Vermont Chiropractic Assistant Education and Continuing Education

• 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

• 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

• 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

• Describe the vertebral architectural distortion that predicts spinal imbalances. 
• Explain the factors involved in the etiology related to the primary components of the proprioceptor-cerebellar network. 
• Cite the law that establishes a classic chiropractic patient via radiograph. 
• Compare the classic manual osseous adjustment to Sensor-Based-Technique in regards to risk and effectiveness for reversing the cause of most chronic subluxations: An aberrant proprioceptor-cerebellar network feedback loop, (usually initiated by injury,) sustained through time by wedged vertebral bodies via Wolff's law, involving neuromuscular fixation engrams compensating for unlevel vertebral architecture. 
• Palpate the tendinous insertions of the paraspinal musculature in the areas of the spinous process tips and identify those areas that show tension, and demonstrate proper cross-friction massage at those points.

• 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.

• List the conditions commonly treated with medical marijuana.
• List the basic physiological mechanism that result from medical marijuana
• Explain the different cannabinol receptors known in human tissues
• Explain the benefits of cannabidiol vs. tetrahydrocannabinols
• List the specific physiological benefits for conditions commonly treated with medical marijuana
• Recognize the side effects and potential dangers of medical marijuana

• Construct examination/radiographic criteria for Osteochondritis Dissecans
• Dissect the elbow as it relates to lateral epicondylitis
• Develop a diagnostic and treatment approach for adhesive capsulitis
• Review possible causes of Intervertebral Disc Degeneration
• Create a list of differential diagnoses of foot pain
• Identify common causes of patellofemoral syndrome
• Understand knee mechanics relative to patellofemoral syndrome
• Differentially diagnose patellofemoral syndrome from other knee conditions
• Define an appropriate treatment program for patellofemoral syndrome
• Identify common causes of shoulder syndrome
• Understand functional mechanics of the shoulder relative to impingement syndrome
• Differentially diagnose shoulder impingement from other shoulder conditions
• Define an appropriate treatment program for impingement syndrome.
• Identify common risk factors and causes for CTS
• Define tests and examination procedures to diagnose CTS
• List the common conditions important in the differential diagnosis of CTS
• Develop a chiropractic treatment plan for CTS

• Discuss the history behind the discovery of and development of releasing somatic dysfunction via positional release techniques via the work of Lawrence Jones, DO, George Goodheart, DC and others
• Discuss the basic concepts of how the body responds to stress and trauma  according to Irvin Korr and how slackening the dysfunctional muscle and joint tissues works to restore normal function.
• Apply anatomy and kinesiology as a means of finding and unwinding somatic dysfunction.
• Include the learned techniques into your practice.
• Compare and contrast the rapid thrust vs. positional release modes of releasing subluxations or somatic dysfunction. 

• Summarize the muscle spindle, specifically, the anatomy and physiology of the spindle subcomponents and how it regulates function of skeletal muscle.
• Breakdown the neural reflex mechanisms of the muscle spindle and appreciate how these mechanisms operate in both somatic function and dysfunction.
• Explain the hypothesis of the “facilitated segment” aka somatic dysfunction, explained both in terms of neurology and by analogies so as to be clear to both the doctor and the patient
• Identify somatic dysfunction via locating tender points and learn the mechanism of slackening in order to relieve the tender point reactivity and restore normal function to the muscle and joint.
• Identify and correct tender point locations and positional releases.

Hour 1:

• 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 (AMT) on the spine and CNS.
• Describe the clinical relevance of biotensegrity, and how to apply these updated architectural and biomechanical principles to the delivery of chiropractic adjustments.

Hour 2:

• Explain the impact of chronic stress
• Recognize common signs and symptoms of sympatheticotonia during initial patient presentation.
• Outline the diagnostic process for sympatheticotonia, including both testing and interpretation.
• Summarize clinical considerations for the patient with sympatheticotonia.

Hour 3:

• Recognize and describe the common signs and symptoms of imbalance during initial patient presentation.
• Outline and demonstrate testing procedures for imbalance.
• Describe clinical interpretation of test results for imbalance.
• Make referral for imbalance when appropriate.

Hour 4:

• Describe statistical incidence and association with head and neck trauma
• Be able to recognize in clinical practice the common signs and symptoms of head and neck trauma
• Outline the diagnostic process for head and neck trauma, including both testing and interpretation.
• Summarize clinical considerations for the patient with head and neck trauma

Hour 1:

• 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 2:

• 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, including dysesthesia, hyperesthesia, reactive erythema, temperature differentials, and other signs.
• Palpate the patient with chronic pain, trauma history, and/or sympatheticotonia without triggering sympathetic bracing.

Hour 3:

• 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 4:

• Describe the relevance of clinical history as it relates to chronic stress and trauma.
• List specific questions to assess for sympatheticotonia.
• List specific questions to assess for indications of head and neck trauma
• Determine appropriate individualized examination procedures based on history answers.

Hour 1:

• List the relevant indications to assess using cross-crawl patterning.
• Describe testing procedures to determine specific cross-crawl pattern issues
• Describe testing procedures to assess for signs of sympatheticotonia.
• Describe testing procedures to assess for signs of imbalance.

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 fascial considerations to modify common orthopedic tests (including straight leg raise, supine apparent arm length inequality, bilateral prone knee flexion, and soto hall).
• 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 sympatheticotonia.
• Recognize patterns of and describe gestalt clinical interpretation for adverse mechanical tension in the Fascial Kinetic Chain
• 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.

• 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

• This contains all courses with the educational objectives listed from Neurology 116 through Neurology 124

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

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

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

• 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

• 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.

• 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.

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

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

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

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

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

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

• Observe a doctor patient encounter where the patient is a young female with a primary complaint of a balance problem
• Improve the history taking process in an actual clinical setting
• Develop improved patient examination techniques
• Evaluate relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint

• Observe a doctor patient encounter where the patient is a middle aged female with a primary complaint of upper extremity paralysis.
• Improve the history taking process in an actual clinical setting
• Develop improved patient examination techniques
• Evaluate relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint.

• Observe a doctor patient encounter where the patient is a young female with a generalized headache without any specific area of pain
• Improve the history taking process in an actual clinical setting
• Develop improved patient examination techniques
• Evaluate relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint

• Observe a doctor patient encounter where the patient is a young female with a primary complaint of tremor
• Explore the history taking process in an actual clinical setting
• Observe patient examination techniques
• Summarize relevant clinical findings
• Illustrate the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint

• Observe a doctor sort through a difficult history in a patient encounter where the patient is a female with multiple and unusual complaints
• Explore the history taking process in an actual clinical setting
• Observe patient examination techniques
• Summarize relevant clinical findings
• Illustrate the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint

• Explore basic principles of the patient interview
• Discuss briefly the relevance of maintaining good history taking procedures
• Describe in detail the benefits of history questionnaires
• Explore different types of patient historians and as strategy for dealing with each type
• Describe specific area constituting a complete patient interview

• Explore basic principles of the mental status examination
• Discuss briefly the relevance of maintaining good history taking procedures
• Describe in detail the need for a mental status assessment
• Explore different techniques and a strategy for dealing with mental status problems
• Demonstrate specific methods of implementing the Mini-Mental State Examination.

• Explore basic principles of the physical examination of the face, head and neck
• Discuss briefly the relevance the physical examination prior to the neurologic examination
• Describe in detail rational and procedure for observation, auscultation, palpation and percussion
• Visualize patient problems and deformities that might go un-noticed by a casual observer
• Demonstrate specific methods of implementing a brief orthopedic examination of the cervical spine.

• Define specific terminology including organic disease, non-organic disease, functional disease, somatoform disease, malingering and others
• Discuss the distinction between somatoform disorders (hysteria) and malingering
• Describe patient presentations and examination techniques which are useful in somatoform disorders of the special senses
• Elaborate on the somatic manifestations of somatoform disease in motor and sensory presentations
• Explore caveats of diagnosing somatoform disorders
• Discuss completely the performance and usefulness of in office "credibility" tests used to unveil non-organic disorders
• Define and describe aspects of the malingering patient

• Describe the reasons for using an ophthalmoscope in the clinical bedside examination
• Define and contrast the Pan-Optic ophthalmoscope from the common ophthalmoscopes
• Discuss common settings and features of the ophthalmoscope
• Define methods of describing findings in the fundus of the eye\
• Identify and define common systemic and local pathologic processes that may be encountered in the course of the ophthalmoscopic examination.

• Outline methods used and estimations as to the incidence of cervical spinal manipulative therapy and subsequent vertebrobasilar ischemia
• Review and describe cerebrovascular anatomy and hemodynamics
• Discuss proposed patho-physiological mechanisms believed responsible for subsequent vertebrobasilar ischemia
• Review and discuss past and present scientific literature to explore the evolution of what we think we know about the process of cervical spinal manipulative therapy and subsequent vertebrobasilar ischemia
• Explore issues and examination procedures related to patient assessment as well as vertebrobasilar ischemia recognition and proper diagnosis
• Define and contrast currently suggested procedures  and develop a vertebrobasilar ischemia plan of action
• Explore various perspectives and reveal bias in both public media and biomedical journals
• Identify and define new theoretical concepts and prophylactic therapies

• Compare and contrast neuronal cells from the neuroglial cells.
• Identify various types of neurons of the peripheral and central nervous system.
• Describe the types of neuroglial cells found in the central nervous system and peripheral nervous system.
• Categorize the types of mammalian nerve fibers by neuron a diameter, conduction velocity and susceptibility to compression.
• Describe the incidence and prevalence of dizziness as a complaint.
• Define the term “motor unit” from a clinical perspective.
• Compare and contrast type one and type two muscle fibers.
• Identify anatomical components and describe physiological function of the cell membrane.
• Define the terms summation and generator potentials.

• Define the terms “electrodiagnosis, nerve conduction study, needle electrode examination, late responses and evoked potentials”.
• Identify the various components of the action potential recording.
• Compare and contrast synaptic versus electrical nerve stimulation.
• Recite the components of the modern electromyographic machine.
• Describe the different types of electrodes used in an electrodiagnostic examination and include the purpose and benefits/drawbacks to each type.
• Categorize the types of electrodiagnostic testing.
• Discuss performance and use of electrodiagnostic testing, including conduction studies and latencies, late responses (including the “H” reflex and “F” wave) and evoked potentials.
• Properly order and interpret the results of electrodiagnostic testing.

• Define the terms “spasm, interexaminar and intraexaminer reliability, global myoelectric activity and muscle fatigue”.
• Identify the various components of the modern paraspinal electrode EMG machine. recording.
• Compare and contrast the use of surface electrodes in the traditional electromyographic examination versus the paraspinal surface electrode electromyographic examination.
• Recite several scientific studies regarding paraspinal surface electrode electromyographic, and strengths and weaknesses of each study.
• Describe tissue filtering, best ways to overcome it, and explain its significance in obtaining useful data.
• Recite the names of the paraspinal musculature organized by their depth, action and activation response.
• Discuss performance and utility of the test for the “flexion relaxation” phenomenon.

Hour 1

• Recite general information regarding incidents and prevalence of multiple sclerosis in the United States, the United Kingdom and Canada.
• Describe the pathophysiological process believed to be responsible for the most common types of multiple sclerosis.

Hour 2

• Recognize the common signs and symptoms of a patient presenting with demyelinating disease.
• Recognize typical lesions in the brain and spinal cord associated with multiple sclerosis on MRI studies.
• Define the McDonald criteria for the diagnosis of multiple sclerosis.

Hour 3

• Identify various blood tests for diseases that may mimic multiple sclerosis.
• Compare and contrast the category types of multiple sclerosis.
• Describe the common medical treatment for multiple sclerosis.

Hour 4

• Recite studies associated with complementary and alternative approaches to management of patients with multiple sclerosis.
• Synthesize a plan for the management of patients with multiple sclerosis.

Hour 1

• Recite statistics regarding the percentage of primary versus secondary tumors found in the central nervous system.
• Recognize the signs and symptoms of a patient with an intracranial or spinal canal tumor.

Hour 2

• Describe the pathophysiological process associated with neoplasia.
• Discuss the most common types of primary intracranial tumors, metastatic neoplasms and other spinal cancers.

Hour 3

• Identify advanced imaging studies of various types of nervous system tumors.
• Describe mechanisms of cerebrospinal fluid flow in their association with symptoms caused by intracranial tumors.

Hour 4

• Contrast and compare the signs and symptoms associated with tumors arising in various parts of the spinal cord.
• Discuss various forms of medical treatment for patients with nervous system tumors.

Hour 1

• Discuss the etiology of congenital conditions of the brain and spinal cord.
• Recite statistics regarding incidence and prevalence of neural tube defects.

Hour 2

• Describe common forms and categories of neural tube defects.
• Recognize various forms of neural tube defects at birth, in infant life as well as on advanced imaging studies.

Hour 3

• Identify defects of the cranial cervical junction including categorizing Chiari Malformation and discuss clinical significance and management of patients with Chiari Malformation I, II and III.
• Utilize plain film radiometrics to identify multiple forms of cranial cervical junction deformities.

Hour 4

• Discuss various congenital syndromes including Dandy-Walker Syndrome and Mobius Syndrome.
• Compare and contrast different types of developmental defects such as hydrocephalus, crainiosynostosis, achondroplasia, microcrania, and others.

• Describe the incidence and prevalence of dizziness as a complaint.
• Define the term vertigo from a clinical perspective.
• Identify anatomical components and describe physiological function of the vestibular system.
• Perform a brief bedside examination for basic evaluation of the dizzy patient.
• Categorize varieties of conditions causing dizziness and identify which are likely to be amenable to conservative care.
• Compare and contrast the function of the utricle, saccule and semicircular canals.

• Relate relatively common but sometimes challenging patient cases including myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.
• Explain diagnostic and therapeutic considerations in myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.
• Give examples of diagnostic and therapeutic considerations in myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.
• Describe diagnostic and therapeutic considerations in myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.

• Identify the areas of proper placement of the stethoscope bell in order to auscultate various arteries and other vascular structures available in the head and neck.
• Perform palpation of the thyroid gland.
• Perform an examination of the cranial nerves.
• Evaluate the head and neck for signs of nervous system trauma.
• Draw out the visual pathways from retina to striate cortex of the occipital lobe.
• Associate patterns of visual field losses with various portions of optic pathway disease.
• List retinal areas to evaluate and associated parameters during the fundoscopic examination.
• Correlate disorders of eye position and movement with peripheral cranial nerve disease, internuclear ophthalmoplegia and gaze palsy’s.
• List current vertebrobasilar risk assessment options as well as the value and limitations of each.
• Outline the position of the Association of Chiropractic Colleges (ACC) in regard to vertebrobasilar ischemia (VBI) provocative testing in the chiropractic office.
• Identify suggested effects of elevated homocystine levels above 7.2 umol/L.
• Perform procedures recommended by the author to evaluate candidates for manipulative therapy.
• Summarize implications of neurological findings for lesions involving the cranial nerves or their central connections.

• 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 T Bilberry and Black Cohosh

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

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

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

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

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

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

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

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

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

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

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

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

• 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

• NOTE: Approved for 7 hours Category A in Ontario
• 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

• 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.

• Defend the implementation of a gluten free diet in celiac and non-celiac gluten sensitive patients based on sound evidence from current literature
• Document reasons why a first-degree relative of a known celiac should be gluten-free
• Summarize the current rate of celiac diagnosis in the US
• Contrast the expected findings of a celiac patient and non-celiac gluten intolerant patient
• Recognize that neurological signs can result from gluten intolerance

• Identify which supplements are commonly used in exercise and sport
• Determine the benefits and risks of individual ergogenic aids
• Discuss the role that individual vitamins have in exercise and sport
• Examine the role that individual minerals have in exercise and sport
• Investigate the value of sport drinks
• Ascertain when fluids are most beneficial in sport
• Apply how exercise effects the immune system
• Review the positive and negative effects of exercise
• Identify the role of antioxidants in sport and exercise

• Summarize the bowel protective mechanisms and their role in health and disease
• Outline a treatment strategy for imbalanced gut flora/leaky gut
• Identify common food allergies and determine appropriate nutritional therapy
• Examine the role of fiber in gastrointestinal health
• Create a treatment plan for common GI complaints of constipation and diarrhea
• Determine appropriate nutritional treatments for ulcers
• Theorize how diet can affect Inflammatory bowel disease
• Understand how to successfully use nutrition to treat a variety of gastrointestinal disorders
• Comprehend a rationale treatment protocol for Irritable bowel syndrome
• Determine correct doses of supplements used for various gastrointestinal disorders
• Ascertain the safety and risks associated with commonly prescribed gastrointestinal supplements

• Identify which supplements are commonly used in exercise and sport
• Ascertain the rationale of using specific individual sport supplements
• Differentiate between fact and fiction of the supplement in relation to sport and exercise
• Determine the practical use in sport for individual supplements
• Determine the benefits of individual ergogenic supplements
• Examine the risks associated with individual supplements
• Investigate the value of specific supplements via studies
• Define contraindications and interactions with the supplement
• Recommend the correct dose of the supplement for sport and exercise

• Identify various energy systems of the body and how they relate to exercise and sport
• Theorize which energy system is used for a specific sport event/activity
• Summarize the physiology of fat, protein and carbohydrate metabolism and utilization in exercise and sport
• Understand the relationship between the energy systems and various exercise parameters
• Create a diet protocol for the athlete prior to their sport or exercise activity
• Determine and understand the timing of meals in exercise and sport
• Outline a useful program for a person to maximize carbohydrate stores
• Theorize how glycemic index can affect exercise and sport activity
• Ascertain differences between food variables and how they affect exercise and sport performance

• Review nutritional supplements useful for weight loss.
• Discuss the research for conjugated linoleic acid for weight loss.
• Outline the associations between thyroid function and weight loss.
• Summarize dietary supplements that increase thermogenesis.

• Differentiate various nutrition assessment techniques.
• Determine which body fat/composition technique is most appropriate for the individual.
• Calculate essential measurements for weight loss patients.

• Appraise the reviewed research studies for salient elements of bias.
• Describe the sensitivity and specificity of common food sensitivity tests.
• Identify the effect of common natural interventions for IBS.
• Compare results of the low FODMAP diet to conventional dietary approach for IBS.
• Differentiate between clinical and statistical significance in natural medicine interventions for IBS
• Grade the magnitude of effect size for natural medicine interventions.
• Interpret the effect size of an intervention as it relates to the numbers needed to treat for benefit.
• Identify the risk of bias level for studies included in a systematic review on yoga for IBS.

• Discuss the role of diet in causing and preventing various diseases, particularly chronic diseases.
• Describe methods used to assess nutrition status.
• Explain how dietary recommendations are formulated.
• Incorporate nutritional information into clinical practice and advise patients about eating for optimum health as well as using dietary change as a therapeutic intervention
• Evaluate the benefits and risks of nutritional recommendations for specific health conditions through an analysis of the existing scientific and clinical evidence

Hour 1 - 3

• Discuss the role of diet in causing and preventing various diseases, particularly chronic diseases.
• Describe methods used to assess nutrition status.
• Explain how dietary recommendations are formulated.
• Incorporate nutritional information into clinical practice and advise patients about eating for optimum health as well as using dietary change as a therapeutic intervention
• Evaluate the benefits and risks of nutritional recommendations for specific health conditions through an analysis of the existing scientific and clinical evidence

Hour 4

• Investigate the importance of nutrient deficiencies
• Review the role of essential nutrients in human health
• Analyze the interaction between nutrients and various illnesses
• Ascertain the role herbs have in health and disease
• Understand drug and nutrient interactions

• Investigate the importance of nutrient deficiencies
• Review the role of essential nutrients in human health
• Analyze the interaction between nutrients and various illnesses
• Ascertain the role herbs have in health and disease
• Understand drug and nutrient interactions

• Review the clinical presentation of Diabetes
• Examine the role of nutrition and diet in Diabetes
• Design an appropriate supplement protocol for the diabetic patient
• Develop nutritional guidelines for hypoglycemia

• This contains all courses with the educational objectives listed from Nutrition 148 through 154

• Identify sources and functions of carbohydrates, proteins, fats, alcohol, vitamins, minerals, and water in the human body.
• Demonstrate the importance of a balanced diet and use tools that can be utilized to evaluate the nutritional adequacy of a diet (RDA, Dietary Guidelines, MyPlate, etc.).
• Identify the relationship between diet and chronic diseases/illnesses (cardiovascular disease, diabetes, obesity, cancer, hypertension, osteoporosis, etc.) and what modifications can be made in the diet to reduce the risk for these diseases/illnesses.
• Recall current nutritional recommendations for healthy eating habits (American Heart Association, American Cancer Society, etc.).
• Utilize nutrition terminology and related terminology appropriately.
• Demonstrate lifelong healthful eating habits by differentiating between beneficial and non-beneficial dietary practices.
• Develop nutritional scripts for 10 of the most common adult pathologies that can be potentially palliative or reverses through dietary changes.

• Understand the relationship between BPH and nutrition/supplements
• Develop a nutrition treatment program for UTI's
• Design a nutrition therapy program for kidney stones and gallstones
• Explore the relationship between diet and hyperestrogenism and its related diseases such as PMS and FBD
• Outline a nutrition treatment program for menopause

• Analyze the relationship between tendonitis/bursitis and nutrition
• Identify the nutritional treatment of muscle cramps/leg cramps and soreness
• Discuss nutrition treatment for Muscular dystrophy
• Determine an appropriate nutrition treatment for Fibromyalgia

• Identify the etiology and pathology of arthritis.
• Outline a diet that is helpful in the treatment of arthritis.
• Apply specific supplements to an arthritic condition.

• Review the risk factors and mechanisms of heart disease.
• Identify the parts of a proper diet to prevent heart disease.
• Evaluate various supplements that are beneficial in prevention and treatment of heart disease.

• Recall various foods with high amounts of Flavonoids and briefly relate their impact health
• Indicate the basic chemical structural similarities and differences of Flavonoids
• Relate potential benefits of combining Flavonoids, and ways of improving their bioavailability and efficacy
• Explain why some Flavonoids may be effective according to their chemical structure, specifically in a study for neuroprotection
• Discuss Flavonoid use and neuromuscular treatment considerations
• Integrate knowledge of Flavonoids and biochemical pathways to prescribe individualized nutrition treatments to your patients and appreciate the potential for overprescribing too many competing herbs
• Examine and demonstrate how and why Green Tea extract may play an inclusive role in health

• This contains all courses with the educational objectives listed in Nutrition 157 and 158

• Quantify the prevalence rates of patients using opioids and herbal products
• Demonstrate the significance to the chiropractor of interactions between different herbs and common prescription drugs
• Discuss the at risk populations for interactions including the pregnant, and elderly populations
• Record and list the most common interactions of common food and herbal products
• Record and list the effects of the common interactions of common heart medication and herbal products
• Demonstrate evidence that supports the use of health care providers assessing patients for these interactions.
• Discuss the role of the chiropractor in the role of identifying these interactions.
• Illustrate several books, and smart phone based electronic applications to make the process of identification easier for a chiropractor and patient.
• Evaluate common case scenarios

Hour 1: Evolutionary Biology Influence on Clinical Physiology

• Discuss infection, evolution, immunity, inflammation, and fibrosis.
• Compare short-term survival v. long-term chronicity.

 Hour 2: Summarize Inflammation in both Pain and Disease

• Utilize Laboratory diagnosis of inflammation.
• Provide Nutritional management for inflammation.

Hour 3: Justification of Sleep Hygiene

• Explain the role for sleep and sleep’s influence on immunity, cognition, psychiatric conditions, hunger, fertility, blood sugar control, vascular health, and more.
• Summarize the influence of sleep on brain neurochemistry.

Hour 4: Define the Recently Discovered Glymphatic System

• Discuss the glymphatic system and how to optimize its influence on health.
• Emphasize the importance of the glymphatic system in relation to neurodegenerative diseases.

Hour 5: Point out the Role of Vitamins for Chronic Disease Prevention

• Emphasize the importance of B vitamins to lower homocysteine.
• Point out the relationship between elevated homocysteine and vascular injury risks.
• Justify why people need between 5-8 different supplements and explain why.

Hour 6: Analyze the Science of a Healthy Diet

• Justify high vegetable, low lectin, low glycemic dietary habits, and their influence on physiology.
• Summarize problems with refined carbohydrates, monosodium glutamate, aspartame, and chemical toxins.
• Explain the drivers and consequences of a leaky gut.
• Demonstrate glycation and its consequences.
• Explore the benefits of Intermittent Fasting

Hour 7: Appraise Chiropractic Clinical Practice and Pain Management

• Integrate the Gate Theory of Pain and the Chiropractic Adjustment
• Quantify the Opioids Epidemic and the Positive Influence of Chiropractic
• Diagram the importance of the omega-6 / omega-3 ratio
• Caution Against the Ingestion of Excitotoxins

Hour 8: Detail the Benefits of Exercise

• Emphasize the Benefits of High Intensity Interval Training.
• Introduce the Harmful Effects of Fructose on Energy Production

• Discuss the Nutritional Aspect of effect size of red meat reduction
• Discuss the importance of the GRADE evidence evaluation method.
• Explain the Nutritional importance of the choice of the red meat reduction target
• Summarize the multiple lines of evidence supporting the guideline recommendation.

• Define very low carb (ketogenic), low carb, and moderate carbohydrate diets
• Describe the proposed mechanism of how low carbohydrate diets may improve outcomes
• Summarize the evidence supporting low and very low carbohydrate diets in diabetes management
• Critique the arguments for the long-term use of ketogenic diets

• Understand the importance of normal bowl defense mechanisms
• Develop a nutritional treatment for candidiasis and gut flora imbalances
• Examine the importance of fiber on human health
• Design a nutritional treatment program for constipation and diarrhea

• Identify different types of natural anti-inflammatories.
• Determine which anti-inflammatory is best for a particular patient.
• Develop an anti-inflammatory diet.
• Examine the concept of health and aging
• Determine an appropriate lifestyle to increase the chances of living longer
• Analyze various diets and dietary patterns that play a role in aging
• Ascertain which foods are of greater benefit in regards to aging and longevity
• Develop an appropriate anti-aging diet
• Identify the risk factors associated with osteoporosis
• Outline a beneficial diet for osteoporosis
• Determine an appropriate supplement protocol
• Examine the role of exercise in the treatment of osteoporosis

• Analyze the role between diet and the immune system.
• Design a nutrition supplement program to stimulate the immune system.
• Develop a nutrition program for colds, flu, sore throat and infections.
• Understand basic detoxification techniques.
• Examine the role of nutrition and diet in regards to chronic fatigue syndrome.

• Analyze the role between diet and the immune system.
• Design a nutrition supplement program to stimulate the immune system.
• Develop a nutrition program for colds, flu, sore throat and infections.
• Understand basic detoxification techniques.
• Examine the role of nutrition and diet in regards to chronic fatigue syndrome.

Hour 1

• Define and explain the chronic illnesses so prevalent in today’s society.
• Recognize and calculate life expectancy statistics
• Describe the difference between traditional and modern (commercial diets)
• Distinguish the differences between raw and pasteurized milk
• Recognize the difference between healthy and commercial butter and eggs
• Discuss the difference between hydrogenated and non-hydrogenated fats/oils

 Hour 2 

• Contrast the differences between lacto fermented and non-fermented soy (tofu, edamame)
• Compare breast milk to soy formula
• Identify the difference between sea salt and industrialized salt
• Summarize the benefits of cholesterol
• Explain the dangers of cholesterol lowering drugs
• List the benefits of sunlight

• Identify the risk factors associated with osteoporosis
• Outline a beneficial diet for osteoporosis
• Determine an appropriate supplement protocol
• Examine the role of exercise in the treatment of osteoporosis

• Identify different types of natural anti-inflammatories.
• Determine which anti-inflammatory is best for a particular patient.
• Develop an anti-inflammatory diet.

• Develop an appropriate nutrition program for an ulcer
• Identify the importance of diet in Celiac’s disease (non-tropical sprue)
• Outline a nutrition program for a patient with lactose intolerance
• Design a nutrition treatment program for GERD
• Examine the role of nutrition and supplements in irritable bowel syndrome

Hour 1

• Recognize normal cognitive and memory lapses and signs of declining cognition.
• Differentiate the assessment tools and the pros & cons of each
• Review evidence-based dietary patterns and specific foods that impact cognition
• Review additional evidence-based lifestyle factors that contribute to cognition
• Summarize dietary supplements which may impact cognition

Hour 2

• Recognize 5 categories of early aging
• Identify nutrient deficiencies associated with aging
• Examine epigenetics in aging, specifically COMT and MTHFR
• Review stress physiology and its contribution to aging
• Review contributions of microbiome to healthy physiology and aging

• Design an effective nutrition treatment program for carpal tunnel syndrome
• Develop a nutritional treatment program for Multiple Sclerosis
• Investigate the role of nutrition and supplements in regards to the treatment of headaches
• Understand how nutrition and nutrition supplements can influence dementia
• Identify appropriate diet and supplement agents in the treatment of dementia

• Identify behaviors associated with artificial sweeteners
• Examine the main artificial sweeteners used in the United States
• Determine why artificial sweeteners are used in the food industry
• Summarize the general risks associated with artificial sweeteners
• Evaluate the benefits and risks of Neotame and Advantame

• Identify the benefits and risks of Saccharin
• Discover the benefits and risks of Acesulfame potassium
• Summarize the benefits and risks of Sucralose
• Differentiate Aspartame benefits and risks
• Critique the current research on artificial sweeteners and cancer risk
• Explain the effect of artificial sweeteners on the gastrointestinal environment
• Interpret the research on artificial sweeteners and blood sugar

• Distinguish between the negative and positive effects on obesity, weight control and artificial sweeteners
• Identify the natural sweeteners that are generally recognized as safe
• Evaluate the effectiveness and safety of Stevia
• Determine the effectiveness and safety of Luo han guo (Swingle fruit or monk fruit extract)
• Analyze the effectiveness and safety of Thaumatin

• Review exercise physiology principles and techniques
• Analyze various exercise prescription principles
• Identify appropriate carbohydrate – fat – and protein recommendations
• Develop meal timing and fluid guidelines for the athlete

• Review the signs and symptoms of neuroinflammation and the processes that drive neurodegeneration.
• Identify the neurological signs and symptoms of long COVID and apply research-based protocols.
• Utilize dietary improvements and selected supplements to reduce neuroinflammation.
• Treatment protocols on testing to identify gut barrier and gut-brain axis imbalances.
• Recognize that neuroplasticity plays a fluctuating but essential role in health and trauma.
• Understand the effect of bacterial toxins originating in the gut on the gut-brain axis as a key to neurological disorders pathogenesis.
• Assess intestinal and blood-brain barrier dysfunction for better managing chronic neurological disorders.
• Understand new functional nutritional strategies for longevity.
• Incorporate leading-edge protocols for extending healthspan and longevity.
• Clarify the effects of intermittent fasting on immunity and longevity.
• Recognize that neuroplasticity plays a fluctuating but essential role in health and trauma.
• Integrate optimal lifestyle adaptations in diet, exercise, and supplement protocols to enhance neuroplasticity and improve quality of life.

• Understand basic concepts of health
• Identify the health spectrum
• Investigate the various facts associated with aging
• Investigate the various theories of aging

• Explain the basic principles of nutrigenomics, focusing on the interaction between nutrition, genetics, and health outcomes, with an emphasis on conditions like headaches.
• Analyze how single nucleotide polymorphisms (SNPs) and other genetic variations impact nutrient metabolism and their potential role in triggering headaches, such as those linked to impaired methylation.
• Examine the mechanisms by which a lack of essential nutrients (e.g., magnesium, B vitamins) contributes to headaches, and how nutrigenomics can inform targeted nutritional interventions.
• Design tailored dietary strategies based on genetic testing results, addressing deficiencies or imbalances that may exacerbate headache conditions.
• Assess the benefits and limitations of using nutrigenomic testing to guide clinical decision-making for headache management and prevention, highlighting the importance of personalized nutrition in improving patient outcomes.

Hour 1

• Compare the differences between acute and chronic inflammation.
• Associate background inflammation with chiropractic treatment outcomes.
• Discuss the aging trends in the U.S. population.
• Summarize the role of aging on background inflammation.
• Explain the differing outcomes of disc disease and radiculitis driven by inflammation.

Hour 2

• Identify the mechanisms by which macrophages activate inflammation.
• Discuss the historical trends in long chain fatty acid intake in relation to inflammation.
• Explain the dependency on the COX 2 enzyme both in inflammatory up-regulation and in resolution.
• Recognized dietary induced “meta-inflammation” and the dietary patterns that induce it.
• Summarize the role of phytonutrients in limiting dietary induced inflammation.

Hour 3

• Define immunosenescence and “inflammaging”.
• Summarize the role of autophagy in limiting inflammaging.
• Summarize the role of apoptosis in eliminating senescent immune cells.
• Examine the phytonutrients with senomorphic/pro-autophagy properties.
• Examine the phytonutrients with senolytic/pro-apoptotic properties.

Hour 4

• Describe the role of vagal nerve activation in regulating the transition to inflammatory resolution.
• Examine the splenic cholinergic anti-inflammatory pathway.
• Outline the mechanisms by which vagal activation increases specialized pro-resolving mediator (SPMs) production from omega-3 fatty acids.
• Summarize the role of transcutaneous vagal nerve stimulation (tVNS) in the inflammatory to pro-resolving transition.
• Contrast the inflammatory suppressing and pro-resolving treatment strategies.

• Explain basic concepts of health
• Identify the health spectrum
• Investigate the various facts associated with aging
• Determine the difference between sickly aging and normal aging
• Investigate the various theories of aging

• This contains all courses with the educational objectives listed from Nutrition 201 to Nutrition 212

• Recognize the most common theory of aging
• Determine the risks associated with being sedentary
• Identify the effect of exercise on the cardiovascular system
• Describe how exercise affects cholesterol and cancer
• Examine the various components of an exercise program

• Identify which exercises are best for health and longevity
• Investigate the relationship between exercise and antioxidants
• Recognize basic concepts of stress
• Explain how stress and other emotions can cause disease and ill health
• Determine the relationship between nutrition and stress

• Differentiate the relationship between various stress reducing techniques
• Identify how social relationships, religion and prayer can affect health and aging
• Investigate the negative and positive factors from consuming alcohol
• Recognize how alcohol affects nutrition
• Identify how smoking affects health

• Identify the relationship between nutrition and smoking
• Investigate the relationship between second hand smoke and nutrition
• Identify various smoking cessation techniques
• Identify the role of antioxidants and free radicals
• Examine the relationship between antioxidants and heart disease

• Determine the relationship between diet, cancer, and the environment
• Identify various antioxidants that can affect cancer
• Describe how caloric restriction affects longevity
• Explore basic concepts of weight control and obesity
• Recognize how obesity affects overall health and promotes disease

• Identify various dietary patterns and habits
• Determine how diet patterns affect health and promote disease
• Explore the typical American diet pattern
• Review the vegetarian diet pattern
• Analyze the Mediterranean diet pattern and its components

• Identify why fruits and vegetables are anti-aging foods
• Determine how fruits and vegetables offer health benefits
• Select what components of fish have positive effects on health
• Investigate how fish affects cardiovascular disease and cancer
• Identify how garlic affects health and inhibits disease

• Demonstrate the role grains have in health and longevity
• Explain the basics of fiber and how it can affect health and disease
• Identify how nuts can positively affect health and decrease disease
• Investigate how legumes and soy can affect heart disease
• Relate how legumes and soy can affect cancer

• Recognize the beneficial components of yogurt
• Identify how yogurt can affect the immune system
• Define what prebiotics are and how they affect health
• Describe how chocolate can promote health and longevity
• Explore how tea can positively affect health and decrease disease risk

• Identify what the beneficial components of wine are
• Determine the how and when of wine consumption
• Explain basic concepts of water and signs of dehydration
• List how water affects disease and promotes health
• Identify who is susceptible to nutrient deficiencies

• Determine the relationship between a daily multiple vitamin and health
• Analyze how growth hormone can promote health and possibly slow aging
• Explain the risk versus benefit of using testosterone and melatonin
• Recognize the role of DHEA and DHEA-S on health and longevity
• Identify the main concepts of an anti-aging strategy

• Discuss the epidemiology and current state of the opioid crisis
• Discuss the use of opioids for pain relief
• Discuss the use of manual therapies for chronic pain management of patients during opioid the crisis
• Outline the evidence for manual therapies for chronic pain
• Discuss the use of lifestyle measures in aiding chronic pain sufferers

• Define addiction, and identify the two main categories of addiction.
• List the main addictions of concern in the current addiction crisis.
• Summarize the neurophysiological and pharmacological dynamics of addiction, and appraise the possible solutions of recovery by using this information and delegating it to various medications and herbs (such as CBD oil).
• Outline some of the solutions indicated for addressing the addiction crisis and critique these treatment plans.
• Assess using herbal medicine (CBD oil) for the treatment of opioid and other addictions.

• Assess the association between opioid use and chiropractic treatment for LBP
• Demonstrate the potential for chiropractic care to reduce the use of prescription opioids in patients with spinal pain
• Summarize two papers exploring the effects of utilization and availability of chiropractic services on opioid usage and medical services
• Evaluate the impact of chiropractic utilization on the use of prescription opioid use in Medicare beneficiaries aged 65 and over with spinal pain
• Describe the comparative risk of treatment escalation in patients with neck pain between recipients of spinal manipulation and nonrecipients of spinal manipulation

• Identify differences between strength and balance training
• Discuss the dynamic aspects of posture
• Learn aspects of Postural control in chronic LBP patients
• Understand relationship of posture and sports injuries
• Review some concepts of posture, mobility and pain in children

• Review normal cervical biomechanics and apply to examination
• Discuss some effects of manipulation on EMG/ROM
• Recognize lumbar movements during mobilization
• Discuss how whiplash invisibility is not evidence of absence of injury
• Understand muscle adaptation through stretching

• Distinguish Chiropractic influences on muscular strength
• Develop the use of hand-held dynamometry in chiropractic practice
• Identify basic strength training principles for chiropractors
• Construct basics of strength training guidelines for all ages

• Review an Introduction to the Clinical Biomechanics of Stability
• Identify causes of select musculoskeletal injuries
• Describe how LBP in golfers alters motor control
• Describe spinal stability changes with posture
• Distinguish how stability improves with resistance training

• Describe neck anticipatory control with pain
• Describe lateralized fatigue with unilateral neck pain
• Assess head and trunk motion during neck manipulation
• Identify neuromuscular dysfunction in neck pain patients
• Outline exercises for the rehabilitation of neck neuromuscular dysfunction

• Discuss the biomechanical, physiological and psychological evidence for the use of back belts
• Identify and describe recent recommendations and findings for the use of back belts.
• Discuss the principle of affordances and how they relate to environmental constraints (such as a back belt) and posture.

• Summarize the affects of low back health status on low back disorder risk
• Discuss the relation between lumbar curvature and LBP risk factors during postural loading
• Assess the relation between asymmetric lifting and spine loading
• Describe the differences in spine kinematics between LBP patients and normal controls
• Analyze the functional deficits that occur following low back disorders

• Summarize recommendations for backpack use
• Appraise recent research on backpacks and human health
• Discuss the effects of backpacks on musculoskeletal and non-musculoskeletal variables
• Describe current studies on backpack use in children: perceptions, load, biomechanics, physiology

• Learn current perspectives on which structures are strongly but variably linked to back pain
• Review the state-of-the art in low back disorders research applied to ergonomics
• Describe workplace design guidelines for asymptomatic and low back pain workers
• Determine the influence of exercise on lumbar spine disorders

• Identify common underlying causes of non-organic pain
• Recognize the eight Waddell signs of non-organic back pain
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to Waddell signs
• Encourage development and nurturing of skill sets in utilizing Waddell signs

• Determine the epidemiology of low back pain in children and adolescents
• Assess the risk factors associated with back pain in school children
• Outline the effect of an intervention to improve sitting habits in schoolchildren
• Assess the effects of reading a book or using a computer on neck and upper back muscle activity in children
• Review the diagnostic criteria of tension-type headaches in children

• Describe the basic principles of postural control
• Clinically assess postural control
• Outline a protocol of postural rehabilitation

• Identify and describe the phases of bone healing
• List and describe 3 objectives that serve as the foundation of fracture management and bone healing
• Define and differentiate osteoblasts, osteoclasts, and osteocytes
• Define and discuss Wolff’s law
• Discuss 3 principles of stress deprivation, immobilization, and normal physiologic stress as they apply to fracture healing
• Identify 3 complications of bone healing
• Outline and describe 6 areas of descriptive organization of classifying fractures
• Describe pathologic fractures and list 4 types
• Discuss 2 ways how osteoporosis affects fractures
• List 2 common methods of fracture fixation, fixation devices, and fracture classifications

• Describe and differentiate between the macrostructure and microstructure of muscle and tendon
• List and describe the 2 main types of muscle fibers. List and describe the 3 mechanisms for a muscle injury
• Describe the difference between a supraphysiologic and a sub-failure load and how each type may contribute to an injury
• Define how a muscle strain differs from a ligament sprain
• Describe the differences between a tendinitis and a tendinosis
• Describe the effects of aging on tendons
• Name and describe the 3 phases of connective tissue healing
• Describe the effects of immobilization on connective tissue

• Examine the association between chiropractic spinal manipulation for newly diagnosed lumbar disc herniation and/or lumbosacral radiculopathy and the odds of lumbar discectomy over 1-year and 2-year follow-up periods 
• Evaluate the clinical outcomes and MRI changes in a cohort of patients who had surgery compared to conservative treatment for sequestered lumbar disc herniations 
• Summarize existing evidence relating to the reliability of the straight leg raise (SLR) and crossed SLR test in patients with suspected lumbar radicular pain 
• Establish the validity of the extended straight leg raise (ESLR) compared to findings on MRI 
• Recognize the effectiveness of neural mobilization interventions in improving pain, disability, and function in adults with low back and radicular pain

Hour 1

• Describe four purposes for performing orthopedic tests
• Describe three approaches to performing orthopedic tests
• Discuss the clinical importance of pertinent negative findings when performing orthopedic tests
• Discuss the concept of “Evidence Based Medicine”
• Define “Orthopedic Test Item Cluster”
• Describe several metrics used in the validation of orthopedic tests for inclusion in orthopedic test item clusters

 Hour 2

• Describe three Orthopedic Test Item Clusters (OSTs) relevant to the evaluation of the sacroiliac region
• Describe the five procedures included in the Laslett Cluster #2 for the assessment of sacroiliac pain
• Describe the two primary types of Thoracic Outlet Syndrome
• Discuss the clinical utility of the Bakody Test and the Reverse Bakody Test

 Hour 3

• Describe four testing procedures included in Wainner’s Cluster for the assessment of cervical radiculopathy
• Describe Cook’s Cervical Myelopathy Cluster
• Discuss potential problems that may arise in the application of OST clusters
• Discuss ways to minimize inappropriate application of OST clusters

• Outline the nature of and hallmarks of cancer
• Summarize the relationship between physical activity and cancer
• Summarize the relationship between nutrition and cancer
• Summarize the relationship between massage therapy and cancer
• Summarize the relationship between acupuncture and cancer
• Summarize the relationship between manual therapy and cancer