edema.
4. Describe the mechanisms leading to transudate
edema and differentiate between venous and lymphatic
obstruction as causes of transudate
edema.
5. Describe the mechanisms of and differentiate
between cardiac and renal edema.
6.
Describe the mechanisms that lead to the formation and
destruction of thrombi and thrombosis.
7. Describe the effects of arterial
thrombosis.
8. Describe the effects of venous
thrombosis.
9. Define embolism and describe the
pathophysiological effects.
10. Describe the mechanisms and consequences of
acute cor pulmonale.
11. Identify and differentiate between
developmental and acquired heart
defects.
12. Define cardiac infarction and describe the
mechanisms that lead to
infarction.
13. Identify and describe angina
pectoris.
14. Describe the functional relationships
between ischemia, necrosis, infarction and angina
pectoris.
15.
Describe the consequences of and clinical signs of right and
left ventricular failure and congestive heart
failure.
16. Identify and describe the following
dysrhythmias:
• ectopic beats
• paroxysmal
tachycardia.
17. Define arteriosclerosis and distinguish
between the following disorders:
• senile
arteriosclerosis
•
arteriolosclerosis
• atherosclerosis.
18. Describe the pathogenesis and consequence of
atherosclerosis.
19. Define and describe aneurysms.
20.
Describe the diseases of the small vessels.
21. Describe the mechanisms leading to the
formation of and the effects of varicose
veins.
C. Respiratory system
pathology
1. Identify and describe the chronic obstructive
pulmonary diseases, including chronic bronchitis, and
emphysema.
2. Describe the effects of chronic bronchitis,
and emphysema on respiration.
3. Identify asthma and describe its effects on
respiration.
D. Digestive system
pathology
1. Identify and describe the following disorders
of the esophagus:
• hiatus hernia
• reflux
esophagitis
2. Identify and describe the effects of chronic
peptic ulceration.
3. Identify and describe the following disorders
of the intestine and colon:
• Crohn's disease
• ulcerative
colitis
• irritable bowel
syndrome
4. Differentiate between type A, type B, and
type C hepatitis.
5. Identify and describe the causes and the
effects of cirrhosis of the
liver.
6. Identify and describe cholecystitis and
cholelithiasis.
E. Endocrine system
pathology
1. Define and describe the following thyroid
disorders
• hyperthyroidism
• hypothyroidism
2. Identify and differentiate between and
describe types I and II diabetes
mellitus.
F. Integumentary system
pathology
1. Identify and describe common bacterial
infections of the skin including the
following:
• impetigo
• ecthyma
• cellulitis
• folliculitis
• furuncles
• carbuncles
2. Identify and describe the following fungal
infections of the skin:
• ringworm
• candidiasis
3. Identify and describe the following parasitic
infections of the skin:
• scabies
• pediculosis (lice
infestations)
4. Identify and describe the following viral
infections of the skin:
• warts
• molluscum
contagiosum
• measles (rubeola)
• german measles
(rubella)
• chicken pox
(varicella)
• herpes simplex
5. Identify and describe the following disorders
of the hair follicles and sebaceous
glands:
• acne vulgaris
• acne rosacea
• pseudofolliculitis
barbae.
6. Identify and describe
psoriasis.
7. Identify, describe and differentiate between
acute, subacute and chronic
dermatitis.
8. Identify the following types of
dermatitis:
• primary irritant contact
dermatitis
• phototoxic
dermatitis
• allergic contact
dermatitis
• photoallergic
dermatitis
• atopic
dermatitis,
• stasis
dermatitis,
• localized scratch
dermatitis
• seborrheic
dermatitis
9. Identify and describe and differentiate
between the following skin
neoplasms:
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