Indiana Chiropractic Assistant Education and Continuing Education

• 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

• Explain the origin of microcurrent therapy
• Differentiate the difference between microcurrent and TENS
• Discuss the importance of microcurrent therapy on healing
• Examine the easy of incorporating microcurrent therapy
• Integrate microcurrent therapy into a practice

• Develop a basic understanding of muscle function, biomechanics, soft tissue repairs, bone injury and exercise physiology as it applies to the Chiropractic Assistant and the application of physical therapy modalities/procedures
• Develop an understanding of the use of cryotherapy and hot moist packs
• Utilize traction and electrical therapy modalities
• Develop an understanding of the effects of soft tissue massage
• Apply stretch programs to patients
• Discuss spinal exercise programs with the treating doctor
• Learn the applicability of isokinetic testing

• Summarize the types of electrical therapy modalities
• List the contraindications and precautions to the use of electrical therapy
• Recognize the appropriate application of low level laser therapy
• Explain the principals of diathermy

• Discuss the concept of Gender as it relates to society, language and culture
• Identify Gender roles in Western Society
• Recognize innate gender traits in males and females
• Summarize socially imposed gender traits
• Identify aspects of male and female psychological development
• Relate basic concepts of Gender and Power
• List female and male leadership factors
• Discuss gender and the Doctor/Patient relationship
• Identify the ways which gender affects the Doctor/Patient relationship
• Describe what accounts for the differences, in practice style and patient care, between males and females healthcare providers
• Define differing sexualities in western culture
• Review sexuality as it relates to the Doctor/Patient relationship
• Identify misconceptions in personal definitions of male, female, power and sexuality
• Recognize when Power is misused and becomes a threat
• Define Touch as it relates to perception, gender and culture
• Discuss the giving up of power as it relates to patients and touch
• Recognize the perception, intention, and uses of touch
• Perform an analysis of individual conceptions of gender and sexuality

• Perform an exercise to identify personal concepts of touch
• Create practical applications for healthcare practitioners with regard to gender, touch, and sexuality
• Define sexual misconduct
• Recognize the difference between sexual misconduct and sexual harassment
• Critique different models of misconduct
• Describe how misconduct occurs
• Distinguish between different types of offenders
• Give examples of case studies in sexual misconduct
• Identify common fears and misconceptions of sexual misconduct
• Specify important concepts of treated a patient who has a history of abuse
• Define professional boundaries and relate the issue of consent
• Describe the three types of power, the three patterns of power, and how power is used
• Discuss the differences between adherence vs. compliance and transference vs. countertransference
• Identify anatomical risk levels for touch
• Develop safe touch guidelines
• Create a set of office based interventions and patient based interventions in the development of safe practice strategies
• Define educational interventions for safe practice strategies
• Define the basics of the supervision for a safe practice strategy

• Develop and outline for safe practice analysis
• Perform a risk factor analysis
• Execute a healthcare provider questionnaire
• Create a staff evaluation to implement at the office
• Develop and implement a buddy/supervisor evaluation of the healthcare provider and staff
• Develop and implement a patient evaluation of the healthcare provider and staff
• Create a system of analysis for the buddy/supervisor, healthcare provider, staff and patient evaluations
• Develop a plan for change based on the risk factor analysis (RFA) and practice evaluation questionnaires
• Identify areas of improvement for touch, consent, communciation and respect
• Address concerns raised by staff and patients
• Discuss ways to defuse attraction
• Develop guidelines of dealing with a patient who is attracted to you
• Develop guidelines of dealing with feeling an attraction
• Discuss the six factors for a safe practice
• Describe the new partnership between healthcare providers and patients

• 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

• 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

• 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

• Outline the evidence regarding rehabilitation interventions following anterior cruciate ligament (ACL) or meniscal injury
• Evaluate the effectiveness of rehabilitation interventions for patients who have undergone anterior cruciate ligament reconstruction surgery 
• Examine the comparative effectiveness of surgery versus rehabilitation treatments after an anterior cruciate ligament (ACL) rupture 
• Compare the effectiveness of exercise therapy with non-steroidal anti-inflammatories (NSAIDs) and opioids for the management of pain in patients with knee osteoarthritis 
• Determine the patellofemoral joint reaction forces during everyday activities, therapeutic exercises, and physical interventions in healthy individuals and those with patellofemoral pain or osteoarthritis

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

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

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

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

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

• Summarize a recent systematic review regarding the use of sacroiliac joint mobility tests
• Determine the prevalence of musculoskeletal dysfunction in patients with chronic pelvic pain
• Explore our current clinical understanding of, and challenges pertaining to, the diagnosis and management of pain in the sacroiliac region
• Evaluate the role of sacroiliac (SI) joint degeneration in mechanical low back pain Investigate and compare typical lumbopelvic movement differences between people with and without low back pain

• Assess the prognostic capabilities of the STarT Back Tool (SBT) and identify pragmatic factors associated with poor outcomes and a transition from acute to chronic low back pain
• Examine the relationship between patients’ pain and functional outcomes over 3-months and their chiropractic visit frequency, visits to other provider types, and other characteristics
• Explore the lived experiences of people with low back pain
• Evaluate the association between depressive symptoms and health outcomes in patients with low back pain
• Quantify the prevalence of facet joint pain in patients with chronic low back pain

• Update the Neck Pain Task Force by providing a best evidence synthesis to determine the reliability and validity of clinical tests used in adults with neck pain and its associated disorders (NAD), specifically those used to assess posture, pain location and cervical mobility
• Evaluate outcomes on seven cervical sensorimotor control tests between patients with chronic idiopathic neck pain and asymptomatic individuals 
• Investigate the association between neck pain and cervical flexion angle during smartphone use (text neck) in adults 
• Rank the effectiveness of physical exercise interventions for chronic non-specific neck pain 
• Compare the effectiveness of adding either instrument-assisted soft tissue techniques or general massage to a therapeutic exercise program for patients with mechanical neck pain and forward head posture

• Asses the differences in primary and secondary clinical outcomes between monodisciplinary chiropractic care and multidisciplinary integrative care for sub-acute and chronic low back pain 
• Evaluate the expectations of patients with low back pain and compare these to the assumptions of physicians 
• Compare the efficacy of thrust and non-thrust spinal manipulation in adults with subacute or chronic low back pain
• Describe the prognosis, pain intensity and proportion of participants seeking care following an acute episode of low back pain in a community cohort 
• Investigate the relationship between specific psychosocial factors and severe pain and functional limitation in patients with low back pain

• Identify the impact of financial conflicts of interest on research outcomes: Understand how industry funding can influence the results and interpretations of clinical trials, and differentiate between industry-sponsored and non-industry funded studies.
• Analyze the significance of transparency and disclosure in research: Examine the importance of transparent reporting of financial and non-financial relationships and activities, and assess how perceptions of conflict of interest can be just as crucial as actual conflicts.
• Evaluate emerging approaches to address conflicts of interest: Explore new methodologies, such as Cochrane's guidance, designed to mitigate the risks of bias in research, and critically assess their potential effectiveness in promoting objectivity.
• Apply ethical considerations in research practices: Examine real-world scenarios of potential conflicts of interest in research and apply ethical principles to discern the appropriate course of action, fostering an understanding of how researchers can uphold integrity and impartiality in their work.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

• Identify common risky mistakes providers make when navigating patient financial matters
• Recognize the providers financial obligation when treating Medicare & Medicare Advantage patients
• Review both federal and payer guidelines on managing patient financial obligations
• Identify practical ways to manage non-covered services and uninsured patients

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

Hour 1

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

Hour 2

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

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

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

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

• Identify the expected standards of a compliant and complete patient medical record
• Audit documentation to ensure the most important details are present
• Analyze and correct for the four most commonly missed components of appropriate documentation
• Apply the federal requirements for Medicare documentation and use this knowledge to initial and routine patient visit documentation

• Assess limits of state, federal and board authority regarding the prohibition of solicitation of patients by, and on behalf of, chiropractors. 
• Explain distinctions between general marketing and intrusive solicitation, and the reasons for the regulation of each
• Demonstrate how the courts protect businesses’ right to advertise and how they discourage deceptive practices. 
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services. 
• Examine criminal and civil laws associated with overly aggressive chiropractic advertising.

• Classify circumstances that trigger Good Samaritan laws for chiropractors.
• Restate duties imposed upon people in the United States to render aid to others in dire circumstances.
• Compare a doctor’s versus a lay person’s duty to render aid to someone in distress.
• Explain principles and philosophical underpinning Good Samaritan laws.
• Discuss the Bystander Effect.and scientific studies that unearth reasons why people are reluctant to render aid/assistance to others in emergency situations.
• Summarize the role compensation, expecting to get paid, plays in the operation of Good Samaritan laws.
• Locate states that impose a duty to render assistance, and those states that remove Good Samaritan law protection from hospitals.
• Identify protections offered under various states’ Good Samaritan Laws.
• Express the relaxation of professional standards, and what behaviors are shielded from liability, under Good Samaritan laws.

• Recognize and execute the rules to avoid inducement violations
• Define what you CAN give away for a first visit that will not break the rules. 
• Implement compliant initial visit screening services as part of a new patient offer
• Apply risk management rules to avoid offering free services to some and not others
• Modify your current marketing strategy to attract new patients while being compliant

• Identify ethical and legal prohibitions against patient deception, misinformation, exaggerating healthcare cures, guaranteeing treatment results, and dishonesty.
• Distinguish between appropriate and inappropriate communications and medical file entries describing patients' healthcare prognoses and progress.
• Explain scientific literature linking patients' attitude and mental states to healthcare outcomes.
• Illustrate placebo-enhancing doctor-patient interactions that comply with states' prohibitions against deception and misinformation.
• Give examples where ethical patient encouragement authentically fosters positive mental states that promote desired patient outcomes.
• Express why patient communications must be consistent with medical file entries regarding prognoses and patient progress.
• Explain office procedures and staff training likely to optimize health-promoting ethical patient communication and the documentation thereof.

• Identify which portion of the complex regulation applies to their practice
• Recognize proper use of a Good Faith Estimate vs Balance Billing Protection form
• Formulate customized forms and training tools to meet regulatory guidelines
• Adopt best practices and regulation standards during the patient intake process

• Discuss the public’s increased use of health data-gathering devices and its effect on dispensing healthcare by professional healthcare providers.
• Identify sources for state authority to regulate the practice of healthcare in the various states.
• Explain states’ prohibition against the unauthorized practice of medicine and identify points where data collection and subsequent evaluation may encounter this prohibition.
• Compare courts’ interpretations of state scopes of practice laws as they relate to the various stages of a doctor-patient encounter.
• Distinguish data collection from activities that may include preliminary evaluation, diagnosis, and treatment - while identifying their relevance to state scopes of practice.
• Analyze how courts interpret activities that may constitute the unauthorized practice of medicine, as distinguished from those that do not.
• Discuss obligations to refer people to other healthcare providers based upon determinations and/or diagnoses related to observation, examination, and evaluation of collected data.
• Distinguish boundaries regarding data collection versus the unauthorized practice of medicine.
• Recognize the public's rights to information and free speech protections.

 Part 1

• Discuss the costs of fraud and financial crime
• Review the technology trajectory and how this affects fraud
• Quote Honesty studies
• Identify behaviors related to cheating

Part 2

• Review the criminological and behavioral theories of fraud in healthcare
• Explain key aspects of the psychological of fraud
• Identify aspects of sociology related to fraud
• Examine: Biological school of criminology

Part 3

•  Examine victimology and victim behavior
• Discuss internal fraud and trends
• Examine opportunity reduction
• Be aware of red flag and fraud indicators

 Part 4

• Apply human based preventative and detection strategies to avoid fraud
• Use technology based preventative and detection strategies to avoid fraud
• Use vulnerability assessment preventative and detection strategies

• Compare the various Responsibilities that patients owe to the doctor-patient relationship
• Describe the doctor-patient relationship as a dynamic one that relies on the active participation of patient and doctor alike, and enlists aspects of trust in order for the interaction to render optimal benefits.
• Recognize how the Hippocratic Oath contributed significantly to the development of chiropractic patient rights
• Discuss the historical evolution of Patients' Rights in the United States and their application to chiropractic
• Explain the various Patients’ Rights
• Present case studies to illustrate how patient rights and responsibilities can be applied in practice.
• Analyze how Patient Obligations contribute to the success of the doctor-patient interaction and can favorably impact patient outcomes.
• Explain how chiropractors’ efforts to enhance profitability could negatively impact both public perception and the bottom line.

• Appreciate the significance of Artificial Intelligence (AI) in transforming the healthcare industry.
• Recognize the potential benefits of AI in improving diagnosis accuracy and treatment outcomes.
• Identify how AI can streamline administrative processes, such as scheduling appointments, billing, forms, and managing patient records.
• Explore compliance with laws and regulations when using AI and chatbots in advertising, including rules around data collection and use
• Understand the challenges of determining who owns the copyright for content generated by AI systems
• Evaluate the importance of keeping up-to-date with technological advancements in healthcare for quality patient care and practice management
• Comprehend the challenges regarding patient data privacy and security associated with AI.

• Recognize different forms of social media and how clinics can benefit from using social media
• Appreciate the risks of using social media and how to avoid any pitfalls
• Develop policy and procedures to protect patient information when using social media
• Ability to identify commonly overlooked risks when communicating to patients on third-party software platforms

• Distinguish Constitutionally-protected expression contributing to a healthy marketplace, from defamatory reviews that damage doctors and impede intelligent consumer activity.
• Explain what triggers patient complaints and discuss how their constructive information improves healthcare services.
• Identify how patient complaints can compromise doctors’ health, devastate their businesses, impede professional performance, and compromise patient outcomes.
• Express how doctors may shape doctor-patient relationships so as to reduce the likelihood and frequency of patient complaints.
• Illustrate how a doctor's proactive remedial behavior can mitigate the incidence and severity of formal disciplinary actions and litigation generally.
• Explain the power traditionally ascribed to word-of-mouth recommendations and how current social media review systems leverage this power.
• Discuss how the Consumer Review Fairness Act restricts prohibitions against posting negative reviews.
• Describe how a complaint navigates a state Board disciplinary process and factors regarding appeal.
• Illustrate the financial and reputational costs that attend doctors responding to negative complaints and/or initiating litigation against patients.

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

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

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

Hour 1

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

Hour 2

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

Hour 3

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

Hour 4

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

Hour 5

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

Hour 6

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

Hour 7

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

Hour 8

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

Hour 1:

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

Hour 2:

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

Hour 3:

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

Hour 4:

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

Hour 5:

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

Hour 6:

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

Hour 7:

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

Hour 8:

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

Hour 9:

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

Hour 10:

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

Hour 11:

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

Hour 12:

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

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

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

• Utilize the World Health Organization (WHO) definition and classifications of headache complexes.
• Discern headache types using the International Headache Society definition and classifications of headache complexes.
• Integrate the Cleveland Clinic Headache classifications, descriptions, causes and treatment protocols.
• Compare efficacy in Cleveland Clinic treatment protocols of stress management, biofeedback, pharmaceuticals and prevention guidelines with manual medicine for outcome for your patients.
• Explain headache complexes in children and adults.
• Discuss Craniopathy and Cranial Osteopathy and its application in treating headaches.
• Apply the three approaches for Cranial Osteopathy; meningeal, reflex and sutural.
• Determine appropriate conditions indicated for use of Craniopathy and contraindications.
• Examine cranial bone anatomy.
• Integrate brain and spinal cord anatomy in relation to cranial bone anatomy and function.
• Relate spinal dural anatomy to dural torque in the cervical spine and cranium and its relationship to headaches.
• Collate signs and symptoms of traumatic brain injury into the evaluation of the cranium and headaches.  
• Relate the function of the cranial bones with the temporomandibular joint (TMJ).
• Utilize the structural and functional anatomy of the soft tissues of the TMJ for differential diagnosis of headaches and jaw dysfunction.
• Apply functional anatomy of the TMJ to functional anatomy of the cranial bones and cervical spine in relation to headaches.
• Demonstrate the evaluation of mandibular gait and disc condyle gait, normal and pathological.
• Define muscles of the jaw and cranium and their interrelationship regarding headaches and cranial faults.
• Relate the function of the cranial bones with the cervical spine.
• Utilize the structural and functional anatomy of the cervical spine for examination of soft tissues and pathology related to headaches.
• Determine which soft tissue structures when dysfunctional lead to headaches.
• Discern soft tissue pathology from examination for the differential diagnosis of causative factors headaches.
• Apply the functional anatomy of the TMJ and cervical spine to pathological conditions in these regions that can cause headaches.
• Explain the history and definitions of Craniopathy from 1596 - present.
• Explain the history and definition of Cranial Osteopathy and Craniosacral Therapy in Osteopathic Medicine.
• Determine pathology in the TMJ through thorough history using passive and active examination procedures and relate findings to headaches.
• Apply the VROM (vertical range of motion) scale to TMJ movement analysis.
• Treat the TMJ using a variety of methods.
• Perform Cranial Bone examination to find cranial faults using Sacro Occipital Technique (SOT) and relate findings to headaches.
• Apply Mind Language to cranial bone evaluation for SOT Category I and II.
• Perform Cranial Bone examination to find cranial faults using Applied Kinesiology (AK) and relate findings to headaches.
• Demonstrate effective muscle testing techniques when applying AK for cranial bone examination.
• Diagram the sequencing of Cranial Bone Examination using AK and its application during treatment.
• Differentially diagnose individual cranial faults and their relationship to one another during examination and treatment.
• Treat cranial bone faults using the methods discussed.
• Determine soft tissue and joint pathology in the cervical spine using active and passive examination procedures as well as functional testing to relate findings to headaches.
• Differentiate pain quality between the soft tissue structures (periosteum, joint, ligament, muscle, tendon, bursa, fascia, vascular and nerve).
• Utilize motion palpation as a tool to determine cervical spine joint fixation and dysfunction.
• Apply soft tissue palpation methods to evaluate the soft tissues of the cervical spine.
• Assess the cervical spine soft tissue structures using passive and active functional testing.
• Detect pathological conditions of the soft tissues of the TMJ as they relate to headaches.
• Relate the mechanics of Acceleration Deceleration Impact of the TMJ as a causative factor in injury and relationship to headaches.
• Assess pathological conditions of the soft tissue structures of the cervical spine (periosteum, joint, ligament, muscle, tendon, bursa, fascia, vascular and nerve) and relate the pertinent conditions to headaches.
• Detect bony defects, osseous and congenital that alter function in the cervical spine with the potential causative factor for headaches.
• Interpolate findings of scoliosis as a complicating factor in cervical spine dysfunction in relation to headaches.
• Relate the mechanics of Acceleration Deceleration Impact of the cervical spine as a causative factor in soft tissue injury and relationship to headaches.
• Apply treatment protocols for headaches using Craniopathy and Sacro-Occipital Technique (SOT) to address pathological conditions of the TMJ.
• Apply treatment protocols for headaches using soft tissue methods, modalities and manipulation for the pathological conditions of the TMJ.
• Apply treatment protocols for headaches using Craniopathy and SOT for the cranial bones and TMJ.
• Apply treatment protocols for headaches using Craniopathy and Applied Kinesiology (AK).
• Develop treatment sequencing practices and corrections for cranial faults in relationship to headaches.
• Integrate sinus congestion corrections into treatment protocols for cranial faults and headaches.
• Determine the effects of the rebound in the closed system of the cranium and apply the findings to cranial bone treatment.
• Apply treatment protocols for headaches using soft tissue methods, modalities and manipulation for the pathological conditions of the cervical spine.
• Determine pain radiation patterns of trigger points in the cervical spine in relation to head pain.
• Evaluate the most conducive manual methods to determine the most affective soft tissue treatments of the soft tissues of the cervical spine including Strain Counterstrain, postfacilitation stretch, somatic technique, postisometric relaxation, modalities, massage, manipulation and mobilization.
• Apply manual methods, modalities, mobilization and manipulation to pathological conditions cervical spine in relation to headaches.
• Apply treatment protocols to scoliosis in relation to cervical spine dysfunction and headaches.
• Relate treatment of the cervical spine after Acceleration Deceleration Impact to the treatment of headaches.
• Review a case study on the use of cranial fault correction, manipulation, manual methods and modalities in a patient with Cluster Headaches.
• Derive confidence in treating severe headache complexes using soft tissue treatments, Craniopathy, modalities and manual methods.

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

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

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

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

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

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

• This contains all courses with the educational objectives listed from Sports Medicine 109 through Sports Medicine 113

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

• Determine appropriate exercise recommendations
• Design a proper fitness program for patients
• Identify proper exercises for the osteoporotic patient
• Review exercise guidelines with patients and encourage compliance

Hour 1

• Review basic concepts of exercise physiology
• Understand the fitness training model
• Identify various communication strategies
• Determine appropriate behavior change techniques

Hour 2

• Identify the components of the client investigation stage
• Review the various tests to determine functional ability of a client
• Discuss the tests necessary to determine a clients physiological sport abilities
• Analyze proper movement patterns through testing

Hour 3

• Design an appropriate resistance exercise program
• Understand the components of an appropriate cardiovascular program
• Determine various ways to progress in training
• Review basic concepts of sport nutrition

• Summarize the current body of literature surrounding the anatomy and biomechanics of the iliotibial band (ITB), to better understand the etiology, clinical examination and treatment of ITB syndrome 
• Explore and integrate connections between tissue structures, function, environmental and personal factors for the management of patients with lateral epicondylosis 
• Outline our contemporary understanding of possible musculoskeletal causes of inguinal-related groin pain in athletes
• Determine whether the Ottawa Ankle Rules accurately rule out ankle fractures in adults 
• Compare non-operative treatment, open surgical repair, and minimally invasive surgery for acute Achilles tendon ruptures

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

• This contains all courses with the educational objectives listed from Stroke and Manipulation 101 through Stroke and Manipulation 104

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

• 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.

• Describe the profile of suicide in the US, noting psychosocial and cultural factors that effect risk
• Identify 3 common precipitating events for suicide attempts
• Describe risk factors for suicide including co-existing psychiatric disorders
• Name the most frequent co-existing psychiatric disorders
• Use the sad person scale to assess suicide risk
• Give examples of primary, secondary, and tertiary interventions
• Describe basic level interventions that take place in the hospital or community
• Identify key elements of suicide precautions and environmental safety factors in the hospital
• Describe the problem on non-suicidal self-injury
• Explain the range of self-protective behavioral responses
• Discuss 3 myths about suicidal behaviors
• Identify 2 cultural or social factors that relate to suicide
• Examine 4 categories of motivation for attempting suicide
• Explain how suicide affects family members and friends
• Describe 3 theories that attempt to explain the causes of suicide
• Discuss the occurrence of suicide throughout each life cycle
• Outline the process for assessing the suicidal potential of a client
• Choose 3 therapeutic goals and interventions for clients with suicidal behaviors

• Understand and differentiate thermal and nonthermal effects of ultrasound
• Understand the effect of ultrasound on tissue repair
• Identify potential hazards to the use of ultrasound
• Identify parameters to the safe use of ultrasound during clinical application
• Identify current trends in the use of ultrasound
• Identify methods for maximizing therapeutic effects of ultrasound and phonophoresis

• List the components of the vital signs
• Cite normal and abnormal pulse rates
• Define Tachycardia, Bradycardia and Arrhythmia
• Recognize factors that can influence heart rate and rhythm
• Identify common locations for palpating the pulse
• Describe the process for determining the pulse
• Outline the chambers of the heart
• Define systole and diastole
• Explain systolic and diastolic pressure
• Describe the procedure for obtaining the blood pressure
• Define hypertension and hypotension
• Recognize the blood pressure categories as define by the American Heart Association
• List causes and risk factors for hypertension and hypotension
• Recognize the ranges for normal body temperature by location
• Describe the procedure for obtaining body temperature, orally, in the ear and over the forehead
• Summarize the accuracy of the body temperature obtained at different locations
• Define fever, hyperthermia and hypothermia
• List causes and risk factors for fever, hyperthermia and hypothermia
• Define respiration rate
• Cite the normal range of respiration rate at different ages
• Define tachypnea and bradypnea
• List causes and risk factors for tachypnea and bradypnea

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

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

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

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

• Identify the differences between the holistic and allopathic models for health and wellness
• Show how the Web of Well-Being can be used to assess and educate clients about the various factors impacting their wellness.
• Describe the conclusions of research into the benefits of meditation for human health.
• Explain the basic principles and practice of a simple mindfulness meditation technique.

• Emphasize the unique anatomy of the cervical spine as related to spinal trauma.
• Point put the importance of the uncinate process joints as related do disc herniation, the nerve root, the vertebral artery, and the spinal cord.
• Explain how cervical spine injury may manifest clinically as low back and leg pain.
• Explain the role for sleep and sleep’s influence on the ability to safely operate a motor vehicle.
• Summarize the influence of sleep on brain neurochemistry.
• Explain the influence of awareness on an impending collision and the muscles ability to protect joints.
• Explain how being “caught by surprise” by a collision is related to a poor prognosis for full recovery.
• Summarize the history of whiplash injuries, including mechanical mechanisms, biological mechanisms, pathology, diagnostics and management.
• Define the issues that the early whiplash literature got wrong.
• Emphasize the issues that early whiplash literature got correct.
• Summarize recent advances in the understanding of whiplash injuries, emphasizing anatomy, diagnostics, pain production and pain suppression.
• Integrate whiplash trauma, chronic pain, and chiropractic care.
• Point out the mathematics of how a low speed vehicle to vehicle collision can result in passenger injury.
• Explain why vehicle damage should not be used as a proxy for passenger injury.
• Integrate the concepts of awareness, rotation, and pre-accident spondylosis in injury magnitude and prognosis.
• Define the three phases of soft tissue healing and point out the time sequence for each phase.
• Justify the clinical interventions that have a positive therapeutic influence on each phase of soft tissue injury healing.
• Emphasize the concept of motion in the healing of injured soft tissues, especially spinal adjusting (specific manipulation) motion.
• Quantify acute injury and ultimate recovery(prognosis) by using measurement outcomes.
• Summarize the biology and published data on treatment frequency and duration for whiplash spinal trauma.
• Point out published studies relating to recovery and prognosis.
• Reference the incidence of acceleration of spondylosis in long-term studies following a whiplash injury.

• Recite exercise guidelines and recommendations by the ACSPPSE, HHS and ACOG
• Outline and describe 6 benefits of exercise during pregnancy
• Describe 4 maternal physiologic changes that occur during pregnancy
• Describe 3 physiologic changes associated with exercise during pregnancy
• List 5 relative and 5 absolute contraindications to exercise during pregnancy
• Describe 2 fetal outcomes associated with maternal exercise during pregnancy

• Review anatomy and physiology of the female patient
• Perform Physical Examination procedures unique to the female patient
• Identify conditions unique to the female patient that require referral to a Medical Doctor
• Discuss the presentation, evaluation, and management of conditions affecting women’s health within the scope of Chiropractic practice
• Discuss risk factors, screening and prevention recommendations with female patients
• Review nutritional supplementations that can augment conditions affecting women’s health within the scope of Chiropractic practice

Hour 1

• Illustrate the patterns behind disordered eating in female athletes.
• Distinguish differences in the hormonal cycle, and menstrual disturbances in different kinds of female athletes.
• Contrast the differences of evaluation and management of female athletes.
• Compare and contrast the chemically and structural differences between male and female athletes.

.Hour 2:

• List common female athletic injuries.
• Explain how to evaluate knee and lower leg injuries.
• Apply knowledge of muscle strength and hormonal differences to provide suitable training recommendations for a strength athlete.
• Explain nutritional deficiencies in female athletes.

 Hour 3:

• List the detriments in health and/or sports performance from lack of proper nutrition.
• Provide recommendations for appropriate nutritional guidelines for female athletes.
• Consider body composition, increase muscle mass, and improve overall sports performance of female athletes.

• This contains all courses with the educational objectives listed from Xray 103 through Xray 118

• 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