Hawaii Chiropractic Continuing Education

• Defend the implementation of a gluten free diet in celiac and non-celiac gluten sensitive patients based on sound evidence from current literature
• Document reasons why a first-degree relative of a known celiac should be gluten-free
• Summarize the current rate of celiac diagnosis in the US
• Contrast the expected findings of a celiac patient and non-celiac gluten intolerant patient
• Recognize that neurological signs can result from gluten intolerance

• Identify which supplements are commonly used in exercise and sport
• Determine the benefits and risks of individual ergogenic aids
• Discuss the role that individual vitamins have in exercise and sport
• Examine the role that individual minerals have in exercise and sport
• Investigate the value of sport drinks
• Ascertain when fluids are most beneficial in sport
• Apply how exercise effects the immune system
• Review the positive and negative effects of exercise
• Identify the role of antioxidants in sport and exercise

• Summarize the bowel protective mechanisms and their role in health and disease
• Outline a treatment strategy for imbalanced gut flora/leaky gut
• Identify common food allergies and determine appropriate nutritional therapy
• Examine the role of fiber in gastrointestinal health
• Create a treatment plan for common GI complaints of constipation and diarrhea
• Determine appropriate nutritional treatments for ulcers
• Theorize how diet can affect Inflammatory bowel disease
• Understand how to successfully use nutrition to treat a variety of gastrointestinal disorders
• Comprehend a rationale treatment protocol for Irritable bowel syndrome
• Determine correct doses of supplements used for various gastrointestinal disorders
• Ascertain the safety and risks associated with commonly prescribed gastrointestinal supplements

• Identify which supplements are commonly used in exercise and sport
• Ascertain the rationale of using specific individual sport supplements
• Differentiate between fact and fiction of the supplement in relation to sport and exercise
• Determine the practical use in sport for individual supplements
• Determine the benefits of individual ergogenic supplements
• Examine the risks associated with individual supplements
• Investigate the value of specific supplements via studies
• Define contraindications and interactions with the supplement
• Recommend the correct dose of the supplement for sport and exercise

• Identify various energy systems of the body and how they relate to exercise and sport
• Theorize which energy system is used for a specific sport event/activity
• Summarize the physiology of fat, protein and carbohydrate metabolism and utilization in exercise and sport
• Understand the relationship between the energy systems and various exercise parameters
• Create a diet protocol for the athlete prior to their sport or exercise activity
• Determine and understand the timing of meals in exercise and sport
• Outline a useful program for a person to maximize carbohydrate stores
• Theorize how glycemic index can affect exercise and sport activity
• Ascertain differences between food variables and how they affect exercise and sport performance

• Review nutritional supplements useful for weight loss.
• Discuss the research for conjugated linoleic acid for weight loss.
• Outline the associations between thyroid function and weight loss.
• Summarize dietary supplements that increase thermogenesis.

• Differentiate various nutrition assessment techniques.
• Determine which body fat/composition technique is most appropriate for the individual.
• Calculate essential measurements for weight loss patients.

• Appraise the reviewed research studies for salient elements of bias.
• Describe the sensitivity and specificity of common food sensitivity tests.
• Identify the effect of common natural interventions for IBS.
• Compare results of the low FODMAP diet to conventional dietary approach for IBS.
• Differentiate between clinical and statistical significance in natural medicine interventions for IBS
• Grade the magnitude of effect size for natural medicine interventions.
• Interpret the effect size of an intervention as it relates to the numbers needed to treat for benefit.
• Identify the risk of bias level for studies included in a systematic review on yoga for IBS.

• Discuss the role of diet in causing and preventing various diseases, particularly chronic diseases.
• Describe methods used to assess nutrition status.
• Explain how dietary recommendations are formulated.
• Incorporate nutritional information into clinical practice and advise patients about eating for optimum health as well as using dietary change as a therapeutic intervention
• Evaluate the benefits and risks of nutritional recommendations for specific health conditions through an analysis of the existing scientific and clinical evidence

Hour 1 - 3

• Discuss the role of diet in causing and preventing various diseases, particularly chronic diseases.
• Describe methods used to assess nutrition status.
• Explain how dietary recommendations are formulated.
• Incorporate nutritional information into clinical practice and advise patients about eating for optimum health as well as using dietary change as a therapeutic intervention
• Evaluate the benefits and risks of nutritional recommendations for specific health conditions through an analysis of the existing scientific and clinical evidence

Hour 4

• Investigate the importance of nutrient deficiencies
• Review the role of essential nutrients in human health
• Analyze the interaction between nutrients and various illnesses
• Ascertain the role herbs have in health and disease
• Understand drug and nutrient interactions

• Investigate the importance of nutrient deficiencies
• Review the role of essential nutrients in human health
• Analyze the interaction between nutrients and various illnesses
• Ascertain the role herbs have in health and disease
• Understand drug and nutrient interactions

• This contains all courses with the educational objectives listed in Nutrition 147 through 157

• Review the clinical presentation of Diabetes
• Examine the role of nutrition and diet in Diabetes
• Design an appropriate supplement protocol for the diabetic patient
• Develop nutritional guidelines for hypoglycemia

• This contains all courses with the educational objectives listed from Nutrition 148 through 154

• Identify sources and functions of carbohydrates, proteins, fats, alcohol, vitamins, minerals, and water in the human body.
• Demonstrate the importance of a balanced diet and use tools that can be utilized to evaluate the nutritional adequacy of a diet (RDA, Dietary Guidelines, MyPlate, etc.).
• Identify the relationship between diet and chronic diseases/illnesses (cardiovascular disease, diabetes, obesity, cancer, hypertension, osteoporosis, etc.) and what modifications can be made in the diet to reduce the risk for these diseases/illnesses.
• Recall current nutritional recommendations for healthy eating habits (American Heart Association, American Cancer Society, etc.).
• Utilize nutrition terminology and related terminology appropriately.
• Demonstrate lifelong healthful eating habits by differentiating between beneficial and non-beneficial dietary practices.
• Develop nutritional scripts for 10 of the most common adult pathologies that can be potentially palliative or reverses through dietary changes.

• Understand the relationship between BPH and nutrition/supplements
• Develop a nutrition treatment program for UTI's
• Design a nutrition therapy program for kidney stones and gallstones
• Explore the relationship between diet and hyperestrogenism and its related diseases such as PMS and FBD
• Outline a nutrition treatment program for menopause

• Analyze the relationship between tendonitis/bursitis and nutrition
• Identify the nutritional treatment of muscle cramps/leg cramps and soreness
• Discuss nutrition treatment for Muscular dystrophy
• Determine an appropriate nutrition treatment for Fibromyalgia

• Identify the etiology and pathology of arthritis.
• Outline a diet that is helpful in the treatment of arthritis.
• Apply specific supplements to an arthritic condition.

• Review the risk factors and mechanisms of heart disease.
• Identify the parts of a proper diet to prevent heart disease.
• Evaluate various supplements that are beneficial in prevention and treatment of heart disease.

• Recall various foods with high amounts of Flavonoids and briefly relate their impact health
• Indicate the basic chemical structural similarities and differences of Flavonoids
• Relate potential benefits of combining Flavonoids, and ways of improving their bioavailability and efficacy
• Explain why some Flavonoids may be effective according to their chemical structure, specifically in a study for neuroprotection
• Discuss Flavonoid use and neuromuscular treatment considerations
• Integrate knowledge of Flavonoids and biochemical pathways to prescribe individualized nutrition treatments to your patients and appreciate the potential for overprescribing too many competing herbs
• Examine and demonstrate how and why Green Tea extract may play an inclusive role in health

• This contains all courses with the educational objectives listed in Nutrition 157 and 158

• Quantify the prevalence rates of patients using opioids and herbal products
• Demonstrate the significance to the chiropractor of interactions between different herbs and common prescription drugs
• Discuss the at risk populations for interactions including the pregnant, and elderly populations
• Record and list the most common interactions of common food and herbal products
• Record and list the effects of the common interactions of common heart medication and herbal products
• Demonstrate evidence that supports the use of health care providers assessing patients for these interactions.
• Discuss the role of the chiropractor in the role of identifying these interactions.
• Illustrate several books, and smart phone based electronic applications to make the process of identification easier for a chiropractor and patient.
• Evaluate common case scenarios

Hour 1: Evolutionary Biology Influence on Clinical Physiology

• Discuss infection, evolution, immunity, inflammation, and fibrosis.
• Compare short-term survival v. long-term chronicity.

 Hour 2: Summarize Inflammation in both Pain and Disease

• Utilize Laboratory diagnosis of inflammation.
• Provide Nutritional management for inflammation.

Hour 3: Justification of Sleep Hygiene

• Explain the role for sleep and sleep’s influence on immunity, cognition, psychiatric conditions, hunger, fertility, blood sugar control, vascular health, and more.
• Summarize the influence of sleep on brain neurochemistry.

Hour 4: Define the Recently Discovered Glymphatic System

• Discuss the glymphatic system and how to optimize its influence on health.
• Emphasize the importance of the glymphatic system in relation to neurodegenerative diseases.

Hour 5: Point out the Role of Vitamins for Chronic Disease Prevention

• Emphasize the importance of B vitamins to lower homocysteine.
• Point out the relationship between elevated homocysteine and vascular injury risks.
• Justify why people need between 5-8 different supplements and explain why.

Hour 6: Analyze the Science of a Healthy Diet

• Justify high vegetable, low lectin, low glycemic dietary habits, and their influence on physiology.
• Summarize problems with refined carbohydrates, monosodium glutamate, aspartame, and chemical toxins.
• Explain the drivers and consequences of a leaky gut.
• Demonstrate glycation and its consequences.
• Explore the benefits of Intermittent Fasting

Hour 7: Appraise Chiropractic Clinical Practice and Pain Management

• Integrate the Gate Theory of Pain and the Chiropractic Adjustment
• Quantify the Opioids Epidemic and the Positive Influence of Chiropractic
• Diagram the importance of the omega-6 / omega-3 ratio
• Caution Against the Ingestion of Excitotoxins

Hour 8: Detail the Benefits of Exercise

• Emphasize the Benefits of High Intensity Interval Training.
• Introduce the Harmful Effects of Fructose on Energy Production

• Discuss the Nutritional Aspect of effect size of red meat reduction
• Discuss the importance of the GRADE evidence evaluation method.
• Explain the Nutritional importance of the choice of the red meat reduction target
• Summarize the multiple lines of evidence supporting the guideline recommendation.

• Define very low carb (ketogenic), low carb, and moderate carbohydrate diets
• Describe the proposed mechanism of how low carbohydrate diets may improve outcomes
• Summarize the evidence supporting low and very low carbohydrate diets in diabetes management
• Critique the arguments for the long-term use of ketogenic diets

• Understand the importance of normal bowl defense mechanisms
• Develop a nutritional treatment for candidiasis and gut flora imbalances
• Examine the importance of fiber on human health
• Design a nutritional treatment program for constipation and diarrhea

• Identify different types of natural anti-inflammatories.
• Determine which anti-inflammatory is best for a particular patient.
• Develop an anti-inflammatory diet.
• Examine the concept of health and aging
• Determine an appropriate lifestyle to increase the chances of living longer
• Analyze various diets and dietary patterns that play a role in aging
• Ascertain which foods are of greater benefit in regards to aging and longevity
• Develop an appropriate anti-aging diet
• Identify the risk factors associated with osteoporosis
• Outline a beneficial diet for osteoporosis
• Determine an appropriate supplement protocol
• Examine the role of exercise in the treatment of osteoporosis

• Analyze the role between diet and the immune system.
• Design a nutrition supplement program to stimulate the immune system.
• Develop a nutrition program for colds, flu, sore throat and infections.
• Understand basic detoxification techniques.
• Examine the role of nutrition and diet in regards to chronic fatigue syndrome.

• Analyze the role between diet and the immune system.
• Design a nutrition supplement program to stimulate the immune system.
• Develop a nutrition program for colds, flu, sore throat and infections.
• Understand basic detoxification techniques.
• Examine the role of nutrition and diet in regards to chronic fatigue syndrome.

Hour 1

• Define and explain the chronic illnesses so prevalent in today’s society.
• Recognize and calculate life expectancy statistics
• Describe the difference between traditional and modern (commercial diets)
• Distinguish the differences between raw and pasteurized milk
• Recognize the difference between healthy and commercial butter and eggs
• Discuss the difference between hydrogenated and non-hydrogenated fats/oils

 Hour 2 

• Contrast the differences between lacto fermented and non-fermented soy (tofu, edamame)
• Compare breast milk to soy formula
• Identify the difference between sea salt and industrialized salt
• Summarize the benefits of cholesterol
• Explain the dangers of cholesterol lowering drugs
• List the benefits of sunlight

• Identify the risk factors associated with osteoporosis
• Outline a beneficial diet for osteoporosis
• Determine an appropriate supplement protocol
• Examine the role of exercise in the treatment of osteoporosis

• Identify different types of natural anti-inflammatories.
• Determine which anti-inflammatory is best for a particular patient.
• Develop an anti-inflammatory diet.

• Develop an appropriate nutrition program for an ulcer
• Identify the importance of diet in Celiac’s disease (non-tropical sprue)
• Outline a nutrition program for a patient with lactose intolerance
• Design a nutrition treatment program for GERD
• Examine the role of nutrition and supplements in irritable bowel syndrome

Hour 1

• Recognize normal cognitive and memory lapses and signs of declining cognition.
• Differentiate the assessment tools and the pros & cons of each
• Review evidence-based dietary patterns and specific foods that impact cognition
• Review additional evidence-based lifestyle factors that contribute to cognition
• Summarize dietary supplements which may impact cognition

Hour 2

• Recognize 5 categories of early aging
• Identify nutrient deficiencies associated with aging
• Examine epigenetics in aging, specifically COMT and MTHFR
• Review stress physiology and its contribution to aging
• Review contributions of microbiome to healthy physiology and aging

• Design an effective nutrition treatment program for carpal tunnel syndrome
• Develop a nutritional treatment program for Multiple Sclerosis
• Investigate the role of nutrition and supplements in regards to the treatment of headaches
• Understand how nutrition and nutrition supplements can influence dementia
• Identify appropriate diet and supplement agents in the treatment of dementia

• Identify behaviors associated with artificial sweeteners
• Examine the main artificial sweeteners used in the United States
• Determine why artificial sweeteners are used in the food industry
• Summarize the general risks associated with artificial sweeteners
• Evaluate the benefits and risks of Neotame and Advantame

• Identify the benefits and risks of Saccharin
• Discover the benefits and risks of Acesulfame potassium
• Summarize the benefits and risks of Sucralose
• Differentiate Aspartame benefits and risks
• Critique the current research on artificial sweeteners and cancer risk
• Explain the effect of artificial sweeteners on the gastrointestinal environment
• Interpret the research on artificial sweeteners and blood sugar

• Distinguish between the negative and positive effects on obesity, weight control and artificial sweeteners
• Identify the natural sweeteners that are generally recognized as safe
• Evaluate the effectiveness and safety of Stevia
• Determine the effectiveness and safety of Luo han guo (Swingle fruit or monk fruit extract)
• Analyze the effectiveness and safety of Thaumatin

• Review exercise physiology principles and techniques
• Analyze various exercise prescription principles
• Identify appropriate carbohydrate – fat – and protein recommendations
• Develop meal timing and fluid guidelines for the athlete

• Review the signs and symptoms of neuroinflammation and the processes that drive neurodegeneration.
• Identify the neurological signs and symptoms of long COVID and apply research-based protocols.
• Utilize dietary improvements and selected supplements to reduce neuroinflammation.
• Treatment protocols on testing to identify gut barrier and gut-brain axis imbalances.
• Recognize that neuroplasticity plays a fluctuating but essential role in health and trauma.
• Understand the effect of bacterial toxins originating in the gut on the gut-brain axis as a key to neurological disorders pathogenesis.
• Assess intestinal and blood-brain barrier dysfunction for better managing chronic neurological disorders.
• Understand new functional nutritional strategies for longevity.
• Incorporate leading-edge protocols for extending healthspan and longevity.
• Clarify the effects of intermittent fasting on immunity and longevity.
• Recognize that neuroplasticity plays a fluctuating but essential role in health and trauma.
• Integrate optimal lifestyle adaptations in diet, exercise, and supplement protocols to enhance neuroplasticity and improve quality of life.

• Explain the complex multidimensional and individual specific nature of pain
• Present the theories and science for understanding pain
• Define the terminology for describing pain and associated conditions
• Describe the impact of pain on society
• Explain how cultural, institutional, societal and regulatory influences affect assessment and management of pain  
• Use valid and reliable tools for measuring pain and associated symptoms to assess and reassess outcomes as appropriate for the clinical context and population.
• Describe patient, provider, and system factors that can facilitate or interfere with effective pain assessment and management
• Assess patient preferences and values to determine pain-related goals and priorities
• Demonstrate empathetic and compassionate communication during pain assessment

• Explain the complex multidimensional and individual specific nature of pain
• Present the theories and science for understanding pain
• Define the terminology for describing pain and associated conditions
• Describe the impact of pain on society
• Explain how cultural, institutional, societal and regulatory influences affect assessment and management of pain  
• Use valid and reliable tools for measuring pain and associated symptoms to assess and reassess outcomes as appropriate for the clinical context and population.
• Describe patient, provider, and system factors that can facilitate or interfere with effective pain assessment and management
• Assess patient preferences and values to determine pain-related goals and priorities
• Demonstrate empathetic and compassionate communication during pain assessment
• Demonstrate the inclusion of patient and others, in the education and shared decision-making process for pain care
• Identify treatment options that can be assessed in a comprehensive pain management plan
• Explain how health promotion and self-management strategies are important to the management of pain
• Develop a pain treatment plan based on benefits and risks of available treatments
• Monitor the effects of pain management approaches to adjust the plan of care as needed
• Differentiate physical dependence, substance use disorder, misuse, tolerance, addiction, and nonadherence
• Develop a treatment plan that accounts for the differences between acute pain, acute-on-chronic pain, chronic/persistent pain, and pain at end of life
• Describe the unique pain assessment and management needs of special populations
• Explain how to assess and manage pain across settings and transitions of care
• Describe the role, scope of practice, and contribution of the different professions within a pain management care team
• Implement an individualized pain management plan that integrates the perspectives of patients, their social support systems, and health care providers in the context of available resources
• Describe the role of the clinician as an advocate in assisting patients to meet treatment goals

• Demonstrate the inclusion of patient and others, in the education and shared decision-making process for pain care
• Identify treatment options that can be assessed in a comprehensive pain management plan
• Explain how health promotion and self-management strategies are important to the management of pain
• Develop a pain treatment plan based on benefits and risks of available treatments
• Monitor the effects of pain management approaches to adjust the plan of care as needed
• Differentiate physical dependence, substance use disorder, misuse, tolerance, addiction, and nonadherence
• Develop a treatment plan that accounts for the differences between acute pain, acute-on-chronic pain, chronic/persistent pain, and pain at end of life
• Describe the unique pain assessment and management needs of special populations
• Explain how to assess and manage pain across settings and transitions of care
• Describe the role, scope of practice, and contribution of the different professions within a pain management care team
• Implement an individualized pain management plan that integrates the perspectives of patients, their social support systems, and health care providers in the context of available resources
• Describe the role of the clinician as an advocate in assisting patients to meet treatment goals

• Identify examples of traumatic spine, soft tissue and other commonly missed injuries
• Develop a post-traumatic diagnostic imaging algorithm and protocol 
  
• Recognize and develop an awareness for PI patient, carrier and attorney risks and liabilities
• Discuss several areas of PI documentation scrutiny including the causation statement

• Identify examples of traumatic spine, soft tissue and other commonly missed injuries
• Develop a post-traumatic diagnostic imaging algorithm and protocol 
  
• Recognize and develop an awareness for PI patient, carrier and attorney risks and liabilities
• Discuss several areas of PI documentation scrutiny including the causation statement

• This contains all courses with the educational objectives listed from Personal Injury 201 - 204

Hour 1 - PI Case Management Part 1

• Identify and avoid common PI history mistakes and liabilities
• Recognize many keys to a quality initial PI patient history
• Develop an awareness for the materials and tools necessary for a PI history
• Create a plan and protocol to improve the quality and thoroughness of the PI history

Hour 2 - PI Case Management Part 2

• Recognize common PI history red flags and contraindications 
• Identify symptoms and clinical history for two common PI traumatic injuries 
• Create a plan to identify and eliminate common patient errors pertaining to the PI history
• Develop an awareness for potential med-legal issues that can arise from a PI history

Hour 3 - How to Humanize Your PI Cases

• Create a protocol to consistently implement outcome assessments into PI cases 
• Recognize other options and opportunities available to humanize PI cases   
• Identify common outcome assessments utilized in PI cases
• Improve awareness of clinical decisions that can be made from humanizing cases

Hour 1 - Your Personal Injury History: Part 1

• Identify and avoid common PI history mistakes and liabilities
• Recognize many “keys’ to a quality initial PI patient history
• Develop an awareness for the materials and tools necessary for a PI history
• Create a plan and protocol to improve the quality and thoroughness of the PI history

Hour 2 - Your Personal Injury History: Part 2

• Recognize common PI history “red flags” and contraindications
• Identify symptoms and clinical history for two common PI traumatic brain injuries 
• Create a plan to identify and eliminate common patient errors pertaining to the PI history
• Develop an awareness for potential med-legal issues that can arise from a PI history

Hour 3 - Your Personal Injury Examination – Part 1

• Recognize the key elements of the Personal Injury post-traumatic examination
• Identify clinical contraindications and precautions prior to an examination
• Develop and map out a post-traumatic cervical spine examination protocol
• Identify and examine common motor vehicle crash shoulder conditions

Hour 4 - Your Personal Injury Examination – Part 2

• Discuss the critical components of a Personal Injury neurological examination
• Develop a traumatic brain injury examination screening protocol
• Recognize the documentation elements necessary in a PI physical examination
• Create a protocol for medical consultations, diagnostic imaging and testing

• Recognize the importance diagnostic imaging and testing in Personal Injury and trauma
• Summarize several of the common diagnostic imaging and testing available  
• Justify medical necessity and clinical rationale for imaging/testing in the treatment records
• Determine both a protocol and clinical necessity for plain film radiographs

• Recognize elements of Personal Injury case management
• Identify common inherent risk within PI case management    
• Summarize several insurance carriers concerns regarding PI case management   
• Discuss current PI case management issues in the med-legal arena

• This contains all courses with the educational objectives listed from Personal Injury 205 through Personal Injury 212

• Discover the importance of identifying case management issues early   
• Summarize emergency, urgent care and early intervention management  
• Recognize med-legal issues in the early providers management  
• Outline the application of home and self-care as part of case management

• Recognize the importance of Personal Injury physical examination
• Outline the examination of common traumatic injuries and conditions       
• Summarize common examination tests and procedures associated with a PI examination    
• Demonstrate support for care and management with examination documentation

• Outline the preparation for traumatic injury care and case management 
• Summarize the application of passive and active modalities in traumatic injuries
• Develop a protocol for implementing active therapeutic procedures and clinical exercise       
• Identify common therapeutic and conservative care risks and mistakes

• Recognize the importance of diagnostic imaging in Personal Injury
• Summarize specific diagnostic imaging tests for common PI injuries  
• Identify several common clinical indicators for PI diagnostic imaging
• Develop a protocol for ordering and monitoring PI diagnostic imaging         

• Recognize the importance of humanizing traumatic patient injuries
• Demonstrate the general application of assessments and PI interrogatories
• Summarize the importance, applications and protocols of medical photography
• Interpret assessments and PI interrogatories for case management decisions

• Recognize the importance of Personal Injury co-management
• Design a process for finding providers for co-management consults and referrals
• Develop protocols for co-management with primary care providers
• Devise a plan to begin, apply and implement PI case management clinical decisions

• Determine options for co-management with pain management providers
• Identify co-management opportunities with orthopedic and neurology providers
• Develop documentation protocols to support co-management decisions
• Summarize and implement Personal Injury case management protocols and procedures

• Recognize the importance the 5 steps represent in PI cases      
• Develop a plan to identify common PI acute injuries and conditions
• Design an in-office process to improve consistency of documentation
• Identify and evaluate several acute injuries and conditions

• Estimate the risk for an association between exposure to neck pain from a motor vehicle accident and future neck pain
• Estimate the risk for an association between exposure to neck pain from a motor vehicle accident and future back pain
• Appraise the validity of employing a biomechanical approach to assess injury risk from minimal damage traffic crashes
• Assess which factors predict the risk of developing post-traumatic headache six months following a motor vehicle collision (MVC) in adult

• 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

• Appraise the combination of pain neuroscience education and exercise or motor control training to alter ‘pain memories’ associated with chronic pain
• Assess the relationship between vibration training and muscle strength and bone mineral density in older adults
• Measure the effects of whole-body vibration (WBV) training on balance and strength in elderly patients suffering from diabetic neuropathy who are at high risk of falls
• Examine the effectiveness of unimodal and multimodal physical therapies for base of thumb osteoarthritis
• Explore the evidence on the effects of manual therapy for the treatment of plantar heel pain

• 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

Hour 1:

• Describe common biomechanically terminology related to rehabilitation such as work, force, mass, vector, strength and power.
• Comprehend the functional biomechanics of the lunge, and squat.
• Identify regressive and progressive nature to common squat and lunge exercises.
• Describe the appropriate standard of care and the process associated with the doctor-patient encounter regarding the evaluation, and management of patients using rehabilitative exercises.   

Hour 2:

• Classify the “McGill Big 3,” and discuss their clinical significance with those with spinal pain.
• Describe an appropriate hip hinge technique for your patients.
• Describe the differences between abdominal bracing and hallowing techniques.
• Review common evidence-based exercise procedures for spinal pain.

• Apply the scientific foundations of neuromuscular re-education, and explore major guidelines and evidence-based practices for spinal pain.
• Construct a treatment plan and exercise script for patient centered care.
• Describe a case scenario involved spinal degeneration and how to create a treatment plan.
• Synthesize the justification and efficacy of evidence-based exercises for different axial spine protocols.

• Enumerate three physical / clinical examination findings associated with rupture of the quadriceps tenon.
• List 3 patient specific factors that need to be considered when following a rehabilitation program following repair of the quadriceps or patella tendon.
• Recall three goals during phase 1 (0-2 weeks) of a rehabilitation program following repair of the quadriceps or patella tendon.
• Identify three goals during phase 3 of a rehabilitation program following repair of the quadriceps or patella tendon.
• Cite five return to play criteria that need to be met following repair of the quadriceps or patella tendon.

• Summarize the key difference between the cartilage restoration vs cartilage reparation procedures.
• List 3 personal (health and demographic) factors that need to be considered when following a rehabilitation program following cartilage restoration/reparative procedures.
• Enumerate 3 lesion-specific factors that need to be considered when following a rehabilitation program following cartilage restoration/reparative procedures.
• Recall three goals during phase 1 (0-2 weeks) of a rehabilitation program following cartilage restoration/reparative procedures.
• Cite five return to play criteria that need to be met following cartilage restoration/reparative procedures.
• Summarize the evidence-based outcomes for the 3 most common cartilage restoration/reparation techniques.

Hour 1

• Recall 2 pathological pitching mechanical patterns that may lead to injury
• List 3 injury risk factors in in the overhead athlete
• Provide 4 injury prevention screening tests for the overhead athlete
• With respect to shoulder strength, cite 3 metrics  that can be used as red flags to identify players who are at higher risk for incurring an injury to the shoulder /elbow

• Recall 2 pathological pitching mechanical patterns that may lead to injury
• List 3 injury risk factors in in the overhead athlete
• Provide 4 injury prevention screening tests for the overhead athlete
• With respect to shoulder strength, cite 3 metrics  that can be used as red flags to identify players who are at higher risk for incurring an injury to the shoulder /elbow
• Describe 1 clinical test to evaluate anterior and posterior shoulder instability
• List the 3 components of an evidence -based test cluster  to assess rotator cuff pathology in the overhead athlete
• Identify 2 components in the rehabilitation program for shoulder instability
• List and define the 3 types of shoulder impingement
• Recall 2 Performance factors in pitching
• Cite 2 return to play criteria for the overhead athlete
• Identify one advantage of weighted ball holds
• Identify one disadvantage of weighted ball programs

• Recall the most common types of lumbar spine injuries among athletes participating in different sports.
• Identify one advantage and one disadvantage of the treatment-based classification system as it applies to the treatment of the athlete’s lumbar spine.
• List 3 contemporary treatment models that can be applied to the management of lower back pain in the athlete.
• Recall the definition and importance of red and yellow flags during the medical screening process.
• Identify 3 red flags that may implicate a non-mechanical source of lower back pain.
• List the difference between central and peripheral sensitization.
• List one treatment goal in phase 2 rehabilitation of the athlete’s lumbar spine.
• Cite one treatment principle in phase 3 rehabilitation of the athlete’s lumbar spine.
• Summarize two variations of the squat exercises that can be used to decrease strain on the lumbar spine.
• Recall three variations of the deadlift exercises that can be used to decrease strain on the lumbar spine.
• Summarize the McGill core endurance ratio tests that can be used to guide the return to sport decision making processes

Hour 1

• Recall the most common types of lumbar spine injuries among athletes participating in different sports.
• Identify one advantage and one disadvantage of the treatment-based classification system as it applies to the treatment of the athlete’s lumbar spine.
• List 3 contemporary treatment models that can be applied to the management of lower back pain in the athlete.

Hour 2

• Recall the definition and importance of red and yellow flags during the medical screening process.
• Identify 3 red flags that may implicate a non-mechanical source of lower back pain.
• List the difference between central and peripheral sensitization.

Hour 3

• List one treatment goal in phase 2 rehabilitation of the athlete’s lumbar spine.
• Cite one treatment principle in phase 3 rehabilitation of the athlete’s lumbar spine.
• Summarize two variations of the squat exercises that can be used to decrease strain on the lumbar spine.
• Recall three variations of the deadlift exercises that can be used to decrease strain on the lumbar spine.
• Summarize the McGill core endurance ratio tests that can be used to guide the return to sport decision making processes

• Recall two important functions of the fascial system.
• Cite 3 factors which impact the mechanical properties of fascia.
• State one structural/ anatomical difference between the fascia of young vs. older individuals.
• List two ways that fascial training can cause remodeling of the fascia.

• Appraise the latest research in terms of the incidence of ACL tears and re-tears.
• Identify the factors associated with higher ACL tear and re-tear rates based on gender and age.
• Describe the importance of “Prehabilitation” programs and their significance on outcomes.
• Analyze the reasons why non-contact knee injuries are the bulk of the problem while listing the biomechanical reasons why non-contact injuries are more prevalent.
• Discuss the objectives of early Phase 1 and Phase 2  rehabilitation protocols while outlining the criteria to be achieved for satisfactory transition from one phase to the next 
• List the objectives of Phase 3 of the rehabilitation protocol and be able to identify potential common faulty movement patterns and compensatory strategies.
• Assess, identify, and address potential limitations in mobility and stability of key core and lower extremity body regions to normalize faulty movement patterns and compensatory strategies.
• List the objectives for phase 4 of the rehabilitation protocol and provide examples of the higher-level movement patterns and compound strengthening exercises incorporated into the program.
• Identify the four common motor performance/neuromuscular imbalances associated with jumping and landing resulting in increased risk
• Describe the identifiable and modifiable risk factors associated with knee injuries and understand how to correct them via exercise and training.
• Recognize the criteria associated with the Return to Sports phase of the rehabilitation program
• Be aware of the complications and adverse events after ACL reconstruction
• Appraise the latest research in terms of common and uncommon complications/adverse events.
• Identify risk factors for the various complications.
• Describe the evaluation and assessment elements needed to identify the various complications
• Based on the evaluation/assessment data, identify and address intervention strategies for each of the complications/adverse events

• Explain the relationship between posture and subluxations
• Describe different types of posture
• Explain the benefits of locating subluxations in different postures
• Explain the difference between the concept of the hologram and posture
• Disucss the differences between Empirical Healthcare and Mechanistic Healthcare
• Define the three Cs - challenge, check and correct

• Summarize the concept of a subluxation as recognized by other Doctors of Chiropractic.
• List and discuss the various definitions of the term subluxation.
• Outline the basic premise of the effects of aging, subluxation and the adjustment.
• List and discuss terms used by other health professions for a similar clinical syndrome.
• Define pain, nociception and antalgia.
• Draw the basic nociceptive pathway to consciousness.
• Describe and differentiate antalgic scoliosis.
• List and discuss the various definitions of spinal adjustment, manipulation, and mobilization.
• List the deep paraspinal muscles responsible for subluxation maintenance.
• Compare and contrast paraspinal muscle response to the acute abdomen.
• List and discuss therapies used by other health professions for similar clinical syndromes.
• Describe and summarize the Maintland manipulation classifications.
• Itemize scientific evidence regarding physiologic studies regarding subluxations.
• Explain how and why documentation of a subluxation is so important for Medicare patients in chiropractic practice.
• Define requirements for chiropractic services to be covered by Medicare.
• List and discuss how a subluxation may be properly documented in the medical record for Medicare patients.

• 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

• This contains all courses with the educational objectives listed from Xray 133 through Xray 144

• 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

• 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

• 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

• Explaining in layman’s terms the basics of cancer
• Determining prognosis when skeletal metastasis is found on plain film
• Identifying osteolytic versus osteoblastic metastasis on plain film and specifying what advanced imaging is appropriate based on the cancer’s radiographic appearance
• Exploring current literature on emerging treatment options
• Discussing pathophysiology of bone metastasis

• This contains all courses with the educational objectives listed from Xray 154 to Anatomy 158

Hour 1

• Describing common conditions affecting the middle aged adult, including the following: osteoarthritis, rheumatoid arthritis, disc herniations, Type 2 diabetes mellitus, and abdominal aortic aneurysms
• Observing diagnostic imaging related to each of the above conditions and determining the best imaging modality to use for the various conditions
• Determining appropriate prevention and ancillary treatments for the discussed conditions

Hour 2

• Analyzing obesity through assessment and intervention
• Discussing breast cancer diagnostic imaging and disease management
• Diagnosing and treating congestive heart failure
• Evaluating diagnosis and treatment options for the osteoporosis patient

• This contains all courses with the educational objectives listed from Xray 155 through Xray 165

• Outline the utility of bone scintigraphy in the pediatric population
• Summarize basic bone physiology & radiopharmaceutical dosing
• Discuss image acquisition and analyze scans for signs of pathology
• Identify common clinical indications for pediatric bone scintigraphy
• Recognize the various imaging phases of bone scintigraphy and their clinical utility

• Review the pathophysiology of spondylolisthesis
• Evaluate the two classifications of spondylolisthesis
• Classify transitional segments
• Determine necessity and efficacy of imaging of spondylolisthesis and transitional segments

• Differential diagnosis osteopenia and its relevance towards Chiropractic practice
• Identify imaging features of osteopenia
• Recognize ominous features of osteopenia
• Select appropriate chiropractic treatments for the osteoporotic patient

• Identify the risk factors for breast cancer – preventable and non-preventable.
• Determine appropriate diagnostic imaging for screening and breast cancer assessment.
• Investigate different CAM approaches to breast cancer prevention and symptom management.

• In plain film radiographs, identify the orthopedic hardware used to treat femur, humerus, tibia, and radius fractures.
• Discuss special situations for fracture repair, such as osteoporosis, metastasis, pediatrics, and obesity.
• Review various fracture risk assessment tools that can be used in clinical practice.
• Evaluate when various hardware such as screws, nails, and plates are utilized.

• Identifying vertebral characteristic features on plain film for the following diagnoses: Adolescent Idiopathic Scoliosis, Neurofibromatosis-1, Multiple myeloma, Paget's disease of bone, and vertebral compression fractures.
• Determining what advanced imaging might be warranted for each of the vertebral conditions.
• Describing general features of each condition such as incidence, clinical presentation and treatment options.

• Determine the incidence and the characteristics of different spine pathology.
• Demonstrate, with plain film radiographs and magnetic resonance imaging, characteristics of central nervous system tumors and metastasis, syringomyelia, disc herniation, and trauma.
• Identify clinical features and treatment for various spine pathologies.

• Understand the general features of the inflammatory arthritides
• Discuss the clinical presentation, radiographic features, and chiropractic treatments for Rheumatoid Arthritis
• Discuss the clinical presentation, radiographic features, and chiropractic treatments for Ankylosing Spondylitis
• Compare the two most common inflammatory arthritides – Rheumatoid Arthritis and Ankylosing Spondylitis – to the other diseases in this category
• Compare the inflammatory arthritides to the most common arthritide – osteoarthritis