Hungary Chiropractic Continuing Education

• Recognize the signs and symptoms of a mid-back disorder
• Be able to list differential diagnosis of mid-back disorders
• Outline the different elements of a mid-back exam
• Understand the importance of “red flags” in the exam and evaluation of mid-back complainants
• Be able to summarize additional mid-back tests that can be performed and the reasons why to use them

• Understand basic genetic and how this new field of medicine may impact your practice
• Learn and key common genomic medicine study type.
• Critically evaluate genomic medicine studies by identifying bias, evaluating effect size, and applying it to your patient.
• Understand the cardiovascular disease association between the SNPs ApoE, Kif6, and MTHFR.
• Consider how polymorphisms may impact the placebo effect.

• List five statistical references that relate to evidence based practice.
• List four Red flags that are pertinent in the evaluation component of treatment.
• Identify the five categories that pertain to possible spinal pain and referred pain.
• Describe two metabolic diseases that can affect the spine.

• This contains all courses with the educational objectives listed from Physical Diagnosis 166 through Physical Diagnosis 169

• Recognize and list four red flags for the cervical and shoulder girdle.
• Identify three medical conditions that may refer to the cervical spine but are non-musculoskeletal in origin and require a physician's intervention.
• Name and describe two CPR for the Cervical Spine.
• List two dural tests that are done for the nervous system in the Cervical region.

• Identify and describe two musculoskeletal issues of the thoracic region.
• List one dural test that is used to evaluate the thoracic region which will assist in determining normal neuromeningeal pathway mobility.
• List two CPR of the spine in the thoracic region that have good reliability and are effective in use.
• List and describe two vascular diagnoses which may relate to Thoracic Spine referred pain

• Identify two serious pathologies that appear to be related to the lumbar spine but are not.
• Describe three categories of pelvic fractures than may occur.
• Describe the objective differences between vascular claudication and neurogenic claudication.
• List the five screening tests for the pelvis and SI joint.

• Discuss the use of electrotherapy to control pain
• Establish parameters for wobble board rehabilitation of the ankle
• Describe how SI manipulation affects anterior knee pain
• Discuss the use of post-fracture manipulation
• Construct therapeutic exercises for patients with lumbar spinal stenosis

• Describe ideal pad placement for interferential therapy
• Discuss increasing muscle strength in the elderly
• Construct screening procedures and treatment for the TMJ
• Relate the evaluation and treatment of whiplash
• Review rehabilitation of ankle injuries

• Explain that the key to increased utilization of ultrasound lies in chiropractic providers knowledge and training
• Recognize the ultrasound procedure, its benefits, effects, proper application, and potential outcomes
• Point out precautions and contraindications affiliated with ultrasound
• Internalize a level of knowledge and comprehension of diathermal principles
• Develop skill sets when rendering ultrasound (continuous or pulsed) therapy

• Discuss the unique properties of lasers and their clinical applications
• Identify indications and contraindications to cold laser therapy
• List parameters and protocols of cold laser therapy
• Evaluate the current body of low level laser therapy clinical research
• Explain the advantages and disadvantages of using cold laser therapy

• Define laser
• Discuss the critical properties of laser light and the categories of lasers
• Define power density and energy density
• Recognize the factors that effect the depth of penetration of light therapies
• Explain why certain frequencies are employed with therapeutic lasers
• Discuss the proposed physiological mechanisms of light therapy
• List the contraindications and precautions for the use of low level laser therapy
• Differentiate continuous wave and super pulsed laser therapy
• Describe the application techniques for low level laser therapy
• Describe light emitting diodes
• Describe ultraviolet radiation and the difference between UVA, UVB and UVC
• List the effects of UV light
• Describe the dosage determination method for UV therapy, MED and E1 - E3
• List the contraindications and precautions to the use of UV therapy

• Identify principles, indications and contraindications for ultrasound, heat, cold and electrical modalities with a focus on the upper extremity
• Utilize clinical guidelines for applying ultrasound, heat, cold and electrical modalities with a focus on the upper extremity
• Recognize and discuss the clinical efficacy and safety parameters of ultrasound, heat, cold and electrical modalities with a focus on the upper extremity

Hour 1

• Discuss the history of elastic taping.
• Define the anatomy of fascial layers in the human body, and how the mechanotransduction concept relates to the use of elastic taping.
• Recognize the most common indications and contraindications for the use of elastic tape within the manual therapist’s practice.
• Describe the application process of elastic taping .

Hour 2

• Discuss the evidence providing support of the use of elastic taping
• Outline various conservative management options for taping musculoskeletal problems
• Construct a treatment plan for a typical patient with acute traumatic swelling
• Apply specific taping techniques for certain biomechanical dysfunctions

Hour 3

• Describe and demonstrate the application of elastic taping procedures for carpal tunnel syndrome
• Describe and demonstrate the application of elastic taping procedures for biomechanical low back pain
• Describe and demonstrate the application of elastic taping procedures for shoulder stabilization
• Describe and demonstrate the application of elastic taping procedures for knee osteoarthritis

• Examine the relationship between hip flexibility and patellofemoral pain
• Summarize the evidence pertaining to the efficacy of manual and physical therapies for the management of Patellofemoral Pain Syndrome
• Outline the possibility of a continuum existing between patellofemoral pain and patellofemoral osteoarthritis
• Discuss the evidence regarding prevalence, diagnosis and management of patellar tendinopathy
• Review the most common clinical tests used to determine balance in those with knee OA a clinical setting

• Outline the innovation of the therapy
• Summarize the Physics behind the modality
• Describe the interaction of LLLT with live tissue
• Detect the contraindications & precautions
• Assess the different LLLT devices.
• Comprehend the different types of LLLT available
• Optimize the LLLT parameters for improved outcomes
• Apply LLLT in a manner that optimizes your treatment
• Explain the physiological effects to your patients
• Examine the current clinical evidence

• Review sensory-motor control and rehabilitation
• Discuss aerobic exercise for LBP patients
• Describe muscle training of the hip, abdominal and paraspinal muscles
• Identify how aerobic exercise improves motor performance in the elderly
• Distinguish the effects of different training styles on the cross-sectional area of paraspinal muscles

• Describe the contribution of hip vs. spinal motion
• Distinguish poor motor patterns of hip and low back movements and what to do about it
• Differentiate the role of exercise for neck disorders and determine what type of exercise works
• Delineate the neural adaptations to exercise and apply towards rehabilitation
• Describe current issues in low back rehabilitation (such as can low back tissues heal within a few weeks)

• Describe the long term course of LBP
• Describe neuromuscular impairments following LBP
• Differentiate the effects of pain on the neuromuscular system
• Discuss the models that explain the nature of motor problems with pain
• Differentiate and discuss the potential sources of LBP

• Identify and describe the major factors influencing muscular strength
• Assess the chiropractic influences on strength
• Identify and discuss the strength training principles
• Illustrate components of a training session
• Apply training principles into a practical strength program

• Define proprioception and describe how it is measured
• Discuss proprioception from a rehabilitative perspective
• Examine ankle, knee and shoulder proprioception and rehabilitation
• Examine spinal proprioception and sensorimotor training
• Summarize rehabilitation recommendations for proprioceptive deficits

• Illustrate basic principles of cardiovascular exercise
• Discuss the mechanisms of cardiovascular responses to exercise
• Discuss the acute effects of exercise on the cardiovascular system
• Discuss the training effects of exercise on the cardiovascular system

• Summarize the functional anatomy of core strength training
• Discuss the principles of core strength
• Develop an assessment of spinal stabilization
• Distinguish specific evaluation tests for spinal stability

• Summarize the effect of training on the fatigue of multifidi muscles
• Discuss which muscles are involved in stabilization exercises
• Assess the relation between low back pain and clinical instability
• Describe a study implementing manipulation and stabilization exercises for chronic LBP
• Introduce the concept of functional restoration vs. physical therapy for LBP

• Describe the early health care utilization for occupational low back pain
• Determine which factors are important in predicting outcome after a spinal stabilization exercise program
• Assess lumbar disc surgery rates before and after implementation of nonsurgical spine clinics
• Determine whether kinematic compromise can be used to predict spine loading in low back pain (LBP) patients under realistic lifting efforts in a workplace
• Determine the effects of subacute LBP and limitation of the straight leg raise on lumbar and hip kinematics during sit-to-stand and its reverse

• Summarize the effect of whiplash on neck muscle strength
• Discuss the effects of manipulation vs. mobilization on head and neck pain in whiplash patients
• Assess the effects of thoracic manipulation in whiplash patients
• Describe a study predicting the response of neck pain patients to neck strengthening exercise
• Introduce the smooth pursuit neck torsion test and its application in whiplash disorders

• Identify the anatomy of upper motor neuron tract systems and discuss the functionality of upper motor neuron tract systems
• Explain the effects of a spinal cord injury
• Discuss the anatomy and functionality of regions of the brain
• Describe complications post injury of brain and spinal cord injury
• Describe standard treatment procedures prior to rehabilitation of brain and spinal cord injured patients
• Explain the difference between neurological deficit rigidity versus disuse atrophy/spasm of spinal cord and head injured patients
• Describe treatment options for rehabilitation of spinal cord and head injured patients
• Explain treatment methods to transition C curve locomotion to S curve locomotion
• Explain treatment methods for atrophy and spasm
• Discuss most current curative research for spinal cord and head injured patients

• Outline the anatomy of cervical spine proprioception
• Review clinical studies investigating cervical spine proprioception
• Assess existing literature on the reliability of cervical spine joint position sense
• Assess the effect of spinal adjustments/manipulation on cervical spine proprioception

• Summarize the central role of muscle protein in whole-body metabolism and muscle mass
• Outline the role of skeletal muscle metabolism in health and disease (such as diabetes, obesity, osteoporosis)
• Describe the role of hormones for influencing muscle metabolism and health
• Identify the catabolic and anabolic mediators of muscle metabolism
• Specify ways to maximize muscle mass and metabolism to promote wellness

• Explain the anatomical constituents of the core musculature
• Consider implications of weak or inadequate core muscles
• Emphasize the importance of the gluteal muscle group in rehabilitation
• Illustrate common compensation patterns when individuals have weak core musculature with clinical examples
• Explain the concept of neural adaptation
• Review reciprocal inhibition and it's clinical application
• Discuss physiological overflow and its clinical application

• Discuss conventional situps and their pitfalls
• Provide a logical rationale for core training
• Explain and demonstrate a logical progression of exercises for core training, emphasizing skill, then endurance and strength

• This contains all courses with the educational objectives listed from Rehab 115 through Rehab 125

• Recognize some of the common mistakes with conventional sit ups and how to correct them
• View and narrate the ideal sit up
• Recognize the importance of the brain and cortex in core training
• Discuss how inhalation and exhalation affect muscular activity, and how to utilize this in training
• Point out the pitfalls of abdominal hollowing and core training
• Examine the importance of the thoracolumbar fascia
• Analyze what cues to look for when evaluating a bench press exercise

• Demonstrate the proper patient positioning for the lunge and squat exercises
• Explain and show common problems with the lunge and squat exercises
• Explain and show Dr cues for proper patient positioning of the lunge and squat exercises
• Explain, evaluate, compare and demonstrate variations of the squat exercise, including ball squats, theraband squats, potty squats, squat shuffles
• Explore and demonstrate how foot function and shoe type impacts squat and lunge activities
• Introduce, explain and demonstrate proper and improper performance of additional, advanced gluteal activation exercises including the Texas walk, ball squats, drops, roman chair and 1 legged dead lifts

• Apply core exercise to facilitate improved lower limb mechanics in women
• Recognize the connection between improved lumbar multifidus function and clinical improvement after spinal manipulation
• Discuss the potential of full kinetic chain manual therapy treatment for hip osteoarthritis
• Assess muscle activation and spinal loading profiles during common Kettlebell exercises
• Describe specific exercises that could improve hip strength and mechanics in women with patellofemoral pain

• Describe the Nordic Hamstring exercise and its potential applications for hamstring injuries
• Summarize the state of the literature on exercise interventions for adolescent scoliosis
• Integrate strength training with flexibility training to improve patient progress
• Appraise the potential role of yoga in managing spinal conditions
• Grade and recognize the state of the literature on physical and rehabilitation interventions for chronic non-specific low back pain

• Compare slower treadmill walking on a moderate incline to faster walking with no incline for moderately obese adults patients
• Summarize the current state of the literature on exercise interventions for Type 2 Diabetes Mellitus
• Explain the utility of interval training for patients with coronary artery disease
• Support the inclusion of resistance training in exercise programs for aging patients based on existing scientific research
• Appraise various types of exercise for patients with metabolic syndrome

• Outline the neuroendocrine-immune interactions and communication pertaining to exercise
• Contrast sprint training with endurance training regarding performance adaptations and cardiac output
• Identify the benefits and underlying mechanisms of agonist-antagonist paired set training for improving strength and power
• Summarize the validity of dehydration signs, compared with body weight change, in marathon runners
• Describe methods for developing maximal neuromuscular power

• Apply contemporary rehabilitation strategies for anterior cruciate ligament patients
• Illustrate the importance of proximal stability and rehabilitation in patients with patellofemoral pain syndrome
• Outline the relationship between quadriceps strength, proprioception and knee osteoarthritis
• Discuss the potential value of gait retraining for improving lower limb biomechanics in runners with patellofemoral pain
• Contrast lower extremity kinematics & muscle activation in patients with and without patellofemoral pain syndrome

• Discuss a proposed model for the logical sequence of active rehabilitation
• Review ‘the core’, its healthy functional role and how it is commonly changed in people with spinal and pelvic girdle pain syndromes
• Describe core muscle activity during physical fitness exercises
• Provide an introduction to dynamic neuromuscular (core) stabilization and athletic performance
• Introduce the basics of exercise prescription

• Illustrate the effects of external pelvic compression on the passive, active and neuromotor control systems of the lumbopelvic region and thigh
• Summarize the importance of core stability assessment and rehabilitation in lumbosacral radiculopathy cases
• Assess the differences in torso motion and muscle activity between elliptical trainer use and treadmill walking
• Discover how even small amounts of daily exercise can positively impact patients with neck and shoulder pain
• Critique and apply periodization concepts to rehabilitation for patients with non-specific low back pain

• Outline the relationship between exercise and brain health
• Describe the evidence for the links between physical activity/exercise and brain function across the lifespan
• Discuss the neurobiology of exercise
• Assess whether exercise is neuroprotective or not
• Summarize the effect of exercise on motor performance

• Identify how the sciatic nerve and adjacent nervous structures respond to tensioning and sliding techniques
• Appraise the potential benefit of adding forward head posture corrective exercise to the management of lumbosacral radiculopathy
• Compare clinical and muscle function outcomes of patients randomized to one of two early multimodal rehabilitation programs following single-level lumbar discectomy
• Analyze the influence of neck strength and muscle activation status on resultant head kinematics after impulsive loading to the head/neck
• Assess the efficacy of corrective exercise interventions for reducing thoracic hyper-kyphosis

• Recognize and document preferred outcomes that result from properly executed active care techniques
• Establish rehab protocols for both cervical and lumbar conditions with suggested core exercise recommendations
• Properly advance a patient through their customized exercise protocol in a systematized fashion
• Identify and document progress on a routine visit basis for patients participating in active care rehab

• Evaluate the long-term effect of exercise therapy in addition to patient education on a patient’s need for total hip replacement (THR)
• Integrate clinical and laboratory research on the function and assessment of abductor muscles about the hip and pelvis 
• Understand how hip weakness can potentially contribute to knee pain and altered running mechanics
• Outline the nomenclature, definition, diagnosis, imaging and management of inguinal disruption (‘Sportsman’s Groin’) 
• Assess the efficacy of exercise interventions for lateral ankle sprains, Achilles tendinopathy and plantar fasciitis 

• Recite 3 risk factors for developing rotator cuff tendonosis
• State the purpose of the scapula reposition and scapula assistance test.
• Explain how to perform the external rotation lag sign and recall the purpose of this test
• Paraphrase one evidence - based test cluster for diagnosing a rotator cuff tear.
• Recall two indications/goals for performing posterior glenohumeral joint mobilizations.
• Cite the clinical prediction rule (CPR) for favorable outcome in patients undergoing conservative management for rotator cuff disorders
• Identify two criteria for phase I rehabilitation exercises for rotator cuff disorders

• Recall 3 potential reasons, based on expert opinion, that may contribute to the high re-tear rate following rotator cuff repair.
• Recite 4 factors that impact the rehabilitation program for patients following rotator cuff repair.
• Summarize the DeOrio classification for rotator cuff tear size.
• State 3 appropriate exercises during weeks 0-2 following rotator cuff repair
• Provide 2 appropriate exercises during weeks 6-8 following rotator cuff repair
• Name 3 appropriate exercises during weeks 8-12 following rotator cuff repair

• Delineate the effects of spinal fixation on degeneration in relation to the chiropractic model of degeneration
• Determine the benefits of 3 common treatments thought to aid chronic spine pain including chiropractic
• Outline and categorize the neurophysiology of spinal manipulation
• Determine the effects of spinal manipulation and exercise on neck pain

• Discuss the epidemiologic evidence and debate about work-related musculoskeletal disorders
• Discuss the costs and financial burden associated with musculoskeletal disorders
• Discuss the factors involved in strain-induced injury of skeletal muscles
• Discuss the inflammatory process as related to musculoskeletal disorders

• Summarize the relation between neural plasticity, LBP and spinal manipulation
• Discuss the concept of intervertebral dysfunction with respect to paraspinal muscle
• Assess the correlation between back pain, disability and quality of life
• Describe a study implementing whole spine manipulation in primary care

• Summarize the dose-response relationship between chiropractic and LBP
• Discuss the differences between chiropractic adjustments and muscle relaxants for LBP
• Assess the relationship between osteopathic manipulation and prenatal outcomes
• Describe the association (or lack thereof) between spinal manipulation and lumbar disk herniations
• Analyze the results of a study on active care vs. manual therapy with active care

• Determine the effects of maintenance chiropractic care on chronic low back pain
• Delineate the demographic and clinic-related predictors for successful outcome of chiropractic patients with low back pain
• Compare individuals with and without chiropractic coverage
• Summarize the efficacy of medication, acupuncture, and spinal manipulation for chronic mechanical spinal pain syndromes
• Determine the effects of simulated spinal manipulation on facet joint strains

• Describe the principles of health behavior change
• Detail the factors that promote positive lifestyle changes
• Discuss current theories and models of behavior change
• Discuss techniques and processes of how to change health behavior

• Review articles addressing the latest information concerning chiropractic and/or spinal manipulation for neck pain and/or headaches
• Provide evidence-informed practice recommendations for the chiropractic treatment of headache in adults
• Determine the short-term effect of chiropractic joint manipulation therapy (CMT) and low-level laser therapy (LLLT) on pain and range of motion in the management of cervical facet dysfunction
• Assess whether adjusting dysfunctional cervical segments in people with subclinical neck pain can improve their upper limb joint position sense accuracy
• Investigate the efficacy of preventive spinal manipulative therapy (SMT) compared to a no treatment group in non-specific neck pain patients
• Assess the effectiveness of thoracic manipulation (TM) on patients with chronic neck pain
• Describe a randomized controlled trial comparing manipulation with mobilization for recent onset neck pain

• Review articles addressing the latest information concerning chiropractic and/or spinal manipulation of the lower back
• Assess the current scientific literature related to manipulation for acute low back pain
• Assess the current scientific literature related to manipulation for chronic low back pain
• Compare the clinical efficacy of spinal manipulation against microdiskectomy in patients with sciatica secondary to lumbar disk herniation (LDH)
• Review the Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) study
• Assess maintenance spinal manipulation therapy for chronic non-specific low back pain

• Review articles addressing the latest information concerning chiropractic and/or spinal manipulation for pregnancy related low back pain and/or post-partum pain
• Review the published evidence regarding chiropractic care, including spinal manipulation, for pregnancy-related low back pain (LBP)
• Describe the clinical outcomes of patients with pregnancy-related lumbopelvic pain (PRLP) treated according to a diagnosis-based clinical decision rule
• Assess osteopathic manipulative treatment of back pain and related symptoms during the third trimester of pregnancy
• Describe the development a clinical prediction rule (CPR) for identifying postpartum women with low back pain (LBP) and/or pelvic girdle pain (PGP) whose functional disability scores improve with a high-velocity thrust technique (HVTT)

• Discuss recent research on Chiropractic Manipulative Therapy for patients with 'Acute Low Back Pain'
• Discuss recent research on Spinal High-Velocity Low Amplitude Manipulation in Acute Nonspecific Low Back Pain
• Review The Quality of Reports on Cervical Arterial Dissection following Cervical Spinal Manipulation
• Describe the Various Mechanisms of Injury in Whiplash Associated Disorders
• Review the Mechanisms of Chronic Pain from Whiplash Injury

• Review methods used by chiropractors to determine the site for applying manipulation
• Review clinical decision rules, spinal pain classification and prediction of treatment outcome in rehabilitation literature
• Describe the trajectories and life course of low back pain
• Discuss the evidence for multisite musculoskeletal pain being common among people suffering from low back pain
• Discuss the relative effectiveness of manipulative therapy vs sham manipulation

• Discuss how spinal manipulation can lead to neural plastic changes involving cortical drive and the H-reflex pathway
• Assess the impact of cervical spinal manipulation on heart rate variability
• Assess how somatosensory evoked potentials (SEPs) can be used to elucidate differences in cortical activity associated with a spinal manipulation (SM) intervention
• Describe alterations in cortical and cerebellar motor processing in subclinical neck pain patients following spinal manipulation
• Apply the effect of spinal manipulation on somato-sympathetic reflexes

• Describe muscle activity patterns in pain development and alleviation
• Discuss the role of anti-inflammatory interventions and their effect on skeletal muscle injury as they pertain to chiropractic examination/treatment
• Assess whether the construct of myofascial pain syndrome caused by trigger points is conjecture
• Review recent fascia research as it pertains to anatomy and biomechanics
• Summarize anatomical and biomechanical properties of fascial tissue with a special focus on fascial dysfunctions and resulting clinical manifestations

• Describe the effect of intervertebral facet joint fixation and segmental thrust level on paraspinal muscle spindle activity
• Determine how contact site for high velocity, low amplitude spinal manipulation affects sensory input to the central nervous system
• Assess the association between low-tech clinical tests commonly used in adult patients with acute, recurrent or chronic LBP and short- and long-term outcome
• Discuss the role for neck manipulation in elderly falls prevention
• Summarize North American chiropractic students’ opinions concerning professional identity, role and future

• Assess whether low back pain (LBP) patients who respond to spinal manipulative therapy (SMT) differ biomechanically from non-responders and untreated asymptomatic controls
• Describe the comparative effectiveness of manipulation versus usual medical care for acute and subacute low back pain
• Determine the effectiveness of adding upper cervical manipulation to a multimodal program for patients with fibromyalgia
• Discuss the effects of forward head posture correction in patients with chronic discogenic lumbosacral radiculopathy
• Summarize US chiropractors' attitudes, skills and use of evidence-based practice

• Review the literature for cases of adverse events in infants and children treated by chiropractors or other manual therapists
• Analyze provider specialties in the treatment of patients with back and joint problems
• Review the role of the cervical spine in post-concussion syndrome
• Assess whether the availability of chiropractic care affects use of primary care physician (PCP) services
• Describe the effect of chiropractic treatment on gastrointestinal (GI) disorders

• Define Fibromyalgia according to the ACR criteria
• Discuss the history and epidemiology of Fibromyalgia
• Assess the differential diagnoses, triggers and possible causes of Fibromyalgia and discuss how they can help in the diagnosis of Fibromyalgia
• Identify several triggers for the exacerbation of Fibromyalgia
• List the symptoms of depression, grief and adjustment disorder that can be clues for the diagnosis of Fibromyalgia
• Recall the symptoms of dysfunctional sleep, chronic pain and fatigue that help to diagnose Fibromyalgia
• Compare some of the triggers that may make pain worse in the Fibromyalgia patient and factors that may decrease pain in the Fibromyalgia patient

• Define Rheumatology and Chiropractic and list similarities
• Critique some of the downfalls in today’s treatment protocol of the Rheumatic patient and explain why Chiropractors should be aware of this patient population
• Discuss Integrative Medicine and outline some of the important options for holistic treatment
• Discuss other health concerns facing the Rheumatic Patient
• List the steps used in evaluating the Rheumatic Patient
• Identify some of the tools used for diagnosis and treatment of the Rheumatic Patient
• Analyze the patient’s symptoms and test values and compare for differential diagnose
• Evaluate laboratory tests and values used to diagnose Rheumatic diseases and syndromes
• Select the best imaging techniques for specific Rheumatic diseases and soft tissue syndromes
• Identify some of the diseases specific issues in a few of the Rheumatic diseases and syndromes discussed
• Recognize the symptoms, diagnosis protocols and treatments of some of the more prevalent arthritic diseases and syndromes

• Construct a list of four specific compliance risk areas for physicians
• Establish internal control mechanisms
• Distinguish aspects of Quality Assurance
• Develop Documentation Principles
• Identify documentation warning signs and components of SNOCAMP

• Review important laws, rules and regulations related to the Georgia Workers' Compensation Act
• Develop an understanding of the rights and responsibilities of the parties and a working knowledge of the Georgia Workers' Compensation Act
• The Georgia chiropractor will expand and/or update current knowledge base relating to the Georgia Workers' Compensation Act and treatment

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to malpractice
• Minimize risks and failure in malpractice actions
• Encourage development and nurturing of skill sets in avoiding malpractice actions
• Identify action steps for minimizing risks of malpractice actions

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to informed consent
• Minimize risks and failure in malpractice actions
• Encourage development and nurturing of skill sets in avoiding malpractice actions by utilizing properly executed informed consent
• Identify action steps for minimizing risks of malpractice actions

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to malpractice actions from neural injury
• Minimize risks and failure in malpractice actions
• Encourage development and nurturing of skill sets in avoiding malpractice actions by utilizing proper manipulative procedures, recognizing post-operative complications and risks, and identifying and managing a complication.
• Identify action steps for minimizing risks of malpractice actions from neural injury

• Emphasize that each chiropractic provider must keep informed as to the laws and their interpretation in their particular state of practice
• Identify various ingredients found in a typical judicial opinion
• Discuss what each chiropractic provider should look for when they read an opinion
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to legal opinions
• Encourage development and nurturing of skill sets in reading legal opinions by utilizing case method

• Describe each of the four elements of malpractice
• Differentiate between a bad treatment result and malpractice
• Define Duty, Dereliction of Duty, Direct causation, and Damage
• Search out a case report on-line or in a law library by using the case citation

• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to fee splits and kickbacks
• Explain the development of current fee-splitting laws
• Distinguish the letter of the law regarding fee-splitting and anti-kickback legislation from unprofessional conduct and consequent harms the statutes were enacted to discourage
• Demonstrate a working knowledge regarding the roles played by the various state and federal enforcement agencies as they related to fee splits and kickbacks
• Assess ones working knowledge regarding the process by which anti-referral safe harbors developed and how they operate

• Evaluate sample healthcare employment agreement
• Explain the components of a well drafted healthcare employment agreement
• Relate likely enforcement of provisions included in healthcare employment contract
• Assess non-compete provisions through a judicial balancing test
• Distinguish the various methods by which a court will rehabilitate certain contract provisions and selectively enforce others
• Explain what kinds of contract provisions may run afoul of state and federal laws, including fee splitting and kickback prohibitions

• Evaluate a sample sale agreement and sample letter issued to patients upon dissolution of practice
• Explain components of any well drafted buy-sell agreement including non-competes
• Identify how to handle patient records vis-à-vis the sale
• Understanding forms and laws relating to the transfer of logos, trademarks and Internet Domain Names
• HIPAA Considerations
• Acquaint oneself with the tax consequences of particular types of practice sales
• Discuss valuation methods used for determining an appropriate practice sales price
• Identify legal concerns associated with the dissolution of a healthcare practice
• Recognize how sales can trigger violations: fee splitting, patient abandonment, kickback, and anti-trust

• Identify "high risk" patients
• Design protection strategies for telephone "advice."
• List the "4 D's" of malpractice
• Differentiate clinical from administrative malpractice risks
• Distinguish malpractice from an adverse patient outcome
• Describe how a non-office encounter can create a dr/patient relationship
• Give examples of statutory duties beyond clinical care
• Explain how you can be guilty of malpractice without being negligent
• Assess office equipment hazards
• Discuss malpractice cases where patient was never given an adjustment

• Discuss problems created by leaving blank spaces in records
• Create practice appropriate SOAP note format to reduce risk exposures
• Recognize Health Questionnaire “red flag” responses

• Integrate protective “rules for recordkeeping"
• Monitor records release authorizations
• Individualize pre-printed forms to conform with your practice and reduce risk exposures

• Identify and document significant patient non-compliance
• Generate appropriate X-ray warning labels
• Identify “bad” forms
• Incorporate protective letters-writing protocols

• Recognize “exposure events” in area's of potential risk management
• Discuss proper communication of a potential exposure event with a malpractice carrier
• Maintain a healthy practice while in litigation
• Prepare staff for dealing with the publicity of litigation

• Prepare for a deposition
• Identify “informed consent” compliance
• Analyze your website for potential risk management issues
• Recognize deposition “tricks & traps”

• Properly prepare for a trial
• Prepare for lawyers questioning techniques
• Avoid detrimental body language in front of a jury
• Prepare for the phases of trial and the "down time" associated with trial

• Find and Analyze Chiropractic Malpractice Court Opinions
• Justify referral protocols
• Plan staff training to avoid "vicarious liability"
• Interpret "lawyer-speak" like "vicarious liability"
• Assess equipment risk
• Differentiate between good PR & sexual harassment
• Generate HIPAA compliance strategies w/o paranoia
• Appraise partnership, independent contractor and doctor/associate risks
• Implement Table safety procedures
• Recognize "exposure events"

• Assess state, federal and board rulings regarding fee discounts, particularly time-of-service discounts and hardship discounts, and the extent to which they may be impacted by anti-kickback legislation, insurance regulations, self-referral laws, marketing restrictions, and the tenets of unprofessional conduct..
• Identify potential problems associated with routine approval of hardship discounts and the requirement for inquiry and documentation regarding qualifying for same.
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services.
• Demonstrate how these discounts are regarded by relevant professional boards, and state and federal enforcement agencies.
• Explain terms associated with time of service discounts and relevant factors associated in calculating an appropriate reduction in fees.
• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to pre-paid fee arrangements.
• Explain the development of current fee discounting legislation, rules and holdings.
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services.
• Demonstrate a working knowledge regarding the roles played by the various state and federal enforcement agencies as they related to fee splits and kickbacks.
• Assess one’s working knowledge regarding the process by which state and federal rulings regarding fees impact a healthcare provider’s practice in light of marketing, fee-splitting and anti-kickback legislation, insurance regulations, self-referrals, and the tenets of unprofessional conduct generally.
• Verify how certain discount practices may be legally actionable as “improper inducements.”
• Evaluate federal Stark legislation and the discouragement of corruption in sound professional healthcare decision-making.
• Identify distinctions between federal anti-kickback and the federal Stark legislation.
• Critique state anti-kickback laws.
• Recognize the role the FTC played, and continues to play, in discouraging the fraudulent marketing of discount health care programs.
• Draw associations between co-pay requirements, consumer habits and federal healthcare expenditures.
• Assess how "professional courtesy" discounts may raise enforcers' concerns under the federal anti-kickback statute.
• Diagram how prepaid fee arrangements often resemble health insurance to unwitting patients.
• Illustrate pitfalls that advertising discounts visit on the practitioner.

• Assess state, federal and board rulings regarding fee discounts, particularly time-of-service discounts and hardship discounts, and the extent to which they may be impacted by anti-kickback legislation, insurance regulations, self-referral laws, marketing restrictions, and the tenets of unprofessional conduct..
• Identify potential problems associated with routine approval of hardship discounts and the requirement for inquiry and documentation regarding qualifying for same.
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services.
• Demonstrate how these discounts are regarded by relevant professional boards, and state and federal enforcement agencies.
• Explain terms associated with time of service discounts and relevant factors associated in calculating an appropriate reduction in fees.
• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to pre-paid fee arrangements.
• Explain the development of current fee discounting legislation, rules and holdings.
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services.
• Demonstrate a working knowledge regarding the roles played by the various state and federal enforcement agencies as they related to fee splits and kickbacks.
• Assess one's working knowledge regarding the process by which state and federal rulings regarding fees impact a healthcare provider's practice in light of marketing, fee-splitting and anti-kickback legislation, insurance regulations, self-referrals, and the tenets of unprofessional conduct generally.

• Assess how state scopes of practice affect chiropractic treatment of nutrition-related health problems.
• Identify the roles the FDA and FTC play in the administration of nutritional healthcare.
• Distinguish between a "food" and a "drug" for purposes of nutritional supplementation.
• Demonstrate how the various states' ban against the practice of medicine affects other disciplines' approach to nutritional healthcare.
• Explain aspects of nutrition labeling.
• Identify issues associated with current performance-enhancing supplementation.
• Explain the significance of distinguishing "treatment" from "informing" as it relates to nutritional counseling.

• Assess the relationship between the implementation of efficient office systems, accurate record keeping, patient communication, and adherence to professional standards of conduct within the context of malpractice allegations by patients who engage in sports.
• Identify actions suggestive of malpractice negligence and conduct that fails to live up to the standard established by law for the protection of others.
• Demonstrate a professional relationship can spring into existence when the healthcare professional is hired by a third party to oversee the health of athletic participants.
• Distinguish the duties an examining physician has regarding informing those athletes he examines about abnormal test results.
• Explain the legal concept of “assumption of the risks” within the context of sports participation and how it affects a healthcare professional’s liability.
• Identify “therapeutic exceptions” to providing informed consent excusing the practitioner from fully disclosing matters where they might unfavorably affect the outcome of a patient’s treatment.
• Explain a healthcare professional’s duty to warn patients engaged in sports regarding injury prevention following treatment.
• Examine a practitioner’s duties regarding athletes’ return to play in instances when head injury and concussion may be a factor.

• Assess the role the doctor-patient relationship plays in allegations of Patient Abandonment
• Identify the components to any successful Patient Abandonment charge
• Discuss court cases evaluating whether the doctor-patient relationship had been terminated lawfully
• Distinguish between proper and improper considerations a doctor may rely upon to either refuse to undertake, or to terminate, a doctor-patient relationship
• Explain the role notice plays in lawfully terminating a doctor-patient relationship
• Evaluate the role consent plays in the establishment of the doctor-patient relationship, and in subsequent treatment

• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to fee splits and kickbacks
• Explain the development of current fee-splitting laws
• Distinguish the letter of the law regarding fee-splitting and anti-kickback legislation from unprofessional conduct and consequent harms the statutes were enacted to discourage
• Demonstrate a working knowledge regarding the roles played by the various state and federal enforcement agencies as they related to fee splits and kickbacks
• Assess ones working knowledge regarding the process by which anti-referral safe harbors developed and how they operate

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to the practice of forensic science
• Identify a new dimension of chiropractic practice that will minimize risks and failure in court appearances as a practitioner
• Construct skill sets in forensic examination and document review

• Acquire a current knowledge base relating to medicolegal issues
• Identify risks and liabilities that may be encountered by examiners with electronic communications
• Develop a level of understanding of the medicolegal system as it relates to Junk Science

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to the ethical expert witness
• Introduce a new dimension of chiropractic practice that will minimize risks and failure in court appearances as an ethical expert witness.
• Encourage development and nurturing of skill sets in forensic examination and appearing as an expert witness through certification.
• Develop a level of understanding of the medicolegal system as it relates to the ethical expert witness.

• Emphasize that each chiropractic provider must keep informed as to the laws and their interpretation in their particular state of practice
• Identify Daubert criteria
• Discuss what each chiropractic expert should look for when preparing for the opposing attorney
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to Daubert challenges
• Encourage development and nurturing of skill sets in proving expert opinions

• Emphasize that each chiropractic provider must keep informed as to the laws and their interpretation in their particular state of practice
• Identify the basics of a deposition
• Discusses the tricky question types and suggested responses
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to the deposition process
• Encourage development and nurturing of skill sets in responding to questions posed in a deposition

• Perform professional advertising and marketing that passes state and federal legal restriction.
• Comprehend requirements for advertising testimonials, press releases, television, radio, Internet, personal solicitation and other marketing initiatives.
• Comprehend the limits of commercial speech (advertising) within the arena of professional healthcare marketing and dissemination of information.
• Train staff and implement policies associated with marketing initiatives and materials vis-a-vis state rules, regulations and statutes.
• Comprehend issues associated with signage, listings, letterhead, and other matters of ostensible agency that may lead to liability.
• Administer professional marketing such that it neither misleads, confuses nor exploits members of the public.
• Discuss how nutritional supplementation labeling and HIPAA affects professional healthcare marketing efforts.
• Undertake a review of marketing materials and initiatives so as to ensure compliance with relevant state rules, regulations and statutes.
• Administer coverage decisions, professional referrals, and communicate same in a manner that limits professional liability.

• Analyze charges and documentation on a daily or per visit basis to ensure accuracy and compliance
• Compile accurate and comprehensive responses to documentation or record requests
• Recognize and avoid confusing HIPAA privacy issues that can cost you time and money
• Identify key areas that lack written policies causing increased risk in the practice
• Evaluate your current written procedures and appraise the need for additional content

Hour 1

• Identify various types of billing irregularities and impact on healthcare expenditures.
• Distinguish upcoding from bundling within the context of irregular billing schemes.
• Demonstrate how and when exceeding a state’s scope of practice becomes “the unauthorized practice of medicine.”
• Explain the restrictions states’ scopes of practice place on healthcare providers’ authority to treat and diagnose patients.
• Discuss how invoicing unrendered medical services impacts third-party payers.
• Interpret chiropractic boards’ positions on testimonial advertising and how best to comply.

Hour 2

• Identify what constitute a false claim under the False Claims Act.
• Discriminate a kickback from a self-referral.
• Trace how anti-kickback legislation arose and examine its prohibitions.
• Explain the enactment of Stark legislation arising on the heels of anti-kickback bans.
• Assess providing nutritional counsel within the context of “the practice of medicine.”
• Evaluate identity theft and its impact on patients, providers and the cost of healthcare.
• Discriminate between illegal copayment waivers from proper hardship waivers.
• Discuss court cases instancing successful prosecution of healthcare fraud.

• Identify the 18 PHI Identifiers
• Awareness of other HIPAA related documentation and the appropriate retention period
• How to confirm retention period for healthcare records
• Recognize required security measures and their value to practice risk management
• Implement policy and protocol for compliant and secure disposal of records

• Be able to identify the definitions of Fraud, Waste and Abuse and how they may show up in day-to-day practice
• Become aware of the source of overpayments, including not-medically necessary care, maintenance care, and active treatment
• Apply the guidance from the OIG to your state and carrier regulations since they are a resource to these groups
• Recognize insufficient documentation and incorrect coding before the billing takes place
• Implement the action steps recommended by the OIG to eliminate incorrect documentation, billing and coding practices to reduce compliance risk

• Distinguish between fraud, waste and abuse
• Review and properly utilize your Medicare Local Coverage Articles (LCA)
• Integrate critical compliance requirements for minimum, mandatory, annual self-audits  
• Detect common billing protocols that are red-flags for third-party auditors and chiropractic boards of examiners

• Explain the anatomy of the spine, cranium and spinal cord components
• Discuss the development of the theory of Sacro-occipital Technique
• Explain the categories of Sacro-occipital Technique
• Explain the physiology of the Cranio-sacral respiratory mechanism
• Define the physical anomalies associated within each category system
• Explain the diagnostic evaluations specific to Sacro-occipital Technique
• Discuss Category I with regards to diagnosis and application
• Discuss Category II with regards to diagnosis and application
• Discuss Category III with regards to diagnosis and application
• Demonstrate the adjustments for each of the categories
• Demonstrate auxiliary treatment methods within the category systems
• Describe rehabilitation methods within the category systems

• Explain the anatomy and functionality of healthy soft tissue components
• Explain the effects of injury on soft tissue
• Define effects of injured soft tissue on functionality of the spine and extremities
• Discuss patterns of musculoskeletal relationships of recruiting other structures after injury and their effects on functionality
• Describe various methods of treatment for dysfunctional soft tissue
• Explain relationship of injured tissue to its surrounding structures, its effects and treatment
• Explain compensation and recruitment of healthy tissue to the broader scope of complications and the effective treatment of primary and now secondary effects of injury
• Describe rehabilitation exercises in relation to proprioception

• This contains all courses with the educational objectives listed from Soft Tissue Injuries 101 to Soft Tissue Injuries 104 

• Explain the types of soft tissue
• Demonstrate and discuss diagnostic evaluation of soft tissue injury
• Explain pain patterns of neurological injury for differential diagnosis
• Discuss types of soft tissue injuries
• Evaluate soft tissue changes associated with pain
• Discuss the mechanisms of healing soft tissue injuries
• Describe diagnostic tools in determining soft tissue injuries
• Explain the use of ice and heat in soft tissue injuries
• Demonstrate and discuss stretching; passive, active and postfacilitation
• Demonstrate and discuss somatic technique
• Demonstrate and discuss strain/counterstrain
• Demonstrate and discuss friction massage
• Demonstrate and discuss Postisometric relaxation
• Demonstrate and discuss electrical muscle stimulation and ultrasound
• Demonstrate and discuss triggerpoint ultrasound in treatment
• Discuss massage therapy
• Demonstrate and discuss myofascial release
• Demonstrate and discuss active release
• Demonstrate and discuss Neuromuscular Therapy (NMT)
• Discuss cold laser therapy
• Demonstrate and discuss exercise rehabilitation and muscle strengthening
• Discuss mobilization and manipulation

• Explain the structural anatomy of the shoulder and its soft tissue
• Explain the functional anatomy of the shoulder and its soft tissue.
• Demonstrate the active and passive examination of the shoulder and soft tissue.
• Describe pathological conditions of the bony structures, joints, ligaments, tendons, bursa and muscles of the shoulder
• Describe sports injures to the shoulder.
• Describe injuries to the nerves, blood vessels and fascia of the shoulder.
• Demonstrate soft tissue treatments for pathological conditions of the bony structures, joints, ligaments, tendons, bursa and muscles of the shoulder.
• Demonstrate soft tissue treatments for the nerves, blood vessels and fascia of the shoulder.
• Define functional relationships of the shoulder with associated regions

• Explain the structural anatomy of the elbow, wrist, and hand and associated soft tissue
• Explain the functional anatomy of the elbow, wrist, and hand and associated soft tissue
• Demonstrate the passive examination of the elbow, wrist, and hand and associated soft tissue
• Demonstrate the active examination of the elbow, wrist, and hand and associated soft tissue
• Describe pathological conditions of the bony structures, joints, ligaments, tendons, muscles, fascia, bursa and nerves of the elbow, wrist, and hand
• Demonstrate soft tissue treatments for pathological conditions of the bony structures of the elbow, wrist and hand
• Demonstrate soft tissue treatments for the joints, ligaments, tendons, muscles, fascia, bursa and nerves of the elbow, wrist and hand
• Define functional relationships between the elbow, wrist and hand and with other regions

• This contains all courses with the educational objectives listed from Soft Tissue Injuries 105 to Soft Tissue Injuries 107 

• Explain the structural anatomy of the bones and joints of the cervical spine, ligaments and muscles of the cervical spine and the nerves, blood vessels and fascia of the cervical spine
• Explain the functional anatomy of the bones and joints of the cervical spine, the ligaments and muscles of the cervical spine and the nerves, blood vessels and fascia of the cervical spine
• Demonstrate the passive examination of the bones and joints of the cervical spine, the ligaments and muscles of the cervical spine and the nerves, blood vessels and fascia of the cervical spine
• Demonstrate the active examination of the bones and joints of the cervical spine, the ligaments and muscles of the cervical spine and the nerves, blood vessels and fascia of the cervical spine
• Discuss imaging of the cervical spine
• Discuss advanced testing of the soft tissue of the cervical spine
• Describe pathological conditions of the bony structures, joints, ligaments, tendons, muscles, nerves, blood vessels and fascia of the cervical spine
• Explain the mechanism of acceleration/deceleration impact
• Explain the effects on the cervical spine from acceleration/deceleration injury, and specifically the effects on the soft tissues structures
• Explain the grading system for acceleration/deceleration injury
• Demonstrate soft tissue treatments for the pathological conditions of the bony structures, joints, ligaments, tendons, muscles, blood vessels, nerves and fascia of the cervical spine
• Demonstrate soft tissue treatments for the sequela of acceleration/deceleration injury
• Define relationships of the cervical spine with other regions

• Explain the structural anatomy of the TMJ and its soft tissue
• Explain the functional anatomy of the TMJ and its soft tissue
• Demonstrate the passive examination of the TMJ and soft tissue
• Demonstrate the active examination of the TMJ and soft tissue
• Describe pathological conditions of the bony structures of the TMJ
• Describe pathological conditions of the joints of the TMJ
• Describe pathological conditions of the ligaments of the TMJ
• Describe pathological conditions of the muscles of the TMJ
• Describe injuries to the nerves, blood vessels and fascia of the TMJ
• Describe injuries from acceleration/deceleration impact to the TMJ
• Demonstrate soft tissue treatments for the joints of the TMJ
• Demonstrate soft tissue treatments for the ligaments of the TMJ
• Demonstrate soft tissue treatments for the muscles of the TMJ
• Demonstrate soft tissue treatments for the nerves, blood vessels and fascia of the TMJ
• Demonstrate soft tissue treatments for acceleration/deceleration injury to the TMJ
• Define functional relationships of the TMJ with associated regions

• Explain the structural anatomy of the bones, joints, ligaments, muscles nerves, blood vessels and fascia of the thoracic spine and rib cage
• Explain the functional anatomy of the bones, joints, ligaments, muscles nerves, blood vessels and fascia of the thoracic spine and rib cage
• Demonstrate the passive examination of the bones, joints, ligaments, muscles nerves, blood vessels and fascia of the thoracic spine and rib cage
• Demonstrate the active examination of the bones, joints, ligaments, muscles nerves, blood vessels and fascia of the thoracic spine and rib cage
• Discuss imaging of the thoracic spine and rib cage
• Describe pathological conditions of the bones, joints, ligaments, muscles nerves, blood vessels and fascia of the thoracic spine and rib cage
• Demonstrate soft tissue treatments for the bones, joints, ligaments, muscles nerves, blood vessels and fascia of the thoracic spine and rib cage
• Discuss relationships of the thoracic spine and ribs with other regions

• Explain the structural anatomy of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the lumbopelvic spine
• Explain the functional anatomy of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the lumbopelvic spine
• Explain biomechanics of the lumbopelvic spine
• Demonstrate the passive examination of bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the lumbopelvic spine
• Demonstrate the active examination of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the lumbopelvic spine
• Discuss radiographic imaging of the lumbopelvic spine
• Discuss advanced testing of the soft tissue of the lumbopelvic spine
• Describe pathological conditions of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the lumbopelvic spine
• Demonstrate soft tissue treatments for the pathological conditions of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the lumbopelvic spine
• Define relationships of the lumbopelvic spine with other regions

• Explain the structural anatomy of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the hip and knee
• Explain the functional anatomy of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the hip and knee
• Explain biomechanics of the hip and knee
• Demonstrate the passive examination of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the hip and knee.
• Demonstrate the active examination of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the hip and knee
• Discuss radiographic imaging of the hip and knee
• Discuss advanced testing of the soft tissue of the hip and knee
• Describe pathological conditions of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the hip and knee
• Demonstrate soft tissue treatments for the pathological conditions of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the hip and knee
• Define relationships of the hip and knee with other regions

• Explain the structural anatomy of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the ankle and foot
• Explain the functional anatomy of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the ankle and foot
• Explain biomechanics of the ankle and foot
• Demonstrate the passive examination of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the ankle and foot
• Demonstrate the active examination of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the ankle and foot
• Discuss radiographic imaging of the ankle and foot
• Discuss advanced testing of the soft tissue of the ankle and foot
• Describe pathological conditions of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the ankle and foot
• Demonstrate soft tissue treatments for the pathological conditions of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the ankle and foot
• Define relationships of the ankle and foot with other regions.

• Discuss the development of strain/counterstrain
• Describe the theory of strain/counterstrain
• Describe the physiology of neuromuscular function
• Describe the diagnosis of tenderpoints and treatment  prioritization
• Discuss the technique of strain/counterstrain
• Explain tenderpoints
• Discuss method to locate tenderpoints
• Describe conditions that respond to strain/counterstrain
• Discuss treatment for the spine, TMJ and extremities
• Discuss treatment for craniosacral dysfunctions

• Discuss the benefits and protocols of stretching
• Discuss the theory and protocols of exercise rehabilitation
• Discuss the evaluation of posture
• Demonstrate postural corrections for the whole body
• Discuss proprioception in relation to core stability
• Demonstrate stretching and strengthening for the core
• Demonstrate balance work in relation to core strength
• Demonstrate stretching and strengthening for the foot, ankle, anterior compartment,  hamstrings, quadratus femoris, tensor fascia lata, adductor group, gluteal group, and iliopsoas, lumbar spine, thoracic spine, ribs, chest, cervical spine, TMG, shoulder, arm, forearm, wrist and hand
• Describe Yoga and Pilates for the whole body

• Explain the function of soft tissues
• Describe the development of scar tissue and adhesions in fascia, connective tissue, muscles, tendons, ligaments and joint capsules
• Discuss the benefits of deep tissue muscle and fascial release
• Define friction massage
• Describe friction massage for the upper extremity, lower extremity, spine and TMJ
• Define myofascial release
• Describe myofascial release for the upper extremity, lower extremity, spine and TMJ
• Define active release
• Describe active release for the upper extremity, lower extremity, spine and TMJ
• Define trigger point ultrasound
• Describe trigger point ultrasound for the upper extremity, lower extremity, spine and TMJ

• Educate patients on the function of soft tissues and the benefits of deep tissue muscle and fascial release.
• Describe the development of scar tissue and adhesions in fascia, connective tissue, muscles, tendons, ligaments and joint capsules.
• Perform postfacilitation stretch to the upper extremity, lower extremity and spine
• Perform somatic technique for the upper extremity, lower extremity and spine
• Utilize active release with your patient population
• Perform postisometric relaxation for the upper extremity, lower extremity and spine
• Apply therapeutic exercise and rehabilitative stretching with patients

• Describe the kinematics of acceleration/deceleration impact.
• Comprehend the history and development of acceleration/deceleration research.
• Defend injury manifestation using Whiplash guidelines and models.
• Apply current model theories to better understand injury from acceleration/deceleration impact.
• Explain to the patient the effects on the body during front, rear and side collisions.
• Educate the patient on variables such as vehicle size and direction and the effects on the human frame during acceleration/deceleration impact.
• Apply the variables of patient age, gender, size, etc during acceleration/deceleration impact.
• Express an understanding of incidence, prevalence, injury and risk factors associated with acceleration/deceleration impact.
• Describe the normal biomechanics of the cervical spine.
• Discuss cervical spinal anatomy vulnerable to injury.
• Define the nature of soft tissue structures; joints, ligaments, muscles, bursa, nerves, blood vessels and fascia.
• Inform your patients of the symptoms and changes to soft tissue structures after acceleration/deceleration impact.
• Explain the differences between scleratomal, dermatomal and myofascial pain.
• Discuss prognosis after acceleration/deceleration impact.
• Describe the normal biomechanics of the TMJ and associated soft tissue structures.
• Discuss injury to the TMJ and associated soft tissue structures.
• Explain the effects of trauma to the soft tissue of the spine, structures of the shoulder, elbow, wrist, hand, hip, knee, ankle and foot after acceleration/deceleration impact.
• Describe the normal biomechanics of the thoracic spine and rib cage.
• Describe the normal biomechanics of the lumbopelvic spine.
• Educate the patient on complicating factors for treatment after acceleration/deceleration impact.
• Determine the necessity and value of imaging and advanced diagnostic imaging after acceleration/deceleration impact.
• Perform complete examination of the soft tissue structures of the cervical spine, TMJ, thoracic spine, rib cage, lumbopelvic spine, shoulder, elbow, wrist, hand, hip, knee, ankle and foot after acceleration/deceleration impact.
• Utilize treatment protocols for soft tissue damage after acceleration/deceleration impact.
• Perform soft tissue treatments such as strain/counterstrain, postisometric relaxation, postfacilitation stretch, somatic technique, active and myofascial release, exercise and stretch, mobilization, manipulation and modalities.
• Utilize above mentioned soft tissue techniques to treat the cervical spine, TMJ, thoracic spine, rib cage, lumbopelvic spine, shoulder, elbow, wrist, hand, hip, knee, ankle and foot after acceleration/deceleration impact.
• Communicate to your patients the late effects of soft tissue injury after acceleration/deceleration impact.

• Describe biomechanics of movement of the joints, ligaments, muscles, tendons, bursa, nerves and fascia of the lower extremity, pelvis and spine, TMJ and upper extremity.
• Explain weight distribution and movement of ligaments, muscle and fascia in relation to the feet as foundation.
• Discuss soft tissue movement during standing, walking, running, twisting, bending, reaching and grasping.
• Relate movement interactions and stresses on soft tissues from one body region to another.
• Demonstrate to your patients, correct posture from the feet as foundation to the cervical spine.
• Educate and demonstrate the correct use of the core in posture.
• Show patients how to relax their shoulders using the thoracic spine as a lever.
• Describe and demonstrate appropriate gait in relation to correct posture.
• Explain to your patient how the soft tissue adapts to an unstable scoliosis.
• Apply understanding of injury dynamics in individual soft tissue structures (ligament, musculotendon, bursa, nerve, fascia).
• Interrelate soft tissue contractures from one region of the body to another.
• Learn passive and active examination techniques for all soft tissue structures of the soft tissue structures mentioned in Educational Objective 1.
• Review Applied Kinesiology as a tool for muscle isolation and clinical testing.
• Differentiate muscle strength testing from the proprioception evaluation of Applied Kinesiology.
• Integrate Applied Kinesiology examination and treatment into soft tissue evaluation and case management.
• Clinical examination of soft tissue structures of the soft tissue structures mentioned in Educational Objective 1.
• Apply examination findings into differentially diagnosing soft tissue fibrosis, scar tissue and adhesions, trigger points and pain radiation patterns.
• Inter-relate different regions of the body with local soft tissue findings.
• Discern appropriate clinical application for advanced imaging studies and soft tissue.
• Apply treatment protocols for ice, heat, stretching, Somatic Technique, Strain/counterstrain, friction massage, post-isometric relaxation, modalities, massage techniques, myofascial release, active release, Neuromuscular therapy, cold laser, exercise rehabilitations, mobilization and manipulation.
• Apply techniques mentioned in Educational Objective (above) as well as Applied Kinesiology to all joints, ligaments, muscles, tendons, bursa, nerves and fascia of the lower extremity, pelvis and spine, TMJ, and upper extremity.
• Relate treatments to improved movement locally, regionally and other affected regions and educate your patient to reasonable goals.
• View the soft tissue structures of the body as a whole with recognizable patterns of dysfunction and treat these soft tissues for greater flexibility and function.

Hour 1

• Discuss the soft tissues of the body for examination protocol and differential diagnosis.
• Correlate soft tissue pain radiation patterns and history to focus examination to appropriate soft tissues.
• Explain to your patient the types of soft tissue pain and injuries related to their condition.
• Identify soft tissue dysfunction consistent with injury.
• Utilize passive examination techniques to accurately record the effects of soft tissue injury to local and regional soft tissues.

Hour 2

• Utilize active examination techniques to accurately record the effects of soft tissue injury to local and regional soft tissues.
• Discern between neurological muscle strength testing, proprioceptive muscle strength testing using Applied Kinesiology and actual muscle fiber strength.
• Apply biomechanics of the upper and lower extremities, spine and TMJ to soft tissue examination protocol.
• Relate the biomechanical movement of the soft tissues of the foot and ankle to associated soft tissues during evaluation.
• Perform examination of the soft tissue structures of the foot and ankle as the biomechanical foundation of the body.

Hour 3

• Apply biomechanics of the entire lower extremity to soft tissue examination protocol.
• Relate the biomechanical movement of the soft tissues of the knee to associated soft tissues for evaluation.
• Perform examination of the soft tissue structures of the knee.
• Relate the biomechanical movement of the soft tissues of the hip to associated soft tissues during evaluation.

Hour 4

• Perform examination of the soft tissue structures of the hip.
• Relate the biomechanical movement of the soft tissues of the lumbopelvic spine to associated soft tissues for evaluation.
• Describe the movement of the soft tissues of the lumbar spine and sacroiliac joints for better patient compliance.
• Perform passive examination of the soft tissue structures of the lumbopelvic spine.

Hour 5

• Perform active examination of the soft tissue structures of the lumbopelvic spine.
• Relate the biomechanical movement of the soft tissues of the thoracic spine and rib cage to associated soft tissues for evaluation.
• Describe the movement of the soft tissues of the thoracic spine and rib cage for better patient compliance.
• Perform passive and active examination of the soft tissue structures of the thoracic spine and rib cage.

Hour 6

• Summarize biomechanics of the soft tissues of the cervical spine in their relation to the cranium.
• Relate the biomechanical movement of the soft tissues of the cervical sp8ine to associated soft tissues for evaluation.
• Perform soft tissue passive and active examination of the cervical spine.
• Determine cervical soft tissue dysfunction and its effects on the trunk, upper extremity and TMJ.

Hour 7

• Explain to patients the biomechanics of the TMJ in relation to their pain; and jaw and cervical spine dysfunction.
• Relate TMJ dysfunction in relation to biomechanical disturbances to the soft tissue of the cervical spine.
• Perform examination of the soft tissues of the TMJ with objective measurements to determine, record and track dysfunction and improvement.
• Describe the biomechanical movements of the shoulder.
• Relate the biomechanical movements of the shoulder to associated soft tissue structures of the cervical spine and thoracic spine and rib cage.

Hour 8

• Summarize biomechanics of the soft tissues of the elbow, wrist and hand for the purposes of examination.
• Relate the rotational movement of the shoulder, elbow, wrist and hand to determine soft tissue injury and dysfunction to associated soft tissue structures.
• Perform examination of the soft tissues of the elbow, wrist and hand to determine injury and dysfunction.
• Utilize appropriate advanced imaging methods for particular soft tissue structures.

Hour 1:

• Comprehend the human frame as interrelated biomechanical systems.
• Relate the functional anatomy of soft tissue structures to the movement of the human frame.
• Discern the six types of soft tissue end feel for evaluation of injury.
• Perform passive and active examination according to protocol developed by James Cyriax, MD.
• Distinguish between the types of injury and their effects on the soft tissues.

Hour 2:

• Identify soft tissue changes associated with injury.
• Discern which phase of healing is associated with the current presentation of injury.
• Apply mechanisms of healing to treatment protocol.
• Discuss diagnostic tools used to identify soft tissue injury.
• Utilize appropriate ice, heat and stretch protocols in the treatment of soft tissue injury.

Hour 3:

• Explain and perform Somatic Technique and Strain/Counterstrain.
• Understand friction anesthesia and palpatory methods for identifying trigger points.
• Differentiate between Postisometric Relaxation and Postfacilitation Stretch.
• Apply specific modalities for particular soft tissue injury patterns.
• Perform soft tissue restriction release methods.

Hour 4:

• Discern between mobilization and manipulation.
• Apply biomechanics of foot arch function to injury.
• Explain dynamic changes of foot during weight bearing, and walking on even and uneven surfaces.
• Utilize treatment protocols for common ankle sprains.
• Perform osseous manipulation to the bones of the foot and ankle.

Hour 5:

• Perform Strain/Counterstrain on the foot and ankle as an effective tool to release spasm and fixations.
• Discern and treat various pathological conditions related to the knee.
• Utilize myofascial release techniques to treat entrapment syndromes of the lower extremity.
• Explain functional movement of the hip.
• Apply functional kinesiology to the evaluation and treatment of the muscles associated with the hip.

Hour 6:

• Utilize treatment methods for contracted soft tissues of the lateral hip.
• Perform treatment protocols for the hamstrings/quadratus femoris.
• Explain the dynamics of correct posture.
• Recognize normal versus abnormal gait in patient observation.
• Describe nutation and counternutation of the pelvis.

Hour 7:

• Understand the various movements and fixations patterns in the Sacroiliac joints.
• Perform Strain/Counterstrain for the pelvis.
• Utilize a disc pump correction for mild to moderate disc lesions.
• Demonstrate James Cyriax MD protocol from manipulation of the low back.
• Devise a treatment protocol for sprain of the iliolumbar ligament.

Hour 8:

• Apply movement dynamics of the lumbopelvic spine to soft tissue injury.
• Utilize chest movement dynamics to help determine injury to the thoracic spine and rib cage.
• Provide affective treatment of the rib cage specific to rib articulations.
• Perform somatic Technique to the trapezius muscle for muscle awareness.
• Apply treatments to soft tissues of the rib cage without using electric modalities.

Hour 9:

• Discuss cervical spine mechanics as it applies to soft tissue injury.
• Create muscle awareness of the cervical extensor group with Somatic Technique.
• Reduce pain and spasm in an acute cervical spine injury using Strain/Counterstrain.
• Apply myofascial release to the soft tissues of the posterior cervico-thoracic spine.
• Educate the patient on corrective scoliosis exercises.

Hour 10:

• Relate the functional anatomy of the TMJ to soft tissue injury.
• Discern between Acute Closed lock and Acute Open Lock of the TMJ.
• Apply soft tissue treatments to the muscles of the TMJ.
• Use movement dynamics of the shoulder to better evaluate injury.
• Utilize a variety of soft tissue treatment in the treatment of adhesive capsulitis of the shoulder.

Hour 11:

• Differentially diagnose acromioclavicular joint injury and apply treatment to grades 1-3.
• Use soft tissue methods to treat the muscles of the rotator cuff.
• Discern and treat soft tissue structures related to the scapula.
• Perform a scapula mobilization technique to free up the functional scapulo-thoracic joint.
• Apply mechanisms of throwing to soft tissue injury and treatment.

Hour 12:

• Describe various soft tissue treatments for the elbow, wrist and hand and related functional dynamics of injury.
• Osseously manipulate the joints of the elbow, wrist and hand.
• Perform soft tissue treatment methods for injury to the myofascia associated with the upper extremity.
• Discern and treat all injured tendon sheath components of the wrist using soft tissue treatment methods.
• Differentially diagnose and treat nerve entrapment syndromes for the upper extremity.

• Explain the structural components of soft tissue.
• Relate impact forces to functional movements of soft tissue and the development of scar tissue and adhesions.
• Demonstrate diagnostic evaluation of soft tissue injury.
• Differentially diagnose types of soft tissue injury.
• Discuss the patterns of healing of soft tissue injuries.
• Describe the diagnostic tools in determining soft tissue injuries.
• Relate stress responses of soft tissues to development of structural and functional changes to injured tissues and their associated regions.
• Perform diagnostic tests and order imaging to best determine injury to soft tissue.
• Instruct the patient on correct application of ice and wet heat for soft tissue injury.
• Perform and explain proper stretching; passive, active and postfacilitation of soft tissues.
• Learn which therapy machines are best suited for your practice.
• Utilize infrared and electrical muscle stimulation in soft tissue injury.
• Apply appropriate contraindications of electric modalities to the individual patient’s care.
• Discern between the various EMS options for each soft tissue and injury (Interferentail current, galvanic, microcurrent, sine wave, Russian stimulation).
• Determine the most effective type of ultrasound for treatment of particular soft tissue injuries.
• Learn the benefits and applications of cold laser therapy.
• Understand the variety of massage therapy protocols and their applications.
• Discuss the benefits of each form of modality with your patient.
• Demonstrate and discuss exercise rehabilitation and muscle strengthening.
• Apply a combination of modalities for specific conditions of the upper and lower extremities and the spine.

• Discuss the normal function of soft tissues for support and movement to relate soft tissue injuries to postural anomalies. 
• Utilize the evaluation of the feet as a foundation for full body postural adaptations.
• Relate normal biomechanics of the foot, ankle, knee, hip, pelvis, spine, TMJ and upper extremities to normal posture and movement.
• Apply findings of injured soft tissues of the foot, ankle, knee, hip, pelvis, spine, TMJ and upper extremities to evaluation of normal and abnormal postural distortions.
• Discuss dynamic muscle stabilizers in the pelvis and abdominal core in relation to normal movement and fixations in the hip and pelvis.
• Relate the thoracic spine and rib cage to dynamic movement and postural adaptations in the spine, upper and lower extremities.
• Evaluate cervical joint dynamics in relation to compensations from the thoracic spine and rib cage, upper extremity and TMJ.
• Discern impact of TMJ function on cervical spine posture and head tilt.
• Relate abnormal scapular, glenohumeral joint and rotator cuff function to specific spinal and upper extremity postural distortions.
• Educate the patient in normal standing, seated, computer ergonomic, reclined, recumbent positions and normal gait to discern and recognize postural abnormalities.
• Relate functional dynamics during Acceleration/Deceleration Impact to soft tissue injury and postural adaptations to those injuries.
• Define causative factors for Scoliosis and relate muscle disparities of the multifidus to spinal, pelvic, rib cage and shoulder postural distortions for treatment protocol.
• Educate on causes of shoulder rounding, shoulder elevation; and backpack, throwing, tennis, golf, swimming, overhead sports injuries and their effects on spinal posture for rehabilitation.
• Understand and apply soft tissue treatment methods for the three posture types of Somatic Technique Theory: Red Light, Green Light and Dark Vise.
• Use Strain/Counterstrain, Friction Massage and Postisometric Relaxation as an effective tool for soft tissue damage contributing to postural distortion.
• Apply soft tissue treatment methods, modalities and rehabilitation to Pelvic Crossed Syndrome and Shoulder Crossed Syndrome.
• Apply Yoga for full body and regional postural corrections.
• Understand and explain proper postures for dance, martial arts, running, cycling, baseball, golf, tennis, standing, walking, sitting, computer ergonomics and sleeping.

• Identify the goals, indications and contraindications of spinal traction and decompression
• Predict responsive patient selection for spinal traction and decompression
• Plot phases of traction and calculate the appropriate force, traction and hold times
• Evaluate the validity of logarithmic pulls and disc targeting
• Define ethical behavior for billing and marketing of non-surgical spinal decompression device

• Develop and overview of Adult Golf Injury Assessment and Rehab
• Identify the nature of balance and applying balance assessment to golfers
• Review and Understand the concepts of coordination as applied to golf

• Identify which trunk muscles are used in the golf swing
• Review the Chiropractic influence on the golf swing
• Construct practical swing suggestions for golf patients
• Discuss fundamental conditioning concepts
• Prepare physical conditioning to improve club speed

• Differentiate the basic fundamentals of the golf swing and ball flight
• Understand the epidemiology of golf injuries in both professionals and amateurs
• Discuss the factors that influence injury formation and prevention
• Learn the shoulder muscles involved in the various phases of the golf swing and apply this knowledge to examination and rehabilitation
• Learn about the relationship between back pain and elite golf mechanics
• Determine the spinal and metabolic loading characteristics associated with golf

• Illustrate basic principles of cardiorespiratory exercise
• Outline health screening and physical fitness testing
• Create cardiorespiratory and strength training exercise prescriptions

• Describe the biomechanical fundamentals of grip, posture and swing
• Identify golf injuries and golfers’ problems
• Develop protocols of rehab, strength training and adjusting for golfers

• Investigate the anatomical structures strained during the Ober and Modified Ober tests for iliotibial band concerns
• Evaluate the utility of screening tests for predicting injury risk in athletes
• Describe the biomechanics associated with the extensor carpi ulnaris and recognize the variety of pathologies that can affect this structure
• Summarize recommendations for the assessment, diagnosis and management of Femoroacetabular Impingement (FAI)
• Assess whether expert and novice Functional Movement Screen raters can report the same scores

• Illustrate the pathogenesis of CADs ­dissection mechanisms
• Identify putative causes and triggers of CAD
• Estimate the purported incidence of cerebrovascular syndromes following cervical manipulation
• Distinguish between the neurological syndromes
• Identify stroke risk factors in general
• Assess the value of pre-manipulation testing: to screen or not to screen?
• Outline the warning signs/symptoms of CAD
• Indicate what to include in the patient history and examination
• Describe what to do if you suspect CAD
• Point out how to communicate risk to patients as well as implementing strategies to prevent CAD
• Assess the current literature on the relationship between stroke and manipulation
• Describe the anatomy of the blood supply to the brain
• Summarize the clinical biomechanics of vertebral arteries
• Outline the epidemiology and classification of cervicocerebral (vertebral and internal carotid) arterial dissections (CAD) or strokes
• Recognize the diseases affecting cervicocerebral arteries

• Compare the associations of chiropractic care and stroke with primary care physician (PCP) care and stroke in the Medicare population
• Quantify risk of stroke after chiropractic spinal manipulation, as compared to evaluation by a primary care physician, for Medicare beneficiaries aged 66 to 99 years with neck pain
• Determine the hemodynamics in the Circle of Willis with Internal Carotid Artery Stenosis under cervical rotatory manipulation: a finite element analysis
• Review compensation claims for chiropractic in Denmark and Norway 2004-2012
• Examine the risk of traumatic injury associated with chiropractic SMT in the Medicare population

• Compare the risk of injury (via Medicare data) between two cohorts of patients treated by chiropractic spinal manipulation versus treatment by a primary care physician
• Investigate the association between chiropractic manipulative treatment and vertebrobasilar artery stroke
• Assess the level and quality of evidence regarding the potential association between cervical manipulation and cervical artery dissection/stroke
• Evaluate the diagnostic accuracy of premanipulative vertebrobasilar tests in terms of sensitivity, specificity, predictive values and likelihood ratios in adults
• Observe vertebral artery blood-flow after cervical manipulation and various head positions

• Outline methods used and estimations as to the incidence of cervical spinal manipulative therapy and subsequent vertebrobasilar ischemia.
• Review and describe cerebrovascular anatomy and hemodynamics.
• Discuss proposed patho-physiological mechanisms believed responsible for subsequent vertebrobasilar ischemia.
• Review and discuss past and present scientific literature to explore the evolution of what we think we know about the process of cervical spinal manipulative therapy and subsequent vertebrobasilar ischemia.
• Identify radiographic signs of a vertebral artery dissection.
• List and discuss the uses, pros and cons of current examination tools as they apply to vertebral artery dissection.
• Explore issues and examination procedures related to patient assessment as well as vertebrobasilar ischemia recognition and proper diagnosis.
• Define and contrast currently suggested procedures and develop a vertebrobasilar ischemia plan of action.
• Explore various perspectives and reveal bias in both public media and biomedical journals.
• Identify and define new theoretical concepts and prophylactic therapies.
• Give multiple examples of anti-chiropractic bias in the biomedical literature
• List and describe the most common red flags for a patient “at risk” for suffering Vertebrobasilar Ischemia following cervical manipulation.
• Recite list of scientific studies relating to laboratory testing of plasma Homocystine levels and its relationship to Vertebrobasilar Ischemia from vertebral artery dissection.
• List examples of bias against chiropractic cited in both the popular media as well as in biomedical journals.
• Critically review landmark articles regarding the issue of cervical manipulation and vertebrobasilar distribution ischemia.
• List studies suggesting that a high plasma homocystine level may be associated with vertebrobasilar dissection.
• Cite studies suggesting that increasing folic acid intake can reduce plasma Homocystine levels.
• Identify laboratory tests that may be useful in helping calculate an individual’s risk of suffering vertebrobasilar stroke following cervical manipulation.

• Cite the strength of evidence about whether chiropractic neck manipulation causes cervical artery dissection (CAD) based on a systematic review, meta-analysis, and evaluation of the body of evidence as a whole
• Summarize our current state of knowledge on cervical artery dissection and how it impacts the practice of cervical spinal manipulation
• Outline the state of knowledge regarding bedside diagnosis and management of an acute vestibular syndrome, with the suspicion for stroke 
• Describe the demographics, past health care utilization, and comorbidities of vertebrobasilar artery stroke patients in Ontario, Canada who consulted a chiropractor within one year prior to their stroke
• Analyze the nature of internal carotid artery biomechanics and associated risk of injury during cervical spinal manipulation

• Determine the epidemiology, etiology and background on obesity
• Assess the theories of obesity development and pathophysiology
• Outline the risks and morbidities related to obesity

• Outline the management of obesity
• Summarize the assessment of obesity for the busy clinician
• Synthesize the literature on the dietary management of obesity
• Discuss the role of exercise and physical fitness in the management of obesity and overweight

• Outline the principles of body composition assessment
• Review the anthropometic measures of body composition
• Discuss the circumference measurements of body composition
• Assess the laboratory and field assessments of body composition

• Outline the definition and components of health and wellness
• Review the dimensions of wellness
• Discuss various models of health and the need for wellness lifestyles
• Outline the publication and goals of Healthy People

• Discuss a common origin of lumbar disc pain
• Describe the orientation of lumbar facet joints
• Identify the effect of lordosis on the position of the nucleus pulposis
• Establish how injuries of the annulus fibrosus can cause nerve root changes
• Identify the dynamic stenosis of the lumbar spine

• Identify anatomical structures of the knee involved with anterior knee pain
• Diagnose fat pad and bursitis syndromes
• Establish pathologies of the patellar tendon in adults and children
• Differentiate different causes of patellofemoral pain
• Match clinical syndromes of knee pain with radiological appearances

• Identify the general anatomy of the knee joint
• Develop an intimate knowledge of the anatomy of the menisci and ligaments of the knee using gross dissection and cross-sectional imaging
• Understand the functional anatomy of the menisci of the knee and define the type and grade of meniscal tears
• Establish the conditions discoid lateral meniscus and meniscal cyst and understand the spectrum of treatment available
• Identify what type treatment is available for meniscal injuries and when it would be prudent to reevaluate a post-op patient with new knee pain

• Outline the physical basis of magnetic resonance imaging
• Identify patients that are candidates for an MRI
• Recognize categories of pathology in the spine that are imaged well with MRI
• Recognize cases that require contrast
• List contraindications for an MRI

• Identify and classify injuries to the anterior cruciate ligament
• Diagnose and develop treatment for injuries to the posterior cruciate ligament
• Diagnose and develop treatment for injuries to the medial collateral ligament
• Diagnose and develop treatment for injuries to the lateral collateral ligament
• Describe and classify ostochondritis dissecans of the knee

• Differentiate ossification from calcification
• Identify the categories of ossification
• Differentiate myositis ossificans progressiva from myositis ossificans traumatica
• Discuss imaging utilization with regards to ossification
• Review common and uncommon entities predisposed to ossification or calcification

• Recognize and identify important key factors for interpreting plain film x-rays of the spine and pelvis
• Recognize important medical/legal issues regarding interpreting plain films of the spine and pelvis and be able to apply appropriate radiographic documentation requirements when charting x-ray findings in the medical record
• Identify, analyze and interpret normal and abnormal anatomical osseous structures, common congenital and acquired pathologies, common normal radiographic variants and soft tissue calcifications/structures of the cervical, thoracic, lumbar, lumbosacral spine and pelvis

• Alert your clinical consciousness to prevent complacency
• Explain ways to identify the most common aneurysms clinically and on x-ray in the abdominal aorta, thoracic aorta, and splenic artery
• Differentiate aneurysm from dissection and pseudoaneurysm

• Identify the source of metastatic lesions
• Determine an advanced imaging protocol once a metastatic lesion is found
• Discuss how to identify on radiographs the two most common primary malignancies of bone - multiple myeloma and osteosarcoma

• Discuss the fundamental role of trauma in musculoskeletal disease and the various diagnostic imaging techniques used to evaluate it
• Identify, describe, and classify fractures by both direct & indirect radiographic signs
• Review fractures of specific etiologies based upon imaging findings
• Evaluate fracture alignment issues, complications, and healing
• Identify non-accidental injury of childhood, as well as normal structures that mimic fractures

• Understand Osteoporosis - (risk factors, incidence, prevalence, morbidity, etc.)
• Understand the fundamentals of DEXA (dual-energy x-ray absorptiometry), the gold standard in bone density testing
• Explain how to interpret the results
• Investigate the advantages and limitations of DEXA
• Investigate the indications and contraindications for utilization of DEXA

• This contains all courses with the educational objectives listed in Xray 119, and, Xray 123 through 127

• Use plain film to identify imaging findings of common diabetic foot fractures
• Discuss foot ulcers and using diagnostic imaging to rule out secondary osteomyelitis
• Identify diagnostic imaging findings of neuropathic osteoarthropathy (Charcot foot)

• Explain the clinical presentation, physical examination findings, orthopedic tests, laboratory findings, and radiographic findings associated with ankylosing spondylitis
• Discuss the extraskeletal manifestations of ankylosing spondylitis
• Explain the similarities and differences between the spondyloarthropathies
• Discuss the surgical and pharmacological management
• Discuss treatment that promotes spine mobility including the chiropractic adjustment

• This contains all courses with the educational objectives listed from Xray 124 through 146

• Explain the origin and pathophysiology of gout
• Understand how to prevent and monitor gout
• Examine gout on plain film
• Determine the clinical presentation of gout
• Describe the differences between the crystal arthritides on plain film

• Describe the patients that are at risk for developing osteoarthritis
• Summarize the pathophysiology behind the disease
• Discuss what osteoarthritis looks like on plain film and which joints are most likely affected
• Discuss the use of advanced imaging in osteoarthritis
• Present the research on many conservative treatment options including: physiotherapy, physical therapy/exercise, diet, and acupuncture

• Describe the anatomy of the disc and what causes the disc herniation
• Discuss the clinical presentation and who is at risk for a disc herniation
• Explain the diagnostic imaging findings for the disc herniation patient
• Evaluate the treatment options for disc herniation patients

• Assess the clinical presentation and diagnostic imaging procedure for vertebral compression fractures
• Discuss the use of plain film, CT, MRI, and DEXA
• Discuss treatments for vertebral compression fractures
• Identify other causes of vertebral fractures
• Identify other fractures besides vertebral fractures

• This contains all courses with the educational objectives listed from Xray 129 to Xray 134

• Summarize the current literature on fracture prevention
• Discuss diagnostic imaging and treatment of hip fractures
• Evaluate common lower extremity fractures, including stress fractures
• Discuss common upper extremity fractures, including the Colle's fracture and stress fractures
• Demonstrate knowledge of fractures in special populations, including adolescents and the developmentally disabled

• Evaluate the plain film images of upper and lower extremity dislocations
• Determine the mechanism of action and clinical presentation for upper and lower extremity dislocations
• Summarize the treatment options for the different upper and lower extremity dislocation
• Use assessment tools to determine treatment outcomes for extremity dislocations

• Determine the risk of MRI procedures and gadolinium contrast agents with respect to children
• Discuss the consequences of ionizing radiation in plain film, computed tomography, nuclear medicine, and fluoroscopy
• Demonstrate procedures to lessen the consequences of diagnostic imaging and discuss alternatives to the riskier modalities

• Determine the risks of ionizing radiation on the fetus
• Demonstrate the usefulness and limitations of ultrasound with regards to the pregnant woman
• Analyze the appropriate usage of magnetic resonance imaging in fetal diagnoses

• Demonstrating the differences between pediatric fractures and adult fractures
• Looking at the red flags for reporting non-accidental trauma (child abuse)
• Identifying fractures in children with osteopenia
• Discussing common upper extremity and lower extremity fractures
• Assessing proper protocol in imaging pediatric fractures, namely the use of plain film, ultrasound, MRI and CT

• Identifying bone and joint uses for PET
• Discussing neurological uses of PET, focusing on Parkinson’s disease and Alzheimer’s disease diagnosis
• Demonstrating the oncology use of PET
• Comparing PET with other diagnostic imaging modalities

• Determine the skeletal manifestations of neurofibromatosis and Paget’s disease
• Assess the diagnostic features of someone with neurofibromatosis or Paget’s disease
• Identify benign and malignant tumors commonly associated with neurofibromatosis and Paget’s disease
• Discuss the pathophysiology of neurofibromatosis and Paget’s disease

• Order proper diagnostic imaging for the lumbar spine
• Determine appropriate imaging for various pediatric musculoskeletal complaints
• Use plain film imaging for extremity complaints
• Determine what advanced imaging is appropriate for different extremity pathology

• Identify common causes of back pain
• Assess pro and con of different imaging modalities related to back pain
• Identify imaging features that may relate to back pain
• Develop imaging strategy for back pain

• Recognize normal bony and soft tissue anatomy of the upper cervical spine.
• Describe the direct and indirect signs of cervical trauma.
• Identify the more common mimics to cervical spine trauma.
• Summarize specific traumatic conditions affecting the upper cervical spine and their imaging findings.
• Assess which traumatic conditions of the upper cervical spine are stable, which are unstable, and how to manage each.

• Determine the diagnostic imaging findings consistent with a diagnosis of emphysema
• Discuss the plain film findings of congestive heart failure and conservative treatment options for these patients
• Determine the stage of sarcoidosis on plain film
• Identify the most common mediastinal masses of the chest
• Analyze different diagnostic imaging manifestations of pneumonia

• Point out the anatomy of the upper cervical spine and associated regional anatomy as seen on the APOM
• Identify variants of anatomy on APOM, noting if they are clinically relevant in providing Chiropractic care
• Differentially Diagnosis pathology noted in the region
• Discuss the advantages and disadvantages of imaging modalities for the upper cervical spine and maxillofacial region

• Recognize the signs and symptoms of patients entering the chiropractic with flu and sinusitis that may mimic musculoskeletal conditions
• Identify radiographic features of sinusitis on standard chiropractic projections and differentially diagnose from other musculoskeletal conditions
• Identify radiographic features of flu on standard chiropractic projections  and differentially diagnose from other musculoskeletal conditions
• Examine basic treatment options within chiropractic scope of practice and when to refer

• Analyze the debate between ALARA and AHARS with respect to the allowable amount of artificial radiation
• Express the cost vs. benefit of using CT, the imaging modality with the highest radiation risk
• Understand the added risk of radiation consequences in children
• Identify the different types of ionizing radiation

• Assess cervical radiographs to identify the radiographic signs of lower cervical spine trauma, recognizing which views are most diagnostic.
• Recognize, differentiate, and classify cervical hyperflexion and hyperextension injuries with respect to spinal stability.
• Identify and describe the imaging findings of neural arch trauma in the lower cervical spine.
• Discuss and categorize the complications of lower cervical spine trauma.
• Summarize the gravity as well as the evolving imaging and management protocols of penetrating neck injury.

• Identify plain film features of abdominal pathology that may present in the Chiropractic office, with an emphasis on calcifications
• Differentiate cystic from solid mass lesions
• Classify vascular calcifications
• Recognize when calcifications need immediate medical referral

• Summarize the radiographic findings of simple compression fractures and discuss how spinal biomechanics predispose to their occurrence.
• Describe the radiographic signs and sequelae of burst fractures and differentiate them from simple compression fractures.
• Identify the imaging findings of Chance type fractures and discuss their most common complications.
• Recognize the common radiographic manifestations of posterior arch trauma.
• Categorize the different types of intervertebral disc lesions and summarize their imaging findings.

• Identify imaging modalities used in sports and musculoskeletal imaging
• List indications for advanced imaging in the athlete
• Explain why imaging of the weekend “athlete” could save your practice
• Integrate imaging into treatment plans
• Assess progress of care with imaging

• Examine common orthopedic hardware on plain film and what needs to be reported
• Explain Xray findings which require Orthopedic referral and the various options
• Determine when advanced imaging is appropriate and what modality to use
• Discuss possible complications when finding orthopedic hardware

Hour 1

• Examine common orthopedic hardware on plain film and what needs to be reported
• Explain Xray findings which require Orthopedic referral and the various options
• Determine when advanced imaging is appropriate and what modality to use
• Discuss possible complications when finding orthopedic hardware

Hour 2

• Discuss congestive heart failure: diagnosis, imaging, and treatment
• Understand the imaging and treatment of multiple myeloma
• Understand the nature of chronic obstructive pulmonary disease, specifically emphysema
• Evaluate the use of DXA in the diagnosis of osteoporosis
• Determining appropriate care for patients with osteoarthritis

Hour 3

• Determining common geriatric conditions that need special consideration in a patient assessment
• Identifying diabetic foot complications, specifically Charcot's foot
• Analyzing bone metastasis in the elderly, specifically carcinomas
• Understanding thoracic and abdominal aorta aneurysms and aorta dissections
• Explaining pneumonia, specifically community acquired pneumonia, from a clinical perspective

Hour 4

• Determining the risk factors, diagnostic imaging and pathophysiology of atherosclerosis
• Assessing patient risk for developing hip fractures
• Understanding prevention and diagnosis of lung cancer
• Identifying normal anatomy of the disc and what goes wrong in degenerative disc disease
• Reviewing common orthopedic hardware found in elderly patients

• Discuss congestive heart failure: diagnosis, imaging, and treatment
• Understand the imaging and treatment of multiple myeloma
• Understand the nature of chronic obstructive pulmonary disease, specifically emphysema
• Evaluate the use of DXA in the diagnosis of osteoporosis
• Determining appropriate care for patients with osteoarthritis