DETAILED GUIDE FOR TUTORS TO TEACH AND PREPARE LEARNERS FOR THE PRACTICAL EXAMINATION Body therapy CIBTAC 1 Detailed guide for Body Therapy September 2013
DETAILED GUIDE FOR TUTORS TO TEACH AND PREPARE LEARNERS FOR THE PRACTICAL EXAMINATION IN BODY THERAPY The treatment incorporates consultation, figure diagnosis, application of electrical treatments covering vacuum suction, gyratory vibrator, galvanic, and neuromuscular electrical stimulation (NMES), body massage and aftercare / homecare advice. GENERAL HYGIENE GUIDELINES Emphasis placed on legal requirements and high standards of health, safety and hygiene e.g. sterilisation / sanitisation processes for tools, equipment and hygiene procedures followed to prevent cross infection. sterilise o refer to suppliers instructions for electrical equipment sanitise / disinfect o plastic spatulas o vacuum suction cups / ventouses o gyratory vibrator attachments o sponge, viscose or foam pads o rubber pads - keep the connecting end dry by washing them with anti bacterial solution and water, rinse; wipe over with disinfectant solution and allow to dry naturally place clean wooden spatulas on tissue and dispose of them after treatment, use both ends to minimise waste. products o use tubs with small apertures or pumps where possible o extract products from bottles and pots each time with a sanitised spatula, orangewood stick or cotton bud to avoid contamination of the product, or, place sufficient product for the treatment in a sanitised container. Do not replace excess product back into the original bottle / pot. o replace lids on bottles and pots immediately after use use lined bin with lid for waste disposal (UK only: waste contaminated with human tissue or body fluids should be placed in yellow refuse sacks and collected by a registered waste carrier) sanitise hands appropriately before, during and after treatment using antibacterial soap and water an appropriate antibacterial gel may be used to sanitise hands during treatment Safe and correct use of equipment and materials are demonstrated during treatment, together with the safe and correct disposal of waste materials at the end of treatment. CIBTAC 2 Detailed guide for Body Therapy September 2013
CONSULTATION AND FIGURE DIAGNOSIS (Candidates may use own consultation cards or adapt the CIBTAC forms) Consultation sheets must be completed at the beginning of the treatment and will be collected at the end of the examination. Marking Criteria Medical history Lifestyle Contra-indications full medical history discussed and recorded information on consultation sheet including medication. general health, occupation, stress levels, energy levels, time for relaxation, sleep pattern, diet etc, identified, discussed and recorded any contra-indications that may: require doctor s permission, or, restrict treatment but can proceed with caution Reasons for treatment established the client s long and short term objectives / goals confirmed if objectives were realistic Today s treatment plan accurately identified the client s condition / needs for this treatment explained fully the content of the treatment plan Visual analysis Height assessed client s: gait (how they walk) posture, standing and sitting body language ensured client removed shoes, placed heels together, back straight and looked ahead. used either a fixed measure attached to the wall or asked the client to stand against the wall and used a tape measure measured accurately Weight weighed the client wearing minimal amount of clothing compared the client s information with the recommended weight charts and advised accordingly. Body measurements measured client wearing minimal amount of clothing fitted tape measure to the part with appropriate tension CIBTAC 3 Detailed guide for Body Therapy September 2013
used a fixed point of the body to gain a true measurement e.g. acromion process, anterior superior iliac spine, patella. Body type Fat distribution Postural analysis identified correct body type or combination of types: ectomorph mesomorph endomorph combination assessed correctly fat deposits / distribution by manual palpation hard soft cellulite analysed the posture correctly from the following positions: anterior posterior lateral used a plumb line to correctly analyse alignment assessed muscle tone identified stretched / contracted muscles e.g. kyphosis, lordosis, scoliosis recorded all the above information accurately Good Practice: client and therapist should be seated during consultation establish a good rapport and put client at ease. adapt a suitable attitude and approach according to client s body language, gestures, responses etc. gain an insight into the client s lifestyle. use follow up questions to find out more detail about the client as opposed to yes and no responses and applies this information to the treatment plan to meet the client s needs. add homecare advice to the consultation form at the end of the treatment CIBTAC 4 Detailed guide for Body Therapy September 2013
ELECTRICAL TREATMENTS Vacuum Suction, Gyratory Vibrator, Galvanic, NMES Machinery must be specifically designed by the manufacturer for body work, facial equipment is not acceptable. All four treatments demonstrated with emphasis placed on correct technique and safety before, during and at the end of treatment. VACUUM SUCTION Marking Criteria Preparation and hygiene of work area Preparation completed preparation of the treatment bed and trolley prior to the start of the examination. treatment bed appropriate height, clean towels, disposable coverings, all necessary items available to avoid a disruptive treatment. positioned trolley on correct side of therapist, ensured easy access to items and avoided obstruction to others. prepared quickly and efficiently machine / attachments ensured machine stable, no trailing wires, dials at zero tested the machine on self, then sanitised before testing on client Hygiene (prior to start of examination) sanitised machine and attachments sanitised vacuum suction cups / ventouses, plastic spatulas and appropriate attachments by washing them with anti bacterial soap and water, placed in disinfectant solution, rinsed and allowed to dry in a ventilated, clean area placed clean wooden spatulas on tissue and disposed of them after treatment Preparation and care of the client gave client clear instructions of how to prepare for the treatment - removed jewellery / body piercing and any clothing that would have inhibited the treatment. covered client appropriately, clothing (and hair) protected cleansed the skin using an appropriate product kept client informed during treatment CIBTAC 5 Detailed guide for Body Therapy September 2013
Marking Criteria Positioning of the client Safe use of the machine positioned client correctly with emphasis on support and comfort throughout the treatment set up for treatment correctly tested the machine prior to use and cleansed the cup / ventouse with a disinfectant agent appropriate and informed use of equipment and products according to manufacturers instructions made sure intensity at zero before switching on did not over treat any area Explanation of the treatment Technique positioning and use of electrodes / attachments explained in terms the client understood, avoided technical terms applied sufficient medium selected correct size of cups / ventouses for area being treated, lifted and glided the cup / ventouse towards appropriate lymph node lifted sufficient tissues - did not exceed 20% of the cup / ventouse released suction just before the lymph node released the suction appropriately before removing from the skin avoided pushing down on the cup when working towards the lymph node slightly overlapped each stroke by 1cm or half inch, covered area 5 10 times depending on the effect required rhythmical movements not too quick or too slow Technique adjustment of controls selected correct level of intensity dependent on resilience of the tissues and monitored both verbally and visually increased intensity of suction slowly CIBTAC 6 Detailed guide for Body Therapy September 2013
Good Practice: sanitise plastic tubes by washing them with anti bacterial soap and water place in disinfectant solution, rinse and allow to dry in a ventilated, clean area. protect client s clothing with tissues use correct amount of medium to minimise waste and prevent dragging of the skin cups / ventouses should be the largest fit for the area being treated without losing suction prepare and treat both legs together to avoid disrupting the treatment by changing cups / ventouses and breaking continuity, emphasis on protecting client s modesty CIBTAC 7 Detailed guide for Body Therapy September 2013
GYRATORY VIBRATOR Marking Criteria Preparation and hygiene of work area Preparation completed preparation of the treatment bed and trolley prior to the start of the examination. treatment bed appropriate height, clean towels, disposable coverings, all necessary items available to avoid a disruptive treatment. positioned trolley on correct side of therapist, ensured easy access to items and avoided obstruction to others. prepared quickly and efficiently machine / attachments ensured machine stable, no trailing wires, dials at zero Hygiene (prior to start of examination) sanitised plastic spatulas and appropriate attachments by washing them with anti bacterial soap and water placed in disinfectant solution, rinsed and allowed to dry in a ventilated, clean area placed clean wooden spatulas on tissue and disposed of them after treatment Preparation and care of the client gave client instructions of how to prepare for the treatment - removed jewellery / body piercing and any clothing that would have inhibited the treatment. covered client appropriately, clothing (and hair) protected cleansed the skin using an appropriate product kept client informed during treatment Positioning of the client Safe use of the machine positioned client correctly with emphasis on support and comfort throughout the treatment set up for treatment correctly held the attachment head down towards the floor and away from the client when switching on the machine avoided / kept pressure light over bony areas CIBTAC 8 Detailed guide for Body Therapy September 2013
Marking Criteria Explanation of the treatment Technique positioning and use of electrodes / attachments explained in terms the client understood, avoided technical terms selected a variety of attachments, minimum of 3, to suit the client s needs and area to be covered ensured the attachment was contoured to the body part to avoid uneven pressure of application worked with the venous return lifted and guided the tissues towards the attachment(s) with one hand when using circular movements correct depth of pressure according to the tissues being treated smooth rhythmical strokes altering pace and depth to suit client s needs Technique adjustment of controls selected correct level of intensity dependent on resilience of the tissues and monitored both verbally and visually Good Practice: consider a pre heat treatment to prepare the tissues for gyratory vibrator use purified unperfumed talc to avoid allergies, apply talc to the area carefully as it can aggravate respiratory problems one hand may be placed before or after the applicator to soothe the skin when using the effleurage attachment take care when carrying out treatment over the abdomen avoid using heavy petrissage movements over bony areas secure a plastic bag around the attachment which can be disposed of after each client or alternatively purchase washable or disposable coverings from the wholesaler avoid breaking the continuity of treatment by selecting only the attachments that will benefit the area prepare and treat both legs together to avoid disrupting the treatment by changing the attachments and breaking continuity, emphasis on protecting client s modesty CIBTAC 9 Detailed guide for Body Therapy September 2013
BODY GALVANISM / IONTOPHORESIS Body Galvanism using saline solution, this method involves the polar and interpolar effects. Body Iontophoresis using specific products for cellulite in the form of gels and ampoules. Marking Criteria Preparation and hygiene of work area Preparation completed preparation of the treatment bed and trolley prior to the start of the examination. treatment bed appropriate height, clean towels, disposable coverings, all necessary items available to avoid a disruptive treatment. positioned trolley on correct side of therapist, ensured easy access to items and avoided obstruction to others. prepared quickly and efficiently machine / attachments ensured machine stable, no trailing wires, dials at zero Hygiene (prior to start of examination) sanitised attachments and plastic spatulas by washing them with anti bacterial soap and water, placed in disinfectant solution, rinsed and allowed to dry in a ventilated, clean area placed clean wooden spatulas on tissue and disposed of them after treatment Preparation and care of the client gave client clear instructions of how to prepare for the treatment - removed jewellery / body piercing and any clothing that would have inhibited the treatment. covered client appropriately, clothing (and hair) protected tested for skin sensitivity (hot, cold, soft, firm) cleansed area thoroughly with appropriate product tested the machine, on self then sanitised before testing on client kept client informed during treatment CIBTAC 10 Detailed guide for Body Therapy September 2013
Marking Criteria Positioning of the client Safe use of the machine positioned client correctly with emphasis on support and comfort throughout the treatment set up for treatment correctly tested the machine on self, then sanitised before testing on client avoided applying electrodes to the anterior and posterior aspects of the body at the same time to prevent thermal / chemical burns unless manufacturers instructions state that this method is acceptable ensured client aware of the sensation to be felt and reporting any discomfort during treatment Explanation of the treatment Technique positioning and use of electrodes / attachments explained in terms the client understood, avoided technical terms used sponge envelopes / pads of an appropriate thickness moistened sponge envelopes / pads evenly with saline solution / iontophoresis gel (follow manufacturers instructions) applied active electrode to the area being treated applied inactive electrode opposite or parallel near to the area but without touching other pads contoured sponge envelopes / pads to the body with sufficient straps ensured sponge envelopes / pads did not touch / overlap applied straps evenly and securely around the pads Technique adjustment of controls selected correct level of intensity dependent on resilience of the tissues and manufacturers instructions, regularly monitored both verbally and visually avoided increasing or reducing current too quickly Good Practice: wash sponge envelopes / pads thoroughly in anti bacterial soap, rinse and dry to remove any chemicals / products left from previous treatment cover any open cuts with petroleum jelly and cover with water proof dressing avoid touching pads with a firm pressure as this may cause discomfort to the client CIBTAC 11 Detailed guide for Body Therapy September 2013
treat the anterior and posterior aspects of the body separately to avoid causing thermal burns understand causes of chemical and thermal burns when treating a client for the full amount of time, avoid carrying out any other treatments over the area as the skin will be extremely sensitive Body Galvanism measure the correct amount of saline solution for a body galvanism treatment (2 teaspoons of salt to 1 litre of warm water) use a 2% saline solution under the cathode and 1% saline solution under the anode wash area thoroughly after treatment using an appropriate product to remove chemicals from the surface of the skin Body Iontophoresis follow manufacturers instructions when using products for body Iontophoresis treatments CIBTAC 12 Detailed guide for Body Therapy September 2013
NMES Marking Criteria Preparation and hygiene of work area Preparation completed preparation of the treatment bed and trolley prior to the start of the examination. treatment bed appropriate height, clean towels, disposable coverings, all necessary items available to avoid a disruptive treatment. positioned trolley on correct side of therapist, ensured easy access to items and avoided obstruction to others. prepared quickly and efficiently machine / attachments ensured machine stable, no trailing wires, dials at zero tested the machine on self, then sanitised before testing on client Hygiene (prior to start of examination) sanitised plastic spatulas and appropriate attachments by washing them with anti bacterial soap and water, placed in disinfectant solution, rinsed and allowed to dry in a ventilated, clean area placed clean wooden spatulas on tissue and disposed of them after treatment Preparation and care of the client gave client clear instructions of how to prepare for the treatment - removed jewellery / body piercing and any clothing that would have inhibited the treatment. covered client appropriately, clothing (and hair) protected cleansed the skin with an appropriate product carried out a skin sensitivity test (hot, cold, soft, firm) kept client informed during treatment Safe use of the machine set up for treatment correctly tested the machine on self, then sanitised before applying pads to client checked intensity controls were at zero before switching on the machine CIBTAC 13 Detailed guide for Body Therapy September 2013
Marking Criteria Explanation of the treatment Technique positioning and use of electrodes / attachments explained in terms the client understood, especially the sensation experienced, avoided technical terms chose appropriate machine settings to meet the client s needs selected appropriate padding layout to meet the client s needs ensured relaxation period was longer than the contraction period moisten the pads evenly with saline solution / product positioned the pads on the motor point(s) of the muscles whenever possible secured the straps evenly around the body ensuring pads contoured the area with no air gaps guided the client through the intensity of current for each pair of pads obtained visible contraction of muscles suitable to the client s tolerance Technique adjustment of controls selected correct level of intensity dependent on resilience of the tissues and increased the intensity during treatment increased the intensity during the surge decreased the intensity during the relaxation period Good Practice: sanitise pads in warm soapy water, rinse and dry encourage the client to have a pre heat treatment to warm the tissues and maximise the effect of the treatment cover any open cuts with petroleum jelly and cover with water proof dressing ensure the saline solution is an appropriate temperature before placing the pads on the client place pads on the motor point of the muscle whenever possible avoid padding opposite muscles i.e. prime movers and antagonists avoid moving pads when the intensity is flowing increase the intensity during treatment as required avoid touching pads with a firm pressure as this may cause discomfort to the client apply and remove pads in a methodical way to avoid tangling the leads avoid placing saline solution too near the machine wipe over the area after treatment CIBTAC 14 Detailed guide for Body Therapy September 2013
MASSAGE The candidate is required to perform a massage incorporating all 5 Swedish massage movements to the upper back, neck and shoulder region and the front of the leg area. The massage should be adapted to meet the client s needs and last for a maximum of 30 minutes Marking Criteria Preparation and hygiene of the work area completed preparation of the treatment bed and trolley prior to the start of the examination. treatment bed appropriate height, clean towels, disposable coverings, all necessary items available to avoid a disruptive treatment. positioned trolley on correct side of therapist, ensured easy access to items and avoided obstruction to others. Preparation and care of the client gave client clear instructions of how to prepare for the treatment - removed jewellery / body piercing and any clothing that would have inhibited the treatment. covered client appropriately, clothing (and hair) protected positioned client correctly with emphasis on support and comfort throughout the treatment maintained modesty throughout the massage kept client informed when relevant during massage Pressure Rhythm Rate Continuity Positioning and support of the area depth of pressure appropriate and varied taking into account the underlying structures and any sensitive areas selected appropriate rhythm throughout the treatment dependent on client s needs, relaxing or vigorous massage selected appropriate speed according to type of movement and area being treated transition between strokes rhythmical, smooth and continuous positioned client correctly for each area, provided additional support where necessary CIBTAC 15 Detailed guide for Body Therapy September 2013
Marking Criteria Technique of all 5 movements correct technique demonstrated for ALL 5 classified Swedish movements Effleurage hands relaxed, supple and adapted to body contours movement followed venous return, working distally to proximally and directed to a group of lymph nodes maintained hand contact on the return stroke with very little pressure Petrissage demonstrated correct technique for particular movements by pressing, lifting, squeezing and releasing the tissues Frictions used fingers or thumb(s) applied transversely across muscle fibres - pressure constant throughout the movement, or, applied in a circular movement, increased depth of pressure completed the movement before moving onto another area Percussion demonstrated striking or tapping the area with springy rhythmical movements avoided bony and sensitive areas Vibrations vibrated the hand / fingers over the area to produce a tremor in the tissues Good Practice: regular hand exercises, together with stretching the back, neck, shoulders and arms to help strengthen muscles and avoid repetitive strain injury select an appropriate medium taking into account the client s needs adapt massage to suit client s needs focus on depth, pressure and rhythm of movements according to the area being massaged concentrate on the client during the massage, observe body language to monitor satisfaction with the treatment maintain client modesty during treatment maximise use of time CIBTAC 16 Detailed guide for Body Therapy September 2013
AFTERCARE AND ADVICE Aftercare advice focuses on points the client should follow immediately after treatment. Homecare advice addresses the points the client should follow to preserve and maintain the effects of the treatment until the next appointment. Marking Criteria Electrical Aftercare: relaxed for a short while before getting up from the treatment bed offered glass of water Homecare: advised on: contra-actions products to increase firmness products to aid the removal of cellulite exfoliators nutrition fluid intake per day how to stand and sit correctly course of treatments follow up appointments other treatments that complement condition being treated CIBTAC 17 Detailed guide for Body Therapy September 2013
Marking Criteria Massage Aftercare: relaxed for a short while before getting up from the treatment bed offered glass of water Homecare: advised on: contra-actions relaxation techniques deep breathing visualisation nutrition fluid intake per day how to stand and sit correctly suitable body products Good Practice: advice given meets the specific needs of the client and retail products and services are promoted that will enhance and complement following treatments. CIBTAC 18 Detailed guide for Body Therapy September 2013
APPEARANCE AND DEPORTMENT As a therapist, the candidate should present a totally professional image in line with CIBTAC standards and the industry code of practice: Marking Criteria Appearance uniform cleaned and pressed, hem neat shoes clean, low heeled, enclosed front and back, trainers not acceptable secured hair away from the face and styled so as not to interfere with the treatment. nails appropriate length, clean and free of polish. no jewellery except a wedding band Posture Walk standing stood one foot in front of the other, knees bent to work up and down the length of the body, the body weight transmitted through the arms to the area being massaged Stride standing stood with feet apart and worked across the body back straight and shoulders relaxed maintained good posture whether standing or sitting during treatment(s) Professionalism Timing adopted a polite and friendly approach, followed hygiene and safety procedures performed effective treatment(s) fully utilised and finished within time full marks awarded utilised the majority of time and finished within 5 minutes of stated time, 50% of the total marks awarded Good Practice: adapt a suitable attitude and approach according to client s body language, gestures, responses etc. CIBTAC 19 Detailed guide for Body Therapy September 2013
Electrical Oral Questions = 4 marks 2 questions from any of the following treatments: Infra-red Ultra violet Steam Sauna Body Therapy Examination, time allowed 3 hours maximum The School / College must ensure suitable clients are available to receive the treatments required for this examination. Please see the relevant course materials for more details regarding the examination procedures. CIBTAC 20 Detailed guide for Body Therapy September 2013