Virginia Chiropractic Continuing Education

Hour 1

• Identify and recite all components of the neurological examination 
• Outline basic peripheral and central nervous system pathways that are clinically relevant to the bedside (ambulatory) neurological examination.
• Perform an examination of the cranial nerve and somatic motor system, including aspects of strength, tone and volume.

Hour 2

• Perform an examination of the cranial nerve and somatic sensory system, including sensory testing of deep and superficial CNS pathways.
• Perform an examination of the reflex system, including testing of deep, superficial, visceral and pathological reflexes.

Hour 3

• Perform an examination of the movement, balance and coordination systems, including tests of cerebellar function.
• Demonstrate an examination flow and performing tests taking the patient from sitting to standing, to the supine and prone positions.
• Summarize implications of neurological findings for lesions in various parts of the central nervous system.
• Summarize implications of neurological findings for lesions in various parts of the peripheral nervous system.

• Identify the domains of and concepts within motor control
• Outline some research on chiropractic's influence on motor control
• Discuss principles of motor control and rehabilitation applied to practice

• 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

• Relate the effects of chemotherapy to the development of neuropathy.
• Draw the pathways specific to Lamina I versus Lamina V sensory pathways.
• Discuss basic science research that links Na, Ca and TRPA1 ion channels with hyper-excitability of sensory neurons.
• Apply Lo-TENs over acupuncture points known to down regulate TRPA1 and PKC for the treatment of neuropathy.
• Utilize natural substances that modulate ions channels related to neuropathy.

• Obtain the most appropriate diagnostic tests  for their patients suspected of suffering from small fiber neuropathy
• Implement the use of serum biomarkers for the management of small fiber neuropathy
• Utilize hair analysis for heavy metals, in cases of chemotherapy induced peripheral neuropathy
• Implement a nutritional detox strategy for the elimination of heavy metals in patients suffering from peripheral neuropathy
• Institute a nutritional strategy to elevate NAD+  or to down regulate NAMPT to protect axons from degeneration in cases of peripheral neuropathy.

• Discuss how small fiber nerve dysfunction may contribute  to painful conditions commonly seen in chiropractic practice.
• Apply the Thermal Grill to evoke Conditioned Pain Modulation and Offset Analgesia to relieve neuropathy pain.
• Utilize techniques to treat deafferentation pain.

• Draw the components of the Central Autonomic Network
• Relate the effects of brain lateralization and asymmetry to sympathetic-parasympathetic balance and tone.
• Apply the technique of High Voltage Galvanic stimulation to create a non-invasive Stellate Ganglion Block.
• Apply Lo-TENs to transcutaneously perform Vagal Nerve Stimulation.

• Formulate a viable alternative treatment for chemotherapy induced neuropathy.
• Offer guidance to patients on how they may prevent or reduce the severity of chemotherapy induced neuropathy.
• Utilize various forms of nervous system  stimulation as a substitute for  acupuncture.
• Apply techniques for determining where nerves are attempting to heal and formulate a treatment strategy designed to accelerate nerve repair.
• Choose the most beneficial type of stimulation and the optimal locations where stimulation should reduce  symptoms and promote nerve repair in chemotherapy induced neuropathy.

• Define physiological lesion & functional lesion
• Differentiate an anatomical pathology from physiological pathology
• Recognize the debate on it’s validity
• Apply the defined lesions to current known brain pathologies
• Illustrate the physiological lesion in known cord pathologies
• Demonstrate how the lesions can be measured
• Examine the applications to manipulative therapy
• Investigate clinical application
• Evaluate the validity of the theory to chiropractic applications.

• List common symptoms and physical examination findings that are seen with concussions and mild traumatic brain injuries.
• Recognize red flags and referrals needed in patients diagnosed with concussion.
• Implement tools like the CDC’s Acute Concussion Evaluation into the patient interview.
• Utilizef advanced imaging and diagnostic testing used for the diagnosis of concussion and pathologies that resemble concussion.
• Identify specific findings from the patient interview and examination that led to the diagnosis of other co-occurring pathologies

• Recall classifications of neurodevelopmental disorders.
• Itemize the four-step approach to management of ADHD.
• Administer sensorimotor integration techniques – Interactive Metronome.
• Assess balance and posture and implement rehabilitation.
• Observe eye movement abnormalities and implement therapeutic protocols.

• Classify a Parkinson's disease patient using the H and Y scale
• Formulate a specific treatment plan for musculoskeletal symptoms experienced by an individual patient.
• Use the Parkinson's Autonomic Rating Scale to formulate a treatment plan for non-motor symptoms of Parkinson's disease.
• Recognize and utilize the three main staging and scoring scales of the conditions.
• Utilize the three major components of the Unified Parkinson's Disease Rating Scale to formulate a specific treatment plan for your patient.
• Understand how the autonomic scoring scale for Parkinson's overlaps and interacts with the Unified Parkinson's Disease Rating Score.
• Combine the rating scales to formulate a stage for disability for the Parkinson's patient.
• Utilize the United Parkinson's Rating Scale to craft a patient-specific rehabilitation program.
• Recognize Parkinsons and refer to appropriate healthcare providers as indicated.

• Develop a comprehensive understanding of common biomarkers relative to Parkinson's disease patients.
• Explore the utility of Cystatin C relative to Parkinson's patients
• Analyze the newly released Neurofilament Light Chain biomarker and its role in Parkinson's disease patients.
• Examine the role of glial cells in the pathophysiology of Parkinson's disease and investigate the potential of the S100B protein as a biomarker for tissue damage in Parkinson's disease patients.
• Gain insights into the significance of glial cells in the pathophysiology of Parkinson's disease and evaluate the efficacy of the S100B protein as a biomarker for tissue damage in individuals suffering from Parkinson's disease.
• Make appropriate referrals to Medical Doctors for Parkinsons Patients

• Apply knowledge of alpha synuclein metabolism to formulate targets for patients suffering with Parkinson’s Disease based on studies of the effect of natural substances on alpha synuclein pathology.
• Match specific herbal and natural formulas to target precise defects in the pathological metabolism of alpha synuclein in Parkinson’s Disease.
• Map out the complex life cycle of alpha synuclein with specific emphasis on known defects that create pathological inclusion bodies in neurons of Parkinson’s Disease patients.
• Recognize natural substances for their potential to reverse pathology related to misfolded alpha synuclein molecules.

• Apply an understanding of NAD+  metabolism to formulate therapeutic targets for patients suffering with Parkinson’s Disease based on  studies of the effect of natural substances on neurodegeneration.
• Match specific herbal and natural formulas to target precise pathways related to neuroprotection.
• Formulate Parkinson’s Disease specific strategies to suppress SARM1 and DLK neurodegeneration pathways.
• Discuss the similarities between alpha synuclein molecules and prion proteins.

• Apply neurotrophic factors to formulate therapeutic targets for patients suffering with Parkinson’s Disease based on  studies of the effect of natural substances on neurotrophic enhancement.
• Match specific herbal and natural formulas to target precise neurotrophic pathways.
• Map out the function of BDNF, GDNF, CDNF, MANF and Nurr-1 related to the proliferation, migration, maturation and functional connection of neural stem cells.
• Utilize specific natural substances for their potential to reverse pathology related to Parkinson’s Disease through the stimulation of neurogenesis.

• Apply available non-invasive neuromodulation techniques to formulate therapeutic targets for patients suffering with Parkinson’s Disease based on the latest studies.
• Match specific non-invasive neuromodulation techniques to target precise physical impairments in Parkinson’s Disease patients.
• Discuss the physiological effects of non-invasive neuromodulation techniques and their applications to the care of Parkinson’s Disease patients.
• Use vagal nerve stimulation, galvanic vestibular stimulation,  transcutaneous spinal cord stimulation, rhythmic auditory stimulation and other neuromodulation techniques to assist in the rehabilitation of Parkinson’s Disease patients.

• Use the function of various deep brain structures  to formulate treatment strategies for patients suffering with Parkinson’s Disease based on the latest studies.
• Match specific non-invasive  techniques to target precise deep brain structures  in Parkinson’s Disease patients.
• Discuss the physiological effects of deep brain activation techniques and their applications to the care of Parkinson’s Disease patients.
• Apply specific techniques related to activation of the Pedunculopontine, Globus Pallidus, Subthalamic Nucleus  and VIM to the rehabilitation of patients wih Parkinson’s Disease.

• Explore cutting-edge cognitive rehabilitation techniques that enhance brain function and recovery.
• Develop personalized strategies to address individual cognitive challenges and improve overall mental agility.
• Gain clinically applicable experience with innovative tools and technologies that support cognitive rehabilitation practices.
• Foster a collaborative learning environment to share insights and best practices for effective cognitive rehabilitation.

• Implement evidence-based strategies to enhance emotional regulation and coping mechanisms for managing hypomimia in individuals with Parkinson's disease.
• Apply advanced techniques for drooling management to promote patient comfort and maintain dignity during activities of daily living.
• Design and instruct patients in effective swallowing exercises to ensure safe and efficient oral intake during meals and hydration.
• Facilitate the strengthening of facial muscles and expressions to improve non-verbal communication and social engagement for Parkinson's patients.

• Discuss briefly the relevant brain anatomy and functional neurology with focus on the frontal lobe and motor cortex.
• Describe the anatomy and physiology of the human brain cortex as it relates to the basic tenants of chiropractic and to spinal subluxation.
• Identify key anatomical components of the frontal lobe and motor cortex.
• Discuss some of the pioneers in neuroscience underscoring their individual contributions.
• Draw basic neurological pathways associated with the frontal lobe and motor cortex.
• Relate function of the frontal lobe and motor cortex to various associated disease conditions.

• This allows you to purchase all 12 hours of 201 level courses. Please see the educational objectives listed for each individual 201 module

• Explore current role of the art and science of clinical neurology for the chiropractor
• Discuss briefly the relevant neurological anatomy and functional neurology
• Describe in detail the anatomy and function of the components of the human skull with attention to aspects which may be important to the chiropractic physician
• Explore the current role of clinical neurology for the practicing chiropractor
• Describe in detail the anatomy and function of the components of the human spine with attention to aspects which may be important to the chiropractic physician

• Explore current role of the art and science of clinical neurology for the chiropractor
• Discuss relevant neurological anatomy of the central nervous system, exclusive of the cortex
• Summarize relevant functional neurology of the central nervous system exclusive of the cortex
• Illustrate the clinical presentation resulting from disease of the various brain and cord areas
• Outline various categories for spinal cord lesions
• Organize findings of central nervous system disease by anatomical location and clinical presentation

• Observe a doctor patient encounter where the patient is a paraplegic
• Explore the relevant issues and action protocols involved in acute spinal cord disease
• Evaluate relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis
• Summarize relevant functional neurology of the spinal cord

• Explore current role of the art and science of clinical neurology for the chiropractor
• Discuss relevant neurological anatomy of the spinal cord
• Summarize relevant functional neurology of the spinal cord
• Illustrate the clinical presentation resulting from disease of the various cord areas
• Outline various categories for spinal cord lesions
• Organize findings of spinal cord disease by anatomical location and clinical presentation

• Discuss relevant neurological anatomy and function of the meninges
• Discuss relevant neurological anatomy and function of the arterial and venous CNS circulation
• Discuss relevant neurological anatomy and function of the cerebrospinal fluid (CSF) circulation
• Illustrate the clinical presentation resulting from disease of the various areas
• Outline various categories for vascular CNS lesions
• Utilize a Grand Rounds type case presentation