Washington Chiropractic Continuing Education

• Provide a rationale for the use of outcome assessments in practice
• Survey the recommended outcome assessment measures used by chiropractors and provide a copy or link to download them electronically
• Describe the recommended outcome measures and provide instruction on how to score them
• Detail the psychometric properties of the commonly used outcome measures to aid in determining clinically relevant change in patients
• Indicate which outcome measures to use and when to use them

• Evaluate the effectiveness of the influenza vaccine in healthy adults and children 
• Evaluate the effectiveness of the influenza vaccine in the elderly 
• Evaluate the importance of influenza vaccination in those with recent cardiac events 
• Explain the key elements in the "Tamiflu Controversy" 
• Discuss limitations to the Tamiflu research base 
• Discuss limitations to using zinc for the common cold 
• Evaluate strengths of study design for pragmatic trials 
• Discuss the effectiveness of using probiotics for the common cold 

• Recognize the initiation and growth of evidence-based  (EBP) or evidence informed practice (EIP)
• Interpret the need to utilize EBP
• Define EBP.
• Explain the levels of evidence and applications to practice
• Contrast EBP/EIP with what is not EBP/EIP and relate to your clinical expertise.
• Evaluate the research evidence for application to practice
• Locate the literature that applies to the doctor’s patient
• Integrate the literature research with their clinical expertise and the patient preferences
• Recognize patient preferences
• Distinguish your patients from the benchmarks of care
• Distinguish the different types of evidence
• Synthesize EBP/EIP into case studies
• Implement EBP/EIP procedures to your practice for increased patient compliance,
• Differentiate individual patient cases with similar diagnoses
• Identify actions contingent upon the level of evidence

• Hypothesize situations where being able to critically evaluate research on your own may be particularly important
• Recall the original definition of evidence-based medicine
• Identify point-of-care resources for high quality evidence
• Categorize the evidence-based resources into point-of-care, summaries, syntheses etc.
• Define “bias” in the context of research studies
• Discover risk of bias in randomized controlled trials as it relates to unmasking and blinding
• Paraphrase the meaning of a “straw man” in the context of study design
• Discover risk of bias in randomized controlled trials as it relates to industry sponsorship, specifically referencing spin, straw man design, selective outcome reporting
• Identify the aspects of ‘non-specific effects’
• Define minimal (clinically) important difference
•  Explain why minimal important differences may be more relevant than p values
• Apply research findings to the patient in front of you

• Explore contemporary healthcare issues from the perspective of Robert Lustig, MA and John Abramson, MD.
• Integrate the relevance of these issues to the chiropractic profession.
• Evaluate at the concept of evidence-based “medicine,” especially the “randomized controlled trial,” and describe how it applies to the chiropractic profession.
• Discriminate recent examples of “randomized controlled trials,” especially as related to pain syndromes and opioid drugs.Discusss the importance of the 2021 Nobel Prize for the chiropractic profession and mechanical-based care.
• Detail the physiology of the Piezo1 mechanical receptor.
• Introduce the concepts of mechanical function and mechanical neurology.
• Integrate the importance of the cerebellum to mechanical integrity and mechanical based care.
• Explain a randomized clinical trial that supports mechanical-based chiropractic care for visceral physiology.
• Distinguish the basic physiology of the neurotransmitter norepinephrine.
• State the basic physiology of the neurotransmitter dopamine.
• Outline the basic physiology of the neurotransmitter serotonin.
• Integrate the balance of the neurotransmitters dopamine and serotonin.
• Recite the relationship between the neurotransmitters dopamine, epinephrine and norepinephrine.
• Explore the concept of Heart Rate Variability (HRV).
• Integrate upper cervical chiropractic care, spinal chiropractic care, and HRV.

• Describe the relationship of the sympathetic nervous system and immunology.
• Relate the sympathetic nervous system and headache.
• Emphasize the importance of the opiate receptors in the periaqueductal gray matter and pain suppression.
• Summarize activation of the periaqueductal gray matter with chiropractic adjusting for pain suppression.
• Define the tensegrous matrix as relevant to chiropractic assessment and care.
• Integrate electrical nerve interference as a component of the subluxation complex.
• Explore the “corking” of cerebral fluid flow as related to the occiput-atlas subluxation.
• Define the prevalence, patterns, and predictors of chiropractic use by the US population.
• Empathize the importance of the first-class lever system of upright posture to the chiropractic profession.
• Establish the functional and physiological relationship between the brain and the cervical spine.
• Discuss the integrated physiology between inflammation, fibrosis, the Gate Theory, and chiropractic adjusting.
• Create a model of pain based upon the fibrosis of repair, motion, and the Gate Theory.
• Complete an interactive model of neuroimmunology using mechanoreceptors, the sympathetic nervous system, norepinephrine and neurological magnification.
• Complete an interactive exercise of spinal mechanoreceptor driven vestibular nuclei controls of somatic function and visceral function.
• Integrate the importance of constant v. non-constant thalamic summation/integration.

• Appreciate the current epidemiologic trends in autoimmune incidence, morbidity and mortality in the Western industrialized countries versus the under-developed world.
• Acknowledge the importance placed in human biology on mucosal immunity and the massive amount of immune tissue and functional resources dedicated to GI mucosal immune surveillance.
• Comprehend the linkage and association between autoimmune disease prevalence and factors including the GI microbiota composition, stealth infections, and molecular mimicry.
• Apply clinical laboratory testing related to autoimmune disease risk assessment and diagnosis, including qPCR molecular-based evaluation of the GI microbiota.

• Appreciate the current epidemiologic trends in autoimmune incidence, morbidity and mortality in the Western industrialized countries versus the under-developed world.
• Acknowledge the importance placed in human biology on mucosal immunity and the massive amount of immune tissue and functional resources dedicated to GI mucosal immune surveillance.
• Comprehend the linkage and association between autoimmune disease prevalence and factors including the GI microbiota composition, stealth infections, and molecular mimicry.
• Apply clinical laboratory testing related to autoimmune disease risk assessment and diagnosis, including qPCR molecular-based evaluation of the GI microbiota.

• This includes all content from Functional Medicine 201 thorugh 205. Please see educational objectives for those courses

• Identify the differences in methodology and application between quantitative molecular testing (qPCR) versus next-generation sequencing of the GI microbiota in the support of clinical decision making.
• Synthesize the available evidence-based integrative and complementary therapeutic GI antimicrobial interventions for treating GI dysbiosis, including in subjects with autoimmune disorders.
• Explore the linkage and association between autoimmune disease prevalence and food immune reactions and sensitivities.
• Apply the available evidence-based integrative and complementary therapeutic interventions using pro and pre-biotics for improving the GI ecology in subjects with autoimmune disorders.

• Identify the linkage and association between autoimmune disease prevalence and factors including lack of early diverse antigen exposure (i.e., the hygiene hypothesis).
• Interpret the available predictive autoantibody test options for autoimmune disorders.
• Learn to determine when to order the available clinical laboratory testing related to autoimmune disease risk assessment, diagnosis, and clinical management, including qPCR molecular-based evaluation of the GI microbiota, various food sensitivity assays, and predictive autoantibody tests.
• Apply evidence-based integrative and complementary therapeutic interventions for improvement of the GI mucosal health and barrier function (i.e., leaky-gut syndrome) in autoimmune disorders. 

• Utilize clinical decision making related to the linkage and association between autoimmune disease prevalence and individual factors, including the GI microbiota composition, food immune reactions, stealth infections, molecular mimicry, and lack of early diverse antigen exposure, in practical clinical cases.
• Interpret the available clinical laboratory testing related to autoimmune disease risk assessment, diagnosis, and clinical management, including qPCR molecular-based evaluation of the GI microbiota and predictive autoantibody tests in specific practical clinical case scenarios.
• Apply the available evidence-based integrative and complementary therapeutic interventions for autoimmune disorders in specific practical clinical case scenarios.
• Refer to other medical specialists and collaborative care opportunities in complex autoimmune disease clinical case scenarios.

• Identify the risks and complications of long-term PPI (Proton Pump Inhibition) exposure, complicating factors increasing our risks and their correction, and “best practices” for prescribing this therapy.
• Demonstrate a hiatal hernia correction technique with a Chiropractic Adjustment
• Integrate and apply phytotherapy treatment of different causes of dysmotility (SIBO, SIFO, IBD, IBS, neuropathy) based upon identifying key colonocyte target receptors in both TH1 (autoimmune) VS TH2 (allergic) situations.
• Identify and summarize Metabolic Inflammation, explain its’ triggers, resultant diseases and prescribe treatment for it.
• Discuss inflammation in the Intestine-Lung axis, apply dietary and lifestyle preventative and corrective treatment.
• Develop the use of therapeutic “biotics” for asthma, airway inflammation, and atopic disorders,
• Associate GI and respiratory biodome imbalances with asthma and allergic disorders, and their relationship to allergic sensitization
• Critique the interaction of the hygiene hypothesis and our “window of opportunity” to prevent asthma and allergic diseases
• Apply home and office based environmental therapy to help limit daily allergic exposure, allergy and asthma reactions.

Hour 1:

• Discuss PNI and its relationship to musculoskeletal conditions
• Review the interaction of the Hippocampus-Pituitary-Adrenal axis with PNI and its effect on musculoskeletal conditions Discuss clinical approach to managing these syndromes

Hour 2:       

• Explain what factors affect the baby boomer population
• Establish Patient education and doctor patient relationship
• Establish protocols to improve treatment outcomes

Hour 3:

• Mind over matter- how the brain and neuropathways affect musculoskeletal conditions
• Describe cellular structure connections
• Evaluate patients with musculoskeletal conditions and consider the effect of the mind, body, cellular and neurological alterations manifesting of these conditions.

• Identify the Importance of the Microbiome in Leaky Gut Syndrome
• Examples of symptoms of Leaky Gut Syndrome
• Discuss the health conditions caused by Leaky Gut Syndrome
• Breakdown the causes of Leaky Gut Syndrome
• Explain Nutritional Therapies used to heal Leaky Gut Syndrome

• Explain the importance of Glutathione as a Nutritional Therapy.
• Demonstrate the Symptoms of Alzheimer’s, Liver dysfunction, Lung conditions and Eyes, Ears, Nose and Throat conditions and the benefits of Glutathione therapy in each case.
• Discuss abstracts that illustrate the benefits of Glutathione therapy in Alzheimer’s, Liver and lung dysfunction and conditions of the Eyes, Ears, Nose and Throat.
• Illustrate the primary benefit of Glutathione therapy for Alzheimer’s and conditions of the liver, lung and ears, eyes, nose, and throat.
• List the primary precursors for Glutathione in the body.

• Simplify the progressive cause-effect relationship of disease from biochemical imbalances to physiological disturbances to cellular/organ degeneration to disease manifestation
• Identify the five primary underlying etiologies of virtually all chronic degenerative disease
• Analyze the most common antecedents and triggers that predispose your patients to disease
• Devise an evaluation algorithm that efficiently guides your testing recommendations
• Discover novel in-office testing procedures that cost-effectively demonstrate patients’ nutrient insufficiencies; unmanaged stress; toxic burden; and sleep “debt”
• Evaluate Heart Rate Variability test results to easily measure and demonstrate patients’ stress adaptability as well as their response to treatment modalities
• Discriminate the meaningful information gleaned from Bio-Impedance Analysis (BIA) testing for monitoring your patients’ health restoration progress
• Interpret evaluation results to efficiently identify which primary factors are contributing to your patients’ health challenges
• Prioritize treatment plans that address both short-term goals (symptomatic relief) and long-term goals (correction, stabilization and prevention)
• Distinguish which nutraceuticals best support patient needs based on history, exam, testing and symptomatology
• Communicate the functional medicine model of health and disease with your patients with greater clarity and ease

• This contains all courses with the educational objectives listed from Functional Medicine 209 through 212.

• Design an efficient and cost-effective approach to evaluating your patients’ underlying health challenges
• Select key questions to ask your patients (consultation, history, questionnaires) to hone-in on their principal underlying imbalances
• Discover in-office, economical evaluation tools to efficiently reveal key diagnostic clues
• Create a systematic decision-making process that directs your testing recommendations
• Devise a practical and effective formula to skillfully evaluate gut health (dysbiosis), adrenal imbalance, blood sugar dysregulation (dysglycemia); oxidative stress; methylation defects; thyroid insufficiency; and sex hormone imbalances
• Generate a logical treatment sequence to competently treat the fundamental underlying conditions revealed in your evaluation
• Differentiate which nutraceuticals best support and rebalance underlying physiological imbalances.

• Identify the appropriate candidates (patients) for a detoxification program
• Effectively communicate the need for detoxification support
• Ensure a safe and comfortable detoxification experience
• Establish realistic expectations - for you and your patient
• Measure the outcome of your patient’s detoxification using novel, in-office, cost-effective evaluation procedures
• Generate 14 and 21 day detoxification programs
• Devise detoxification programs for various levels of patient commitment and participation
• Easily and readily respond to common patient questions and concerns about detoxification
• Address post-detoxification clinical considerations and directions

• Identify the most common pre-disposing factors for the initiation of cancer
• Design a screening protocol to evaluate cancer risk factors
• Discover specific evaluation procedures that identify biochemical imbalances indicative of cancer risk
• Interpret specialized laboratory test results that portray a physiological environment conducive to cancer promotion
• Devise treatment strategies shown to reverse cancer related imbalances
• Hone diagnostic skills by reviewing and analyzing a series of patient case studies, inclusive of history, exam findings, lab test results
• Develop safe and effective treatment recommendations for some of the more common chronic degenerative conditions, e.g., thyroid imbalances, chronic fatigue, inflammatory bowel disease

• Explain how beneficial commensal microbes support gastrointestinal health
• Describe the major components of the intestinal barrier
• Summarize the microbial composition of a typical stool sample
• Explain the role of comprehensive stool testing in assessing gastrointestinal health

• Recognize the three most common types of microbial dysbiosis
• Describe common factors that can reduce beneficial microbes and disrupt the intestinal barrier
• Assess pathogens and opportunistic microbes identified with comprehensive stool testing
• Discuss how the selection of microbial testing methodology may affect the identification of pathogens and opportunists
• Outline therapeutic approaches that address common dysbiosis types identified via comprehensive stool testing

• This course contains all courses with the educational objectives listed from Functional Medicine and Nutrition Virtual Classroom 201 through 210

• Describe the current epidemiologic trends in autoimmune incidence, morbidity and mortality.
• Associate the linkage between autoimmune disease prevalence and factors including the GI microbiota composition, food immune reactions, stealth infections, molecular mimicry, lack of early diverse antigen exposure, and other elements.
• Examine the available clinical laboratory testing related to autoimmune disease risk assessment, diagnosis, and clinical management, including qPCR molecular-based evaluation of the GI microbiota.
• Explain the difference between quantitative molecular testing (qPCR) versus next-generation sequencing of the GI microbiota in the support of clinical decision making.
• Appraise the available evidence-based integrative and complementary therapeutic interventions for autoimmune disorders.

• Describe the current common routes and mechanisms of toxic exposure for individuals living in the industrialized world.
• Associate the linkage between chronic diseases, including mitochondrial dysfunction, obesity, diabetes, Alzheimer’s disease, Parkinson’s disease, cancer and others with increased levels of exposure to various environmental and food toxins.
• Examine the available clinical laboratory testing related to toxic load and related disease risk assessment, diagnosis, and clinical management using various lifestyle and nutritional approaches.
• Explain the difference between the various methods to assess toxic burden and detoxification at the level of the individual in the support of clinical decision making.
• Appraise the available evidence-based integrative and complementary therapeutic interventions for lowering toxic load and improving detoxification function.

Hour 1

• Describe the general diagnostic criteria of Metabolic Syndrome and CVD.
• Demonstrate an understanding of the enhanced diagnostic criteria and the importance of investigating these potential earlier markers.
• Demystify the “Cholesterol and HDL hypothesis” and explain the compensation mechanisms of the body for this.
• Recognize the biometric and physical signs of the progressive nature of CVD, CHD and MetS.
• Investigate Lifestyle Modification Programs as the major intervention strategy for the reversal and stagnation of these comorbidities. 

• Describe the general dietary interventions of Metabolic Syndrome and CVD.
• Demonstrate an understanding of sodium/salt as it relates to CVD/HTN.
• Demystify the confusion of major supplements and foods as it relates to CVD/HTN. 
• Recognize the associations between insomnia and CVD, CHD and MetS.
• Investigate various peer reviewed studies and the outcomes of nutritional interventions.  

• Provide an understanding of the clinical applications of biochemical/metabolic evaluations to determine a patient’s hormonal status
• Explain the differences between various assessments of hormonal status
• Evaluate hormonal imbalances and disorders
• Evaluate nutrient needs in metabolic disorders Plan and monitor nutrient interventions to correct abnormalities found by the tests

• Describe the origin of mitochondria from an evolutionary perspective.
• Understand the critical role that the thyroid plays in metabolism and how this relates to healthy mitochondrial function.
• Explain how to test for mitochondrial function/dysfunction.
• Show how living in a thermos neutral modern society contributes to obesity.
• Recognize how antibiotics can damage mitochondria and how that can play a role in obesity.
• Give examples of toxins/drugs that can adversely affect mitochondria.

• Describe how common mitochondrial genetic problems are in the general population.
• Explain how mitochondria are needed to produce glutathione and why glutathione is needed for healthy mitochondria.
• Discover how oxidative stress can be both good and bad for the body.
• Discuss how mitochondrial dysfunction plays a key role in a variety of diseases ranging from Parkinson’s, Cancer, NASH, Alzheimer’s, Autism and Diabetes.
• Discover key ways to optimize mitochondrial function in patients.

• Describe the associations of micronutrient deficiencies as it relates mental health disorders.
• Demonstrate an understanding of major prescriptive medications and their negative influence on mental health disorders. 
• Explain the overlap of certain pathophysiological conditions and mental health disorders.
• Recognize the current lack of proper diagnosis of mental health disorder.

• Describe the associations of micronutrient and nutritional deficiencies as it relates mental health disorders.
• Demonstrate an understanding of the major biochemical pathways, their enzymes and nutritional elements as it relates to psychological issues.
• Explain the importance of fatty acids in mental health disorders.
• Recognize the current lack of proper nutritional interventions as it pertains to TBI, mTBI and PCS.

• Provide an understanding of the clinical applications of biochemical/metabolic evaluations to determine a patient’s status of nutrients, toxicants and cell regulators, and functional gastrointestinal status.
• Explain the differences between various assessments of element status
• Evaluate specific nutrient deficiency states
• Determine weaknesses in digestive, assimilative and intestinal microbiological status
• Plan and monitor nutrient interventions to correct abnormalities found by the tests

• Define and explain the difference between "calories in, calories out" versus the “carbohydrate-insulin model of obesity”. Discuss the causes of increased intestinal permeability in competitive athletes and identify strategies to combat the condition. Identify the energy intake athletes require by calculating their total energy expenditure.
• Recall the quality and function of macronutrients and their role in physical performance.
• Describe common micronutrient deficiencies seen in competitive athletes and identify strategies to prevent such occurrences.

• Summarize the physiological energy and macronutrient requirements of the sprint/power athlete and game-playing athlete. Identify supplement strategies to support the sprint/power athlete and game-playing athlete.
• Summarize the physiological energy and macronutrient requirements of the endurance athlete.
• Identify supplement strategies to support the endurance athlete.
• Outline an effective whole food diet to support competitive athletes.

• Describe the secondary metabolites in whole foods.
• Understand the role of phytochemicals.
• Demonstrate an understanding of how they interact with our cells.
• Explain how to preserve them during cooking.

• Recognize the challenges caused by ultra-processed foods
• Identify the compounds in the Brassicaceae family
• Explain the health benefits of sulforaphane
• Explain the importance of preserving secondary metabolites
• Recognize the benefits of the fungal kingdom

Hour 1

• Describe the characteristics and mechanisms of actions of essential oils.
• Explain several key controversies in aromatherapy and the implications.
• Generalize the safety and quality issues surrounding the clinical use of essential oils.
• Compare the various modes of applications of essential oils.
• Summarize the pharmacology and biotransformation of essential oils and its constituents.
• Recognize the potential interactions of essential oils with medications and nutraceuticals.

Hour 2 

• Generalize the various considerations for prescribing essential oils.
• Calculate equivalent dosages of essential oils using several different units of measurement.
• Apply the guidelines for appropriate prescribing the internal use of essential oils.
• Determine the proper application and dosage for various essential oils used for digestive health.
• Specify the usage and dose determination for essential oils for mental health.

• Analyze the concept of central pain processing and the consequences of dysfunction of descending inhibition.
• Associate FM with trauma and abuse, depression, anxiety, sleep disorder and pain processing disorders with emphasis on limbic system dysfunction, aberrant stress physiology, and ultimate failure of descending anti-nociception. 
• Assess the difference between regionalized somatic pain and true central allodynia
• Describe the accurate differential diagnosis of patients presenting with suspicion of FMS
• Identify common subsets of clinical disorders that may lead to an erroneous diagnosis of FMS (i.e., “pseudo” FMS)

• Describe and Identify the functional medicine approach to common pediatric problems
• Develop a comprehensive functional medicine assessment and treatment of common pediatric problems such as constipation, headaches and migraines, upper respiratory infections and otitis media, food sensitivities, allergies, asthma and atopy
• Examine the salient features of history, physical examination and laboratory testing to best implement functional medicine interventions to common pediatric problems
• Utilize a functional medicine approach to assess what each child may need to get or get rid of to treat each of these common pediatric problems 
• Summarize the literature supporting the use of functional medicine in pediatrics
• Recognize the four pillars of a functional medical approach to chronic pediatric illness – gastroenterologic, immunologic, metabolic and neurologic
• Classify and explain the importance of the genetic and genomic susceptibilities/predisposition and environmental triggers of chronic pediatric illnesses
• Utilize a functional medicine approach to assessing and treating chronic pediatric disease such as ADHD, Autism, Autoimmune Encephalitis, Anxiety, Allergy and Atopy
• Interpret the literature citations and develop protocols based on emerging evidence supporting a functional medicine approach to these chronic pediatric problems
• Appraise the assessment and management of the importance of the microbiome in immune tolerance, allergy and autoimmunity.

• Discuss the catecholamine pathway will be presented in an organized fashion with emphasis on real world applications. 
• Review clinical case studies. 
• Assess different genetic mutations within the catecholamine pathway . 
• Individualize treatment plans in practice. 
• Demonstrate a basic road map of the catecholamine pathway. 
• Use genetic parsing software and the tools attained form this course to highlight and modulate genes/SNPs of interest. 
• Derive natural therapeutic agents to modulate epigenetic expression. 
• Utilize basic nutrigenomic assessment and treatment knowledge in the catecholamine pathway.

• Define and explain the different terms that identify exercise intensity and their relationship to maximal oxygen uptake (VO2 max).
• Discuss the history of exercise physiology and how technology influenced research and ultimately, exercise guidelines.
• Differentiate the physiological responses to sprint interval training and to low-to-moderate intensity continuous training.
• Reconstruct a lay explanation to patients and/or clients of why sprint interval training is an extremely effective strategy for improving overall health and fitness.
• Summarize key research studies that support sprint interval training.

Hour 2

• Recognize additional research that supports sprint interval training.
• Identify key physiological benefits of sprint interval training.
• Recall important case study benefits.
• Outline effective overall strategies for implementing sprint interval training.
• Distinguish appropriate sprint interval exercises for differing populations.

Hour 1:

• Summarize the differences between genomics, genetics, and epigenetics
• Illustrate how genomics can affect risk and outcomes in auto-immune and inflammatory conditions
• Interpret relative function of genes based on presence of relevant SNPs
• Identify genes and SNPS involved in autoimmune disease and chronic inflammation
• Assess Dietary, Lifestyle and Herb/Nutrient recommendations based on genomics

 Hour 2:

• Apply nutritional genomics in autoimmune and inflammatory diseases
• Outline basic disease pathogenesis in autoimmune and inflammatory diseases
• Explain which genes and SNPs are relevant depending on the clinical scenario
• Assess other contributors to chronic inflammation and autoimmune disease

• Summarize the current state of legal status and research on fecal microbial transplants (FMT)
• Describe the state of research of FMT for irritable bowel syndrome
• Describe the state of research of FMT for hepatic encephalopathy
• Describe the state of research of FMT for antibiotic associated diarrhea/dysbiosis
• Describe the state of research of FMT for ulcerative colitis
• Describe the state of research of FMT for Clostridium difficile infection
• Describe the state of research of FMT for autism

• Define leaky gut
• Recall basic histology/molecular biology involved in leaky gut
• List conditions associated with leaky gut
• Compare diagnostic tools in the differential diagnosis of leaky gut
• Recite how the lactulose mannitol test works
• List therapeutic interventions for leaky gut

• Define Small Intestinal Bacterial Overgrowth (SIBO) 
• List common causes/ associations/risk factors of SIBO
• Recall the various estimates of SIBO prevalence
• Explain why SIBO prevalence estimates vary
• Describe the trajectory of SIBO research over the past decades

• Explain the limitations of using breath tests for the diagnosis of SIBO compared to other alternatives.
• Describe the specific issues with glucose-based breath tests for SIBO diagnosis.
• Describe the specific issues with lactulose-based breath tests for SIBO diagnosis.
• Critique the North American consensus document on breath testing for SIBO

• Implement the 2020 ACG Guidelines as it relates to breath testing for patients with IBS.
• Implement the 2020 ACG Guidelines as it relates to breath testing for patients taking PPIs.
• Discriminate between normal and abnormal ppm of H2S on a breath test.
• Contrast between the microbial diversity of the small intestine in those with and without SIBO.
• Identify the aberrant organism most associated with SIBO in the REIMAGINE study.
• Implement the 2020 ACG Guidelines as it relates to testing IBS patients for food sensitivities.
• Implement the 2020 ACG Guidelines as it relates to the use of low FODMAP diets in IBS patients.
• Select the Gut Directed Hypnotherapy regimen associated with the largest effect size.
• Explain the need for GRADE within the context of Guideline development.
• Critique a guideline using the AGREE-II criteria.
• Define the concepts of pre- and post-test probability.
• Calculate a post-test probability.

• Describe the role of GRADE in Guideline development
• Recall the recommendations of the ACG SIBO Guidelines
• Identify key concepts of SIBO as delineated by the authors
• Appraise the ACG Guidelines

• Recall the pathophysiology of the progression of Barrett’s esophagus to adenocarcinoma
• Implement the 2022 ACG guidelines on the use of PPIs for Barrett’s esophagus
• Evaluate the conclusions from the three competing meta-analyses on PPIs for Barrett’s
• Apply relative risk reduction calculations to the determination of the benefit of PPIs for Barrett’s

Hour 1

• Distinguish what gases are measured with Aire versus Aire2
• Judge the diagnostic agreement between Quintron and Aire devices in patients suspected of having SIBO
• Map the relationship between ‘fermentation scores’ and ppm
• Illustrate how you could use the Aire device to conduct formal SIBO breath tests

Hour 2

• Extrapolate hydrogen levels in the background of high methane
• Compare and contrast the pros and cons of using the Aire device
• Implement the clinician dashboard for breath testing
• Clarify why CO2 levels are not needed for Aire

• Recall the most common symptoms which H2S patients present with 
• Identify which H2S treatment interventions led to a statistically significant rate of adequate patient response 
• Evaluate an H2S SIBO case with a focus on severity and treatment history 
• Determine reasonable treatment options for an H2S SIBO case

• Summarize the effect of exercise on wound healing in older adults
• Discuss the relationship between trunk muscle composition and functional capacity
• Assess the effects of high-intensity strength training on balance
• Describe a study that examines the reliability and validity of a new steadiness measure
• Assess the effect of an endurance exercise program on depression, anxiety and quality of life

• Summarize the concept of mitochondrial degeneration
• Discuss the free-radical mitochondrial theory of aging and the susceptibility of the brain to oxidative stress
• Assess the relationship between mitochondrial decay and age-related neurodegenerative diseases, such as Alzheimer's disease (AD) and Parkinson's disease (PD)
• Illustrate the array of mitochondrial nutrients and the various vitamins that may improve mitochondrial function

• Breakdown the biomechanical processes of spinal degeneration
• Explain the biochemical processes that occur in the geriatric population in 
• Differentiate between various diagnosis of structural and chemical conditions seen in geriatric patients
• Analyze the radiological findings and how they influence clinical decisions
• Explain Syndrome X and how it affects physiology
• Differentiate trauma and its late effects on the body

• This contains all courses with the educational objectives listed from Geriatrics 103 through 106

Hour 1

• Describe psychoneuroimmunology and its application to clinical diagnosis of geriatric patients
• Apply psychoneuroimmunology to activities of daily living

Hour 2

• Differentiate clinical approaches to managing psychoneuroimmunology
• Measure clinical treatment outcomes

Hour 3

• Relate what factors contribute to this field in the elderly patient
• Incorporate hormonal balancing with nutrition in clinical treatment plans for Chiropractic Patients

• Implement nutrients that promote spinal and joint function to obtain positive clinical outcomes
• Explain Ph., alkalinity and acidity as it impacts the physiology of the body in regards to healing
• Categorize toxins in the environment that create clinical presentations of  geriatric patients clinical care
• Utilize vitamins herbals and supplements to augment patients’ care
• Factor nutritional aspects of protein, fats and carbs into clinical treatment plans to improve healing
• Create treatment goals and nutritional plans

• Assess various treatment modalities
• Implement treatment protocols as found in the latest research
• Progress patients to incorporate wellness into their lifestyle
• Perform postural evaluations and discuss clinical significance to the patient
• Appropriately factor radiographic findings into diagnosis and clinical decision making of the geriatric patient
• Examine physical findings and set specific and measurable patient treatment goals

• This contains all courses with the educational objectives listed from Geriatrics 106 through 108

• Review evidence-based recommendations regarding best practices for chiropractic care of older adults
• Outline the relationship between individual sagittal posture and risk falling in an elderly back pain population
• Explore the cost impact of utilizing chiropractic in older patients with chronic low back pain and multiple comorbidities
• Examine the effectiveness of nonpharmacological therapies for dizziness in older people
• Assess the impact of chiropractic care on measures of sensorimotor function associated with the risk of falls in older adults

• Summarize the United Nations (UN) Decade of Healthy Aging and its initiatives
• Describe challenges specific to conducting clinical research on older patients
• Examine epidemiological trends and opportunities related to an aging population
• Define agism and elderspeak
• Explore relevant concepts of, and goals for, healthy aging
• Outline relevant clinical considerations for aging patients in a chiropractic practice
• Specify red flags in older patients that would warrant clinical referral
• Assess general function in elderly patients using simple clinical tests
• Examine our unique clinical opportunities (and challenges) relating to providing chiropractic care for older patients
• Recognize the clinical impact of multi-site pain in elderly patients
• Cite existing data on chiropractic care patterns for older patients
• Summarize and critique the existing body of research on chiropractic care for spinal conditions in older patients
• Explore the relationship between hip and spine function in elderly patients
• Integrate existing literature pertaining to the patient experience and understand what matters to them
• Summarize best practices for providing chiropractic care for older patients
• Discuss the rational use of imaging in chiropractic practice
• Define osteoarthritis and review the societal impact of this condition
• Identify risk factors for the development of osteoarthritis
• Outline our current state of knowledge on the pathophysiology and diagnosis of osteoarthritis
• Appraise the state of the evidence regarding general treatment recommendations for osteoarthritis
• Explore the scientific literature regarding various treatment modalities for osteoarthritis
• Recognize the value of exercise for managing osteoarthritis
• Critique the literature regarding common medical interventions for osteoarthritis
• Define lumbar spinal stenosis and review the societal impact of this condition
• Classify pathognomonic signs and symptoms of lumbar spinal stenosis
• Differentiate lumbar spinal stenosis from other clinical conditions
• Breakdown the evolving evidence relating to the management of lumbar spinal stenosis
• Discover the important role chiropractic can play in the treatment of lumbar spinal stenosis
• Outline our current state of knowledge on the pathophysiology and diagnosis of degenerative cervical (spondylotic) myelopathy
• Recognize the importance of identifying this pathology in aging patients to facilitate appropriate care

• Discuss ethical standards of insurance reporting and coding
• Illustrate how documentation can affect state board complaints
• Discuss why insurance companies file complaints against chiropractors
• Discuss why patients file board complaints against chiropractors
• Define the Problem Oriented Medical Record (POMR)
• Illustrate taking a thorough history using the OPQRST method
• Discuss the components of the ortho/neuro exam

Hours 1 - 3

• Discuss ethical standards of insurance reporting and coding
• Illustrate how documentation can affect state board complaints
• Discuss why insurance companies file complaints against chiropractors
• Discuss why patients file board complaints against chiropractors
• Define the Problem Oriented Medical Record (POMR)
• Illustrate taking a thorough history using the OPQRST method
• Discuss the components of the ortho/neuro exam

• Discuss the misrepresentation of certain orthopedic tests
• Illustrate sensitivity and specificity of orthopedic tests
• Define the 2021 changes to Evaluation and Management codes
• Discuss the differences between using time vs. medical decision making for E/M
• Distinguish between subjective and objective outcome assessments Illustrate methods of proving medical necessity
• Illustrate the CMS requirements of chiropractic documentation
• Illustrate condition-specific functional outcome questionnaires
• Define the A of P.A.R.T. from Centers for Medicare/Medicaid Services
• Define the R of P.A.R.T. from Centers for Medicare/Medicaid Services
• Illustrate the different methods of evaluating spinal range of motion
• Define the T of P.A.R.T. from Centers for Medicare/Medicaid Services
• Describe the timing of the first re-assessment
• Demonstrate proper coding for range of motion measurements
• Describe the P.A.R.T. format of documentation
• Define the P of P.A.R.T. from Centers for Medicare/Medicaid Services
• Describe the concept of outcome assessments in clinical practice

• Illustrate different outcome assessments for the T of P.A.R.T
• Demonstrate the POMR and P.A.R.T. formats for the initial patient encounter
• Integrate the POMR and P.A.R.T. formats for subsequent patient encounters
• Discuss proper diagnosing in notes and on a claim form
• Define the short, moderate and long-term diagnoses for Medicare
• Define proper Assessments
• Illustrate how to determine an assessment for each condition
• Illustrate complicating factors that can be documented for each condition

• Illustrate the two types of Plan
• Discuss common therapeutic modalities
• Demonstrate proper documentation for time-based codes
• Illustrate how to document measurable treatment goals
• Describe the red flags of a record review
• Demonstrate the determination of causation for a motor vehicle collision
• Discuss the different mechanisms of injury for motor vehicle collisions
• Discuss some of the key value drivers of Colossus
• Discuss the difference between impairment and disability
• Illustrate the determination of the end of justifiable treatment
• Define the main components of an impairment evaluation
• Illustrate Duties Under Duress and Loss of Enjoyment
• Illustrate the important diagnoses for personal injury cases
• Define the 5 Colossus prognoses
• Demonstrate the 5 grades of injury severity for the Croft Guidelines for the Treatment of CAD Injuries

• Prepare to manage and document protocols, for litigation protection, in a crisis, such as Covid.
• Discover how to avoid a HIPAA investigation and becoming a ‘HIPAA statistic’, often by surprise.
• Operate an office with protocols to avoid ransom ware and other Cyber-attacks.
• Complete a HIPAA program to be prepared for document production, demanded by the government, when a complaint (or even a simple inquiry) is made by a patient, peer, or ex-employee.

• This contains all courses with the educational objectives listed in Government HIPAA and Cybersecurity Compliance 201 - 208

• Prepare for the required OIG compliance program, required for all who treat one of more Medicare patients per year.
• Aid in understanding and preparing required written documented policies under the HIPAA law.
• Identify what thieves do with stolen patient information.
• Discover what is included in a comprehensive table of contents for a HIPAA compliance program.
• Describe the type and number of complaints against doctors and their often surprise origins
• Use of required accounting logs

• Classifying what you say and when, when notified of an investigation or audit, to avoid saying the wrong thing and complicating your case.
• Examine what every office must do, regarding the ONC law, to deliver patient records electronically if so requested, even if you don’t have computers.
• Show a step-by-step approach to responding to the government in the event of a breach, investigation, or audit.
• Solve the puzzle as to avoiding audits and compliance investigations.

• Explain tele-health pros and cons.
• Categorize the risks that lead to being turned in for violations, often not knowing you were doing anything wrong.
• Point out the most common HIPAA scams that involve impersonating a federal official.
• Examine the parts of the HIPAA law that enforcers are enforcing and those parts they are not enforcing.

• Discover how to conduct the required ISAR (information system activity review) that leads to maximum fines if not completed.
• Aid you and/or your staff in conducting the required risk analysis that leads to maximum fines, if not completed.
• Prepare an electronic device maintenance schedule to protect yourself relative to data breaches.
• Examine how to reduce your exposure to HIPAA fines.

• Discover illegal fee structures and the legal options that do exist.
• Prepare the four requirements relative to the notice of patient privacy policy.
• Generate a legally required BAA process for every individual or company with whom you share or provide access to your patient data.
• Discuss the requirements for data recover and emergency mode operations under HIPAA.

• Prepare a protocol for creating required policies under HIPAA.
• Assess the risks of seeing Medicare patients with inadequate use of the ABN form.
• Operate proper procedures to appropriately use the ABN form in a Medicare practice.
• Summarize the Ohio workers’ compensation requirements that elevate chiropractic and put restrictions upon spinal surgeons.

• Generate proper staff training to meet HIPAA requirements.
• Examine the pitfalls around a physical plant audit and what you must do to avoid them.
• Completing a required disciplinary policy that will pass an investigation.
• Classify the little-known training requirements above and beyond the ‘annual HIPAA training’.

• Identify ePHI assets within the clinic and assess exposure to threats and vulnerabilities
• Understand how to create an action plan and implement Security Safeguards
• Recognize the components of the Risk Assessment that must be considered when developing policies and procedures

• Manage Risk Assignments and assign Target Dates to comply with federal requirements
• Audit Risk Factors that may be present
• Manage Security Events that may come up during the course of everyday workflow
• Set up Workforce Security Standards to be complied with by all team members
• Ongoingly Monitor Security Safeguards to ensure the integrity of your data and minimize risk

• Recognize PHI Identifiers- Know what you are looking for
• Identify important components of the Notice of Privacy Practices and how it puts the patient in the driver seat
• Execute, track and audit Business Associate Agreements
• Apply the rules of Patient Authorizations regarding when TPO applies

Hour 1

• List 3 factors which impact the mechanical properties of fascia
• Recall 3 important functions of fascia
• Cite 3 negative biological effects of fibrosis
• Describe 3 proposed neurophysiological effects of IASTM
• Itemize three biological effects of IASTM

Hour 2

• Cite 8 indications for using IASTM for upper/lower quarter musculoskeletal conditions
• Provide 8 indications for using IASTM for upper/lower quarter musculoskeletal conditions
• Enumerate 8 indications for using IASTM for upper/lower quarter musculoskeletal conditions
• when using IASTM for musculoskeletal disorders.
• List 2 features of IASTM tools and the effect that these features have on the treatment effect (tissue penetration)
• Summarize 5 IASTM basic stroke techniques
• Apply IASTM techniques for over 30 common upper quarter musculoskeletal conditions

Hour 3

• Outline 3 general purposes for using instrument-assisted soft tissue mobilizations (IASTM) for lower quarter musculoskeletal disorders.
• Recall 3 clinical indications for using IASTM to the hip
• State 3 clinical indications for providing IASTM to the lumbar spine
• Present 3 clinical indications for using IASTM for knee-related musculoskeletal disorders
• Itemize 3 clinical conditions of the lower leg and foot for which IASTM would be appropriate

• Acquire additional skill sets in impairment and disability rating
• Develop cognitive interpretive thinking in addressing impairment and disability issues
• Expand the current knowledge base required by the AMA Guides 5th edition

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to apportionment
• Minimize risks and failure risks when addressing the apportionment issue
• Encourage development and nurturing of skill sets risks when addressing the apportionment issue based on evidence-based literature and science
• Identify action steps for minimizing risks when addressing the apportionment issue

• Identify some of the criteria used by formally trained forensic examiners
• Identify certain practices that lead forensic examiners to question the credibility of reports or "IME providers"
• Develop a level of knowledge, comprehension, and understanding of the criteria used by impairment rating reviewers
• Identify certain practices that lead impairment rating reviewers/auditors to question the credibility of reports or raters
• Encourage development and nurturing of skill sets when formulating an impairment rating based on evidence-based literature, science and AMA Guides 5th edition criteria
• Identify action steps for minimizing risks when submitting an impairment rating report

• Identify some of the criteria used by formally trained forensic examiners
• Identify certain practices that lead forensic examiners to question the credibility of reports or "IME providers"
• Develop a level of knowledge, comprehension, and understanding of the criteria used by impairment rating reviewers
• Identify certain practices that lead impairment rating reviewers/auditors to question the credibility of reports or raters
• Encourage development and nurturing of skill sets when formulating an impairment rating based on evidence-based literature, science and AMA Guides 4th edition criteria
• Identify action steps for minimizing risks when submitting an impairment rating report

• Produce accurate impairment rating reports.
• Identify AMA Guides the criteria for CTS
• Develop a level of knowledge, comprehension, and understanding of the criteria used for rating CTS
• Identify certain practices that lead impairment rating reviewers/auditors to question the credibility of reports or raters
• Identify the commonly occurring errors seen in rating impairment due to CTS.

• Develop a level of understanding of the evaluation criteria as it relates to the AMA Guides 5th edition
• Apply skill sets in impairment evaluation
• Interpolate aspects of the AMA Guides to report writing
• Identify the certification available through the American Board of Forensic Professionals

• Define an IME and identify key concepts
• Comment on ideal qualifications of the examiner
• Discuss IME methodology and procedures
• Suggest a generalized report format and quality assurance
• Discuss the job task analysis (ABFP) for the IME process

• Develop an instructional basis for performing IMEs
• Expand current knowledge database pertaining to IMEs
• Identify risks and liabilities that may be encountered by examiners

• Expand the current knowledge base relating to documentation required by the Social Security Administration
• Develop documentation requirements for writing an appeal
• Review regulations of the Social Security Administration

• Recall and integrate the function of the individual endocrine organs and all hormones into the diagnosis and treatment plan
• Identify the causative factors present in the patient that led to a hormonal imbalance
• Discuss Estrogen Dominance and thus educate the patient
• Diagnose Metabolic Syndrome
• Differentiate Adrenal Fatigue from menopause and perimenopause
• Explain lifestyle modifications to the patient
• Prepare for the intricacies of treating the hormonally imbalanced patient

• Summarize the advantages and disadvantages of salivary hormone testing, its interfering factors and hormones
• Illustrate hormone metabolism and biochemistry, and identify diseases that are associated with hormonal imbalances
• Outline the biochemistry of tryptophan and its metabolites
• Discover salivary adrenal functional assessments and the measurement of cortisol, DHEA and DHEAS
• Discuss nutritional support for women's health and define the action of phytoestrogens, saw palmetto and zinc on hormone balance

• Utilize reproducible, implementable protocols in your practice
• Apply neurodynamic tests and corrective laser protocols
• Assess and understand traumatic brain injuries (concussion, neurodegenerative diseases)
• Summarize strategies to initiate the positive impact of gut health on the musculoskeletal system
• Elucidate the science of the different types of fasting
• Discuss the breakthrough technique for non-invasive fat reduction
• Apply clinical breakthroughs in the treatment of musculoskeletal injuries
• Appreciate new laser research and its clinical applicability
• Assess intestinal and blood-brain dysfunctions
• Perform laser applications

• Integrate infection, evolution, immunity, inflammation, fibrosis, blood flow, mitochondria, ATP, oxidative stress, and DNA.
• Integrate mechanical integrity in gravity, weight, load, levers, posture, mechanoreception, mechanotransduction, mechanobiology, tensegrity, neurology, blood flow, and DNA.
• Justify high vegetable, low lectin, low glycemic dietary habits, and their influence on physiology.
• Summarize problems with refined carbohydrates, monosodium glutamate, aspartame, and chemical toxins.
• Support high intensity interval training, weight lifting, brain derived neurotrophic factor, human growth hormone, and interleukin-10.
• Explain the biphasic nature of laser photon therapy, wavelength, frequency, speed of light, fluence, penetration, secondary and primary physiological influences.
• Develop the relationship between mitochondria, free radicals, ATP, cytochrome c oxidase enzyme, and laser photon therapy
• Justify why all people need between 5-8 different supplements and explain why.
• Diagram a protocol for influencing immunology and the brain through the intestinal tract; integrating the vagus nerve and the nucleus tractus solitarius.
• Integrate a protocol for brain function that discusses trauma, degenerative, and vascular compromise.
• Demonstrate a protocol for chronic low back pain that integrates the intervertebral disc, posture, mechanics, exercise, and laser therapy.
• Support a protocol for acute whiplash that includes applying controlled motion and anti-inflammation strategies.
• Apply a protocol for remodeling scar tissue and the fibrosis of repair.

• Summarize the volume of research that led to the USSR implementing laser by 1974 as standard care
• Summarize the differences between LEDs and different classes of lasers
• Discover which wavelength was preferred by the Soviets, and has 18 of the 21 FDA clearances
• Utilize case studies to support that this is not a placebo
• Summarize the results of the level 1, double blind study that showed a 635 nm class 2 laser was more effective than opioids for chronic low back pain of a minimum duration of 8 years
• Discover how to easily integrate laser therapy into an existing practice for better patient outcomes
• contrast the difference in clearances and uses for a class 4 laser vs a class 2 laser for chronic condition for better implementation into treatment protocols
• illustrate treatment applications and contraindications with videos and pictures
• identify the injuries that respond to laser therapy and the research that supports them
• generate a treatment plan with lasers for each condition described
• Contrast the effectiveness of different types of lasers and NSAIDS and Opioids vs laser
• Illustrate techniques via video/pictures
• Identify the specific pathways that research has shown that laser can be beneficial for support of these conditions when applied transcranially
• Classify which conditions are contraindications and which types of lasers are contraindicated transcranially
• Summarize the findings on the autism study and its submission to the FDA for review
• Summarize what occurs on a cellular level after a concussion, and what occurs when laser is applied, and nutrients are utilized
• Classify which injuries and conditions respond well to low level laser
• Illustrate set up methods and treatment protocols for several conditions
• Utilize case studies with video/picture demonstrations
• Summarize the studies that showed improvement from laser therapy in performance metrics like muscle strength, endurance, and recovery
• Discuss the studies that show a 25 to 35% faster recovery for several sports injuries and auto accident injuries when laser therapy is applied
• Determine how to use laser therapy with athletes in the office both for injuries and for performance enhancement

• Recognize areas of risk and liability within Personal Injury cases
• Identify common med-legal concerns
• Recognize various important components associated with the Personal Injury history
• Improve the accuracy and thoroughness of the initial Personal Injury history
• Examine and document common Personal Injury traumatic injuries 
• Create a plan to minimize patient risk and improve provider outcomes
• Recognize the versatility and benefits of low level laser therapy for musculoskeletal injuries  
• Develop clinical protocols for low lever laser application and documentation for musculoskeletal injuries  
• Recognize conditions, injuries and symptoms requiring advanced imaging 
• Apply diagnostics and humanize trauma cases
• Discover the importance and relevance of Personal Injury case management 
• Identify opportunities for improved clinical decision making and case management

• Summarize the differences between the effects of 635 nm laser and 405 nm laser
• Illustrate effective protocols with the laser and exercises to support each condition
• Discuss case studies to demonstrate potential therapeutic outcomes
• Summarize the results of the level 1, double blind study that showed the effectiveness of class 2 635 nm for chronic pain and inflammation
• Discuss how inflammation can lead to many chronic musculoskeletal conditions that affect people in the United States
• Use lab testing to identify inflammation
• Illustrate treatment applications and contraindications
• Identify the conditions that respond to laser therapy for support, the research that supports them, and to identify which conditions are either not supported with laser therapy or are contraindicated
• Aggregate which class of lasers can be used for support and which are contraindicated
• Generate a treatment plan with lasers for different musculoskeletal conditions
• Categorize the negative impacts of scar tissue on range of motion, pain, and function
• Classify which conditions are contraindications and which types of lasers are contraindicated 
• Summarize the changes that occur in scar tissue and when movement of tissue or a joint triggers pain for a prolonged period
• Apply low level laser to musculoskeletal injuries that respond well to low level laser
• Summarize the studies that have been published on PubMed for these conditions being supported with lasers
• Set up methods and treatment protocols for several conditions
• Summarize the studies that showed improvement from laser therapy in performance metrics like muscle strength, endurance, and recovery
• Comprehend the studies that show a 25 to 35% faster recovery for several sports injuries and auto accident injuries when laser therapy is applied
• Use laser therapy with athletes in the office both for injuries and for performance enhancement by rehabilitating their balance and coordination with lasers

Hour 1

• Breakdown the implications of inflammation on epigenetics and relate inflammation to genetic damage and musculoskeletal disease.
• Develop a plan for clinical anti-inflammatory protocols

Hour 2

• Interpret blood chemistry markers related to inflammation and translate into laymen’s terms for patient understanding.
• Devise office strategies for obtaining blood chemistry markers, delivering the report of findings to the patient
• Discuss the physiological mechanisms of the gut-brain axis, distinguish the molecular players in gut-brain axis syndromes, and identify behavioral modifications and nutritional therapies
• Demonstrate knowledge of calcium ions as an egregious free radical

Hour 3

• Identify blood chemistry markers
• Differentiate between different classes of lasers, Class I, II, IIIA, IIIB, and IV lasers, and outline the therapeutic effects of each

Hour 4

• Explain the difference between nIR and fIR saunas, and identify key physiological mechanisms
• Discuss Low Level Laser Therapy wavelengths as they pertain to various upregulation of metabolic functions and integrate into the health of the body.
• Differentiate between Class 1, Class 2, Class 3R, Class 3B, and Class 4 lasers, and determine proper clinical application of each laser
• Develop plans to calculate Joules of output for various lasers using physics and demonstrate fundamental understanding of laser frequency output to address various clinical cases.

Hour 5

• Discuss Clinical Cases and outcomes citing specific patient histories and medical studies from the National Institute of Health and PubMed.com; integrate these ideas and extrapolate health plans into current clinical situations.
• Discuss how low-level laser therapy affects the body
• Discuss supplementation and integrate effective neuroprotective supplementation protocols in a clinical setting based on the work of the world’s best universities’ studies

Hour 6

• Outline the basic types of intermittent fasting, relate to patient goals as determined in nutritional consultations, and design intermittent fasting protocols for clinical settings.
• Summarize the concepts of ketosis, brain energy utilization, and neuroprotection; relate to medium-chain triglyceride consumption.

• Build the ultimate back: from chronic back pain to high performance
• Evaluate exercise’s effect on hormones and human performance
• Create a flowchart explaining laser therapy and its application during the correlated stages of healing
• Review the newest laser research and its clinical applicability
• Apply neurodynamic tests and advanced corrective laser protocols
• Evaluate techniques for non-invasive fat reduction
• Elucidate the science of different types of fasting
• Utilize advanced clinical breakthroughs in the treatment of musculoskeletal injuries
• Implement strategies to initiate the positive impact of gut health on the musculoskeletal system
• View hands-on reproducible, implementable protocols 
• Incorporate laser effectively into your practice
• Assess intestinal and blood-brain barrier dysfunction
• Integrate leading-edge protocols for SIBO
• Identify modern lifestyle and environmental triggers that affect the gut brain axis

Hour 1

• Discuss the etiology, pathophysiology, and symptoms of trauma and post-auto whiplash.
• Translate how low-level laser impacts inflammation and trauma.
• Explain modern neuron theory and how low-level laser can optimize cellular communication within the PNS/CNS.
• Conceptualize how to change the brain and body by using low-level laser and sensory inputs to modify central circuitry.

Hour 2

• Discuss the interplay between the sympathetic and parasympathetic systems.
• Explain how changes in autonomic function affect the brain and body following trauma.
• Share relevant research about the gut/brain connection.
• Give an overview of the neuroinflammatory cascade of trauma and how low-level laser impacts inflammatory processes.

Hour 3

• Discuss the anatomy/physiology of the cerebellum and it’s integration with the cervical spine.
• Outline how changes in cerebellar function and the cervical spine affect the brain and body following trauma
• Explain how low-level laser therapy can optimize structural, neurological, and metabolic parameters following trauma.
• Create a greater understanding for providers to know how to utilize their skillset to treat complex cases.

Hour 4

• Discuss the anatomy and physiology of the visual and vestibular systems.
• Identify how changes in the visual and vestibular system affect the brain and body following trauma.
• Share mechanisms and treatment applications for utilizing low-level laser therapy.
• Create awareness around the modern utilization of structural, neurological, and metabolic treatment paradigms for complex cases.

Hour 1:

• Integrate the following concepts as it pertains to laser therapy:  wavelength, frequency, speed of light, fluence, penetration, secondary and primary physiological influences
• Contrast the differences between thermal and non-thermal laser therapy

Hour 2:

• Conceptualize the relationship between mitochondria, free radicals, ATP, cytochrome coxidase enzyme, and laser photon therapy
• Explain the biphasic nature of laser therapy

Hour 3:

• Introduce evidence as to the integrative physiology between chiropractic care for musculoskeletal pain syndromes and improved systemic health.
• Develop a neuroanatomical and neurophysiological model for the influence of spinal mechanical function with visceral neurology.

Hour 4:

• Correlate upper cervical spine symmetry and the function of the nucleus tractus solitarius of the vagus nerve.
• Explore the mechanical, vascular and cerebrospinal fluid dynamics as related to spinal anatomy.

Hour 5:

• Show the history and modern-day evidence for the influence of exposure to non-ionizing electromagnetic field waveforms.
• Detail the two most plausible mechanisms of exposure non-ionizing electromagnetic field waveforms on human biology.

Hour 6:

• Explore the various relationships from a functional neurological perspective.
• Contrast the relationship between various neurochemicals

Hour 7:

• Justify why many people need between 5-8 different supplements and explain why.
• Connect the link between dietary lectins, leak gut, systemic inflammation and autoimmune conditions.

Hour 8:

• Explain some of the physiological complications to COVID-19.
• Review studies that explain the biological plausibility related to COVID-19.

• This contains all courses with the educational objectives listed from Laser 215 through Laser 216

Hour 1

• Discuss the physiology associated with laser therapy
• Describe the electron transport chain
• Examine common cervical and plexus pathologies through orthopedic and soft tissue testing
• Treat the scapular area using non-thermal lasers
• Outline a description of electron volts

Hour 2

• Summarize important factors regarding wavelengths relative to using laser therapy
• Describe mitochondiral function
• Recognize damage to mitochondria and appreciate its role in disease
• Examine patients with potential upper extremity nerve entrapments using orthopedic testing, soft tissue testing 

Hour 3

• Discuss neuron receptors
• Explain pain to patients
• Identify soft tissue structures
• Summarize the function of progenitor cells

Hour 4

• Perform an evaluation of the shoulder
• Perform an evaluation of the elbow
• Perform an evaluation of the wrist and the hand
• Perform an evaluation of the lower extremities

• Integrate concepts in laser photon therapy: wavelength, frequency, speed of light, fluence, penetration, secondary and primary physiological influences
• Contrast the differences between thermal and non-thermal laser therapy
• Develop the relationship between mitochondria, free radicals, ATP, cytochrome c oxidase enzyme, and laser photon therapy
• Discuss the physiology of applying laser therapy to both the anatomical part of injury/complaint and to the nerve roots that innervate that anatomical part
• Explain the biphasic nature of laser photon therapy as related to evolutionary biology and current clinical applications

Hour 1:   

• Improve specific elements of the four PI office visits.
• Outline the documentation steps of a causation statement.

Hour 2:  

• Identify med-legal considerations associated with PI documentation.
• Develop an outline to create a PI final discharge report.

Hour 3: 

• Recognize and evaluate several commonly missed traumatic injuries.  
• Create a to plan improve the capture of acute objective findings.

Hour 4:  

• Recognize LLLT versatility and benefits with PI-related conditions.   
• Develop clinical protocols for LLLT application in PI cases.

 Hour 5:  

• Identify and avoid inherent risks within PI case management.       
• Create an algorithm for case management clinical decisions.

Hour 6:  

• Discover the importance and relevance of PI co-management.
• Assess cases for co-management decisions and opportunities.

Hour 1:

• Define the Basics of light: Properties of light, electromagnetic spectrum, visible light wavelengths.
• Describe Laser principles: Stimulated emission, different types of lasers, laser safety standards.
• Review the Tissue interaction with light: Absorption, scattering, penetration depth, photothermal and photochemical effects.
• Define Laser safety protocols and equipment
• Discuss Potential risks and adverse effects of laser therapy
• Describe Informed consent and patient education
• Describe Regulatory requirements for laser therapy
• Determine Ethical considerations for laser therapy

Hour 2:

• Clinically use a laser for conditions such as chronic pain and discuss the wavelength, time and other factors
• Clinically use a laser for various conditions seen by Chiropractic Doctors, with specifics to the wavelength, time and other factors
• Review clinical studies demonstrating the use of a laser for various conditions seen by Chiropractic Doctors
• Discuss protocols as discovered in the latest research for successful outcome cases of various conditions seen by Chiropractic Doctors
• Discuss clinical cases with aspects of pain management in acute pain

 Hour 3:

• Review other potential applications for conditions Chiropractic Doctors may encounter
• Give examples of successful laser therapy protocols based on various conditions seen by Chiropractic Doctors
• Discuss clinical studies for the use of laser in various conditions seen by Chiropractic Doctors
• Identify clinical studies that provide empirical support for the user of laser therapy
• Clinical use of lasers in personal injury cases, efficacy, standard of care and application

• Recognize lumbar disc signs and symptoms.
• Differentiate disc prolapse from disc extrusion.
• Identify anatomical structures related to lumbar disc conditions.
• Describe neuro-muscular physiology as it relates to disc injuries.
• Determine appropriate exam procedures for diagnosing disc conditions.
• Assess static range of motion coupled with cross-plane evaluation.
• Analyze dynamic joint motion using outcome-based assessment tools.
• Interpret manual muscle testing using eccentric break testing protocols.
• Grade muscle tone and discover muscle palpation techniques.
• Interpret neurological tests to determine levels of disc involvement.
• Design treatment plans based on exam findings.
• Apply manual manipulation techniques to address the lumbo-pelvic joint lesions.
• Demonstrate manual methods to reduce abdominal and pelvic muscular dysfunction.
• Create new muscle memory patterns to correct chronic conditions.
• Compare pre- and post- treatment findings to support care plans.

• Discuss different types of lumbar stretching and their effects.
• Define therapeutic stretching goals, protocols and precautions for the lumbar spine.
• Measure lumbar pain, agility and joint crepitus associated with therapeutic stretching.
• Apply lumbo-pelvic circumduction training to improve disc related joint mobility.
• Integrate PreActive therapeutic stretching techniques to reduce lumbo-pelvic muscle tension.
• Devise strengthening protocols for the lumbo-pelvic region using graduated isometric protocols.
• Discuss mobility during lumbar traction to reduce disc pressure.
• Compare static traction versus dynamic traction.
• Define contra-indications for decompression therapy of the lumbar spine.
• Apply appropriate lumbar decompression therapy to various patient populations.
• Demonstrate lumbar mobility training exercises used to enhance decompression effectiveness.
• Justify reimbursement through accurate documentation of lumbar disc treatment progression.
• Diagnose lumbar disc conditions with clarity.
• Select outcome-based assessment tools to monitor patient progress.
• Illustrate lumbar range of motion and muscle testing deficiencies concisely.
• Summarize patient status for lumbar mobility, crepitus and pain intensity.

• Recognize concussion signs and symptoms.
• Differentiate concussion grades.
• Identify anatomical structures related to concussions.
• Describe pathophysiology as it relates to concussions.
• Determine appropriate exam procedures for diagnosing concussions.
• Apply diagnostic skills to on-field and clinic settings.
• Interpret diagnostic tests to evaluate concussion progress.
• Design treatment plans based on exam findings.
• Demonstrate manual manipulation techniques to address concussion symptoms.
• Compare pre- and post-treatment findings to support care plans.

• Discuss neurophysiology of musculoskeletal dysfunction.
• Create new memory patterns to restore neuromascular integration.
• Demonstrate manual methods to reduce muscular dysfunction.
• Address cranial nerve lesions with manipulation techniques.
• Introduce the half-somersault maneuver for vertigo relief.

• Recognize cervical disc signs and symptoms.
• Differentiate disc prolapse from disc extrusion.
• Identify anatomical structures related to cervical disc conditions.
• Describe neuro-muscular physiology as it relates to disc injuries.
• Determine appropriate exam procedures for diagnosing disc conditions.
• Assess static range of motion coupled with cross-plane evaluation.
• Analyze dynamic joint motion using outcome-based assessment tools.
• Interpret manual muscle testing using eccentric break testing protocols.
• Develop muscle palpation skills and grade muscle tonicity.
• Interpret neurological tests to determine levels of disc involvement.
• Design treatment plans based on exam findings.
• Apply manual manipulation techniques to address the cervical joint lesions.
• Demonstrate manual methods to reduce cervical muscular dysfunction.
• Create new muscle memory patterns to correct chronic conditions.
• Compare pre- and post-treatment findings to support care plans.

• This contains all courses with the educational objectives listed from Management of Common Conditions 204 through Management of Common Conditions 209

• Discuss different types of cervical stretching and their effects.
• Define therapeutic stretching goals, protocols and precautions for the cervical spine.
• Measure cervical pain, agility and joint crepitus associated with therapeutic stretching.
• Integrate PreActive therapeutic stretching techniques to reduce cervical muscle tension and improve disc related joint mobility.
• Devise strengthening protocols for the cervical region using graduated isometric protocols.
• Discuss cervical mobility during traction to reduce disc pressure.
• Compare static traction versus dynamic traction of the cervical spine.
• Define contra-indications for cervical decompression therapy.
• Apply appropriate cervical decompression therapy to various patient populations.
• Demonstrate cervical mobility training exercises used to enhance decompression effectiveness.
• Justify reimbursement through accurate documentation of cervical disc treatment progression.
• Diagnose cervical disc conditions with clarity.
• Select outcome-based assessment tools to monitor patient progress for cervical conditions.
• Illustrate cervical range of motion and muscle testing deficiencies concisely.
• Summarize patient status for cervical mobility, crepitus and pain intensity.

• Summarize the relationship between glenohumeral internal rotation deficit (GIRD), SLAP tears, posterior impingement, scapula dyskinesis and shoulder micro-instability
• Effectively diagnose SLAP tears, posterior impingement, scapula dyskinesis and shoulder mico-instability using screening and clinical tests.
• Cite common pitching pathomechanics and describe their association with specific elbow injuries.
• Paraphrase the peel back model for SLAP tears
• Relate proper pitching biomechanics with injury prevention strategies for the adolescent overhead athlete

• Define and differentiate the anatomical relationship between the rotator cuff muscles and the glenohumeral joint capsule
• Gain deeper insight into the causes and treatment of scapula dyskinesia
• Describe and perform contemporary scapula mobilization techniques
• Apply innovative soft tissue mobilization techniques to patients with shoulder hypomobility
• Perform soft tissue mobilization techniques for sub deltoid bursitis

• Classify functional anatomy and biomechanics of the shoulder - scapula complex
• Apply current strategies for the evaluation of patients with scapular disorders
• Perform innovative  scapular mobilization techniques for the patient with scapular dyskinesia
• Differentiate the relationship between scapular dyskinesia, soft tissue/muscle tightness, and shoulder pathology
• Integrate a systematic scapular muscle training program / protocol for patients with scapular dyskinesia

• Discuss the prevalence and etiology of temporomandibular joint dysfunction (TMD)
• Define the anatomy of the TMJ and surrounding facial structures.
• Recognize the three most common causes of temporomandibular joint dysfunction (TMD) seen within the chiropractic practice.
• Outline various types of pain referral sources to the temporomandibular joint (TMJ).
• Evaluate the TMJ using physical examination procedures
• Compare and contrast TMJ synovitis and capsulitis
• Distinguish the difference between anterior disc displacements with and without reduction
• Describe standard imaging processes ordered for specific TMJ conditions
• Outline various conservative management options for temporomandibular disorders
• Construct a treatment plan for a typical patient with temporomandibular dysfunction
• Apply specific myofascial techniques for the muscles of mastication
• Define the co-management care of a dental professional with patients presenting temporomandibular joint dysfunction

• Discuss the state of the literature on common treatment options for adhesive capsulitis
• Apply an effective and streamlined exercise program in the management of subacromial impingement
• Recognize the value of radial nerve mobilization in patients with thumb carpometacarpal osteoarthritis
• Appraise the potential value of adding low-level laser therapy to other interventions for subacromial impingement
• Summarize the state of the literature regarding Kinesiotape for preventing sports injuries

Hour 1

• Determine appropriate protocols for patient progress.
• Discuss tools to reduce vertigo symptoms.
• Incorporate nutritional support for better brain function.
• Utilize brain therapy programs to improve cognition.
• Apply traction therapy to reduce intrathecal pressure.
• Introduce vision evaluation testing tools.

Hour 2

• Incorporate gaze stabilization exercises for oculomotor function. Evaluate balance and stability with a variety of tools.
• Demonstrate balance exercises to improve proprioception.
• Discuss cardio exercise to stimulate blood flow and neogenesis.
• Apply cervical strength protocols using graduated isometrics.

Hour 3

• Apply jaw exercises to reduce TMJ symptoms.
• Discuss post-exercise therapy recovery strategies.
• Demonstrate mobility exercises to improve joint function.
• Integrate therapeutic stretching protocols to improve agility.
• Illustrate self release techniques to enhance mobility.

• Present literature based dietary recommendations for Parkinson’s disease symptom management
• Discuss literature based exercise recommendations for Parkinson’s disease symptom management, with an emphasis on aerobic exercise
• Review the literature regarding acupuncture for Parkinson’s disease symptom management
• Discuss lifestyle modifications that can be helpful with Parkinson’s disease symptom management

Hour 1

• Discuss shoulder anatomy.
• Differentiate the causes of shoulder pain
• Assess joint mobility and muscle function.
• Apply manual manipulation to reduce shoulder dysfunction.
• Incorporate rehab techniques to restore strength and flexibility.

Hour 2

• Discuss scapulo-thoracic anatomy.
• Define the causes of scapulo-thoracic pain.
• Assess joint mobility and muscle function.
• Apply manual manipulation to reduce scapular dysfunction.
• Introduce rehab techniques to restore strength and mobility.

Hour 3

• Discuss gleno-humeral anatomy.
• Define the causes of gleno-humeral pain.
• Assess joint mobility and muscle function.
• Apply manual manipulation to reduce joint dysfunction.
• Introduce rehab techniques to restore strength and mobility.

Hour 1

• Discuss concussion causes and pathophysiology.
• Introduce return to play guidelines.
• Explore other return to lifestyle guidelines.
• Understand modifying factors for RTP.
• Examine concussion grading procedures.

Hour 2

• Review tools for concussion evaluation.
• Understand the health concerns of pediatric athletes.
• Incorporate strategies for pediatric patients.
• Apply pediatric RTP guidelines for football.

Hour 3

• Investigate medico-legal issues of RTP.
• Explore appropriate documentation standards.
• Read state concussion law development.
• Compare professional Position Papers.
• Discuss the role of Chiropractors.

Hour 1

• Describe techniques and principles of examination for peripheral joints
• Identify important surface anatomy of the shoulder, elbow, wrist and hand
• Identify normal range of motion of the joints of the upper extremity
• Describe how to perform an examination of the upper extremity
• Recognize common musculoskeletal abnormalities 

Hour 2

• Outline special maneuvers for the evaluation of carpal tunnel syndrome
• Outline special maneuvers for the evaluation of shoulder impingement syndrome
• Identify important landmarks necessary for the exam of lower extremities
• Describe the physical examination technique for the lower extremities
• Interpret normal findings, including range of motion of the hip, knee and ankle
• Recognize some common abnormal findings through physical examination
• Describe some special maneuvers for examination of the hip, knee and ankle

Hour 3

• Outline special maneuvers for the evaluation of knee instability.
• Outline special maneuvers for the evaluation of an inversion ankle sprain
• Distinguish the differences between anterior interosseous membrane syndrome and tibial stress fracture.
• Design a treatment plan for acute patients with myofascial dysfunction for the upper and lower extremities.

• This contains all courses with the educational objectives listed from Management of Common Conditions 216 through Management of Common Conditions 221

Hour 1

• Describe pathophysiology as it relates to concussions. 
• Discuss the diagnosis and prognosis of concussions.
• Review concussion red flags and dangers of manipulation.
• Understand the health concerns of pediatric athletes.
• Explore diagnostic tests to evaluate concussion status.

Hour 2

• Demonstrate non-thrust treatment techniques.
• Introduce the half-somersault maneuver for vertigo relief.
• Address cranial nerve lesions with manipulation techniques.
• Explore sleep strategies for concussed patients.
• Incorporate nutritional support for better brain function.
• Discuss cardio exercise to stimulate blood flow to the brain.

Hour 3

• Apply mobility exercises to improve musculoskeletal function.
• Integrate PreActive StretchingSM protocols to improve agility.
• Explain return to lifestyle guidelines.
• Understand modifying factors for RTP.
• Compare professional Position Papers.
• Discuss the role of Chiropractors and concussions.

• Update the findings of the Neck Pain Task Force (NPTF) and examine the effectiveness of interventions for the management of headache in patients with neck pain
• Assess the effectiveness of conservative interventions for cervicogenic headache
• Examine the extent to which changes in specific cervical spine impairments contribute to the effectiveness or ineffectiveness of treatment for chronic tension-type headache
• Evaluate existing evidence regarding the reliability and diagnostic accuracy of physical examination tests used for diagnosing cervicogenic headache (CGH)
• Outline the clinical relevance of the cervical myodural bridge

• Recall the clinical definition of adhesive capsulitis, based on shoulder range of motion measurements.
• List 5 risk factors for adhesive capsulitis.
• Enumerate the 4 pathophysiological stages of adhesive capsulitis.
• List and define the 3 sub-components of the tissue-response classification system for adhesive capsulitis.
• Provide 2 clinical findings for each of the 3 sub-components of the tissue-response classification system for adhesive capsulitis.
• State 3 treatment guidelines for each of the 3 sub-components of the tissue-response classification system for adhesive capsulitis.
• Summarize the grades of evidence for common physical therapy interventions (i.e. therapeutic exercise, joint mobilizations, modalities and patient education) for adhesive capsulitis

• Discuss the specific pattern of contracted and weak muscles found with Pelvic Crossed Syndrome.
• Discern the effects on the spine and pelvis from the spastic and weak muscle pattern.
• Apply modalities and manual methods to treat weak and contracted muscles.
• Rehabilitate weak and atrophied muscles using stretching and exercise.
• Determine spinal and pelvic effects of the abnormal muscular patterns found with Pelvic Crossed Syndrome and apply treatment protocol.

Hour 1

• Discuss a functional overview of the Autonomic nervous System
• Describe Autonomic Nervous System Dysfunction specifically associated with neuromusculoskeletal injury
• Identify the role of the Vagus Nerve in Controlling the Inflammatory cascade with neuromusculoskeletal injury

Hour 2

• Include physical examination procedures specific to autonomic nervous system and vagus nerve dysfunction
• Perform neurological exam procedures specific to autonomic nervous system and vagus nerve dysfunction
• Perform chiropractic exam procedures specific to autonomic nervous system and vagus nerve dysfunction

Hour 3

• Describe therapeutic Protocols for musculoskeletal injuries with concomitant signs associated with dysfunction of the autonomic nervous system
• Discuss structural chiropractic treatment protocols of musculoskeletal injuries with concomitant signs associated with dysfunction of the autonomic nervous system
• Present phytonutrient protocols for musculoskeletal injuries with concomitant signs associated with dysfunction of the autonomic nervous system

Hour 1

• Discuss a functional overview of the Cerebellar dysfunction
• Describe Cerebellar Dysfunction specifically associated with neuromusculoskeletal injury
• Identify the role of the Cerebellum in balance disorders associated with neuromusculoskeletal injuries

Hour 2

• Include physical examination procedures specific to the cerebellar system
• Perform neurological exam procedures specific to the cerebellar system
• Perform chiropractic exam procedures specific to the cerebellar system

Hour 3

• Describe therapeutic Protocols for musculoskeletal injuries with concomitant signs associated with dysfunction of the cerebellum
• Discuss structural chiropractic treatment protocols of musculoskeletal injuries with concomitant signs associated with dysfunction of the cerebellum
• Present phytonutrient protocols for musculoskeletal injuries with concomitant signs associated with dysfunction of the cerebellum

• Discuss the histological features of Scoliosis
• Discern Structural vs. Functional Scoliosis and their primary causes
• Coordinate treatment protocols to cervical, thoracic and lumbopelvic spine, rib cage and scapula for Scoliosis curvature
• Utilize modalities and soft tissue treatment methods to address functional changes resulting in a Scoliosis curvature
• Advise the Scoliosis patient in effective methods of stretching and exercise

• Discuss the specific pattern of contracted and weak muscles found with Shoulder Crossed Syndrome.
• Discern the effects on the spine, upper extremity and pelvis from the spastic and weak muscle pattern.
• Apply modalities and manual methods to treat weak and contracted muscles.
• Rehabilitate weak and atrophied muscles using stretching and exercise.
• Determine spinal, extraspinal and pelvic effects of the abnormal muscular patterns found with Shoulder Crossed Syndrome and apply treatment protocol.

• Discuss the specific pattern of fibrosis development around and within the glenohumeral joint found with Adhesive Capsulitis.
• Discern the effects of the fibrosis and adhesions on the glenohumeral joint and associated soft tissues.
• Understand the rules of treatment specific to Adhesive Capsulitis.
• Apply modalities and manual methods to treat fibrosis and adhesions in the soft tissue structures around and within the glenohumeral joint as well as associated contracted muscle tissue.
• Rehabilitate weak and atrophied muscles using stretching, exercise and modalities.

• Describe the relationship among SLAP tears, posterior shoulder tightness and scapula dyskinesis  
• Explain how to perform the modified dynamic labral shear test and summarize the clinical usefulness of this test
• Cite the clinical prediction rule (CPR) for favorable outcome in patients undergoing conservative management for SLAP lesions
• Paraphrase the efficacy of conservative treatment for patients with SLAP disorders.
• List one indication for performing an anterior to posterior mobilization of the humerus on the glenoid (posterior shoulder mobilization) 
• Identify one appropriate intervention (specific manual technique or exercise) for phase I, phase II and phase III   SLAP rehabilitation program.

• Describe the relationship among shoulder micro-instability, scapula dyskinesis and hyperlaxity  
• Explain how to perform the surprise test and summarize the clinical usefulness of this test
• Paraphrase the efficacy of conservative treatment for patients with atraumatic shoulder instability.
• Contrast the difference between a capsule reconstruction/ shift and a capsular repair.
• Cite 2 major precautions, and corresponding time frames following an anterior capsule reconstruction or repair (during the first 12 weeks)
• Identify one appropriate intervention (exercise) for phase I, phase II and phase III   post- rehabilitation program following capsular shift / reconstruction or repair

• Compare active cervical range of motion in patients with neck pain to those with whiplash or no neck pain
• Critically appraise and synthesize recommendations of evidence-based clinical practice guidelines for the management of common conditions related to traffic collisions
• Investigated the possibility of posttraumatic cervical artery dissections (including those involving the vertebral artery) in patients who have sustained a whiplash injury in a motor vehicle collision
• Update findings from the Neck Pain Task Force regarding the effectiveness of manual therapies, passive physical modalities, and acupuncture for the management of whiplash and neck pain
• Determine which treatments or combinations of treatments are most effective for the management of neck pain- (NAD) and whiplash-associated disorders (WAD)

• Discuss the specific pattern of fibrosis development around and within the iliotibial band found with Iliotibial Band Syndrome at the Hip.
• Discern the effects of the fibrosis and adhesions on the iliotibial band, associated soft tissues and the functional biomechanics of the region.
• Understand the rules of treatment specific to Iliotibial Band Syndrome at the Hip.
• Apply modalities and manual methods to treat fibrosis and adhesions in the soft tissue structures around and within the iliofemoral joint as well as associated contracted muscle tissue.
• Rehabilitate weak and atrophied muscles using stretching, exercise and modalities.

• Discuss the specific pattern of fibrosis development around and within the plantar myofascia of the foot.
• Discern the effects of the fibrosis and adhesions on the plantar fascia, associated soft tissues and the functional biomechanics of the region.
• Understand the rules of treatment specific to Plantar Fasciitis of the Foot.
• Apply modalities and manual methods to treat fibrosis and adhesions in the soft tissue structures around and within the foot and ankle joint as well as associated contracted muscle tissue.
• Rehabilitate weak and atrophied muscles using stretching, exercise and modalities.

• Justify examination of the cervico-thoracic spinal regions for dysfunction in lateral epicondylalgia patients
• Explain and identify posterolateral rotary instability (PLRI) of the elbow
• Optimize clinical assessment and diagnosis for the long head of biceps complex
• Explore the potential pathological commonalities amongst adhesive capsulitis, metabolic syndrome and low-grade inflammation
• Discuss current neuroanatomical and biochemical theories as they pertain to shoulder pain and its clinical management

• Assess the effectiveness of three nonsurgical interventions on symptoms, physical function, and physical activity in patients with lumbar spinal stenosis.
• Compare the effectiveness of a structured, comprehensive conservative treatment program with a focus on self-management and improved walking ability (including lumbar manipulation, exercise and education) to a self-directed program in patients with neurogenic claudication due to lumbar spinal stenosis.
• Summarize the 2013 North American Spine Society (NASS) clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis.
• Examine the literature pertaining to the diagnostic accuracy of available tests for lumbar spinal stenosis.
• Analyze the effectiveness of the 6-week Boot Camp Program for Lumbar Spinal Stenosis

• Demonstrate an understanding of the epidemiology of fibromyalgia, its impact on patient health, and the clinical controversy surrounding the syndrome.
• Evaluate available treatment options and design a treatment plan for the patient with fibromyalgia.
• Evaluate the available evidence regarding chiropractic manipulation, and complementary and alternative medicine for fibromyalgia.
• Justify the role of patient self-care in the treatment of fibromyalgia.

Hour 1

• Define and apply viscerosomatic reflexes and influences.
• Define and apply somatoviscera reflexes and influences.
• Define and apply psychosomatic reflexes and influences.
• Apply autonomic reflexes to clinical conditions including somatic dysfunction.

Hour 2

• Identify the general nature of pain and its mechanisms including the physiology and psychology of pain.
• Describe the effect of somatic dysfunction on the autonomic nervous system and apply this knowledge to the use of manipulative therapy
• State the definition, location, and identification of Chapman’s points on the body.
• Express Chapman’s points in relation to the major organ systems of the body.

Hour 3

• Illustrate Chapman’s points of the cardiovascular system.
• Illustrate Chapman’s points of the respiratory system.
• Describe management of Chapman’s reflexes in a common clinical scenario.
• Critically appraise, and utilize relevant scientific literature and information to assess and improve patient care practices; and, contribute to the ongoing scholarly development of the chiropractic profession

• Provide an overview of the complex regional anatomy of the shoulder girdle and how this allows the scapula to act as a both a dynamic and static stabilizer to the upper limb.
• Explore the normal biomechanics and the etiology, epidemiology and pathological occurrences which can disrupt the normal function and lead to scapula dyskinesis.
• Summarize the typical scapular dyskinesis clinical assessment which is most likely to identify the source of the pathology and guide the treatment.
• Demonstrate common extremity and shoulder manipulations that may help the patient with scapular dyskinesis.

• Enumerate five physical / clinical examination findings associated with lumbar spinal stenosis
• List 3 essential components of a rehabilitation program for patients with lumbar spinal stenosis
• Recall four flexion-based exercises that are part of a rehabilitation program for a patient with lumbar spinal stenosis
• Identify three common soft tissue mobility impairments associated with lumbar spinal stenosis
• Cite two common joint mobility impairments associated with lumbar spinal stenosis
• Provide two evidence-based exercises that elicit high EMG activity of the transverse abdominis
• Enumerate three evidence-based exercises that elicit high EMG levels of the gluteus medius

• Relate the effects of posture on compression of the cervical cord and nerve roots and use this knowledge to develop decompression exercises for their cervical stenosis patients.
• Decompress the cervical spine utilizing the Cervico 2000 ambulatory traction device.
• Implement a strategy of upper extremity peripheral nerve stimulation to relieve symptoms of cervical spinal stenosis.
• Develop and institute a comprehensive cervical spinal stenosis rehabilitation protocol as a potential alternative to surgery. 

• Relate the effects of spinal stenosis in the development of intermittent claudication.
• Utilize a treadmill and a stopwatch, to quantify both the effects of stenosis on functional ability of patients and the effectiveness of treatment of spinal stenosis.
• Apply TENs over acupuncture points known to increase nerve blood supply and how to reverse the pathophysiology of lumbar spinal stenosis.
• Utilize dynamic imaging techniques, to gain a full appreciation of the changes in compression of the neural elements in different postures and spinal positions.

• Summarize the available literature and assess the effect of aerobic exercise on the number of headache days, duration and pain intensity in patients with migraine headache.
• Explore the efficacy of manual acupuncture and quantify the true placebo response in the prophylaxis of episodic migraine without aura.
• Outline the existing evidence and theories pertaining to the evolutive nature of migraine headaches for most patients.
• Assess the impact of spinal manipulation on pain and disability associated with migraine headache.
• Critically review the prevalence and patient-related factors associated with the use of manual therapy for treatment of chronic recurrent headaches.

• Investigate whether manipulations of the ankle joint complex increase the force production and muscle activation of the hip abductors on the affected limb in individuals with a history of ankle sprain
• Summarize the latest evidence pertaining to the diagnosis and treatment of insertional Achilles tendinopathy
• Outline the association between ankle dorsiflexion and dynamic knee valgus
• Discuss the state of the evidence pertaining to the clinical effects of joint mobilization on grades I and II ankle sprains
• Describe how manual therapy can help alleviate symptoms of Cuboid Syndrome in spite of the presence of active bony pathology

• Compare the effectiveness of multiple interventions for patellofemoral pain.
• Assess the literature on the effects of spinal or local joint manipulation or mobilization for patellofemoral pain syndrome.
• Evaluate the efficacy of knee strengthening with or without hip strengthening for improving strength and decreasing pain in patients with patellofemoral pain.
• Summarize the factors that contribute to the development of patellofemoral pain.
• Investigate the influence of exerted state running on lower extremity kinematics during the stance phase in runners with patellofemoral pain.

• Describe relevant anatomy, and the structural components of femoroacetabular impingement
• Explain factors associated with development of femoroacetabular impingement
• Discuss integration of manual therapies along with rehabilitation and lifestyle modification
• Outline what a successful treatment plan may look like for the non-surgical management of femoroacetabular impingement
• Analyze what factors my influence and necessitate modifications for treatment plans in individuals with femoroacetbular impingement syndrome

• This contains all courses with the educational objectives listed from Management of Common Conditions 244 through Management of Common Conditions 247

• Discuss up to date research on the etiology of PatelloFemoral Pain Syndrome
• Differentiate the diagnosis of patellofemoral pain syndrome from other painful diagnosis of the knee
• Discuss what interventions are effective in managing patellofemoral pain syndrome
• Integrate manual techniques with rehabilitative techniques for optimal outcomes in patients with patellofemoral pain syndrome
• Summarize optimal treatment strategies and plans for the treatment of patellofemoral pain syndrome

Hour One:

• List three non-musculoskeletal diagnoses that can affect the hip with referred pain.
• Describe two symptoms of axial spondyloarthropathy that may mimic posterior gluteal pain
• Describe sacral insufficiency.
• List three risk factors of statin involved muscle pain.

 Hour Two:

• Describe the key features of soft tissue posterior buttock pain.
• Describe the key features of peripheral nerve related posterior buttock pain.
• List three variable in the proposed CPR for lumbar radiculopathy.
• Describe the referral pattern of thoracolumbar involvement.

 Hour Three:

• List three symptoms of a labral defect of the hip.
• List two variables for the CPR of Osteoarthritis of the hip.
• List four factors documented in the clinical presentation of Gluteal tendinopathy.
• Describe four aspects of the pathomechanics for gluteal tendinopathy

• Explain the biomechanics of the cervical spine
• Demonstrate examination of the cervical spine
• Explain the mechanism of acceleration/deceleration impact
• Describe pathological conditions of the cervical spine
• Demonstrate soft tissue treatments for pathological conditions of the cervical spine

• Explore the societal burden of headaches
• Rank the prevalence of common headache types
• Give examples of common lifestyle contributors to headache syndromes
• Recognize the difference between primary and secondary headaches
• Review clinical characteristics of common headache types
• Differentiate cervicogenic headache from occipital neuralgia
• Contrast trigeminal neuralgia and idiopathic facial pain
• Summarize relevant clinical history questions for headache patients
• Recognize red flags specific to headache patients
• Define ‘dizziness’, ‘vertigo’ and other related terms
• Review common differential diagnoses and assessment strategies for the dizzy or vertiginous patient
• Utilize a TiTrATE approach to differentially diagnose and/or classify dizzy patients
• Breakdown our contemporary understanding of cervicogenic dizziness
• Summarize current diagnostic criteria for cervicogenic dizziness
• Outline various physical examination procedures for evaluating cervical sensorimotor function
• Define and outline the defining features of sports-related concussion
• Outline the ‘neuro-metabolic cascade’ in concussion injuries
• Summarize known risk factors for concussion
• Contrast on-field versus in-clinic evaluation of concussion
• Explore various clinical tools for evaluating concussion (ex. SCAT5, CRT, VOMS)
• Identify and categorize common concussion symptoms
• Recognize risk factors for prolonged recovery from concussion
• Explore short- and long-term consequences of concussion
• Summarize contemporary concussion management considerations for chiropractors
• Appraise the reasons for concern relating to neck manipulation and stroke
• Classify cervical artery strokes
• Explore the epidemiology of cervical artery strokes
• Summarize best-evidence relating to the association between spinal manipulation and cervical artery stroke
• Outline relevant challenges and other factors relating to researching the relationship between neck manipulation and cervical artery stroke
• Define protopathic bias and how it relates to stroke and neck manipulation
• Critique potential mechanisms of injury relating to cervical manipulation and the cervical arteries
• Integrate best practices into your clinical approach for ruling our emergent stroke in neck pain and headache patients
• Review the HINTS examination as a mechanism to differentially diagnose acute vestibular syndrome
• Review the evidence on the appropriateness and efficacy of manual therapy for treating headaches
• Explore the literature pertaining to the complex interplay between cervical spine function and dizziness, persistent post-concussion symptoms, neck pain and headache
• Critique the literature pertaining to the management of cervicogenic dizziness
• Summarize existing evidence regarding the chiropractic management of concussion

• Explain the biomechanics of the elbow, wrist and hand.
• Administer thorough examination of the elbow, wrist and hand.
• Differentially diagnose the pathological conditions of the elbow, wrist and hand.
• Perform soft tissue treatments for the elbow, wrist and hand.
• Apply functional relationships of the elbow, wrist and hand to associated regions for thorough evaluation and treatment.

• Explain the biomechanics of the thoracic spine and ribs 
• Describe the examination of the thoracic spine and ribs 
• Describe the pathological conditions of the thoracic spine and ribs 
• Demonstrate soft tissue treatments for pathological conditions of the thoracic spine and ribs 
• Define functional relationships of the thoracic spine and ribs with associated regions

• Investigate the association between brain age and chronic low back pain duration and pain severity 
• Compare Medicare expenditures over time in older adults with chronic low back pain who initially receive opioid analgesic therapy versus spinal manipulation 
• Recognize the impact of spinal manipulation on escalation of care and risk of adverse drug events among older Medicare patients with chronic low back pain 
• Summarize existing clinical practice guidelines on fall prevention and management for older adults 
• Outline the neuroinflammatory contribution to the development of tissue damage and joint-related pain in osteoarthritis and rheumatoid arthritis

• Discuss relevant anatomy associated with specific injuries to climbers
• Summarize common climbing movements and grip types
• Apply knowledge of relevant anatomy, movement, and grip types in discussing etiology of climbing injuries
• Differentiate common presentations of injuries in rock climbers
• Determine which presentations and etiologies require further interventions such as imaging, surgical consult etc..
• Briefly describe active management strategies and treatment plans for rock climbing injuries

• Summarize the recent NASS clinical guideline on the diagnosis and treatment of low back pain 
• Assess the literature to determine which mode(s) of exercise is/are best for treating chronic low back pain 
• Discuss the comparative effectiveness of currently available treatments for acute and subacute mechanical non-specific low back pain 
• Explore how clinicians can optimally facilitate self-management in patients with back pain 
• Evaluate the effectiveness of Foot Levelers shoe orthotics with and without chiropractic treatment for chronic low back pain as compared with no treatment

• Explain current best practices for the diagnosis and management of Achilles tendinopathy 
• Synthesize the evidence from randomized controlled trials to determine the clinical effectiveness of shockwave therapy, either as a monotherapy or part of a multimodal package of care for chronic mid- and insertional-Achilles tendinopathy 
• Appraise an international, multi-disciplinary consensus statement on return to sport decisions after lateral ankle injuries 
• Outline best practices in the management of plantar heel pain based on the latest evidence 
• Establish the effectiveness of the Nordic Hamstring Exercise for preventing hamstring injuries in athletes

• Explain the biomechanics of the lumbopelvic spine
• Describe the examination of the lumbopelvic spine
• Explain the mechanism of scoliosis
• Describe the pathological conditions of the lumbopelvic spine
• Demonstrate soft tissue treatments for pathological conditions of the lumbopelvic spine  

• Explain the biomechanics of the TMJ
• Describe the examination of the TMJ
• Describe the pathological conditions of the TMJ
• Demonstrate soft tissue treatments for pathological conditions of the TMJ
• Define functional relationships of the TMJ with associated regions

• Explain the biomechanics of the TMJ
• Describe the examination of the TMJ
• Describe the pathological conditions of the TMJ
• Demonstrate soft tissue treatments for pathological conditions of the TMJ
• Define functional relationships of the TMJ with associated regions

• Explain injury and healing of soft tissues
• Perform somatic technique and strain/counterstrain
• Utilize friction massage and post isometric relaxation
• Perform active release and myofascial release
• Apply trigger point ultrasound, exercise, stretching and manipulation

Introduction

• Distinguish the anatomical structures involved in TMJ dysfunction, including the temporomandibular joint, mandible, and associated muscles and the different types of jaw movements and their biomechanical implications.
• Interpret the normal biomechanics of the temporomandibular joint during various jaw movements.
• Identify the key ligaments and soft tissues supporting the temporomandibular joint and the factors that can lead to abnormal biomechanics and dysfunction of the temporomandibular joint.
• Explain the role of muscle imbalances and joint misalignments in TMJ dysfunction.
• Differentiate the relationship between the temporomandibular joint and adjacent anatomical structures.

Examination

• Appraise the various assessment tools used in evaluating TMJ dysfunction, such as patient history, physical examination, and imaging studies.
• Arrange a comprehensive physical examination of the temporomandibular joint, including range of motion assessment, palpation, loading, stressing, and compressing.
• Demonstrate the ability to perform a comprehensive evaluation of TMJ dysfunction and posture, including assessing range of motion, muscle strength, joint stability, and postural alignment.
• Discriminate the indications of differential diagnoses for TMJ dysfunction.
• Analyze the findings from a TMJ dysfunction and posture assessment to formulate an accurate clinical diagnosis.

Mobilization and Adjusting

• Develop a holistic approach to managing TMJ dysfunction, considering both conservative and interventional treatment options.
• Apply specific chiropractic techniques and adjustments aimed at restoring normal joint alignment and function of the temporomandibular joint and about occlusal splints and their use in managing TMJ dysfunction.
• Propose a role of therapeutic exercises and stretching in improving jaw mobility and strengthening supporting muscles and the importance of patient education and lifestyle modifications in the management of TMJ dysfunction.
• Develop a treatment plan for patients with TMJ dysfunction and posture issues, incorporating therapeutic exercises, manual therapy techniques, postural re-education, and other appropriate interventions.
• Evaluate the efficacy of potential benefits and risks associated with various treatment modalities for TMJ dysfunction and posture problems, considering evidence-based practices and patient-specific factors