Maine Naturopathic Physician Continuing Education

• Identify various dietary patterns and habits
• Determine how diet patterns affect health and promote disease
• Explore the typical American diet pattern
• Review the vegetarian diet pattern
• Analyze the Mediterranean diet pattern and its components

• Identify why fruits and vegetables are anti-aging foods
• Determine how fruits and vegetables offer health benefits
• Select what components of fish have positive effects on health
• Investigate how fish affects cardiovascular disease and cancer
• Identify how garlic affects health and inhibits disease

• Demonstrate the role grains have in health and longevity
• Explain the basics of fiber and how it can affect health and disease
• Identify how nuts can positively affect health and decrease disease
• Investigate how legumes and soy can affect heart disease
• Relate how legumes and soy can affect cancer

• Recognize the beneficial components of yogurt
• Identify how yogurt can affect the immune system
• Define what prebiotics are and how they affect health
• Describe how chocolate can promote health and longevity
• Explore how tea can positively affect health and decrease disease risk

• Identify what the beneficial components of wine are
• Determine the how and when of wine consumption
• Explain basic concepts of water and signs of dehydration
• List how water affects disease and promotes health
• Identify who is susceptible to nutrient deficiencies

• Determine the relationship between a daily multiple vitamin and health
• Analyze how growth hormone can promote health and possibly slow aging
• Explain the risk versus benefit of using testosterone and melatonin
• Recognize the role of DHEA and DHEA-S on health and longevity
• Identify the main concepts of an anti-aging strategy

• Assess the association between opioid use and chiropractic treatment for LBP
• Demonstrate the potential for chiropractic care to reduce the use of prescription opioids in patients with spinal pain
• Summarize two papers exploring the effects of utilization and availability of chiropractic services on opioid usage and medical services
• Evaluate the impact of chiropractic utilization on the use of prescription opioid use in Medicare beneficiaries aged 65 and over with spinal pain
• Describe the comparative risk of treatment escalation in patients with neck pain between recipients of spinal manipulation and nonrecipients of spinal manipulation

• Identify differences between strength and balance training
• Discuss the dynamic aspects of posture
• Learn aspects of Postural control in chronic LBP patients
• Understand relationship of posture and sports injuries
• Review some concepts of posture, mobility and pain in children

• Review normal cervical biomechanics and apply to examination
• Discuss some effects of manipulation on EMG/ROM
• Recognize lumbar movements during mobilization
• Discuss how whiplash invisibility is not evidence of absence of injury
• Understand muscle adaptation through stretching

• Distinguish Chiropractic influences on muscular strength
• Develop the use of hand-held dynamometry in chiropractic practice
• Identify basic strength training principles for chiropractors
• Construct basics of strength training guidelines for all ages

• Review an Introduction to the Clinical Biomechanics of Stability
• Identify causes of select musculoskeletal injuries
• Describe how LBP in golfers alters motor control
• Describe spinal stability changes with posture
• Distinguish how stability improves with resistance training

• Describe neck anticipatory control with pain
• Describe lateralized fatigue with unilateral neck pain
• Assess head and trunk motion during neck manipulation
• Identify neuromuscular dysfunction in neck pain patients
• Outline exercises for the rehabilitation of neck neuromuscular dysfunction

• Discuss the biomechanical, physiological and psychological evidence for the use of back belts
• Identify and describe recent recommendations and findings for the use of back belts.
• Discuss the principle of affordances and how they relate to environmental constraints (such as a back belt) and posture.

• Summarize the affects of low back health status on low back disorder risk
• Discuss the relation between lumbar curvature and LBP risk factors during postural loading
• Assess the relation between asymmetric lifting and spine loading
• Describe the differences in spine kinematics between LBP patients and normal controls
• Analyze the functional deficits that occur following low back disorders

• Summarize recommendations for backpack use
• Appraise recent research on backpacks and human health
• Discuss the effects of backpacks on musculoskeletal and non-musculoskeletal variables
• Describe current studies on backpack use in children: perceptions, load, biomechanics, physiology

• Learn current perspectives on which structures are strongly but variably linked to back pain
• Review the state-of-the art in low back disorders research applied to ergonomics
• Describe workplace design guidelines for asymptomatic and low back pain workers
• Determine the influence of exercise on lumbar spine disorders

• Identify common underlying causes of non-organic pain
• Recognize the eight Waddell signs of non-organic back pain
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to Waddell signs
• Encourage development and nurturing of skill sets in utilizing Waddell signs

• Determine the epidemiology of low back pain in children and adolescents
• Assess the risk factors associated with back pain in school children
• Outline the effect of an intervention to improve sitting habits in schoolchildren
• Assess the effects of reading a book or using a computer on neck and upper back muscle activity in children
• Review the diagnostic criteria of tension-type headaches in children

• Describe the basic principles of postural control
• Clinically assess postural control
• Outline a protocol of postural rehabilitation

• Identify and describe the phases of bone healing
• List and describe 3 objectives that serve as the foundation of fracture management and bone healing
• Define and differentiate osteoblasts, osteoclasts, and osteocytes
• Define and discuss Wolff’s law
• Discuss 3 principles of stress deprivation, immobilization, and normal physiologic stress as they apply to fracture healing
• Identify 3 complications of bone healing
• Outline and describe 6 areas of descriptive organization of classifying fractures
• Describe pathologic fractures and list 4 types
• Discuss 2 ways how osteoporosis affects fractures
• List 2 common methods of fracture fixation, fixation devices, and fracture classifications

• Describe and differentiate between the macrostructure and microstructure of muscle and tendon
• List and describe the 2 main types of muscle fibers. List and describe the 3 mechanisms for a muscle injury
• Describe the difference between a supraphysiologic and a sub-failure load and how each type may contribute to an injury
• Define how a muscle strain differs from a ligament sprain
• Describe the differences between a tendinitis and a tendinosis
• Describe the effects of aging on tendons
• Name and describe the 3 phases of connective tissue healing
• Describe the effects of immobilization on connective tissue

• Examine the association between chiropractic spinal manipulation for newly diagnosed lumbar disc herniation and/or lumbosacral radiculopathy and the odds of lumbar discectomy over 1-year and 2-year follow-up periods 
• Evaluate the clinical outcomes and MRI changes in a cohort of patients who had surgery compared to conservative treatment for sequestered lumbar disc herniations 
• Summarize existing evidence relating to the reliability of the straight leg raise (SLR) and crossed SLR test in patients with suspected lumbar radicular pain 
• Establish the validity of the extended straight leg raise (ESLR) compared to findings on MRI 
• Recognize the effectiveness of neural mobilization interventions in improving pain, disability, and function in adults with low back and radicular pain

Hour 1

• Describe four purposes for performing orthopedic tests
• Describe three approaches to performing orthopedic tests
• Discuss the clinical importance of pertinent negative findings when performing orthopedic tests
• Discuss the concept of “Evidence Based Medicine”
• Define “Orthopedic Test Item Cluster”
• Describe several metrics used in the validation of orthopedic tests for inclusion in orthopedic test item clusters

 Hour 2

• Describe three Orthopedic Test Item Clusters (OSTs) relevant to the evaluation of the sacroiliac region
• Describe the five procedures included in the Laslett Cluster #2 for the assessment of sacroiliac pain
• Describe the two primary types of Thoracic Outlet Syndrome
• Discuss the clinical utility of the Bakody Test and the Reverse Bakody Test

 Hour 3

• Describe four testing procedures included in Wainner’s Cluster for the assessment of cervical radiculopathy
• Describe Cook’s Cervical Myelopathy Cluster
• Discuss potential problems that may arise in the application of OST clusters
• Discuss ways to minimize inappropriate application of OST clusters

• Outline the nature of and hallmarks of cancer
• Summarize the relationship between physical activity and cancer
• Summarize the relationship between nutrition and cancer
• Summarize the relationship between massage therapy and cancer
• Summarize the relationship between acupuncture and cancer
• Summarize the relationship between manual therapy and cancer

• Summarize the assessment and diagnosis of pain
• List and describe 5 common causes of back pain and how to prevent injury
• Outline the causes of fibromyalgia
• Illustrate the mechanisms of inflammation and pain
• Discuss the pain of peripheral neuropathy

• Evaluate the test-retest, intra- and inter-examiner reliability of the body pain diagram for determining pain distribution and location for musculoskeletal conditions
• Summarize the current state of knowledge on neuropathic pain, with focus on how it differs from nociception
• Review of the current literature regarding the epidemiology, diagnosis and management of Complex Regional Pain Syndrome
• Explore central nervous system neuroplastic adaptations that may contribute to the pathophysiology of chronic conditions
• Differentiate symptoms and signs of central sensitization, peripheral neuropathic pain and nociceptive pain in patients with low back pain (with or without leg pain)

• Gain insight into the different types of pain
• Differentiate different sources of spinal pain
• Summarize the societal and clinical challenges of the pain patient
• Describe the difference between acute and chronic pain
• Provide an initial appreciation of alternative treatment options
• Understand the importance of chiropractic principles with the pain patient

• Describe 3 ways how pain can be a burden to the patient and society
• Describe 2 key components of the biopsychosocial model for treating pain
• Describe how pain is a multisystem output
• Describe the neuromatrix and how it relates to a person’s neural signature
• List 3 medical terms that can influence a patient’s level of fear and anxiety
• Describe 3 body systems that can be influenced by a persistent state of pain
• Outline the 12 treatment principles in the context of therapeutic neuroscience education for patients with persistent pain

• Evaluate the relationships among thoracic spinal stiffness, pain and muscle activity in healthy subjects and those with chronic thoracic pain
• Summarize updated chronic pain classification updates from the ICD-11
• Compare and contrast the clinical presentation and pathophysiology of Fibromyalgia (FM) and Myofascial Pain Syndrome (MPS)
• Summarize a clinical framework to sub-categorize pain patients based on an individual’s dominant pain etiology 
• Examine the effect of neural tissue management on pain and disability in patients with chronic musculoskeletal pain