Rhode Island Naturopathic Physician Continuing Education

Hour 1

• Discuss the history of elastic taping.
• Define the anatomy of fascial layers in the human body, and how the mechanotransduction concept relates to the use of elastic taping.
• Recognize the most common indications and contraindications for the use of elastic tape within the manual therapist’s practice.
• Describe the application process of elastic taping .

Hour 2

• Discuss the evidence providing support of the use of elastic taping
• Outline various conservative management options for taping musculoskeletal problems
• Construct a treatment plan for a typical patient with acute traumatic swelling
• Apply specific taping techniques for certain biomechanical dysfunctions

Hour 3

• Describe and demonstrate the application of elastic taping procedures for carpal tunnel syndrome
• Describe and demonstrate the application of elastic taping procedures for biomechanical low back pain
• Describe and demonstrate the application of elastic taping procedures for shoulder stabilization
• Describe and demonstrate the application of elastic taping procedures for knee osteoarthritis

• Examine the relationship between hip flexibility and patellofemoral pain
• Summarize the evidence pertaining to the efficacy of manual and physical therapies for the management of Patellofemoral Pain Syndrome
• Outline the possibility of a continuum existing between patellofemoral pain and patellofemoral osteoarthritis
• Discuss the evidence regarding prevalence, diagnosis and management of patellar tendinopathy
• Review the most common clinical tests used to determine balance in those with knee OA a clinical setting

• Outline the innovation of the therapy
• Summarize the Physics behind the modality
• Describe the interaction of LLLT with live tissue
• Detect the contraindications & precautions
• Assess the different LLLT devices.
• Comprehend the different types of LLLT available
• Optimize the LLLT parameters for improved outcomes
• Apply LLLT in a manner that optimizes your treatment
• Explain the physiological effects to your patients
• Examine the current clinical evidence

• 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

• 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

• Summarize the relation between neural plasticity, LBP and spinal manipulation
• Discuss the concept of intervertebral dysfunction with respect to paraspinal muscle
• Assess the correlation between back pain, disability and quality of life
• Describe a study implementing whole spine manipulation in primary care

• Summarize the dose-response relationship between chiropractic and LBP
• Discuss the differences between chiropractic adjustments and muscle relaxants for LBP
• Assess the relationship between osteopathic manipulation and prenatal outcomes
• Describe the association (or lack thereof) between spinal manipulation and lumbar disk herniations
• Analyze the results of a study on active care vs. manual therapy with active care

• Determine the effects of maintenance chiropractic care on chronic low back pain
• Delineate the demographic and clinic-related predictors for successful outcome of chiropractic patients with low back pain
• Compare individuals with and without chiropractic coverage
• Summarize the efficacy of medication, acupuncture, and spinal manipulation for chronic mechanical spinal pain syndromes
• Determine the effects of simulated spinal manipulation on facet joint strains

• Describe the principles of health behavior change
• Detail the factors that promote positive lifestyle changes
• Discuss current theories and models of behavior change
• Discuss techniques and processes of how to change health behavior

• Review articles addressing the latest information concerning chiropractic and/or spinal manipulation for neck pain and/or headaches
• Provide evidence-informed practice recommendations for the chiropractic treatment of headache in adults
• Determine the short-term effect of chiropractic joint manipulation therapy (CMT) and low-level laser therapy (LLLT) on pain and range of motion in the management of cervical facet dysfunction
• Assess whether adjusting dysfunctional cervical segments in people with subclinical neck pain can improve their upper limb joint position sense accuracy
• Investigate the efficacy of preventive spinal manipulative therapy (SMT) compared to a no treatment group in non-specific neck pain patients
• Assess the effectiveness of thoracic manipulation (TM) on patients with chronic neck pain
• Describe a randomized controlled trial comparing manipulation with mobilization for recent onset neck pain

• Review articles addressing the latest information concerning chiropractic and/or spinal manipulation of the lower back
• Assess the current scientific literature related to manipulation for acute low back pain
• Assess the current scientific literature related to manipulation for chronic low back pain
• Compare the clinical efficacy of spinal manipulation against microdiskectomy in patients with sciatica secondary to lumbar disk herniation (LDH)
• Review the Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) study
• Assess maintenance spinal manipulation therapy for chronic non-specific low back pain

• Review articles addressing the latest information concerning chiropractic and/or spinal manipulation for pregnancy related low back pain and/or post-partum pain
• Review the published evidence regarding chiropractic care, including spinal manipulation, for pregnancy-related low back pain (LBP)
• Describe the clinical outcomes of patients with pregnancy-related lumbopelvic pain (PRLP) treated according to a diagnosis-based clinical decision rule
• Assess osteopathic manipulative treatment of back pain and related symptoms during the third trimester of pregnancy
• Describe the development a clinical prediction rule (CPR) for identifying postpartum women with low back pain (LBP) and/or pelvic girdle pain (PGP) whose functional disability scores improve with a high-velocity thrust technique (HVTT)

• Define Fibromyalgia according to the ACR criteria
• Discuss the history and epidemiology of Fibromyalgia
• Assess the differential diagnoses, triggers and possible causes of Fibromyalgia and discuss how they can help in the diagnosis of Fibromyalgia
• Identify several triggers for the exacerbation of Fibromyalgia
• List the symptoms of depression, grief and adjustment disorder that can be clues for the diagnosis of Fibromyalgia
• Recall the symptoms of dysfunctional sleep, chronic pain and fatigue that help to diagnose Fibromyalgia
• Compare some of the triggers that may make pain worse in the Fibromyalgia patient and factors that may decrease pain in the Fibromyalgia patient

• Define Rheumatology and Chiropractic and list similarities
• Critique some of the downfalls in today’s treatment protocol of the Rheumatic patient and explain why Chiropractors should be aware of this patient population
• Discuss Integrative Medicine and outline some of the important options for holistic treatment
• Discuss other health concerns facing the Rheumatic Patient
• List the steps used in evaluating the Rheumatic Patient
• Identify some of the tools used for diagnosis and treatment of the Rheumatic Patient
• Analyze the patient’s symptoms and test values and compare for differential diagnose
• Evaluate laboratory tests and values used to diagnose Rheumatic diseases and syndromes
• Select the best imaging techniques for specific Rheumatic diseases and soft tissue syndromes
• Identify some of the diseases specific issues in a few of the Rheumatic diseases and syndromes discussed
• Recognize the symptoms, diagnosis protocols and treatments of some of the more prevalent arthritic diseases and syndromes

• 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