Rhode Island Naturopathic Physician Continuing Education

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

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

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

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

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

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

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

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

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

• Describe the importance of the primitive reflexes
• Explain the role of fundamental patterns
• Summarize the generation of cortical release signs

• Diagram the muscle – brain interactions and the hypothalamus – hormonal feedback loop
• Define deaffrentation
• Explain spinal dyscoupling and its effect on the neuraxis

• Describe the importance of the primitive reflexes
• Explain the role of fundamental patterns
• Summarize the generation of cortical release signs

• Diagram the muscle – brain interactions and the hypothalamus – hormonal feedback loop
• Define deaffrentation
• Explain spinal dyscoupling and its effect on the neuraxis

Hour 3

• Explain how the balance system depends on symmetrical input
• Describe the relationship between the deep tendon monosynaptic reflexes and posture control
• Explain the importance of the tonic neck reflexes to posture and functional assessment

Hour 4

• Describe the flexion and extension synergistic patterns
• Explain the function of the flexor withdrawal reflex in relation to central pattern generators
• Outline the role of the Galant reflex in postural control

Hour 5

• Explain the relationship between the flexor withdrawal reflex and the crossed extensor reflex.
• Describe the anticipated response in testing the upper Galant reflex
• Outline the normal display of the tonic lumbar reflex

Hour 6

• Explain the etiology of cortical release signs
• Describe the determinant of posture
• Outline the test for normal stance and gait and analyze the results

• Describe the types of muscle fibers and how they respond to deaffrentation
• Outline the anatomy of the cerebellum
• Explain the function of the various areas of the cerebellum

Hour 8

• Outline the afferent cerebellar pathways
• Describe the efferent cerebellar pathways and their interconnections
• Summarize the blood supply to the cerebellum and brain stem

Hour 9

• Describe the relationship between cerebellar output and autonomic function
• List the signs of pathological cerebellar expression
• Explain the concept of surround inhibition

Hour 10

• Recognize how variations in functional muscle testing procedure will yield different clinical information
• Explain the difference is the influence of uniarticulate muscles versus multiarticulate muscle on stability and affrentation
• Describe the normal responses of the primitive reflexes

Hour 11

• Explain the role of the pyramidal and extrapyramidal systems
• Select appropriate procedures to test for pyramidal distribution of weakness
• Describe exercises to address pyramidal distribution of weakness
• Recognize the foundational concept of receptor input
• Explain the role of the primitive reflexes as a diagnostic tool
• Summarize how functional manual muscle testing can reveal the presence of deaffrentation

Hour 1

• Explain how the balance system depends on symmetrical input
• Describe the relationship between the deep tendon monosynaptic reflexes and posture control
• Explain the importance of the tonic neck reflexes to posture and functional assessment

Hour 2

• Describe the flexion and extension synergistic patterns
• Explain the function of the flexor withdrawal reflex in relation to central pattern generators
• Outline the role of the Galant reflex in postural control

Hour 3

• Explain the relationship between the flexor withdrawal reflex and the crossed extensor reflex.
• Describe the anticipated response in testing the upper Galant reflex
• Outline the normal display of the tonic lumbar reflex

Hour 4

• Explain the etiology of cortical release signs
• Describe the determinant of posture
• Outline the test for normal stance and gait and analyze the results

• Describe the types of muscle fibers and how they respond to deaffrentation
• Outline the anatomy of the cerebellum
• Explain the function of the various areas of the cerebellum

Hour 2

• Outline the afferent cerebellar pathways
• Describe the efferent cerebellar pathways and their interconnections
• Summarize the blood supply to the cerebellum and brain stem

Hour 3

• Describe the relationship between cerebellar output and autonomic function
• List the signs of pathological cerebellar expression
• Explain the concept of surround inhibition

Hour 4

• Recognize how variations in functional muscle testing procedure will yield different clinical information
• Explain the difference is the influence of uniarticulate muscles versus multiarticulate muscle on stability and affrentation
• Describe the normal responses of the primitive reflexes

Hour 5

• Explain the role of the pyramidal and extrapyramidal systems
• Select appropriate procedures to test for pyramidal distribution of weakness
• Describe exercises to address pyramidal distribution of weakness
• Recognize the foundational concept of receptor input
• Explain the role of the primitive reflexes as a diagnostic tool
• Summarize how functional manual muscle testing can reveal the presence of deaffrentation

• Identify the correlation of resistance exercise and lipoprotein Patterns
• Discuss the effect of boswelia on arthritis
• Review the effect of green tea on weight loss
• Establish the relationship of exercise and water replacement
• Identify the relationship of red wine and the cardiovascular system

• Review aspects of antioxidants and free radicals
• Discuss how silymarin can improve an alcohol-damaged liver
• Describe the connection/mechanism between atherosclerosis and vitamin E
• Identify research evidence between whole grains and disease
• Delineate the relationship of magnesium and hypertension

• Identify risk factors of cardiovascular disease
• Construct a list of appropriate food and food groups associated with cardiovascular disease prevention
• Evaluate various supplements that are beneficial in prevention and treatment of cardiovascular disease
• Differentiate various diets in regard to cardiovascular disease

• Discuss various diet and lifestyle factors involving hypertension
• Recognize the relationship between various minerals and hypertension
• Distinguish the nutritional aspects of various related cardiovascular conditions
• Identify the relationship between various herbs and peripheral vascular diseases

• Discuss the basics of herbal medicine
• Identify the conditions treated with herbs
• List the effects, indications and dosages for T Bilberry and Black Cohosh

• Identify the conditions treated with specific herbs
• List the effects, indications and dosages for Boswellia, Burdock Root, Bromelain, Calendula, Cascara sagrada, Cayenne, CBD (cannabis), Chamomile, Echinacea

• Discuss the mechanism and effects of Feverfew, Garlic, Ginger, Ginkgo Biloba, Ginseng, Goldenseal, Gugulipid, Gymnena Sylvestre, Horse Chestnut, Lemon Balm, Licorice, Milk Thistle, Nettle, Passionflower, Psyllium, Pygeum, Senna, Shiitake, St. Johns Wort, Saw Palmetto, Tea Tree Oil, Tumeric, Valerian Root, and White Willow

• Identify changes in vitamin needs and status that occurs with aging and in the elderly
• List changes in mineral needs and status that occurs with aging and in the elderly
• Demonstrate an understanding of protein, fiber and water needs of the elderly
• Identify important antioxidants in the elderly and the interactions that exist between them
• Create a list of nutritional deficiencies and how they can lead to disease and illness in the elderly

• Demonstrate an understanding of the role of calcium and other minerals in osteoporosis
• Design a treatment protocol for the osteoporotic patient
• Create nutritional guidelines for the pregnant female
• Identify changes in vitamin and mineral requirements in pregnancy
• Review the nutritional changes that occur with lactation

• Understand proper growth rates and weight gain in early childhood
• Identify specific minerals involved in childhood nutrition
• Explain the stages of obesity development in childhood
• Review the importance and problems associated with childhood obesity
• Evaluate the role of fiber in childhood

• Identify the link between obesity and disease
• Understand body composition and assessment methods
• Design a practical weight loss diet program
• Perform obesity related calculations quick and easily in the office
• Recognize the role of exercise and other lifestyle factors that can influence obesity.

• Identify the challenges inherent in the diagnosis and management of patients with complex and chronic multi-factorial problems
• Associate a multitude of common symptomatic complaints with foundational metabolic disorders such as elevated total toxic load and "leaky gut"
• Apply a systematic approach to functional laboratory diagnostics and associate the findings with the need for specific therapeutic strategies using nutrients, botanical medicines, and nutraceutical compounds
• Demonstrate an ability to institute life-style modifications, such as dietary changes, stress management techniques, and exercise in the management of patients with complex chronic illness
• Measure your ability to assess, diagnose, and treat patients with fatigue-related disorders, vague gastrointestinal complaints, cognitive dysfunction, thyroid-adrenal problems, food intolerance, and more

• Identify the challenges inherent in the diagnosis and management of patients with complex and chronic multi-factorial problems
• Associate findings such systemic skin problems with foundational metabolic disorders
• Apply a systematic approach to functional laboratory diagnostics and associate the findings with the need for specific therapeutic strategies
• Discuss the modification of your approach to case management based on outcome-assessment
• Assess, diagnose, and treat patients with serious food allergy and sensitivity, dermatologic disorders, immune dysfunction, and persistent serious hypertension

• Identify the sources of toxic exposure in modern industrial society, the prevalence of exposure, and the health ramifications of elevated total toxic body burden
• Associate a multitude of common symptomatic complaints (ie: fatigue, cognitive dysfunction, skin problems, global pain, etc.) with foundational metabolic disorders related to issues such as elevated total toxic load and "leaky gut"
• Discover the specific biochemical methodology utilized by human metabolism to render toxins harmless and excrete them from the body
• Explain the inherent complications within the normal detoxification process related to the formation of toxic intermediates and the increase in oxidative stress
• Explore the effect of elevated oxidative stress on mitochondrial function and cellular energy production

• Identify various pathologies associated with increased toxicity and total oxidative stress
• Outline specific strategies of patient assessment to determine toxic load and individual hepatic detoxification capacity
• Discriminate between the various pathways of hepatic detoxification biochemistry and objectively assess each pathway
• Explain the use of specific nutrients, nutraceutical compounds, botanical medicines, and foods to lower oxidative stress
• Explore the benefits and complications of adjunctive therapies in the management of patients with elevated toxic load and poor detoxification capacity

• Identify common drug and nutrient interactions
• Identify herbal interactions
• Identify nutrient and nutrient interactions
• Recognize different toxicity levels for various nutrients
• To formulate treatment recommendations based a patient's medication intake.

• Identify some of the functions of Co Q10
• Use Co Q10 for as appropriate as a supplement
• List the issues of performance changes with Co Q10
• Discuss the reasons for, and application of, Co Q10 for patients with Parkinson Disease and migraines