New Zealand Chiropractic Continuing Education

• Describe the physiology of breathing and how altered pH can affect the body.
• Describe two functions of the diaphragm.
• Identify limited chest expansion and Bradcliff angles and ski jumps
• Identify limited lateral costal breathing and how to facilitate normal lateral costal breathing

• Describe how altered breathing patterns can alter pH and how this can affect the body.
• Describe the autonomic nervous system and function.
• Name three physiological consequences of respiratory alkalosis.
• Describe suboptimal breathing patterns and their effect on the cervical spine and chronic pain.

• Name and describe the different types of sleep apnea.
• Describe the three levels of Apnea-hypopnea index AHI.
• List five symptoms of sleep apnea.
• List two treatments for sleep apnea.

• Describe the physiological response of aerobic exercise on the respiratory system.
• Describe the effect of running on the viscera and the diaphragm.
• Describe the response to inspiratory muscle fatigue on the body.
• List one device than may increase endurance of the respiratory muscles.

• Describe the anatomical structure of the diaphragm including innervation and blood supply.
• List four causes that may damage the innervation to the diaphragm and effect normal function.
• Describe the factors involved in Intensive Care Unit Acquired Weakness.
• Be able to describe the pros and cons of early mobilization in the ICU.

• Outline the most commonly encountered neurological complaints of pregnancy that a D.C. might encounter in practice
• Differentiate between similar complaints to establish best course of care
• Modify normal practices, techniques and methods to accommodate for the biomechanical changes of the pregnancy patient
• Integrate other palliative therapies to relieve these complaints
• Analyze and adjust according to the complaint and concomitant exam findings

• This contains all courses with the educational objectives listed from Chiropractic and Pregnancy 201 through Chiropractic and Pregnancy 207

• Outline eight commonly encountered complaints of pregnancy that a DC might encounter in practice
• Differentiate between similar complaints to establish best course of care
• Understand the various causes of each complaint and how to address these causes
• Integrate other palliative therapies to relieve these complaints
• Analyze and adjust according to the complaint and concomitant exam findings

• Outline the most common herbal and homeopathic remedies that may be useful to a DC who cares for pregnant patients
• Differentiate between helpful remedies and those contraindicated for use during pregnancy
• How and when to successfully integrate these palliative therapies to relieve common complaints of pregnancy
• Recognize the basics of homeopathy, why and how it works, how to administer remedies and proper use and storage of remedies
• Generalize the use and need for these remedies to accommodate the special needs and concerns of the pregnancy patient

• Outline necessary dietary requirements for the mother to be
• Differentiate between safe and unsafe exercises that can be recommended to the expectant mother
• Give examples of safe exercise practices to the pregnant patient
• Identify the normal and customary weight gain during a healthy pregnancy
• Offer dietary recommendations and healthy food choices to the pregnant patient

• Identify the most common birth trauma(s) to a newborn
• Assess the biomechanics of the pregnant pelvis
• Recognize how certain maternal pelvic misalignments can lead to increased incidence of various birth traumas
• Modify adjustive techniques and methods to better care for the pregnant patient
• Reduce the prevalence of certain birth traumas due to distortions and misalignments in the maternal pelvis

• Identify the most common medical tests and procedures performed on pregnant and laboring women
• Recognize the risks of these tests and procedures
• Assess the benefits of these tests and procedures
• Effectively explain these risks and benefits to the pregnant patient
• Assist in the preparation of a well thought out and defined birth plan for the pregnant patient

• Outline commonly encountered misalignment and/or subluxation patterns that present with a breech presentation
• Outline commonly encountered misalignment and/or subluxation patterns that present with various common complaints of pregnancy
• Identify the various causes of a breech presentation and how to address these causes
• Integrate or eliminate other palliative therapies to aid in the reversal of a breech presentation and common complaints of pregnancy
• Analyze and adjust according to the patient history and concomitant exam findings

• Outline commonly encountered misalignment and/or subluxation patterns that present with a breech presentation
• Outline commonly encountered misalignment and/or subluxation patterns that present with various common complaints of pregnancy
• Outline commonly encountered misalignment and/or subluxation patterns that present with a twin breech presentation
• Integrate or eliminate other palliative therapies to aid in the reversal of a breech presentation and common complaints of pregnancy
• Analyze and adjust according to the patient history and concomitant exam findings

• Outline commonly encountered misalignment and/or subluxation patterns that present with a breech presentation
• Identify the correlation between a misaligned pubic bone and an occiput posterior presentation
• Draw a parallel between a superior pubic bone misalignment and round ligament pain
• Develop a pregnancy care plan based on exam findings and presenting complaints

• Outline commonly encountered postpartum complaints that a chiropractor might encounter in practice
• Understand the various chiropractic causes of each complaint and how to address these causes.
• Integrate other palliative therapies to relieve these complaints if applicable
• Analyze and adjust according to the complaint and concomitant exam findings
• Modify adjustive techniques and methods to better care for the postpartum patient

Hour 1

• Examine all reported cases of serious adverse events in infants and children receiving manual therapies from chiropractors as well as practitioners from other disciplines
• Outline the connection between pregnancy-related pelvic girdle pain and biomechanical changes during pregnancy
• Review differential diagnostic consideration for the important causes of back pain in children and adolescents
• Analyze the design and results of a pragmatic study on chiropractic care for infant colic
• Justify the chiropractic management of pregnant patients with low back or pelvic pain

Hour 2

• Outline the state of the literature on the treatment of childhood respiratory conditions with manual therapy
• Evaluate the effect of supplementing various combinations and types of micronutrients on the course and outcomes of pregnancy
• Examine whether a multimodal approach of musculoskeletal and obstetric management (MOM) was superior to standard obstetric care to relieve pain and reduce impairment and disability in the antepartum period
• Assess the peer-reviewed literature on the effectiveness of physical therapy interventions in treating lumbopelvic pain during pregnancy
• Summarize the results of a systematic review evaluating the evidence for the use of spinal manipulative therapy for pediatric conditions

• Appraise the literature pertaining to the safety of acupuncture for pregnant women
• Summarize consensus-based recommendations regarding best practices for the chiropractic care of children
• Explore the association between exercise levels and types pre-pregnancy and pelvic girdle pain during pregnancy in nulliparous women
• Assess alterations in pelvic floor function in pregnant women secondary to spinal manipulation
• Compare the effectiveness of Kinesio taping combined with exercise on abdominal recovery in women post-caesarean section compared with exercise alone

• Identify safety measures involved with essential oils
• Understand the various possible reactions if safety measures are not followed properly 
• Outline common methods of applications of various essential oils
• Identify the essential oils commonly used during pregnancy and labor and the uses of each
• Further identify essential oils that are contraindicated during pregnancy and labor

Hour 1

• Discuss the Inflammatory Cascade
• Identify the mechanics of concussion that results in inflammation
• Describe the neuro-chemical cascade of concussion

Hour 2

• Perform physical exam protocols in inflammation as it relates to concussion
• Perform Neurological exam protocols in inflammation as it relates to concussion
• Perform Chiropractic exam protocols including incorporating AK exam
• Apply Chiropractic exam protocols in inflammation
• Utilize advanced examination protocols in inflammation

Hour 3

• Perform structural treatment protocols to treat inflammation related to concussion
• Utilize phytonutrient protocols to treat inflammation related to concussion
• Use specific therapeutic protocols to resolve inflammation with literature citations

Hour 1

• Discuss the Selye Stress Response
• Discuss the mechanics of concussion that results in the inflammatory response
• Describe the cortisol cascade response associated with concussion

Hour 2

• Perform physical exam protocols in the stress response
• Perform Neurological exam protocols in the cortisol cascade
• Apply Chiropractic exam protocols in the cortisol cascade
• Utilize advanced examination protocols in evaluating the stress response

Hour 3

• Perform chiropractic treatment protocols to treat the stress response
• Utilize nutritional protocols to treat inflammation related to the stress response and concussion
• Use evidenced based therapeutic protocols to address the cortisol cascade associated with concussion with literature citations

Hour 1 and 2

• Describe the components of the core and the function of the core.
• Describe the function of the diaphragm as it relates to posture, muscular relationships and stability of the spine.
• Describe the function and structure of the superficial muscle system of the body.
• Describe two concepts of spinal stability. 

Hour 3

• Demonstrate how to determine the length of quadratus lumborum and erector spinae. 
• Demonstrate how to evaluate Transversus abdominus function
• Demonstrate how to facilitate the core and initiate a core training program

Hour 4

• List three pathologies related to less than optimal core function.
• Describe three postural strategies that the patient may develop when the core is in dysfunction.
• Describe how weakness of the abdominals can alter diaphragm contractions.
• Explain how respiratory fatigue can alter core control.

• Develop an appreciation of the impact of culture group, minority group and racial group on the health care relationship
• Increase sensitivity, knowledge and skills to promote effective intercultural interactions
• Identify the professional's own cultural identity/judgments /biases and their impact on their behavior and how they are perceived by clients and patients
• Recognize cultural variables that appear in verbal and non-verbal communication
• Examine the influence of culture in our patient population
• Differentiate the provider's culture

• Examine the historical background of the various Latino/Hispanic groups in the U.S.
• Develop the skills needed to care for people from Spanish speaking parts of the world
• Increase our understanding of the cultural traits of Latino/Hispanic groups in the U.S.
• Summarize specific traits of various Latino/Hispanic groups
• Recognize how we can narrow the gap between us

• Develop an appreciation of the impact of culture group, minority group and racial group on the health care relationship.
• Increase sensitivity, knowledge and skills to promote effective intercultural interactions.
• Identify our own provider culture/judgments /biases and their impact.
• Examine characteristics of Asians, Blacks and Middle Easterners.
• Summarize how to care for patients of these three ethnic/racial groups and how to narrow the gap between us
• Develop an understanding/plan of how to reach out to these populations.

• Describe cultural diversity
• Recognize the need for cultural competence in health care
• Explain the concept of health disparity
• Define culture and cultural competence
• Differentiate between the concepts of culture, race, ethnicity, diversity, and minority
• Describe the Cultural Competence Continuum
• Discuss the interdependency between the levels of cultural competence

• Discuss the evolution of multicultural policy
• Describe the phases of multiculturalism
• Discuss three major perspectives on culture and diversity that have influenced healthcare literature and practice
• Identify the common myths and misconceptions associated with culture
• Recognize the paradoxical dilemmas associated with cultural competence

• Develop an understanding of the physiologic principles involved in nerve depolarization and the propagation of action potentials as they relate to Motor and Sensory nerve conduction studies
• Identify the physiology and nerve pathology in clinical conditions presenting in Chiropractic practice, and how they present on electrodiagnostic examination
• Classify the utilization of electrodiagnostic testing in the process of differential diagnosis
• Develop a working clinical knowledge of the setup and recording of Compound Muscle Action Potentials, Sensory Nerve Action Potentials, F-Responses in all major peripheral nerves, as well as H-reflex testing
• Demonstrate a practical knowledge of the neuroanatomy, as well as clinical applications of EMG and Somatosensory and Dermatomal Evoked Potentials

• Know how to prepare for a medical emergency
• Review four emergency medical conditions: Stroke, Heart Attack, Difficulty Breathing, Diabetic Emergencies
• Recognize the causes, symptoms and signs for these emergencies
• Understand how to provide the appropriate emergency treatments

• Gain the knowledge to develop an Emergency Preparedness Manual for your office
• Define crisis management procedures in advance for fires, child abduction, workplace violence, bomb threats and other situations
• Explain the importance of an emergency continuity plan
• Recognize why CPR was changed and compare the new rules
• Perform more effective CPR even before you refresh your certification

• Recognize Altered Mental Status and apply the appropriate emergency response
• Distinguish types of Burns, their mechanisms of injury and pathophysiology
• Plan for the treatment of burns and the appropriate emergency response
• Apply and use the Rule of Nines
• Recognize Allergic Reactions, discuss their pathophysiology and the proper emergency response

• Identify the most common emergencies that occur on airline flights
• Describe what may be expected of you in caring for a patient at high altitude
• Describe what resources and equipment may be available to you as an in flight medical provider
• Observe important clinical differences seen on examination of patients on airplanes
• Demonstrate to patients skills to prevent medical emergencies during air travel

• Describe the basis of the American legal system
• Compare and contrast constitutional, statutory, common and administrative law
• List the differences between criminal and civil law
• Explain the civil litigation explosion
• Summarize tort reform

• Differentiate morals and ethics
• Explain the purpose of professional codes of ethics
• Compare and contrast legal and professional health care ethics
• Define situational ethics
• Identify the four principles of biomedical ethics

• List the external and internal factors affecting the exposure to malpractice liability
• Describe the legal basis for imposing malpractice liability of a patient injury
• Define the concept of abandonment
• Outline the four elements needed to prove malpractice
• Compare and contrast ordinary negligence versus professional negligence
• Explain vicarious liability
• Summarize defenses to malpractice actions
• Describe the importance of patient care documentation

• Describe the concept of intentional torts
• Differentiate assault and battery
• Define defamation, slander and libel
• Summarize the mandatory reporting requirements for health care professionals
• Outline the four principle forms of invasion of privacy
• Classify the types of criminal activity 
• Describe the steps in a criminal prosecution
• Explain the classifications of homicide

• Differentiate employment at will versus employment under contract
• Summarize the history of federal regulation of labor – management relations
• Describe the five major sections of the Americans with Disabilities Act of 1990
• Recognize sexual harassment in the workplace
• Define “ordinary reasonable person” as it pertains to sexual harassment
• Differentiate the vicarious liability of an employer relative to employees and independent contractors
• Explain the considerations in writing a letter of recommendation
• Outline the requirements for an enforceable restrictive covenant

• Summarize the antitrust laws
• Discuss the importance of the attorney – heath care professional client relationship
• Define the elements of a binding contract
• Explain breach of contract and possible contractual remedies
• Describe the various forms of business organization
• Outline the good Samaritan laws
• Recognize the requirements for HIPAA compliance
• Assess the necessity and limitations of professional liability insurance

• Summarize the major federal statutes regulating education
• Discuss federal education law derived from constitutional protections
• Outline a risk management strategy for academic discipline in health professional educational programs
• Assess liability for student conduct in the clinical setting
• Outline procedures to minimize liability when incorporating students in the clinical setting

• Explain patient informed consent to intervention
• List the requirements of sufficient informed consent
• Describe pertinent considerations in life and death decision making including euthanasia
• Recognize issues of nondiscrimination against participants in health care delivery
• Explain pro bono health care services
• Outline professional practice issues of financial responsibility and gifts
• Summarize the ethical issues of impaired providers and intra and inter-professional relations
• Define the ethical issues in research and the informed consent process

• Demonstrate the importance of communicating in an ethical manner and what that entails
• Develop an understanding of what 'spin' is, why it is unethical and how to monitor and minimize/stop it
• Evaluate the barriers to effective and ethical communication
• Develop an understanding of exactly what takes place/needs to take place during the provider/client interaction
• Discover what it is that patients want from their visits to a provider
• Appraise how to deal with challenging clients and situations
• Discover how to become a skilled helper by studying the tools of communication
• Apply listening skills to the provider's repertoire
• Demonstrate the importance of the impact of nonverbal communication on the caregiver/client relationship
• Develop, analyze and apply the verbal and nonverbal skills that will help to gather information and support the patient effectively
• Write an Ethical Communication Protocol (EPC) for your practice

• Determine how critical it is for us to take excellent are of ourselves
• Indicate the ways in which we can stay healthy physically, mentally and emotionally
• Examine the impact of stress on providers
• Recognize the issue of burnout
• Demonstrate the fiduciary duty that providers have

• Differentiate between assault and battery
• Outline various kinds of legal problems that may result from sexual impropriety claims
• Identify and describe distinctions between innocent flirtatious behavior and sexual misconduct
• Evaluate possible defenses to sexual misconduct Disciplinary complaints
• Discuss the applicability of the transference phenomenon to Doctors of Chiropractic

• Define anti-aging medicine
• Compare and contrast the differing opinions on anti-aging medicine
• List the moral questions associate with the anti-aging movement
• Describe how the anti-aging movement is viewed from a feminist perspective

• Describe the moral questions concerning home care for the elderly
• Identify the relationship between the cared for and the care giver
• Explain the focus of governmental programs for dependent elderly care
• List the values necessary to support elder care at home

• Outline the history of the nursing home
• Describe the evolution of bioethical thought on nursing home care
• List strategies for creating a more ethical nursing home environment
• Ways nursing homes can aid residents in addressing end-of-life concerns

• Give examples of the roots of an ageist attitude in the United States
• Describe the dynamics of the power relationship between care giver and cared for
• Explain the issues involved in setting boundaries in the institutional environment
• Describe the difference between independent and relational autonomy

• Define elder abuse, neglect and self-neglect
• Describe the “expressive – collaborative” model of approaching ethics
• Compare and contrast the classical definition of autonomy with “actual autonomy”
• Explain how remaining in an abusive / neglectful environment may constitute the best alternative for an individual

• Cite the historical perspective on senility
• Describe how the pervasive bioethical viewpoint affects the experience of people with dementia
• Explain the concepts of dignity
• Compare and contrast various definitions of dignity relative to those with dementia

• List the foundational assumptions that define advance care planning in the United States
• Differentiate hospice care from palliative care
• Describe the issues that arise when individual choice is the main focus of advance care planning
• Explain how the modern culture of medicine influences end – of – life care
• Compare and contrast the current approach towards end – of – life care with the authors. “bottom up,” approach

• Cite examples of how the elderly have been marginalized during disasters
• Define what is meant by the “axes of susceptibility”
• Identify the ethical obligation to the elderly during major disasters
• Describe how planning, communication and coordination is an ethical imperative in disasters
• Explain the concept of “place holding,” and how it fits into disaster planning

• Define morality and ethics and distinguish between the two
• Describe three moralities that health professionals must integrate into their own moral life
• Identify some major sources of moral beliefs in Western societies
• Distinguish between an ethical issue and ethical problem
• List three ways that ethics is useful in everyday professional practice
• Describe what material cooperation entails
• Identify some mechanisms available to protect the personal moral convictions of health professionals

• This contains all courses with the educational objectives listed from Ethics for Professionals 101 to Ethics for Professionals 105.

• Identify the goal of professional ethics activity.
• Describe the basic idea of a caring response and some ways this response in a professional relationship is distinguished from expressions of care in other types of relationships.
• Identify three component parts of any ethical problem.
• Describe what an agent is and, more importantly, what it is to be a moral agent.
• Name the three prototypical ethical problems.
• Describe the role of emotions in ethical distress.
• Distinguish between two varieties of ethical distress.
• Compare the fundamental difference between ethical distress and an ethical dilemma.
• Define ethical paternalism or parentalism.
• Describe a type of ethical dilemma that challenges a professionals desire (and duty) to treat everyone fairly and equitably.
• Identify the fundamental difference between distress or dilemma problems and locus of authority problems.
• Identify four criteria that will assist you in deciding who should assume authority for a specific ethical decision to achieve a caring response.
• Become familiar with AOTA and APTA Code of Ethics
• Become familiar with the Guide to Professional Conduct for PT
• Indiana PTs - become familiar with the IN PT Rules and Practice Act
• Texas PTs - become familiar with the TX PT Rules and Practice Act
• Utah PTs - become familiar with the UT PT Rules and Practice Act

• Identify six steps in the analysis of ethical problems encountered in everyday professional life and how each plays a part in arriving at a caring response.
• Describe the central role of narrative and virtue theories in gathering relevant information for a caring response.
• List four areas of inquiry that will be useful when gathering relevant information to make sure you have the story straight.
• Describe the role of conduct-related ethical theories and approaches in arriving at a caring response.
• Describe why imagination is an essential aspect of seeking out the practical alternatives in an ethically challenging situation.
• Discuss how courage assists you in a caring response.
• Identify two benefits of taking time to reflect on and evaluate the action afterward.
• Become familiar with AOTA and APTA Code of Ethics
• Become familiar with the Guide to Professional Conduct for PT's

• Define the terms confidential information and confidentiality.
• Identify the relationship of a patient's legal right to privacy with his reasonable expectations regarding confidential information.
• Describe how the telling and keeping of secrets is relevant to understanding the importance of confidentiality.
• Discuss the ethical norms involved in keeping and breaking professional confidences.
• Name five general legal exceptions to the professional standard of practice that confidences should not be broken.
• Consider practical options that a professional can take when faced with the possibility of breaking a confidence.
• Discuss some important aspects of documentation that affect confidentiality.
• Compare ethical issues of confidentiality traditionally conceived with those that have arisen because of computerized medical records and patient care information systems.
• Describe the key ethical strengths and challenges of the recent U.S. federal regulations related to privacy considerations (Health Insurance Portability and Accountability Act of 1996).
• Become familiar with AOTA and APTA Code of Ethics
• Review and become familiar with the TX PT Rules
• Read case scenarios illustrating ethical decision making

• Describe three basic legal concepts that led to the doctrine of informed consent.
• Describe three approaches to determining the disclosure standard for judging that a patient or client has been informed.
• Discuss three major aspects of the process of obtaining informed consent.
• Distinguish "general consent" from "special consent" documents.
• Differentiate between the never-competent and once-competent patient or client and the challenges posed by each in regard to informed consent.
• Compare informed consent as it is used in health care practice and in human studies research.
• Describe some considerations one must always take into account to be sure one is being culturally competent and honoring cultural difference when informed consent is the standard.

• Assess the current literature on outcomes assessment in chiropractic practice
• Describe the psychometric properties outcome measures
• Summarize the utility of patient related outcome measures
• Outline the various domains of outcome assessments
• Describe the clinical significance of common patient reported outcome measures
• Identify guidelines and recommendations for use of outcomes measures in daily practice
• Identify clinician driven outcome measures and discuss the strength of evidence supporting them along with their clinical significance and utility

• Define Evidence Based Practice (EBP)
• Identify problems/obstacles to EBP
• Outline the process of EBP
• Learn how to ask good clinical questions: PICO
• Describe how to search PubMed and learn how PubMed translates a search query
• Define MeSH terms and describe their use
• Illustrate how to limit or broaden your search to find the appropriate content
• Compare the results of boolean operators AND, OR and NOT

• Provide a rationale for the use of outcome assessments in practice
• Survey the recommended outcome assessment measures used by chiropractors and provide a copy or link to download them electronically
• Describe the recommended outcome measures and provide instruction on how to score them
• Detail the psychometric properties of the commonly used outcome measures to aid in determining clinically relevant change in patients
• Indicate which outcome measures to use and when to use them

• Evaluate the effectiveness of the influenza vaccine in healthy adults and children 
• Evaluate the effectiveness of the influenza vaccine in the elderly 
• Evaluate the importance of influenza vaccination in those with recent cardiac events 
• Explain the key elements in the "Tamiflu Controversy" 
• Discuss limitations to the Tamiflu research base 
• Discuss limitations to using zinc for the common cold 
• Evaluate strengths of study design for pragmatic trials 
• Discuss the effectiveness of using probiotics for the common cold 

• Identify the differences between the deposition and trial
• Understand the fundamentals and subtleties of the discovery of evidence
• Distinguish between discovery and impeachment
• Describe the steps involved in a deposition and trial
• Discuss critical issues encountered in the deposition and trial

• Demonstrate how to get started in marketing new skill sets
• Recognize how to contract work
• Establish case preparation protocols
• Distinguish between oral and written reports
• Describe the steps involved in opinion forming

• Discuss demonstrative evidence and props
• Distinguish between discovery and impeachment
• Understand the steps involved in a deposition
• Recognize the worth of your knowledge as a forensic examiner
• Review the steps involved in civil and criminal cases

• Understand the steps involved in a trial
• Identify critical issues encountered in a trial
• Create a defensible curriculum vitae
• Explain the concept of work product
• Discuss critical issues encountered in discovery of work product

• Understand critical issues encountered in a forensic practice
• Recognize pertinent case law
• Explain the concept of absolute immunity
• Recognize risk management protocols for the forensic examiner
• Discuss the future challenges for the forensic examiner

• Develop a level of knowledge and understanding of the federal and state legal system
• Develop a level of knowledge, comprehension, and understanding of the deposition process as it relates to the practice of forensic chiropractic and testifying as an expert witness
• Integrate the Rules of Evidence
• Illustrate which Federal Rules of Evidence apply to the expert witness
• Explain discovery techniques
• Discuss that the expert witness may need to produce business records
• Emphasize that each chiropractic provider must keep informed as to the laws and their interpretation in their particular state of practice
• Assess Daubert criteria
• Explain what each chiropractic expert should look for when preparing for the opposing attorney relating to hearsay
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to Daubert challenges

• Discuss trick question posed on cross examination
• Assist judges in implementing effective management of expert evidence involving scientific issues
• Identify judicial notice, aggregation, and compensation schedules for specific injuries
• Develop a level of knowledge, comprehension, and understanding of the cross examination process as it relates to the practice of forensic chiropractic and testifying as an expert witness
• Develop a level of knowledge and understanding of the federal and state court appointed expert process
• Discuss evidentiary framework
• Identify which Federal Rules of Evidence apply to the expert witness
• Critique the nature of the claims, the theories of general and specific causation, the defenses, and in particular the bases for disagreement among experts
• Explore the use of reference guides

• Integrate Scientific Reasoning vs. Methodology
• Critique questions relating to scientific validity
• Assess Frye criteria
• Discuss hearsay exceptions
• Explore statistical estimates
• Emphasize that judges will exclude certain evidence
• Identify scientific theories that are not testable
• Comment on forensic techniques that have fallen into disfavor
• Discuss implicit error

• Discuss the Reference Manual on Scientific Evidence
• Emphasize keeping junk science out of court
• Review and critique literature refuting whiplash syndrome
• Summarize the amended Rules of Evidence and their impact of Daubert
• Identify which Federal Rules of Evidence apply to the expert witness
• Demonstrate how to read a legal opinion
• Assess the concept of ipso facto as it relates to the practice of forensic chiropractic and testifying as an expert witness
• Integrate case law as it relates to the practice of forensic chiropractic and testifying as an expert witness

• Develop a level of knowledge, comprehension, and understanding of the federal legal system as it relates to malpractice and testifying as an expert witness
• Explain punitive or exemplary damages
• Discuss the "but for" test
• Assess the concept of res ipsa loquitur
• Summarize battery and assault
• Emphasis adequate informed consent
• Contrast breach of contract or warranty to cure
• Detect the opposing attorney's intent
• Develop a level of knowledge, comprehension, and understanding of the ethical expert witness

• Examine the impact of sexual boundaries on the health care relationship
• Recognize the most common misconceptions about sexual boundaries
• Distinguish between sexual misconduct and sexual harassment
• Demonstrate the need for providing safety for patients
• Identify the inherent dangers of being in a power position

• Define sex abuse
• Identify the characteristics of an abused individual
• Appraise the effects of abuse on the health care relationship
• Create an individualized Patient Protection Protocol
• Develop office procedures and policies that will create a safe and comfortable environment for all patients

• Summarize the effect of exercise on wound healing in older adults
• Discuss the relationship between trunk muscle composition and functional capacity
• Assess the effects of high-intensity strength training on balance
• Describe a study that examines the reliability and validity of a new steadiness measure
• Assess the effect of an endurance exercise program on depression, anxiety and quality of life

• Summarize the concept of mitochondrial degeneration
• Discuss the free-radical mitochondrial theory of aging and the susceptibility of the brain to oxidative stress
• Assess the relationship between mitochondrial decay and age-related neurodegenerative diseases, such as Alzheimer's disease (AD) and Parkinson's disease (PD)
• Illustrate the array of mitochondrial nutrients and the various vitamins that may improve mitochondrial function

• Breakdown the biomechanical processes of spinal degeneration
• Explain the biochemical processes that occur in the geriatric population in 
• Differentiate between various diagnosis of structural and chemical conditions seen in geriatric patients
• Analyze the radiological findings and how they influence clinical decisions
• Explain Syndrome X and how it affects physiology
• Differentiate trauma and its late effects on the body

• This contains all courses with the educational objectives listed from Geriatrics 103 through 106

Hour 1

• Describe psychoneuroimmunology and its application to clinical diagnosis of geriatric patients
• Apply psychoneuroimmunology to activities of daily living

Hour 2

• Differentiate clinical approaches to managing psychoneuroimmunology
• Measure clinical treatment outcomes

Hour 3

• Relate what factors contribute to this field in the elderly patient
• Incorporate hormonal balancing with nutrition in clinical treatment plans for Chiropractic Patients

• Implement nutrients that promote spinal and joint function to obtain positive clinical outcomes
• Explain Ph., alkalinity and acidity as it impacts the physiology of the body in regards to healing
• Categorize toxins in the environment that create clinical presentations of  geriatric patients clinical care
• Utilize vitamins herbals and supplements to augment patients’ care
• Factor nutritional aspects of protein, fats and carbs into clinical treatment plans to improve healing
• Create treatment goals and nutritional plans

• Assess various treatment modalities
• Implement treatment protocols as found in the latest research
• Progress patients to incorporate wellness into their lifestyle
• Perform postural evaluations and discuss clinical significance to the patient
• Appropriately factor radiographic findings into diagnosis and clinical decision making of the geriatric patient
• Examine physical findings and set specific and measurable patient treatment goals

• Review evidence-based recommendations regarding best practices for chiropractic care of older adults
• Outline the relationship between individual sagittal posture and risk falling in an elderly back pain population
• Explore the cost impact of utilizing chiropractic in older patients with chronic low back pain and multiple comorbidities
• Examine the effectiveness of nonpharmacological therapies for dizziness in older people
• Assess the impact of chiropractic care on measures of sensorimotor function associated with the risk of falls in older adults

• Recognize acute situations for which homeopathic remedies are appropriate and effective
• Apply limited homeopathic remedies to acute care situations that arise in practice and day- to-day life
• Evaluate methods of application of homeopathic remedies to fit the situation at hand
• Distinguish between the available homeopathic remedies for a specific situation in order to select the most appropriate remedy for the individual
• Use homeopathic remedies in concert with existing therapeutic training

Hour 1

• List 3 factors which impact the mechanical properties of fascia
• Recall 3 important functions of fascia
• Cite 3 negative biological effects of fibrosis
• Describe 3 proposed neurophysiological effects of IASTM
• Itemize three biological effects of IASTM

Hour 2

• Cite 8 indications for using IASTM for upper/lower quarter musculoskeletal conditions
• Provide 8 indications for using IASTM for upper/lower quarter musculoskeletal conditions
• Enumerate 8 indications for using IASTM for upper/lower quarter musculoskeletal conditions
• when using IASTM for musculoskeletal disorders.
• List 2 features of IASTM tools and the effect that these features have on the treatment effect (tissue penetration)
• Summarize 5 IASTM basic stroke techniques
• Apply IASTM techniques for over 30 common upper quarter musculoskeletal conditions

Hour 3

• Outline 3 general purposes for using instrument-assisted soft tissue mobilizations (IASTM) for lower quarter musculoskeletal disorders.
• Recall 3 clinical indications for using IASTM to the hip
• State 3 clinical indications for providing IASTM to the lumbar spine
• Present 3 clinical indications for using IASTM for knee-related musculoskeletal disorders
• Itemize 3 clinical conditions of the lower leg and foot for which IASTM would be appropriate

• Acquire additional skill sets in impairment and disability rating
• Develop cognitive interpretive thinking in addressing impairment and disability issues
• Expand the current knowledge base required by the AMA Guides 5th edition

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to apportionment
• Minimize risks and failure risks when addressing the apportionment issue
• Encourage development and nurturing of skill sets risks when addressing the apportionment issue based on evidence-based literature and science
• Identify action steps for minimizing risks when addressing the apportionment issue

• Identify some of the criteria used by formally trained forensic examiners
• Identify certain practices that lead forensic examiners to question the credibility of reports or "IME providers"
• Develop a level of knowledge, comprehension, and understanding of the criteria used by impairment rating reviewers
• Identify certain practices that lead impairment rating reviewers/auditors to question the credibility of reports or raters
• Encourage development and nurturing of skill sets when formulating an impairment rating based on evidence-based literature, science and AMA Guides 5th edition criteria
• Identify action steps for minimizing risks when submitting an impairment rating report

• Identify some of the criteria used by formally trained forensic examiners
• Identify certain practices that lead forensic examiners to question the credibility of reports or "IME providers"
• Develop a level of knowledge, comprehension, and understanding of the criteria used by impairment rating reviewers
• Identify certain practices that lead impairment rating reviewers/auditors to question the credibility of reports or raters
• Encourage development and nurturing of skill sets when formulating an impairment rating based on evidence-based literature, science and AMA Guides 4th edition criteria
• Identify action steps for minimizing risks when submitting an impairment rating report

• Produce accurate impairment rating reports.
• Identify AMA Guides the criteria for CTS
• Develop a level of knowledge, comprehension, and understanding of the criteria used for rating CTS
• Identify certain practices that lead impairment rating reviewers/auditors to question the credibility of reports or raters
• Identify the commonly occurring errors seen in rating impairment due to CTS.

• Develop a level of understanding of the evaluation criteria as it relates to the AMA Guides 5th edition
• Apply skill sets in impairment evaluation
• Interpolate aspects of the AMA Guides to report writing
• Identify the certification available through the American Board of Forensic Professionals

• Define an IME and identify key concepts
• Comment on ideal qualifications of the examiner
• Discuss IME methodology and procedures
• Suggest a generalized report format and quality assurance
• Discuss the job task analysis (ABFP) for the IME process

• Develop an instructional basis for performing IMEs
• Expand current knowledge database pertaining to IMEs
• Identify risks and liabilities that may be encountered by examiners

• Expand the current knowledge base relating to documentation required by the Social Security Administration
• Develop documentation requirements for writing an appeal
• Review regulations of the Social Security Administration

• Define the terminology of decontamination, disinfection and sterilization in a clinical setting.
• Explain the basis of universal precautions and its implementation
• Discuss the latest research and evidence for risk of treatment table contamination in chiropractic and manual therapy offices.
• Learn the recommended evidence based disinfection methods of clinician hands, tables and equipment for manual providers.
• Identify the Spaulding Classification System for disinfection and sterilization of patient care items and equipment.

• Recall and integrate the function of the individual endocrine organs and all hormones into the diagnosis and treatment plan
• Identify the causative factors present in the patient that led to a hormonal imbalance
• Discuss Estrogen Dominance and thus educate the patient
• Diagnose Metabolic Syndrome
• Differentiate Adrenal Fatigue from menopause and perimenopause
• Explain lifestyle modifications to the patient
• Prepare for the intricacies of treating the hormonally imbalanced patient

• Summarize the advantages and disadvantages of salivary hormone testing, its interfering factors and hormones
• Illustrate hormone metabolism and biochemistry, and identify diseases that are associated with hormonal imbalances
• Outline the biochemistry of tryptophan and its metabolites
• Discover salivary adrenal functional assessments and the measurement of cortisol, DHEA and DHEAS
• Discuss nutritional support for women's health and define the action of phytoestrogens, saw palmetto and zinc on hormone balance

• Describe the concept of intersectionality and how it can affect the lives of young black gay and bisexual men
• Identify factors contributing to adverse health outcomes in young black gay and bisexual men
• Summarize special considerations for the care of LGBTQ youth
• Identify strategies that individual providers can use to provide more patient-centered care for LGBTQ youth
• Summarize the current knowledge in scope, clinical presentation, screening and management of eating disorders
• Identify the prevalence of body image dissatisfaction and eating disorders in sexual minority adolescents

• Recognize lumbar disc signs and symptoms.
• Differentiate disc prolapse from disc extrusion.
• Identify anatomical structures related to lumbar disc conditions.
• Describe neuro-muscular physiology as it relates to disc injuries.
• Determine appropriate exam procedures for diagnosing disc conditions.
• Assess static range of motion coupled with cross-plane evaluation.
• Analyze dynamic joint motion using outcome-based assessment tools.
• Interpret manual muscle testing using eccentric break testing protocols.
• Grade muscle tone and discover muscle palpation techniques.
• Interpret neurological tests to determine levels of disc involvement.
• Design treatment plans based on exam findings.
• Apply manual manipulation techniques to address the lumbo-pelvic joint lesions.
• Demonstrate manual methods to reduce abdominal and pelvic muscular dysfunction.
• Create new muscle memory patterns to correct chronic conditions.
• Compare pre- and post- treatment findings to support care plans.

• Discuss different types of lumbar stretching and their effects.
• Define therapeutic stretching goals, protocols and precautions for the lumbar spine.
• Measure lumbar pain, agility and joint crepitus associated with therapeutic stretching.
• Apply lumbo-pelvic circumduction training to improve disc related joint mobility.
• Integrate PreActive therapeutic stretching techniques to reduce lumbo-pelvic muscle tension.
• Devise strengthening protocols for the lumbo-pelvic region using graduated isometric protocols.
• Discuss mobility during lumbar traction to reduce disc pressure.
• Compare static traction versus dynamic traction.
• Define contra-indications for decompression therapy of the lumbar spine.
• Apply appropriate lumbar decompression therapy to various patient populations.
• Demonstrate lumbar mobility training exercises used to enhance decompression effectiveness.
• Justify reimbursement through accurate documentation of lumbar disc treatment progression.
• Diagnose lumbar disc conditions with clarity.
• Select outcome-based assessment tools to monitor patient progress.
• Illustrate lumbar range of motion and muscle testing deficiencies concisely.
• Summarize patient status for lumbar mobility, crepitus and pain intensity.

• Recognize concussion signs and symptoms.
• Differentiate concussion grades.
• Identify anatomical structures related to concussions.
• Describe pathophysiology as it relates to concussions.
• Determine appropriate exam procedures for diagnosing concussions.
• Apply diagnostic skills to on-field and clinic settings.
• Interpret diagnostic tests to evaluate concussion progress.
• Design treatment plans based on exam findings.
• Demonstrate manual manipulation techniques to address concussion symptoms.
• Compare pre- and post-treatment findings to support care plans.

• Discuss neurophysiology of musculoskeletal dysfunction.
• Create new memory patterns to restore neuromascular integration.
• Demonstrate manual methods to reduce muscular dysfunction.
• Address cranial nerve lesions with manipulation techniques.
• Introduce the half-somersault maneuver for vertigo relief.

• Recognize cervical disc signs and symptoms.
• Differentiate disc prolapse from disc extrusion.
• Identify anatomical structures related to cervical disc conditions.
• Describe neuro-muscular physiology as it relates to disc injuries.
• Determine appropriate exam procedures for diagnosing disc conditions.
• Assess static range of motion coupled with cross-plane evaluation.
• Analyze dynamic joint motion using outcome-based assessment tools.
• Interpret manual muscle testing using eccentric break testing protocols.
• Develop muscle palpation skills and grade muscle tonicity.
• Interpret neurological tests to determine levels of disc involvement.
• Design treatment plans based on exam findings.
• Apply manual manipulation techniques to address the cervical joint lesions.
• Demonstrate manual methods to reduce cervical muscular dysfunction.
• Create new muscle memory patterns to correct chronic conditions.
• Compare pre- and post-treatment findings to support care plans.

• This contains all courses with the educational objectives listed from Management of Common Conditions 204 through Management of Common Conditions 209

• Discuss different types of cervical stretching and their effects.
• Define therapeutic stretching goals, protocols and precautions for the cervical spine.
• Measure cervical pain, agility and joint crepitus associated with therapeutic stretching.
• Integrate PreActive therapeutic stretching techniques to reduce cervical muscle tension and improve disc related joint mobility.
• Devise strengthening protocols for the cervical region using graduated isometric protocols.
• Discuss cervical mobility during traction to reduce disc pressure.
• Compare static traction versus dynamic traction of the cervical spine.
• Define contra-indications for cervical decompression therapy.
• Apply appropriate cervical decompression therapy to various patient populations.
• Demonstrate cervical mobility training exercises used to enhance decompression effectiveness.
• Justify reimbursement through accurate documentation of cervical disc treatment progression.
• Diagnose cervical disc conditions with clarity.
• Select outcome-based assessment tools to monitor patient progress for cervical conditions.
• Illustrate cervical range of motion and muscle testing deficiencies concisely.
• Summarize patient status for cervical mobility, crepitus and pain intensity.

• Summarize the relationship between glenohumeral internal rotation deficit (GIRD), SLAP tears, posterior impingement, scapula dyskinesis and shoulder micro-instability
• Effectively diagnose SLAP tears, posterior impingement, scapula dyskinesis and shoulder mico-instability using screening and clinical tests.
• Cite common pitching pathomechanics and describe their association with specific elbow injuries.
• Paraphrase the peel back model for SLAP tears
• Relate proper pitching biomechanics with injury prevention strategies for the adolescent overhead athlete

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

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

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

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

Hour 1

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

Hour 2

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

Hour 3

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

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

Hour 1

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

Hour 2

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

Hour 3

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

Hour 1

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

Hour 2

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

Hour 3

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

Hour 1

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

Hour 2

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

Hour 3

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

Hour 1

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

Hour 2

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

Hour 3

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

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

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

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

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

• This contains all courses with the educational objectives listed from Manipulation 103 through Manipulation 114

• Determine the effect of chiropractic on movement time
• Assess the effects of spinal manipulation and ultrasound on chronic low back pain
• Describe heart rate variability as a measurement tool
• Assess the effects of chiropractic on heart rate variability

• Determine the effect of thoracic spine manipulation on autonomic output to the heart
• Review criteria for the diagnosis of cervicogenic headaches
• Describe a clinical assessment for cervicogenic headaches
• Assess the effects of chiropractic and spinal manipulation on cervicogenic headaches

• Describe spinal manipulation use by time, place, and person, identify predictors of the use of spinal manipulation
• Review cost-effectiveness of SMT compared to other treatment options for people with spinal pain of any duration
• Describe the current literature on patient-centered outcomes following a specific type of commonly used SM, high-velocity low-amplitude (HVLA), in patients with LBP
• Review the putative mechanical features of the subluxation and three theories that form the foundation for much of chiropractic practice

• Provide an overview of research on the effects of spinal manipulation on sensory processing, motor output, functional performance and sensorimotor integration
• Examine performance based outcome measures used in an attempt to objectively measure the ramifications of spinal manipulation
• Update knowledge regarding several physical characteristics of an applied SMT, and review what is known about the signaling characteristics of sensory neurons innervating the vertebral column in response to spinal manipulation
• Review the physiological evidence that spinal manipulation can impact visceral function

• Outline the limitations of a recent trial on preventive treatments including spinal manipulation for neck pain and how they contribute to our interpretation of the results of the study
• Interpret results of an important trial on spinal manipulation and exercise for neck pain
• Discuss recent evidence comparing spinal manipulation to mobilization for recent onset neck pain
• Use recent evidence to justify manipulating various spinal regions for patients with neck pain
• Critique the potential for chest and neck mobilizations to affect spirometric performance (breathing)

• Contrast Clinical Guideline-based care with usual medical care for acute low back pain
• Recognize the potential benefit of adding exercise prescription to spinal manipulation for low back pain
• Compare the effectiveness of spinal manipulation to McKenzie Method interventions for persistent low back pain
• Outline factors that may help predict improvement in patients seeking chiropractic care for low back pain
• Explain the benefits of evidence-based care for low back pain

• Compare the efficacy of standard medical care (SMC) alone versus chiropractic spinal manipulation + SMC for acute low back pain patients
• Discuss the value of a combined (pragmatic) chiropractic approach for treating low back pain
• Analyze the state of the research literature directly comparing spinal manipulation, exercise and acupuncture as treatments for low back pain
• Update your understanding of joint cavitation during side posture lumbar manipulation
• Critique the only study (to date) on maintenance care for low back pain including spinal manipulation

• Develop evidence-based chiropractic treatment recommendations for nonspecific (mechanical) neck pain in adults
• Discuss the clinical criteria justifying spinal manipulative therapy for neck pain
• Assess the relative effectiveness of spinal manipulative therapy and rehabilitative exercise for neck pain in seniors
• Describe the working mechanism of manual therapy in participants with chronic tension-type headache
• Examine the cerebrovascular hemodynamic response of cervical spine positions using MRI on the vertebral artery

• Critique the state of the evidence for manual therapy interventions in the treatment of cervical radiculopathy
• Compare two common interventions – spinal manipulation and nerve root injection – for patients with MRI-confirmed lumbar disc herniation
• Critique the state of the evidence for spinal manipulation (specifically) in the treatment of cervical radiculopathy
• Interpret the results of a cohort study of MRI-confirmed symptomatic cervical disc herniation patients treated with cervical manipulation
• Compare isolated cervical SMT versus a combination of cervical, cervico-thoracic and thoracic SMT in patients with chronic mechanical neck pain

• Describe the science behind chiropractic care
• Translate the intent of manipulative therapy to patients and other healthcare providers
• Describe the potential results of not having recommended chiropractic care
• Outline the different theories of the subluxation complex
• Justify the care you recommend based on electrodiagnostic, imaging, and laboratory studies

• Define the basic principles of MRI imaging as it relates to the musculoskeletal system.
• Summarize current criteria utilized to identify Lumbar pathology and the appropriate lexicon utilized in neuroradiology to assist the Doctor of Chiropractic in interpreting studies ordered.
• Identify normal anatomy of the lumbar spine on MRI images.
• Differentiate gross pathology associated with the most common MRI presentations associated with general Chiropractic practice.
• Assess the necessity of MRI imaging for lumbar pathology, with an understanding of the pathophysiology of the degenerative process associated with lumbar spine aging

• Demonstrate skills to properly perform a patient interview
• Properly record a chief complaint
• Perform a neurological examination of the head and neck
• Perform a mental status examination

• This course contains all content from Neurological Exam 101 through 107. Please see educational objectives for those courses

• Cite anatomy and function of the cranial nerves
• Examine the twelve cranial nerves during a clinical examination
• Discuss disorders of cranial nerves

• Perform and chart a neurological examination of the voluntary motor system and the somatic sensory system
• Apply results of the examination findings in the differential diagnosis of patients
• Describe the three neuron pathway involved with sensorineural innervation
• Discuss multimodal sensations

• Perform an appropriate examination of the reflexes, including deep tendon, superficial, visceral and pathological reflexes
• Describe the anatomy associated with reflexes
• Properly grade and record reflexes
• Interpret the Results of Reflex Testing

• Perform an examination of the systems involved with Movement and Coordination
• Discuss cerebellar anatomy
• Differentially Diagnose by applying clinical signs of cerebellar dysfunction
• Recognize cerebellar syndromes by their anatomical areas
• Apply specific principles of examination to improve the Chiropractic Spinal Examination
• Describe specific procedures of the spinal examination

• Perform a clinical assessment of pain and function
• Explain the psychophysiological profile of pain patients
• Discuss the treatment of pain

• Maintain proper records of neurological examination in the SOAP format
• Write narrative reports reflecting the neurological examination
• Apply an outline of fundamental procedures in performing a complete chiropractic neurological examination

• Identify the neurological aspects of manipulation
• Review the basics of cellular physiology as it relates to manipulation
• Discuss action potentials and synapses
• Evolve an understanding of receptors
• Describe nociception and effects of manipulation

• Further elucidate the neurological aspects of manipulation
• Discuss nociceptive input to the spinal cord
• Review mechanoreceptors and their fibers
• Identify the relationship of mechanoreceptors with endorphin/enkephalin
• Analyze the history of referred pain patterns

• Describe axonal degeneration in inflammatory neuropathy
• Construct criteria for diagnosis of multiple sclerosis
• Discuss the use of antioxidant therapy in neurologic disease
• Review the sensory innervation of the SI joint
• Identify mechanoreceptor control of shoulder musculature

• Evaluate the basics of nerve conduction
• Comment on recording action potentials
• Review NCV/EMG recording issues
• Identify the diagnostic usefulness of H-reflex and F-response
• Construct differential diagnosis with Nerve Conduction

• Define the use of Co-Enzyme Q as preventive treatment for migraines
• Discuss the modular headache theory
• Describe the neurovascular aspects of cluster headaches
• Identify the nutritional etiology of headache and ataxia
• Review the relationship of migraines and menstruation

• Describe the effect of chiropractic on motor control
• Discuss theories of how movements are chosen
• Discuss how movements are sequenced, and skills are learned
• Develop a motor control examination for your practice
• Distinguish components of the motor assessment

• Describe an approach to the assessment and diagnosis of functional symptoms in neurology
• Outline an approach to the management of functional symptoms in neurology
• Discuss concepts in neuropathic pain

• Explore current understanding of pain concepts, physiology and theories behind neuropathic pain
• Discuss in detail the relevant neurological anatomy and functional neurology
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to pain receptors and neural integration
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to neural plasticity, articular neurology, and mechanisms of pain

• Explore current understanding of pain concepts, physiology and theories behind neuropathic pain and allodynia
• Discuss the importance of the neurological implications of a nerve injury
• Describe mechanisms of neural plasticity
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to neural plasticity, articular neurology, and mechanisms of pain

• Summarize the anatomy and hemodynamics of the upper cervical spine and brain
• Discuss the nature of the pathophysiological changes common in arterial dissection
• Outline the various forms and limitations of the bedside examination and laboratory tests and diagnostic imaging
• Develop criteria for necessity of evaluation procedures (physical, orthopedic, neurologic)
• Justify the development and significance of recognition and management of vascular accidents
• Integrate current considerations regarding risk factors and therapeutic intervention

• Discuss common conditions that are associated with neuropathy
• Identify presenting signs and symptoms in patients that would lead to examination for neuropathy
• Differentiate different conditions that can present with signs and symptoms similar to neuropathy
• Measure and interpret blood chemistries to demine the possible cause of neuropathy in a patient
• Prepare a comprehensive diagnostic and management strategy for patients with neuropathy
• Comprehend and be able to assess relative to neuropathy, drug-nutrient interactions in patients
• Breakdown possible contributions of poly-pharmacy to the development and or maintenance of the neuropathic condition in their patients
• Appraise risk factors for complications such as neuropathy and diabetic ulcers in patients with elevated blood sugar
• Order and interpret neuropathy screening tests for patients with symptoms of neuropathy
• Devise a strategy to reduce risk factors of neuropathy and translate this strategy into a treatment plan for the patient
• Choose and apply biomarker lab tests to manage patients with neuropathy
• Provide basic interpretation of  nerve conduction and EMG findings for patients
• Discuss the use of medications in neuropathy and explain their  mechanisms  of action
• Advise patients on possible side effects of neuropathy medications
• Use Tinel's Sign as a diagnostic procedure and translate these findings into optimal location for therapy in neuropathy patients

• This contains all courses with the educational objectives listed from Neurology 115 through Neurology 116

• Contrast historical versus neuroanatomical theories of acupuncture
• Describe the 4 basic mechanisms of acupuncture analgesia.
• Identify and utilize the local, segmental and central effects of acupuncture for neuropathy pain control
• Combine nutraceutical substances that may enhance the effectiveness of acupuncture
• Prepare a comprehensive acupuncture point prescription for maximum analgesic effects in patients suffering from neuropathy 
• Contrast real versus placebo acupuncture and discuss the pitfalls in placebo controlled trials
• Utilized knowledge of the effects of acupuncture on GABA, Glutamate & 5HTP to maximize acupuncture analgesia in neuropathy patients
• Utilize basic pharmacognosy to support and enhance the neurotransmitter effects of acupuncture
• Apply sensory stimulation techniques to promote Neurotrophic factors in nerve repair and regeneration
• Apply the basic science of acupuncture as a bridge to non-invasive neuromodulation in neuropathy patients

• This contains all courses with the educational objectives listed from Neurology 116 through Neurology 124

• Relate the effects of voltage gated sodium and calcium channels to the development of neuropathy
• Draw the pathways specific of TRPs, NaV 1.8 and CaV 3.2 ion channels in the nervous system
• Understand the application of selective NaV 1.8 and CaV 3.2 channel blockers in patients with neuropathy
• Discuss basic science research that links ion channels with the signs and symptoms of neuropathy
• Utilize the neurobiology of the Rubber Hand phenomena to treat patients with peripheral neuropathy.
• Discuss various ion channels and their roles in neuron hyper-excitability related to neuropathy
• Utilize natural substances that modulate ions channels related to neuropathy
• Differentiate the roles of Protein Kinase C and Aldose Reductase  in neuropathy
• Identify potential signaling pathways that are targets of neuromodulation through natural substances
• Prepare a comprehensive natural-substance management strategy for patients with neuropathy

• This contains all courses with the educational objectives listed from Neurology 117 through Neurology 121

• Discuss how insulin signaling abnormalities can directly and indirectly contribute to neuropathy
• Utilize natural substances that modulate insulin signaling pathways
• Differentiate the roles of Endocannabinoid receptors in pain processing versus recreation “High”
• Create a strategy to modulation Endocannabinoids receptors with legal natural substances for pain relief
• Understand the role of Nerve Growth Factors (NGF) in the development of symptoms of neuropathy and also the role of NGF promoting natural substances which may stimulate repair and regeneration.

• Utilize natural substances as neurotransmitter based treatments for neuropathy.
• Identify GABA modulating substances and their effects on GABA metabolism and GABA receptors
• Utilize natural substances that modulate Glutamate metabolism and receptors
• Differentiate the roles of GABA, Glutamate and Glycine receptors in pain processing
• Create a strategy to modulation neurotransmitter receptors using natural substances for pain relief

• Compared and contrast usual transcutaneous nerve stimulation techniques (TENs) with techniques of non-invasive neuromodulation using High Voltage Pulsed Galvanic stimulation
• Identify the anatomical location of electrode placement for central and peripheral non-invasive neuromodulation techniques
• Differentiate various forms of peripheral versus central non-invasive neuromodulation techniques
• Discuss the theory of application and be able to apply techniques of non-invasive neuromodulation in practice.
• Create a strategy for neuromodulation of the patient suffering from neuropathy
• Identify appropriate choices of non-invasive neuromodulation techniques for a patient suffering from neuropathy.
• Breakdown risk versus benefits of neuromodulation and be able to discuss them with the patient suffering from neuropathy
• Appraise a neuropathy patient and construct a comprehensive neuropathy treatment plan which includes non-invasive neuromodulation techniques
• Breakdown and discuss the investigational nature of non-invasive neuromodulation techniques and understand the importance of obtaining written informed consent before proceeding with non-invasive neuromodulation in neuropathy patients
• Comprehend the basic electronics of non-invasive neuromodulation techniques.

• Discuss stimulation parameters for using High Voltage Galvanic stimulation for neuromodulation
• Identify optimal ranges for pulse-width, milli-AMPs, phase and other parameters of electrical stimulation
• Differentiate and choose optimal types of electrical stimulation (TENS vs. HVG) for clinician applications
• Draw out the neuro-anatomical pathways of vagal nerve stimulation and use this information to guide appropriate use of vagal nerve stimulation in clinical practice
• Discuss the investigational nature of tVNS, potential risk-benefits, with patients and construct a treatment plan using tVNS with a properly informed and consenting patient.

• Understand the differences and similarities between TENs, low voltage and high voltage galvanic and be able to use this knowledge to select the most appropriate type to stimulation for use in ts-DC applications
• Apply precautions, other safety considerations and informed consent when administering high voltage galvanic stimulation for non-invasive spinal cord stimulation.
• Craft evidence-based treatment strategies using ts-DC stimulation for pain control and modulation of both ascending sensory and descending motor pathways based on recently published literature on central nervous systems effects of direct current stimulation.
• Be able to select optimal electrode placement for ts-DC based on clinical presentation of the patient
• Understand the basic technique for non-invasive Stellate Ganglion transcutaneous stimulation and its possible application for sympathetic maintained pain.

• Discuss the history of GVS and the historic use of GVS as diagnostic procedure.
• Identify the effects of GVS on the nervous system and use this information to construct an effective clinical protocol for his/her patient
• Apply GVS as an adjunct procedure to assist in balance rehabilitation.
• Understand and apply GVS as part of a comprehensive strategy for the treatment of neuropathic pain syndromes.
• Create a treatment protocol in terms of electrode placement, intensity, duration and precautions for the use of GVS in clinical practice.

• Communicate the risks, potential benefits and the investigational nature of tDC with a potential patient for the purpose of securing a written informed consent prior to treatment
• Understand the similarities and differences between low voltage direct current and high voltage pulsed galvanic and how to apply knowledge of their polarity specific effects in clinical neuromodulation
• Identify brain targets for neuromodulation and construct a therapeutic electrode montage, treatment protocol in terms of intensity, duration, frequency and dose of tDC 
• Explain the theory of tDC as it relates to pain modulation based on contemporaneous scientific literature
• Apply tDC  as an adjunct procedure to assist in intractable pain relief

• Compared and contrast galvanic vestibular stimulation and Tone Burst Vestibular Stimulation in the treatment of the balance impaired patient.
• Apply the polarity specific effects of the anode and cathode on the vestibular system for amelioration of common balance impairments.
• Identify the anatomical location of electrode placement for Galvanic Vestibular Stimulation.
• Create a treatment strategy using Tone Bursts based on physiological pairing of semicircular canals.
• Apply Specific Tone Protocols based on Saccule versus Utricle dysfunction in balance impaired patients.

• Recognize Traumatic Brain Injury (TBI) in your chiropractic patients
• Summarize the prevalence in your patient population
• Identify the type of patient that presents with TBI
• Explain why a chiropractor needs to differential diagnose TBI patients
• Compile correlations of TBI inciting factors with your patient presentations
• Demonstrate the pathology that occurs with TBI
• Classify the grades of TBI and discriminate what can be treated conservatively
• Identify the incidence of injuries that commonly cause TBI
• Evaluate the probability of TBI in your patient
• Describe the many different types of evaluations, in the field, in the office and upon referral
• Implement in-office Screening Tools and apply diagnostic criteria
• Identify the risk of post-concussive syndrome
• Detect patients with “Brain Cognitive Reserve”
• Identify Second Impact Syndrome
• Assess the value of MRI
• Identify Chronic Traumatic Encephalopathy
• Integrate the current concepts of conservative treatment
• Design Cognitive Rehab
• Provide appropriate patient advice, treatment or referral options

Hour 1 - 5

• Recognize Traumatic Brain Injury (TBI) in your chiropractic patients
• Summarize the prevalence in your patient population
• Identify the type of patient that presents with TBI
• Explain why a chiropractor needs to differential diagnose TBI patients
• Compile correlations of TBI inciting factors with your patient presentations
• Demonstrate the pathology that occurs with TBI
• Classify the grades of TBI and discriminate what can be treated conservatively
• Identify the incidence of injuries that commonly cause TBI
• Evaluate the probability of TBI in your patient
• Describe the many different types of evaluations, in the field, in the office and upon referral
• Implement in-office Screening Tools and apply diagnostic criteria
• Identify the risk of post-concussive syndrome
• Detect patients with “Brain Cognitive Reserve”
• Identify Second Impact Syndrome
• Assess the value of MRI
• Identify Chronic Traumatic Encephalopathy
• Integrate the current concepts of conservative treatment
• Design Cognitive Rehab
• Provide appropriate patient advice, treatment or referral options

Hour 6

• Define the trophic model
• Describe the pathology of trophic model to your patients
• Apply the trophic model of subluxation into clinical practice
• Detect signs & symptoms that correlate with the trophic model
• Extrapolate the model to patient care, especially maintenance manipulative therapy.

• Define the trophic model
• Describe the pathology of trophic model to your patients
• Apply the trophic model of subluxation into clinical practice
• Detect signs & symptoms that correlate with the trophic model
• Extrapolate the model to patient care, especially maintenance manipulative therapy.

Hour 1

• Identify and recite all components of the neurological examination 
• Outline basic peripheral and central nervous system pathways that are clinically relevant to the bedside (ambulatory) neurological examination.
• Perform an examination of the cranial nerve and somatic motor system, including aspects of strength, tone and volume.

Hour 2

• Perform an examination of the cranial nerve and somatic sensory system, including sensory testing of deep and superficial CNS pathways.
• Perform an examination of the reflex system, including testing of deep, superficial, visceral and pathological reflexes.

Hour 3

• Perform an examination of the movement, balance and coordination systems, including tests of cerebellar function.
• Demonstrate an examination flow and performing tests taking the patient from sitting to standing, to the supine and prone positions.
• Summarize implications of neurological findings for lesions in various parts of the central nervous system.
• Summarize implications of neurological findings for lesions in various parts of the peripheral nervous system.

• Identify the domains of and concepts within motor control
• Outline some research on chiropractic's influence on motor control
• Discuss principles of motor control and rehabilitation applied to practice

• Discuss briefly the relevant brain anatomy and functional neurology with focus on the frontal lobe and motor cortex.
• Describe the anatomy and physiology of the human brain cortex as it relates to the basic tenants of chiropractic and to spinal subluxation.
• Identify key anatomical components of the frontal lobe and motor cortex.
• Discuss some of the pioneers in neuroscience underscoring their individual contributions.
• Draw basic neurological pathways associated with the frontal lobe and motor cortex.
• Relate function of the frontal lobe and motor cortex to various associated disease conditions.

• This allows you to purchase all 12 hours of 201 level courses. Please see the educational objectives listed for each individual 201 module

• Explore current role of the art and science of clinical neurology for the chiropractor
• Discuss briefly the relevant neurological anatomy and functional neurology
• Describe in detail the anatomy and function of the components of the human skull with attention to aspects which may be important to the chiropractic physician
• Explore the current role of clinical neurology for the practicing chiropractor
• Describe in detail the anatomy and function of the components of the human spine with attention to aspects which may be important to the chiropractic physician

• Explore current role of the art and science of clinical neurology for the chiropractor
• Discuss relevant neurological anatomy of the central nervous system, exclusive of the cortex
• Summarize relevant functional neurology of the central nervous system exclusive of the cortex
• Illustrate the clinical presentation resulting from disease of the various brain and cord areas
• Outline various categories for spinal cord lesions
• Organize findings of central nervous system disease by anatomical location and clinical presentation

• Observe a doctor patient encounter where the patient is a paraplegic
• Explore the relevant issues and action protocols involved in acute spinal cord disease
• Evaluate relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis
• Summarize relevant functional neurology of the spinal cord

• Explore current role of the art and science of clinical neurology for the chiropractor
• Discuss relevant neurological anatomy of the spinal cord
• Summarize relevant functional neurology of the spinal cord
• Illustrate the clinical presentation resulting from disease of the various cord areas
• Outline various categories for spinal cord lesions
• Organize findings of spinal cord disease by anatomical location and clinical presentation

• Discuss relevant neurological anatomy and function of the meninges
• Discuss relevant neurological anatomy and function of the arterial and venous CNS circulation
• Discuss relevant neurological anatomy and function of the cerebrospinal fluid (CSF) circulation
• Illustrate the clinical presentation resulting from disease of the various areas
• Outline various categories for vascular CNS lesions
• Utilize a Grand Rounds type case presentation

• Properly record a chief complaint
• Demonstrate skills to properly perform a patient interview
• Perform a neurological examination of the head and neck
• Perform a mental status examination
• Cite anatomy and function of the cranial nerves
• Examine the twelve cranial nerves during a clinical examination
• Discuss disorders of cranial nerves
• Discuss, in detail, aspects of neural ischemia and Cervical Spinal Manipulation
• Overview cerebrovascular anatomy and hemodynamics
• Describe pathophyiological mechanisms in vascular injuries
• Clinically test a patient to evaluate predisposition
• Recognize postadjustment vertebrobasilar insufficiency and review case studies

• This allows you to purchase all 26 hours of 202 level courses. Please see the educational objectives listed for each individual 202 module