Quebec Naturopathic Physician Continuing Education

• Define and differentiate the anatomical relationship between the rotator cuff muscles and the glenohumeral joint capsule
• Gain deeper insight into the causes and treatment of scapula dyskinesia
• Describe and perform contemporary scapula mobilization techniques
• Apply innovative soft tissue mobilization techniques to patients with shoulder hypomobility
• Perform soft tissue mobilization techniques for sub deltoid bursitis

• Classify functional anatomy and biomechanics of the shoulder - scapula complex
• Apply current strategies for the evaluation of patients with scapular disorders
• Perform innovative  scapular mobilization techniques for the patient with scapular dyskinesia
• Differentiate the relationship between scapular dyskinesia, soft tissue/muscle tightness, and shoulder pathology
• Integrate a systematic scapular muscle training program / protocol for patients with scapular dyskinesia

• Discuss the prevalence and etiology of temporomandibular joint dysfunction (TMD)
• Define the anatomy of the TMJ and surrounding facial structures.
• Recognize the three most common causes of temporomandibular joint dysfunction (TMD) seen within the chiropractic practice.
• Outline various types of pain referral sources to the temporomandibular joint (TMJ).
• Evaluate the TMJ using physical examination procedures
• Compare and contrast TMJ synovitis and capsulitis
• Distinguish the difference between anterior disc displacements with and without reduction
• Describe standard imaging processes ordered for specific TMJ conditions
• Outline various conservative management options for temporomandibular disorders
• Construct a treatment plan for a typical patient with temporomandibular dysfunction
• Apply specific myofascial techniques for the muscles of mastication
• Define the co-management care of a dental professional with patients presenting temporomandibular joint dysfunction

• Discuss the state of the literature on common treatment options for adhesive capsulitis
• Apply an effective and streamlined exercise program in the management of subacromial impingement
• Recognize the value of radial nerve mobilization in patients with thumb carpometacarpal osteoarthritis
• Appraise the potential value of adding low-level laser therapy to other interventions for subacromial impingement
• Summarize the state of the literature regarding Kinesiotape for preventing sports injuries

Hour 1

• Determine appropriate protocols for patient progress.
• Discuss tools to reduce vertigo symptoms.
• Incorporate nutritional support for better brain function.
• Utilize brain therapy programs to improve cognition.
• Apply traction therapy to reduce intrathecal pressure.
• Introduce vision evaluation testing tools.

Hour 2

• Incorporate gaze stabilization exercises for oculomotor function. Evaluate balance and stability with a variety of tools.
• Demonstrate balance exercises to improve proprioception.
• Discuss cardio exercise to stimulate blood flow and neogenesis.
• Apply cervical strength protocols using graduated isometrics.

Hour 3

• Apply jaw exercises to reduce TMJ symptoms.
• Discuss post-exercise therapy recovery strategies.
• Demonstrate mobility exercises to improve joint function.
• Integrate therapeutic stretching protocols to improve agility.
• Illustrate self release techniques to enhance mobility.

• Present literature based dietary recommendations for Parkinson’s disease symptom management
• Discuss literature based exercise recommendations for Parkinson’s disease symptom management, with an emphasis on aerobic exercise
• Review the literature regarding acupuncture for Parkinson’s disease symptom management
• Discuss lifestyle modifications that can be helpful with Parkinson’s disease symptom management

Hour 1

• Discuss shoulder anatomy.
• Differentiate the causes of shoulder pain
• Assess joint mobility and muscle function.
• Apply manual manipulation to reduce shoulder dysfunction.
• Incorporate rehab techniques to restore strength and flexibility.

Hour 2

• Discuss scapulo-thoracic anatomy.
• Define the causes of scapulo-thoracic pain.
• Assess joint mobility and muscle function.
• Apply manual manipulation to reduce scapular dysfunction.
• Introduce rehab techniques to restore strength and mobility.

Hour 3

• Discuss gleno-humeral anatomy.
• Define the causes of gleno-humeral pain.
• Assess joint mobility and muscle function.
• Apply manual manipulation to reduce joint dysfunction.
• Introduce rehab techniques to restore strength and mobility.

Hour 1

• Discuss concussion causes and pathophysiology.
• Introduce return to play guidelines.
• Explore other return to lifestyle guidelines.
• Understand modifying factors for RTP.
• Examine concussion grading procedures.

Hour 2

• Review tools for concussion evaluation.
• Understand the health concerns of pediatric athletes.
• Incorporate strategies for pediatric patients.
• Apply pediatric RTP guidelines for football.

Hour 3

• Investigate medico-legal issues of RTP.
• Explore appropriate documentation standards.
• Read state concussion law development.
• Compare professional Position Papers.
• Discuss the role of Chiropractors.

Hour 1

• Describe techniques and principles of examination for peripheral joints
• Identify important surface anatomy of the shoulder, elbow, wrist and hand
• Identify normal range of motion of the joints of the upper extremity
• Describe how to perform an examination of the upper extremity
• Recognize common musculoskeletal abnormalities 

Hour 2

• Outline special maneuvers for the evaluation of carpal tunnel syndrome
• Outline special maneuvers for the evaluation of shoulder impingement syndrome
• Identify important landmarks necessary for the exam of lower extremities
• Describe the physical examination technique for the lower extremities
• Interpret normal findings, including range of motion of the hip, knee and ankle
• Recognize some common abnormal findings through physical examination
• Describe some special maneuvers for examination of the hip, knee and ankle

Hour 3

• Outline special maneuvers for the evaluation of knee instability.
• Outline special maneuvers for the evaluation of an inversion ankle sprain
• Distinguish the differences between anterior interosseous membrane syndrome and tibial stress fracture.
• Design a treatment plan for acute patients with myofascial dysfunction for the upper and lower extremities.

Hour 1

• Describe pathophysiology as it relates to concussions. 
• Discuss the diagnosis and prognosis of concussions.
• Review concussion red flags and dangers of manipulation.
• Understand the health concerns of pediatric athletes.
• Explore diagnostic tests to evaluate concussion status.

Hour 2

• Demonstrate non-thrust treatment techniques.
• Introduce the half-somersault maneuver for vertigo relief.
• Address cranial nerve lesions with manipulation techniques.
• Explore sleep strategies for concussed patients.
• Incorporate nutritional support for better brain function.
• Discuss cardio exercise to stimulate blood flow to the brain.

Hour 3

• Apply mobility exercises to improve musculoskeletal function.
• Integrate PreActive StretchingSM protocols to improve agility.
• Explain return to lifestyle guidelines.
• Understand modifying factors for RTP.
• Compare professional Position Papers.
• Discuss the role of Chiropractors and concussions.

• Update the findings of the Neck Pain Task Force (NPTF) and examine the effectiveness of interventions for the management of headache in patients with neck pain
• Assess the effectiveness of conservative interventions for cervicogenic headache
• Examine the extent to which changes in specific cervical spine impairments contribute to the effectiveness or ineffectiveness of treatment for chronic tension-type headache
• Evaluate existing evidence regarding the reliability and diagnostic accuracy of physical examination tests used for diagnosing cervicogenic headache (CGH)
• Outline the clinical relevance of the cervical myodural bridge

• Recall the clinical definition of adhesive capsulitis, based on shoulder range of motion measurements.
• List 5 risk factors for adhesive capsulitis.
• Enumerate the 4 pathophysiological stages of adhesive capsulitis.
• List and define the 3 sub-components of the tissue-response classification system for adhesive capsulitis.
• Provide 2 clinical findings for each of the 3 sub-components of the tissue-response classification system for adhesive capsulitis.
• State 3 treatment guidelines for each of the 3 sub-components of the tissue-response classification system for adhesive capsulitis.
• Summarize the grades of evidence for common physical therapy interventions (i.e. therapeutic exercise, joint mobilizations, modalities and patient education) for adhesive capsulitis

• Discuss the specific pattern of contracted and weak muscles found with Pelvic Crossed Syndrome.
• Discern the effects on the spine and pelvis from the spastic and weak muscle pattern.
• Apply modalities and manual methods to treat weak and contracted muscles.
• Rehabilitate weak and atrophied muscles using stretching and exercise.
• Determine spinal and pelvic effects of the abnormal muscular patterns found with Pelvic Crossed Syndrome and apply treatment protocol.

Hour 1

• Discuss a functional overview of the Autonomic nervous System
• Describe Autonomic Nervous System Dysfunction specifically associated with neuromusculoskeletal injury
• Identify the role of the Vagus Nerve in Controlling the Inflammatory cascade with neuromusculoskeletal injury

Hour 2

• Include physical examination procedures specific to autonomic nervous system and vagus nerve dysfunction
• Perform neurological exam procedures specific to autonomic nervous system and vagus nerve dysfunction
• Perform chiropractic exam procedures specific to autonomic nervous system and vagus nerve dysfunction

Hour 3

• Describe therapeutic Protocols for musculoskeletal injuries with concomitant signs associated with dysfunction of the autonomic nervous system
• Discuss structural chiropractic treatment protocols of musculoskeletal injuries with concomitant signs associated with dysfunction of the autonomic nervous system
• Present phytonutrient protocols for musculoskeletal injuries with concomitant signs associated with dysfunction of the autonomic nervous system

Hour 1

• Discuss a functional overview of the Cerebellar dysfunction
• Describe Cerebellar Dysfunction specifically associated with neuromusculoskeletal injury
• Identify the role of the Cerebellum in balance disorders associated with neuromusculoskeletal injuries

Hour 2

• Include physical examination procedures specific to the cerebellar system
• Perform neurological exam procedures specific to the cerebellar system
• Perform chiropractic exam procedures specific to the cerebellar system

Hour 3

• Describe therapeutic Protocols for musculoskeletal injuries with concomitant signs associated with dysfunction of the cerebellum
• Discuss structural chiropractic treatment protocols of musculoskeletal injuries with concomitant signs associated with dysfunction of the cerebellum
• Present phytonutrient protocols for musculoskeletal injuries with concomitant signs associated with dysfunction of the cerebellum

• Discuss the histological features of Scoliosis
• Discern Structural vs. Functional Scoliosis and their primary causes
• Coordinate treatment protocols to cervical, thoracic and lumbopelvic spine, rib cage and scapula for Scoliosis curvature
• Utilize modalities and soft tissue treatment methods to address functional changes resulting in a Scoliosis curvature
• Advise the Scoliosis patient in effective methods of stretching and exercise

• Discuss the specific pattern of contracted and weak muscles found with Shoulder Crossed Syndrome.
• Discern the effects on the spine, upper extremity and pelvis from the spastic and weak muscle pattern.
• Apply modalities and manual methods to treat weak and contracted muscles.
• Rehabilitate weak and atrophied muscles using stretching and exercise.
• Determine spinal, extraspinal and pelvic effects of the abnormal muscular patterns found with Shoulder Crossed Syndrome and apply treatment protocol.

• Discuss the specific pattern of fibrosis development around and within the glenohumeral joint found with Adhesive Capsulitis.
• Discern the effects of the fibrosis and adhesions on the glenohumeral joint and associated soft tissues.
• Understand the rules of treatment specific to Adhesive Capsulitis.
• Apply modalities and manual methods to treat fibrosis and adhesions in the soft tissue structures around and within the glenohumeral joint as well as associated contracted muscle tissue.
• Rehabilitate weak and atrophied muscles using stretching, exercise and modalities.

• Describe the relationship among SLAP tears, posterior shoulder tightness and scapula dyskinesis  
• Explain how to perform the modified dynamic labral shear test and summarize the clinical usefulness of this test
• Cite the clinical prediction rule (CPR) for favorable outcome in patients undergoing conservative management for SLAP lesions
• Paraphrase the efficacy of conservative treatment for patients with SLAP disorders.
• List one indication for performing an anterior to posterior mobilization of the humerus on the glenoid (posterior shoulder mobilization) 
• Identify one appropriate intervention (specific manual technique or exercise) for phase I, phase II and phase III   SLAP rehabilitation program.

• Describe the relationship among shoulder micro-instability, scapula dyskinesis and hyperlaxity  
• Explain how to perform the surprise test and summarize the clinical usefulness of this test
• Paraphrase the efficacy of conservative treatment for patients with atraumatic shoulder instability.
• Contrast the difference between a capsule reconstruction/ shift and a capsular repair.
• Cite 2 major precautions, and corresponding time frames following an anterior capsule reconstruction or repair (during the first 12 weeks)
• Identify one appropriate intervention (exercise) for phase I, phase II and phase III   post- rehabilitation program following capsular shift / reconstruction or repair

• Compare active cervical range of motion in patients with neck pain to those with whiplash or no neck pain
• Critically appraise and synthesize recommendations of evidence-based clinical practice guidelines for the management of common conditions related to traffic collisions
• Investigated the possibility of posttraumatic cervical artery dissections (including those involving the vertebral artery) in patients who have sustained a whiplash injury in a motor vehicle collision
• Update findings from the Neck Pain Task Force regarding the effectiveness of manual therapies, passive physical modalities, and acupuncture for the management of whiplash and neck pain
• Determine which treatments or combinations of treatments are most effective for the management of neck pain- (NAD) and whiplash-associated disorders (WAD)

• Discuss the specific pattern of fibrosis development around and within the iliotibial band found with Iliotibial Band Syndrome at the Hip.
• Discern the effects of the fibrosis and adhesions on the iliotibial band, associated soft tissues and the functional biomechanics of the region.
• Understand the rules of treatment specific to Iliotibial Band Syndrome at the Hip.
• Apply modalities and manual methods to treat fibrosis and adhesions in the soft tissue structures around and within the iliofemoral joint as well as associated contracted muscle tissue.
• Rehabilitate weak and atrophied muscles using stretching, exercise and modalities.

• Discuss the specific pattern of fibrosis development around and within the plantar myofascia of the foot.
• Discern the effects of the fibrosis and adhesions on the plantar fascia, associated soft tissues and the functional biomechanics of the region.
• Understand the rules of treatment specific to Plantar Fasciitis of the Foot.
• Apply modalities and manual methods to treat fibrosis and adhesions in the soft tissue structures around and within the foot and ankle joint as well as associated contracted muscle tissue.
• Rehabilitate weak and atrophied muscles using stretching, exercise and modalities.

• Justify examination of the cervico-thoracic spinal regions for dysfunction in lateral epicondylalgia patients
• Explain and identify posterolateral rotary instability (PLRI) of the elbow
• Optimize clinical assessment and diagnosis for the long head of biceps complex
• Explore the potential pathological commonalities amongst adhesive capsulitis, metabolic syndrome and low-grade inflammation
• Discuss current neuroanatomical and biochemical theories as they pertain to shoulder pain and its clinical management

• Assess the effectiveness of three nonsurgical interventions on symptoms, physical function, and physical activity in patients with lumbar spinal stenosis.
• Compare the effectiveness of a structured, comprehensive conservative treatment program with a focus on self-management and improved walking ability (including lumbar manipulation, exercise and education) to a self-directed program in patients with neurogenic claudication due to lumbar spinal stenosis.
• Summarize the 2013 North American Spine Society (NASS) clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis.
• Examine the literature pertaining to the diagnostic accuracy of available tests for lumbar spinal stenosis.
• Analyze the effectiveness of the 6-week Boot Camp Program for Lumbar Spinal Stenosis

• Demonstrate an understanding of the epidemiology of fibromyalgia, its impact on patient health, and the clinical controversy surrounding the syndrome.
• Evaluate available treatment options and design a treatment plan for the patient with fibromyalgia.
• Evaluate the available evidence regarding chiropractic manipulation, and complementary and alternative medicine for fibromyalgia.
• Justify the role of patient self-care in the treatment of fibromyalgia.

Hour 1

• Define and apply viscerosomatic reflexes and influences.
• Define and apply somatoviscera reflexes and influences.
• Define and apply psychosomatic reflexes and influences.
• Apply autonomic reflexes to clinical conditions including somatic dysfunction.

Hour 2

• Identify the general nature of pain and its mechanisms including the physiology and psychology of pain.
• Describe the effect of somatic dysfunction on the autonomic nervous system and apply this knowledge to the use of manipulative therapy
• State the definition, location, and identification of Chapman’s points on the body.
• Express Chapman’s points in relation to the major organ systems of the body.

Hour 3

• Illustrate Chapman’s points of the cardiovascular system.
• Illustrate Chapman’s points of the respiratory system.
• Describe management of Chapman’s reflexes in a common clinical scenario.
• Critically appraise, and utilize relevant scientific literature and information to assess and improve patient care practices; and, contribute to the ongoing scholarly development of the chiropractic profession

• Enumerate five physical / clinical examination findings associated with lumbar spinal stenosis
• List 3 essential components of a rehabilitation program for patients with lumbar spinal stenosis
• Recall four flexion-based exercises that are part of a rehabilitation program for a patient with lumbar spinal stenosis
• Identify three common soft tissue mobility impairments associated with lumbar spinal stenosis
• Cite two common joint mobility impairments associated with lumbar spinal stenosis
• Provide two evidence-based exercises that elicit high EMG activity of the transverse abdominis
• Enumerate three evidence-based exercises that elicit high EMG levels of the gluteus medius

• Relate the effects of posture on compression of the cervical cord and nerve roots and use this knowledge to develop decompression exercises for their cervical stenosis patients.
• Decompress the cervical spine utilizing the Cervico 2000 ambulatory traction device.
• Implement a strategy of upper extremity peripheral nerve stimulation to relieve symptoms of cervical spinal stenosis.
• Develop and institute a comprehensive cervical spinal stenosis rehabilitation protocol as a potential alternative to surgery. 

• Relate the effects of spinal stenosis in the development of intermittent claudication.
• Utilize a treadmill and a stopwatch, to quantify both the effects of stenosis on functional ability of patients and the effectiveness of treatment of spinal stenosis.
• Apply TENs over acupuncture points known to increase nerve blood supply and how to reverse the pathophysiology of lumbar spinal stenosis.
• Utilize dynamic imaging techniques, to gain a full appreciation of the changes in compression of the neural elements in different postures and spinal positions.