Texas Chiropractic Continuing Education

• 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.

 Hour 2

• Evaluate balance and stability with a variety of tools.
• Demonstrate mobility exercises to improve musculoskeletal function.
• Discuss cardio exercise to stimulate blood flow to the brain.
• Apply exercise therapy to stimulate neogenesis.
• Devise strength protocols using graduated isometrics.

Hour 3

• Discuss the benefits of flexibility training.
• Define contra-indications for flexibility training.
• Interpret evaluation tools to discover zones of tension.
• Measure pain, agility and crepitus with outcome-based tools.
• Integrate PreActive StretchingSM protocols to improve agility.

• 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.
• Discuss the modifying factors for RTP.
• Examine concussion grading procedures.

Hour 2

• Review tools for concussion evaluation.
• Review 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.

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.

• 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

• Apply guidelines and recommendations for return to play associated with neuromusculoskeletal injuries
• Discuss Return to Participation Criteria
• Outline a Literature Review of How Primary Care Givers are performing in Return to participation

Hour 2

• Utilize the 6 steps necessary for Return to Participation
• Identify limitations of the Return 2 Participation Guidelines
• Discuss specific exam/diagnostic protocols that will influence when Return 2 Participation can be initiated

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

• 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

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

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

• Compare headache criteria and classifications from the World Health Organization, International Headache Society and Cleveland Clinic for chronic, acute and traumatic headaches. 
• Explain primary and secondary headaches for patient comprehension and communication of their condition with other healthcare practitioners. 
• Devise appropriate history, examination and treatment protocols for your adult and child headache patient.
• Utilize Headache categories and criteria to accurately diagnose your patient’s condition for migraines, cluster headaches, tension headaches, medication induced headaches, traumatic headaches and more. 
• Determine headache sequela that may be emergencies for adult and youth headache sufferers.

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

• Interpret cranial bone, suture and meninges anatomy applicable to the practice of Craniopathy treatment.
• Relate the principles of Craniopathy and cranial faults to their effect on the brain regarding headaches and other conditions.
• Assess the temporomandibular joint, cranial faults and the cervical spine as they interrelate for effective headache treatment protocols.
• Examine cranial bones and sutures using Applied Kinesiology.
• Apply treatment protocols using Craniopathy for cranial bones and sutures, and manipulative therapeutics and manual methods for treating the TMJ and cervical spine.

• Discuss the immediate effect of different sitting postures during a standardized computer task on perceived pain in healthy participants 
• Analyze the immediate and short-term effects of three common sitting postures (slouched, upright and supported sitting with a backrest) on pain, lumbar range of motion, proprioception and trunk muscle activity in asymptomatic subjects
• Summarize the evidence regarding the association between objectively measured sitting time and immediate increases in perceived low back pain 
• Compare the effectiveness of the Smart Work and Life (SWAL) intervention, with and without a height adjustable desk, on daily sitting time during and outside of work

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

• Determine spinal cord, nerve root and nerve root injuries of the upper extremity.
• Diagnose nerve impingement along the median, musculocutaneous, radial, ulnar, axillary, long thoracic, spinal accessory, suprascapular and greater occipital nerves.
• Detect Pronator Syndrome, Anterior Interosseous Syndrome, Carpal Tunnel Syndrome, Radial Tunnel Syndrome, Posterior Interosseous Nerve Syndrome, Distal Posterior Interosseous Nerve Syndrome and Guyon’s Tunnel Syndrome.
• Apply Manual Methods for treatment of upper extremity nerve compression/elongation and associated syndromes.
• Apply Modalities for treatment of upper extremity nerve compression/elongation and associated syndromes.

• Identify spinal cord, nerve root and nerve injuries of the lower extremity.
• Recognize signs and symptoms of nerve root impingement of the lumbar plexus
• Recognize signs and symptoms of of Entrapment Syndromes involving the lower extremities
• Apply Manual Methods and Modalities for treatment of lower extremity nerve compression/elongation and associated syndrome

Hour 1

• Discuss an overview of Cerebellar Tonsillar Ectopia
• Discuss the statistical incidence and association with head and neck trauma
• Identify associated and confounding Factors
• Recognize in clinical practice the common signs and symptoms of CTE
• Refer for appropriate evaluation and diagnostic imaging for patients with this condition

 Hour 2

• Appraise Updated Biomechanics: The Biotensegrity Model
• Describe the tensegrity model as it relates to biomechanics from a cellular to organism level.
• Define fascia, including anatomical lines and physical properties.
• Describe the Dural Fascial Kinetic Chain and its relationship to Adverse Mechanical Tension
• Describe the clinical relevance of biotensegrity, and how to apply these updated architectural and biomechanical principles to the delivery of chiropractic adjustments.
• Identify the different types of Adverse Mechanical Tension affecting patients
• Discuss the relationship between fascia and CNS function, including both direct mechanical tension and embedded proprioceptive/nociceptive feedback mechanisms influencing autonomic neurological function.

 Hour 3

• Explain CNS distortion: Chronic Stress
• Summarize the impact of chronic stress on CNS processing.
• List Common types of dysautonomia
• Recognize common signs and symptoms of dysautonomia during initial patient presentation.
• Explain the diagnostic process for dysautonomia, including both testing and interpretation.
• Summarize clinical considerations for the patient with sympatheticotonia.

 Hour 4

• Recognize CSF hydrodynamics and cranial anatomy, and related symptomatology.
• Recognize and describe the common signs and symptoms of abnormal hydrodynamics and Adverse Mechanical Tension (AMT) affecting cranial and dural dynamics.
• Refer for appropriate evaluation and testing procedures for CSF and cranial dynamics.
• Perform modified cranial and fascial release techniques

• This contains all courses with the educational objectives listed from Management of Common Conditions 269 through Management of Common Conditions 271

Hour 1

• Describe the relevance of clinical history as it relates to chronic stress and trauma.
• Recognize signs and symptoms of sympatheticotonia.
• Recognize signs and symptoms of possible CTE.
• Determine appropriate individualized examination procedures based on history answers.

Hour 2

• Refer for diagnosis and advanced testing for CTE.
• Describe layered components of restrictions including updated osseous, muscular, and fascial relational anatomy.
• Describe how to palpate muscle tension versus fascial adhesion versus fascial tension lines.
• Differentiate between osseous restriction, muscular tension, and fascial restriction as they relate to spinal motion restriction.
• Use palpatory findings to select technique application for adjustments that last longer by addressing mechanical root cause and encourage parasympathetic dominance at rest.

Hour 3

• Describe the difference between static misalignments and dynamic spinal restrictions (joints incapable of full range of motion).
• Differentiate with palpation both static and dynamic spinal restrictions.
• Describe neurological information gathered from palpation
• Palpate the patient with chronic pain, trauma history, and/or sympatheticotonia without triggering sympathetic bracing.

Hour 4

• Describe the Oxford Grading Scale for manual muscle testing.
• Describe interpretation of manual muscle testing findings, including differentials for clinical significance of findings other than normal.
• Demonstrate manual muscle testing of major postural muscles.
• Apply manual muscle testing as pre- and post-clinical intervention measures during adjustment visits and to track change during review examination.

Hour 1

• List the relevant indications to assess for imbalance in cross-crawl patterning.
• Describe testing procedures to determine specific cross-crawl pattern imbalances.
• Describe testing procedures to assess for signs of dysautonomia.
• Assess patients for cranial and spinal nerve involvement and refer as appropriate

Hour 2

• Perform seated functional range of motion testing with segmental and curve analysis.
• Perform standing functional range of motion testing with segmental and curve analysis.
• Describe considerations that required modification to common orthopedic tests
• List the orthopedic exam procedures specifically relevant to Fascial Kinetic Chain tension.

Hour 3

• Describe clinical considerations in terms of safety of providing care (knowing when to adjust and when NOT to adjust).
• Define what is “primary” (including considerations of “cause” as well as “least stressful point of access” to determine what to adjust or otherwise apply therapeutic input).
• Recognize patterns of and describe gestalt clinical interpretation for different conditions
• Describe patterns of peripheral nerve interference found through synthesis of clinical history and exam procedures.

Hour 4

• Summarize the concept of an initial Therapeutic Trial of care, including reasoning behind it and how to complete this extension of initial assessment in order to customize patient care.
• Describe considerations for technique selection (including where to start, how intensely to adjust, and how to adjust).
• Explain reasoning behind initial frequency of care, and how/when/why to modify this frequency.
• Describe the considerations for projecting response to care and prognosis.
• Summarize guidelines for patient home care recommendations, including considerations for movement and rest, ergonomics, nutrition, and referrals when appropriate.

• Describe pertinent differential diagnoses for facial pain 
• Breakdown the available interventions available for chronic pain secondary to temporomandibular disorders 
• Compare the effectiveness of two types of treatment – dry needling and upper cervical spinal manipulation versus interocclusal splint therapy, topical NSAIDs and TMJ mobilization for patients with temporomandibular disorder 
• Evaluate the comparative effectiveness of cervical versus combined cervico-craniomandibular manual therapy in patients with temporomandibular disorders (TMD)

• Develop a better understanding of the clinical course of low back pain across different pain durations and populations 
• Assess the literature linking hip biomechanics to low back pain 
• Outline prolonged standing pain developer characteristics and risk factors associated with standing-induced low back pain 
• Investigate the clinical and cost effectiveness of an individualized, progressive walking and education program for preventing recurrences of low back pain 
• Examine the effects of diagnostic labels for low back pain on patients’ perceived need for imaging and other aspects of their condition

• Update the 2013 Cochrane review and determine the current state of the literature on non-operative treatment for neurogenic claudication caused by lumbar spinal stenosis 
• Summarize a treatment algorithm for the management of lumbar spinal stenosis derived from and international expert Delphi consensus process 
• Identify the relevant clinical indicators and pertinent physical examination procedures that can assist in the identification of peripheral arterial diseases or lower limb blood flow limitations 
• Assess the value of adding spinal manipulation and electrical dry needling to standard physical therapy for lumbar spinal stenosis patients 
• Evaluate whether primary care patients with lumbar spinal stenosis symptoms benefit from programs designed for patients with non-specific low back pain

• Explain the origin of the vagus nerve, its anatomy, and its critical role in regulating bodily functions, including its connection to the sympathetic and parasympathetic nervous systems.
• Describe common causes of headaches and explore how the vagus nerve contributes to the pathophysiology of headache conditions.
• Discuss the science behind vagus nerve stimulation, its impact on neurological pathways, and its therapeutic benefits for treating headaches, epilepsy, treatment-resistant depression, reduced anxiety, and improved mood.
• Assess the efficacy and limitations of vagus nerve stimulation as a non-invasive treatment for headache reduction, referencing current research and clinical findings.
• Review the range of vagus nerve stimulation devices, from surgically implanted medical devices to over-the-counter options, and discuss their appropriate uses and considerations.

• Identify the different types of headaches, their triggers, and how they affect the nervous system, particularly through the trigeminal nerve and thalamus
• Examine how temporomandibular joint (TMJ) dysfunction can contribute to headaches and how chiropractic care can effectively address this issue
• Discuss how stress, poor posture, food choices, and other lifestyle factors can contribute to headaches, and how adjustments in these areas can improve symptoms
• Assess the benefits of chiropractic adjustments in reducing headache frequency and severity by improving spinal alignment and nerve function
• Provide guidance on selecting a chiropractor who specializes in TMJ-related headaches and other misalignment issues to achieve optimal patient outcomes.

• Determine the effect of chiropractic on movement time
• Assess the effects of spinal manipulation and ultrasound on chronic low back pain
• Describe heart rate variability as a measurement tool
• Assess the effects of chiropractic on heart rate variability

• Determine the effect of thoracic spine manipulation on autonomic output to the heart
• Review criteria for the diagnosis of cervicogenic headaches
• Describe a clinical assessment for cervicogenic headaches
• Assess the effects of chiropractic and spinal manipulation on cervicogenic headaches

• Describe spinal manipulation use by time, place, and person, identify predictors of the use of spinal manipulation
• Review cost-effectiveness of SMT compared to other treatment options for people with spinal pain of any duration
• Describe the current literature on patient-centered outcomes following a specific type of commonly used SM, high-velocity low-amplitude (HVLA), in patients with LBP
• Review the putative mechanical features of the subluxation and three theories that form the foundation for much of chiropractic practice

• Provide an overview of research on the effects of spinal manipulation on sensory processing, motor output, functional performance and sensorimotor integration
• Examine performance based outcome measures used in an attempt to objectively measure the ramifications of spinal manipulation
• Update knowledge regarding several physical characteristics of an applied SMT, and review what is known about the signaling characteristics of sensory neurons innervating the vertebral column in response to spinal manipulation
• Review the physiological evidence that spinal manipulation can impact visceral function

• Outline the limitations of a recent trial on preventive treatments including spinal manipulation for neck pain and how they contribute to our interpretation of the results of the study
• Interpret results of an important trial on spinal manipulation and exercise for neck pain
• Discuss recent evidence comparing spinal manipulation to mobilization for recent onset neck pain
• Use recent evidence to justify manipulating various spinal regions for patients with neck pain
• Critique the potential for chest and neck mobilizations to affect spirometric performance (breathing)

• Contrast Clinical Guideline-based care with usual medical care for acute low back pain
• Recognize the potential benefit of adding exercise prescription to spinal manipulation for low back pain
• Compare the effectiveness of spinal manipulation to McKenzie Method interventions for persistent low back pain
• Outline factors that may help predict improvement in patients seeking chiropractic care for low back pain
• Explain the benefits of evidence-based care for low back pain

• Compare the efficacy of standard medical care (SMC) alone versus chiropractic spinal manipulation + SMC for acute low back pain patients
• Discuss the value of a combined (pragmatic) chiropractic approach for treating low back pain
• Analyze the state of the research literature directly comparing spinal manipulation, exercise and acupuncture as treatments for low back pain
• Update your understanding of joint cavitation during side posture lumbar manipulation
• Critique the only study (to date) on maintenance care for low back pain including spinal manipulation

• Develop evidence-based chiropractic treatment recommendations for nonspecific (mechanical) neck pain in adults
• Discuss the clinical criteria justifying spinal manipulative therapy for neck pain
• Assess the relative effectiveness of spinal manipulative therapy and rehabilitative exercise for neck pain in seniors
• Describe the working mechanism of manual therapy in participants with chronic tension-type headache
• Examine the cerebrovascular hemodynamic response of cervical spine positions using MRI on the vertebral artery

• Critique the state of the evidence for manual therapy interventions in the treatment of cervical radiculopathy
• Compare two common interventions – spinal manipulation and nerve root injection – for patients with MRI-confirmed lumbar disc herniation
• Critique the state of the evidence for spinal manipulation (specifically) in the treatment of cervical radiculopathy
• Interpret the results of a cohort study of MRI-confirmed symptomatic cervical disc herniation patients treated with cervical manipulation
• Compare isolated cervical SMT versus a combination of cervical, cervico-thoracic and thoracic SMT in patients with chronic mechanical neck pain

• Describe the science behind chiropractic care
• Translate the intent of manipulative therapy to patients and other healthcare providers
• Describe the potential results of not having recommended chiropractic care
• Outline the different theories of the subluxation complex
• Justify the care you recommend based on electrodiagnostic, imaging, and laboratory studies

• Compare chiropractic maintenance care to symptom-guided care for patients with persistent or recurrent low back pain
• Investigate whether adding chiropractic care to usual medical care improves outcomes for military personnel suffering from low back pain
• Evaluate the research on the effectiveness of mobilization and manipulation for chronic non-specific low back pain
• Determine the effects of spinal manipulation on biochemical markers in humans
• Appraise the associations between chiropractic and primary care physician care in relation to acute lumbar disc herniation with early surgery

• This contains all courses with the educational objectives listed from Manipulation 117 through Manipulation 122

• Identify a sub-group of recurrent low back pain patients that might respond most favorably to a maintenance care schedule
• Summarize existing research literature on chiropractic maintenance care
• Investigate short-term changes in pain-pressure threshold (PPT) and temporal summation (TS) after lumbar spinal manipulation (SMT) compared to a credible sham intervention
• Determine whether cervical spinal manipulation leads to meaningful changes in vertebral and cerebral hemodynamics, compared to neutral or end-range neck rotation postures in adults with chronic neck pain
• Summarize the current state of the literature regarding the neurophysiological effects of high-velocity, low-amplitude spinal manipulative therapy (HVLA-SMT) in asymptomatic and symptomatic humans
• Critique the existing, sham-controlled literature evaluating the acute changes in autonomic nervous system (ANS) markers and function in patients receiving manipulation to spinal or peripheral joints

Hour 1

• Identify important spinal anatomy with relation to joint pain, degeneration and stabilization.
• Explain the efficacy of spinal manipulation (SM) for various clinical presentations
• Discuss current literature reviews regarding safety concerns and controversies with SM.
• Perform joint manipulative procedures to the spine and pelvis

 Hour 2

• Discuss common clinical anatomy related to the trunk and torso, with practically to joint manipulation.
• Examine the thoracic and lumbar spine through important clinical landmarks and topical anatomical structures.
• Perform alternative manipulative procedures to the spine and pelvis

 Hour 3

• Discuss common clinical anatomy related to the head, and neck.
• Examine the cervical spine through important clinical landmarks and topical anatomical structures.
• Perform joint manipulative procedures for cervical spine.
• Perform manipulative and mobilization procedures to the temporomandibular joints.

• Examine the effect of chiropractic manipulation on reaction and response time in combat-ready special operations forces qualified personnel
• Assess the influence of chiropractic care on the strength, balance, and/or endurance in active-duty United States military personnel
• Evaluate the impact of upper- vs lower-extremity chiropractic manipulation on postural sway and dual task performance
• Provide an update regarding the mechanisms of action for manual therapy, the impact of manual therapy on pain management, health care conditions for which manual therapy may be beneficial and treatment plans

Hour 1

• Review common foot and ankle anatomy.
• Evaluate the foot and ankle.
• Perform physical and neurological examinations and tests related to the foot and ankle.
• Identify uncomplicated common conditions during the evaluation of the foot and ankle.

 Hour 2

• Discuss evidence-based literature suggesting the practically of manipulation of the foot and ankle.
• Perform adjustments of the foot.
• Perform adjustments of the ankle.
• Utilize a speeder/toggle board for the foot.

 Hour 3

• Describe the impact of disturbances on the determinant factors of health in the structures of the foot and ankle
• Apply corrective and preventative measures to conditions affecting the health of the foot and ankle
• Utilize evidence-based low technology rehabilitative methods to manage patient care of common foot and ankle conditions.
• User strategies to address challenges patients have with adhering to rehabilitative programs.

Hour 1

• Review common hand, wrist and shoulder anatomy.
• Evaluate the hand write and shoulder.
• Perform physical and neurological examinations and tests related to hand wrist and shoulder.
• Identify uncomplicated common conditions during the evaluation of the hand wrist and shoulder

Hour 2

• Discuss evidence-based literature suggesting the practically of manipulation of the hand, wrist and shoulder.
• Perform adjustments of the hand.
• Perform adjustments of the wrist.
• Perform adjustments of the shoulder

Hour 3

• Describe the impact of disturbances on the determinant factors of health in the structures of the hand, wrist and shoulder
• Apply corrective and preventative measures to conditions affecting the health of the hand, wrist and shoulder
• Utilize evidence-based low technology rehabilitative methods to manage patient care of common hand, wrist and shoulder
• User strategies to address challenges patients have with adhering to rehabilitative programs.

• Summarize existing literature regarding the neurophysiological mechanisms of spinal manipulation for spine pain 
• Identify the beliefs, perceptions and practices of chiropractors and patients regarding benign adverse events after spinal manipulation and potential strategies to mitigate them
• Explore recent research pertaining to the importance or segmental pain and stiffness when targeting the application of spinal manipulation
• Assess the literature on the effect of SMT on acute neck pain, including pain, disability and quality of life measures and reported adverse effects
• Examine the evidence pertaining to the efficacy and effectiveness of spinal manipulation for preventing infectious disease and improving disease-specific health outcomes among patients with infectious disease

• Define and classify adverse events associated with manipulation and mobilization
• Review symptoms patients perceive as adverse
• Describe the incidence of severe adverse events among chiropractic recipients
• Outline adverse events in the pregnant and postpartum periods

• Summarize our current understanding of biomechanical and biochemical processes that contribute to the development of discogenic back pain 
• Assess the possible association between receiving chiropractic spinal manipulation and the risk of subsequent cauda equina syndrome (CES) in adults with low back pain 
• Determine the impact of receiving chiropractic spinal manipulation on the odds of being prescribed Benzodiazepines for radicular low back pain 
• Establish if receiving chiropractic spinal manipulation following a radicular low back pain diagnosis influences the likelihood of subsequently receiving a gabapentin prescription 
• Examine the association between receipt of spinal manipulation and tramadol prescription among adults with a new diagnosis of radicular low back pain

History and Background

• Recognize the historical emergence of spinal manipulation (SMT) throughout numerous time periods and among different professions
• Outline the development of the chiropractic profession from the late 1800s to modern day
• Briefly review existing and historical models of spinal manipulative therapy (SMT)

What’s that sound?

• Distinguish cavitation from tribonucleation and explore the relevance of the popping sound with SMT.

 Mechanisms

• Integrate the concept of mechanotransduction into your understanding and appraisal of SMT mechanisms
• Outline different ways methods to provide mechanical stimulation during chiropractic treatment
• Explain what the evidence tells us about joint motion, gapping and location of popping sounds with SMT
• Explore contemporary areas of scientific inquiry into the neurophysiologic mechanism(s) of action for high-velocity spinal manipulation
• Describe how SMT may influence pain modulation
• Critique the evidence relating to the influence of SMT on blood biomarkers and immunity
• Discuss the potential brain and sensorimotor functional impacts of SMT
• Appreciate the relevance of spinal stiffness and the potential impact of SMT on spinal biomechanics
• Summarize existing evidence relating to the SMT and muscle function.

Clinical Considerations

• Describe clinical factors that could influence how SMT exerts its effect(s).
• Discuss existing evidence on the dose-response relationship between SMT and clinical outcomes.
• Recognize the importance of contextual factors, patient expectations and comfort in driving positive clinical outcomes.
• Briefly summarize existing research on studies evaluating SMT for non-spinal conditions.

Course Conclusion

• Propose an integrated, conceptual model of how SMT may exert its effects for our patients.
• Recognize that chiropractic care helps patients via many aspects of the clinical encounter.

• Identify the neurological aspects of manipulation
• Review the basics of cellular physiology as it relates to manipulation
• Discuss action potentials and synapses
• Evolve an understanding of receptors
• Describe nociception and effects of manipulation

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

• Describe axonal degeneration in inflammatory neuropathy
• Construct criteria for diagnosis of multiple sclerosis
• Discuss the use of antioxidant therapy in neurologic disease
• Review the sensory innervation of the SI joint
• Identify mechanoreceptor control of shoulder musculature

• Describe the effect of chiropractic on motor control
• Discuss theories of how movements are chosen
• Discuss how movements are sequenced, and skills are learned
• Develop a motor control examination for your practice
• Distinguish components of the motor assessment

• Describe an approach to the assessment and diagnosis of functional symptoms in neurology
• Outline an approach to the management of functional symptoms in neurology
• Discuss concepts in neuropathic pain

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

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

• Summarize the anatomy and hemodynamics of the upper cervical spine and brain
• Discuss the nature of the pathophysiological changes common in arterial dissection
• Outline the various forms and limitations of the bedside examination and laboratory tests and diagnostic imaging
• Develop criteria for necessity of evaluation procedures (physical, orthopedic, neurologic)
• Justify the development and significance of recognition and management of vascular accidents
• Integrate current considerations regarding risk factors and therapeutic intervention

• Discuss common conditions that are associated with neuropathy
• Identify presenting signs and symptoms in patients that would lead to examination for neuropathy
• Differentiate different conditions that can present with signs and symptoms similar to neuropathy
• Measure and interpret blood chemistries to demine the possible cause of neuropathy in a patient
• Prepare a comprehensive diagnostic and management strategy for patients with neuropathy
• Comprehend and be able to assess relative to neuropathy, drug-nutrient interactions in patients
• Breakdown possible contributions of poly-pharmacy to the development and or maintenance of the neuropathic condition in their patients
• Appraise risk factors for complications such as neuropathy and diabetic ulcers in patients with elevated blood sugar
• Order and interpret neuropathy screening tests for patients with symptoms of neuropathy
• Devise a strategy to reduce risk factors of neuropathy and translate this strategy into a treatment plan for the patient
• Choose and apply biomarker lab tests to manage patients with neuropathy
• Provide basic interpretation of  nerve conduction and EMG findings for patients
• Discuss the use of medications in neuropathy and explain their  mechanisms  of action
• Advise patients on possible side effects of neuropathy medications
• Use Tinel's Sign as a diagnostic procedure and translate these findings into optimal location for therapy in neuropathy patients

• This contains all courses with the educational objectives listed from Neurology 115 through Neurology 116

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

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

• This contains all courses with the educational objectives listed from Neurology 117 through Neurology 121

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

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

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

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

• Understand the differences and similarities between TENs, low voltage and high voltage galvanic and be able to use this knowledge to select the most appropriate type to stimulation for use in ts-DC applications
• Apply precautions, other safety considerations and informed consent when administering high voltage galvanic stimulation for non-invasive spinal cord stimulation.
• Craft evidence-based treatment strategies using ts-DC stimulation for pain control and modulation of both ascending sensory and descending motor pathways based on recently published literature on central nervous systems effects of direct current stimulation.
• Be able to select optimal electrode placement for ts-DC based on clinical presentation of the patient
• Understand the basic technique for non-invasive Stellate Ganglion transcutaneous stimulation and its possible application for sympathetic maintained pain.

• Discuss the history of GVS and the historic use of GVS as diagnostic procedure.
• Identify the effects of GVS on the nervous system and use this information to construct an effective clinical protocol for his/her patient
• Apply GVS as an adjunct procedure to assist in balance rehabilitation.
• Understand and apply GVS as part of a comprehensive strategy for the treatment of neuropathic pain syndromes.
• Create a treatment protocol in terms of electrode placement, intensity, duration and precautions for the use of GVS in clinical practice.

• Communicate the risks, potential benefits and the investigational nature of tDC with a potential patient for the purpose of securing a written informed consent prior to treatment
• Understand the similarities and differences between low voltage direct current and high voltage pulsed galvanic and how to apply knowledge of their polarity specific effects in clinical neuromodulation
• Identify brain targets for neuromodulation and construct a therapeutic electrode montage, treatment protocol in terms of intensity, duration, frequency and dose of tDC 
• Explain the theory of tDC as it relates to pain modulation based on contemporaneous scientific literature
• Apply tDC  as an adjunct procedure to assist in intractable pain relief

• Compared and contrast galvanic vestibular stimulation and Tone Burst Vestibular Stimulation in the treatment of the balance impaired patient.
• Apply the polarity specific effects of the anode and cathode on the vestibular system for amelioration of common balance impairments.
• Identify the anatomical location of electrode placement for Galvanic Vestibular Stimulation.
• Create a treatment strategy using Tone Bursts based on physiological pairing of semicircular canals.
• Apply Specific Tone Protocols based on Saccule versus Utricle dysfunction in balance impaired patients.

• Recognize Traumatic Brain Injury (TBI) in your chiropractic patients
• Summarize the prevalence in your patient population
• Identify the type of patient that presents with TBI
• Explain why a chiropractor needs to differential diagnose TBI patients
• Compile correlations of TBI inciting factors with your patient presentations
• Demonstrate the pathology that occurs with TBI
• Classify the grades of TBI and discriminate what can be treated conservatively
• Identify the incidence of injuries that commonly cause TBI
• Evaluate the probability of TBI in your patient
• Describe the many different types of evaluations, in the field, in the office and upon referral
• Implement in-office Screening Tools and apply diagnostic criteria
• Identify the risk of post-concussive syndrome
• Detect patients with “Brain Cognitive Reserve”
• Identify Second Impact Syndrome
• Assess the value of MRI
• Identify Chronic Traumatic Encephalopathy
• Integrate the current concepts of conservative treatment
• Design Cognitive Rehab
• Provide appropriate patient advice, treatment or referral options

Hour 1 - 5

• Recognize Traumatic Brain Injury (TBI) in your chiropractic patients
• Summarize the prevalence in your patient population
• Identify the type of patient that presents with TBI
• Explain why a chiropractor needs to differential diagnose TBI patients
• Compile correlations of TBI inciting factors with your patient presentations
• Demonstrate the pathology that occurs with TBI
• Classify the grades of TBI and discriminate what can be treated conservatively
• Identify the incidence of injuries that commonly cause TBI
• Evaluate the probability of TBI in your patient
• Describe the many different types of evaluations, in the field, in the office and upon referral
• Implement in-office Screening Tools and apply diagnostic criteria
• Identify the risk of post-concussive syndrome
• Detect patients with “Brain Cognitive Reserve”
• Identify Second Impact Syndrome
• Assess the value of MRI
• Identify Chronic Traumatic Encephalopathy
• Integrate the current concepts of conservative treatment
• Design Cognitive Rehab
• Provide appropriate patient advice, treatment or referral options

Hour 6

• Define the trophic model
• Describe the pathology of trophic model to your patients
• Apply the trophic model of subluxation into clinical practice
• Detect signs & symptoms that correlate with the trophic model
• Extrapolate the model to patient care, especially maintenance manipulative therapy.

• Define the trophic model
• Describe the pathology of trophic model to your patients
• Apply the trophic model of subluxation into clinical practice
• Detect signs & symptoms that correlate with the trophic model
• Extrapolate the model to patient care, especially maintenance manipulative therapy.

Hour 1

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

Hour 2

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

Hour 3

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

Hour 1

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

Hour 2

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

Hour 3

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

• Explain the neurophysiological basis of motor deficits in Parkinson's disease, focusing on basal ganglia dysfunction and its impact on fine motor control and gait.
• Evaluate evidence-based interventions for improving hand dexterity in Parkinson's patients, including task-specific training and emerging technologies like virtual reality.
• Analyze the neuroscientific principles behind gait rehabilitation strategies, such as external cueing and dual-task training, and their effects on neural plasticity in Parkinson's disease.
• Design a comprehensive rehabilitation program that integrates hand dexterity and gait interventions, considering the latest research on neuroplasticity and motor learning in Parkinson's disease.

• Analyze normal postural control mechanisms and identify common postural abnormalities associated with Parkinson's Disease. 
• Explain the pathophysiology of Parkinson's Disease and its impact on functional mobility and balance. 
• Evaluate evidence-based rehabilitation strategies and interventions for managing postural instability in individuals with Parkinson's Disease.
• Demonstrate understanding of the clinical assessment tools used to measure postural control and track rehabilitation progress in Parkinson's Disease patients.

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

• Distinguish how orange juice can improve blood lipid profiles
• Discuss dietary aspects for the vegetarian athlete
• Identify the relationship between bromelain and acute inflammation
• Develop the anti-septic activity of tea tree oil
• Describe Probiotics

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

• Identify how free radicals are formed and what parts of the body are affected.
• Determine the relationship between antioxidants and cardiovascular disease and cancer
• Discuss the role that vitamins, amino acids and herbs have in pain control.
• Examine inflammation and the pro-inflammatory state.
• Construct an anti-inflammatory diet
• Determine which vitamins, minerals and herbs are useful as natural anti-inflammatories.
• Identify the role of Proteolytic enzymes and inflammation and review sources of fatty acids.

• Frame the problem and basic epidemiology of chronic G.I. disorders
• Present evidence of linkage between chronic G.I. disorders with other common medical conditions
• Discuss the current hypothesis of associations between intestinal hyperpermeability and systemic illnesses
• Review cutting edge assessment tools and tests for G.I. disorders
• Outline and suggest rational and efficacious cutting-edge non-drug treatment interventions for functional G.I. disorders.

• Understand how muscle contraction occurs
• Review practical muscle physiology
• Determine how the body responds to exercise
• Discuss the role of hormones in regards to muscle
• Identify the components of proper assessment for physical fitness
• Review the main components of a weight training exercise program
• Identify various exercise training methods
• Discuss the practical aspects of body composition
• Review basic nutrition and how it relates to sport and exercise
• Determine the energy needs and energy balance of the athlete

• Discuss the causes and genetics of Alzheimer's Disease
• Review the diagnosis of Alzheimer's Disease, including symptoms, incidence, course, and risk factors
• Understand conventional lab tests for Alzheimer's Disease
• Review the conventional treatment options for Alzheimer's disease, including drug therapies
• Understand new drug research and innovative drug strategies for Alzheimer's disease
• Utilize nutritional strategies for Alzheimer's disease, including vitamin, mineral and herbal therapies
• Discuss and define drug-vitamin-herb interactions for nutritional supplements recommended for Alzheimer's disease

• Define the common signs and symptoms leading to the diagnosis of Amyotrophic Lateral Sclerosis
• Utilize conventional and alternative lab test for Amyotrophic Lateral Sclerosis
• Learn about the conventional treatment options for ALS, including drug therapies and new drug research
• Utilize nutritional support strategies for ALS, including diet, and nutritional supplements
• Coordinate care with the Medical Profession for innovative drug strategies for ALS

• Review Age-Associated Mental Decline, including its symptoms, causes and innovative drug therapies
• Discuss and define nutritional support strategies for Age-Associated Mental Decline, including vitamins, hormones and antioxidants
• Outline innovative drug strategies for cognitive enhancement
• Apply nutritional support strategies for cognitive enhancement

• Discuss the interactions between nutritional supplements and diuretics, statins and anticoagulant drugs
• Discuss the interactions between nutritional supplements and antidepressants, antidiabetic medications, and antibiotics
• Discuss the interactions between drugs and the B vitamins, fat soluble vitamins
• Discuss the interactions between drugs and vitamin C, folic acid, PABA, progesterone, tyrosine, phenylalanine, and therapeutic oils

• Define the criteria for diagnosing chronic fatigue syndrome
• Outline the causes of chronic fatigue syndrome
• Summarize the relationship between chronic fatigue syndrome and the endocrine system
• Discuss natural therapies that may be helpful for CFS patients
• Describe the relationship between neurotransmitters and chronic fatigue syndrome

• Define obesity, including its symptoms, epidemiology and effects on health and wellness.
• Review conventional treatments for obesity
• Discuss popular diets for obesity and weight loss, and the macronutrients: carbohydrates, protein, and fats
• Review nutritional support strategies for weight loss.

• Adequately frame the problem and basic epidemiology of cardiovascular disorders (CVD)
• Present evidence of the relationship between obesity, insulin resistance, inflammation, stress and CVD
• Summarize the standard medical and laboratory evaluation techniques and why they may only screen for approximately 50% of people at significant risk for CVD
• Appraise the latest laboratory evaluations, including Lp (a), Apo A1, Apo B, hs-CRP, homocysteine, fibrinogen, AA/EPA, LDL-subclass and others to determine CVD risk
• Critique the current dietary, lifestyle, nutritional supplement, nutraceutical, and herbal strategies as therapeutic management options to reduce CVD risk and for the treatment of those who already have cardiovascular issues, including: high cholesterol and dyslipidemia, genetic susceptibilities, chronic inflammation, coagulation abnormalities, and insulin resistance-related risk factors

• Generate a list of disorders associated with gluten sensitivity
• Describe to patients where gluten is likely to be found and which foods are generally safe for a gluten sensitive patient
• Interpret journal articles or general publication articles in the light of the history of gluten sensitivity diagnosis
• Critique articles and authors who claim that celiac disease is the only proven form of gluten reaction
• Detect and differentiate chronic gluten reactions in patients from other causes of inflammation and disease

• Describe the historical context of celiac understanding
• Document reasons why celiac disease is nearly always misdiagnosed
• Present valid arguments from cited literature how celiac disease is an autoimmune condition
• Defend recent scientific advances for the leaky gut syndrome
• Discuss reasons why celiac disease is a global concern, not just an American issue.