Massage Therapy Journal Fall 2024

52 • Massage Therapy Journal

AMTA Continuing Education

Approximately 1.7 million people in the United States use a prosthetic limb. The most common prosthetic limb types are those located below the knee, accounting for approximately 70 percent of prosthetic use. Complications associated with the use of prostheses are skin irritation and discomfort. Some people experience “phantom limb” sensations and feel like the missing limb is still present. 34 Massage can have a positive physiological and psychological effect on people with amputations. 35 In fact, massage and scar mobilization are standards of care for lower extremity amputations to decrease hypersensitivity of the remaining limb and to reduce pain. 36 Massage Practice Setting: Consider using the following suggestions in the massage room itself and when interacting with individuals who have mobility impairments. • Ensure adequate access into and throughout your place of business (access ramps, curb cuts, large entrances, wide pathways and doorways). The ADA provides guidelines for public accommodations of wheelchairs and other mobility aids. They include barrier-free, no step access from the street or parking areas into and throughout the facility, with a minimum of 36-inch wide pathways and doorways and a minimum of 32-inch wide openings. 22 • If the massage facility is not wheelchair

• Have intake forms and consent forms available in multiple formats (i.e., paper, digital). • Sit down when speaking with the client, such as during the consultation, instead of standing and looking down. • Ask the client to describe the degree of limitation they are experiencing. This information will help you determine any additional modifications. • A wheelchair or a mobility aid is part of a client’s personal space. Do not lean on it or touch it, and do not push the chair unless asked. • If the client has a service animal, do not pet, grab the harness, talk to, feed or distract the animal in any way. In fact, many handlers do not give out their animal’s name to avoid the possibility of the animal becoming distracted. It is best to pretend the service animal is not there. • A client with a mobility impairment may or may not want assistance in a particular situation, such as removing or putting on shoes. Ask before assisting and wait for a response. Listen to any instructions the client may give. By virtue of experience, the client knows the safest and most efficient way to accomplish the task at hand. Respond to a “no thank you” graciously if your offer for assistance is declined. Massage Modifications for Clients With Mobility Impairments When working with individuals who have mobility impairments, implement the following massage modifications for their safety and comfort. • The client may be more comfortable in certain positions or need to avoid others entirely. Use bolsters and pillows for the client’s comfort as well as to preserve your body mechanics. • If a seated position is used for the massage, place pillows on the massage table or use a face rest frame that attaches to the edge of a regular table. • The client should be supported during the massage by using a tripod

A client with a mobility impairment may or may not want assistance in a particular situation, such as removing or putting on shoes. Ask before assisting and wait for a response. Listen to any instructions the client may give. By virtue of experience, the client knows the safest and most efficient way to accomplish the task at hand.

accessible, it may be better to go to the client’s home or a mutually agreed-upon accessible establishment. Approximately 28 percent of massage therapists provide massages in their place of residence. 37

• Clients may encounter barriers during transport to your office, such as inconvenient parking places or mechanical problems with wheelchairs or scooters. Allow clients to change the length of their services without penalty. • Because fatigue is frequently reported, include a rest period when the client arrives and limit the number of times the client repositions themselves and turns over on the massage table.

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