Kentucky Chiropractic Continuing Education

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

• 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

• 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

• 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

• 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

• 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

• 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.

• 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

• 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.

• 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

• Summarize the assessment and diagnosis of pain
• List and describe 5 common causes of back pain and how to prevent injury
• Outline the causes of fibromyalgia
• Illustrate the mechanisms of inflammation and pain
• Discuss the pain of peripheral neuropathy

• Evaluate the test-retest, intra- and inter-examiner reliability of the body pain diagram for determining pain distribution and location for musculoskeletal conditions
• Summarize the current state of knowledge on neuropathic pain, with focus on how it differs from nociception
• Review of the current literature regarding the epidemiology, diagnosis and management of Complex Regional Pain Syndrome
• Explore central nervous system neuroplastic adaptations that may contribute to the pathophysiology of chronic conditions
• Differentiate symptoms and signs of central sensitization, peripheral neuropathic pain and nociceptive pain in patients with low back pain (with or without leg pain)

• Gain insight into the different types of pain
• Differentiate different sources of spinal pain
• Summarize the societal and clinical challenges of the pain patient
• Describe the difference between acute and chronic pain
• Provide an initial appreciation of alternative treatment options
• Understand the importance of chiropractic principles with the pain patient

• Evaluate the relationships among thoracic spinal stiffness, pain and muscle activity in healthy subjects and those with chronic thoracic pain
• Summarize updated chronic pain classification updates from the ICD-11
• Compare and contrast the clinical presentation and pathophysiology of Fibromyalgia (FM) and Myofascial Pain Syndrome (MPS)
• Summarize a clinical framework to sub-categorize pain patients based on an individual’s dominant pain etiology 
• Examine the effect of neural tissue management on pain and disability in patients with chronic musculoskeletal pain

• Expand your application of the biopsychosocial model of chronic pain by exploring an enactive approach to pain
• Recognize the clinical complexities involved in identifying malingering in chronic pain patients
• Outline relevant factors pertaining to clinical presentation, pathophysiology and treatment of chronic neuropathic pain
• Investigate the hypoalgesic effect of thoracic spinal manipulation on pain induced by temporal summation
• Explore the potential brain mechanisms involved in pain relief achieved via Transcutaneous Electrical Nerve Stimulation (TENS) application

• Outline a recent clinical guideline on the chiropractic management of chronic musculoskeletal pain 
• Identify a common set of recommendations from high-quality clinical guidelines that can be applied to a wide range of musculoskeletal pain conditions 
• Explore which target concepts are important to patients who improved following a pain science education intervention for persistent pain 
• Investigate whether untrained trait mindfulness is associated with differential responses to pain stimuli and whether these intrinsic differences reflect differential patterns of resting-state functional connectivity in the brain 
• Characterize the pain-based mechanisms of thoracic spinal manipulation and advance the preliminary validation of brain-based models as potential clinical biomarkers of pain

Hour 1

• Define interventional pain management and how it can be applied to help solve acute and chronic pain.
• Outline and critique different pain theories.
• Outline the Biopsychosocial model of chronic pain and explain why this model is the most comprehensive for acute and chronic pain management.
• Summarize how to integrate interventional pain management with conservative care for acute and chronic pain.

Hour 2:

• Describe common interventional pain management procedures and how to integrate them into a comprehensive plan of care.
• List the most utilized injections and when they are considered.
• Identify when a spinal cord stimulator may be considered and how it can aid conservative management.
• Explain the use of endoscopic procedures and when they may be utilized to treat acute and chronic pain.

• Explore chiropractic patients’ perceptions of discomfort, pain, and stiffness to determine if and how they differentiate among the concepts 
• Describe the relationship between the presence of an audible pop during spinal manipulative therapy and pain outcomes
• Evaluate the effect of spinal manipulation on pressure pain thresholds in a real-world clinical setting 
• Assess whether a 10-second one legged stance test can independently predict survival in middle and older aged men and women 
• Illustrate the relationship between physical activity levels and pain

• Relate the different neurophysiologic mechanisms to the development of chronic pain states. 
• Draw the pathways specific to Lamina I versus Lamina V sensory pathways.
• Discuss basic science research that supports the main theories of chronic/central pain syndromes.  
• Apply basic neurorehabilitation techniques to modulate chronic pain circuits.
• Develop treatment plans for chronic pin patients consistent with current pain models.

• Relate the effects of interoceptive dysfunction to the development of chronic pain.
• Draw the pathways specific to Lamina I versus Lamina V sensory pathways.
• Discuss how the interoceptive nervous system may relate to Functional Neurologic Symptom Disorder.
• Apply knowledge of how interoceptive dysfunction may negatively affect higher cortical functions.
• Design and utilize strategies that normalize interoception to improve intractable patient symptoms.

• Relate the effects of cold sensory deficit to chronic central pain states.
• Map the pathways specific to Lamina I versus Lamina V sensory afferents.
• Discuss basic science research that links C-Fiber subpopulations with hyper-excitability of sensory neurons.
• Apply techniques to gate pain processing through the Dorsal Insula/Anterior Cingulate pain switch.
• Utilize relationship between cold pathways and pain pathways to gate chronic pain.

• Identify the relationship between the ANS and chronic pain.
• Explore the cause of sympathetic maintained pain.
• Discuss the emerging role of the brain and spinal cord in CRPS.
• Apply non-invasive neuromodulation techniques for pain control.
• Formulate an effective treatment plan based on current knowledge.

• Relate the effects of failure within the DNIC to the development of chronic pain.
• Draw the pathways specific to ascending sensory and descending pain modulatory circuits.
• Apply knowledge of the DNIC, as it relates to chronic lower back pain.
• Discuss basic science research that links the PAG with the phenomena of offset analgesia and conditioned pain modulation.
• Formulate and apply treatment plans based on stimulation of the DNIC utilizing spinal cord stimulation, motor cortex activation and heterotopic noxious conditioning stimulation.

• Relate the effects of cingulate cortex activation on chronic pain suppression.
• Draw and identify regions of the cingulate cortex pertinent to pain and suppression.
• Discuss basic science research that links area’s 32, 24 and 25 with pain and its relief.
• Apply specific techniques to modulate cortical areas 32, 24, and 25 for pain suppression.
• Formulate and implement a treatment plan based on the M1-ACC pain model.

• Explain the complex multidimensional and individual specific nature of pain
• Present the theories and science for understanding pain
• Define the terminology for describing pain and associated conditions
• Describe the impact of pain on society
• Explain how cultural, institutional, societal and regulatory influences affect assessment and management of pain  
• Use valid and reliable tools for measuring pain and associated symptoms to assess and reassess outcomes as appropriate for the clinical context and population.
• Describe patient, provider, and system factors that can facilitate or interfere with effective pain assessment and management
• Assess patient preferences and values to determine pain-related goals and priorities
• Demonstrate empathetic and compassionate communication during pain assessment

• Demonstrate the inclusion of patient and others, in the education and shared decision-making process for pain care
• Identify treatment options that can be assessed in a comprehensive pain management plan
• Explain how health promotion and self-management strategies are important to the management of pain
• Develop a pain treatment plan based on benefits and risks of available treatments
• Monitor the effects of pain management approaches to adjust the plan of care as needed
• Differentiate physical dependence, substance use disorder, misuse, tolerance, addiction, and nonadherence
• Develop a treatment plan that accounts for the differences between acute pain, acute-on-chronic pain, chronic/persistent pain, and pain at end of life
• Describe the unique pain assessment and management needs of special populations
• Explain how to assess and manage pain across settings and transitions of care
• Describe the role, scope of practice, and contribution of the different professions within a pain management care team
• Implement an individualized pain management plan that integrates the perspectives of patients, their social support systems, and health care providers in the context of available resources
• Describe the role of the clinician as an advocate in assisting patients to meet treatment goals

• Identify examples of traumatic spine, soft tissue and other commonly missed injuries
• Develop a post-traumatic diagnostic imaging algorithm and protocol 
  
• Recognize and develop an awareness for PI patient, carrier and attorney risks and liabilities
• Discuss several areas of PI documentation scrutiny including the causation statement

Hour 1 - PI Case Management Part 1

• Identify and avoid common PI history mistakes and liabilities
• Recognize many keys to a quality initial PI patient history
• Develop an awareness for the materials and tools necessary for a PI history
• Create a plan and protocol to improve the quality and thoroughness of the PI history

Hour 2 - PI Case Management Part 2

• Recognize common PI history red flags and contraindications 
• Identify symptoms and clinical history for two common PI traumatic injuries 
• Create a plan to identify and eliminate common patient errors pertaining to the PI history
• Develop an awareness for potential med-legal issues that can arise from a PI history

Hour 3 - How to Humanize Your PI Cases

• Create a protocol to consistently implement outcome assessments into PI cases 
• Recognize other options and opportunities available to humanize PI cases   
• Identify common outcome assessments utilized in PI cases
• Improve awareness of clinical decisions that can be made from humanizing cases

Hour 1 - Your Personal Injury History: Part 1

• Identify and avoid common PI history mistakes and liabilities
• Recognize many “keys’ to a quality initial PI patient history
• Develop an awareness for the materials and tools necessary for a PI history
• Create a plan and protocol to improve the quality and thoroughness of the PI history

Hour 2 - Your Personal Injury History: Part 2

• Recognize common PI history “red flags” and contraindications
• Identify symptoms and clinical history for two common PI traumatic brain injuries 
• Create a plan to identify and eliminate common patient errors pertaining to the PI history
• Develop an awareness for potential med-legal issues that can arise from a PI history

Hour 3 - Your Personal Injury Examination – Part 1

• Recognize the key elements of the Personal Injury post-traumatic examination
• Identify clinical contraindications and precautions prior to an examination
• Develop and map out a post-traumatic cervical spine examination protocol
• Identify and examine common motor vehicle crash shoulder conditions

Hour 4 - Your Personal Injury Examination – Part 2

• Discuss the critical components of a Personal Injury neurological examination
• Develop a traumatic brain injury examination screening protocol
• Recognize the documentation elements necessary in a PI physical examination
• Create a protocol for medical consultations, diagnostic imaging and testing

• Recognize the importance diagnostic imaging and testing in Personal Injury and trauma
• Summarize several of the common diagnostic imaging and testing available  
• Justify medical necessity and clinical rationale for imaging/testing in the treatment records
• Determine both a protocol and clinical necessity for plain film radiographs

• Recognize elements of Personal Injury case management
• Identify common inherent risk within PI case management    
• Summarize several insurance carriers concerns regarding PI case management   
• Discuss current PI case management issues in the med-legal arena

• Discover the importance of identifying case management issues early   
• Summarize emergency, urgent care and early intervention management  
• Recognize med-legal issues in the early providers management  
• Outline the application of home and self-care as part of case management

• Recognize the importance of Personal Injury physical examination
• Outline the examination of common traumatic injuries and conditions       
• Summarize common examination tests and procedures associated with a PI examination    
• Demonstrate support for care and management with examination documentation

• Outline the preparation for traumatic injury care and case management 
• Summarize the application of passive and active modalities in traumatic injuries
• Develop a protocol for implementing active therapeutic procedures and clinical exercise       
• Identify common therapeutic and conservative care risks and mistakes

• Recognize the importance of diagnostic imaging in Personal Injury
• Summarize specific diagnostic imaging tests for common PI injuries  
• Identify several common clinical indicators for PI diagnostic imaging
• Develop a protocol for ordering and monitoring PI diagnostic imaging         

• Recognize the importance of humanizing traumatic patient injuries
• Demonstrate the general application of assessments and PI interrogatories
• Summarize the importance, applications and protocols of medical photography
• Interpret assessments and PI interrogatories for case management decisions

• Recognize the importance of Personal Injury co-management
• Design a process for finding providers for co-management consults and referrals
• Develop protocols for co-management with primary care providers
• Devise a plan to begin, apply and implement PI case management clinical decisions

• Determine options for co-management with pain management providers
• Identify co-management opportunities with orthopedic and neurology providers
• Develop documentation protocols to support co-management decisions
• Summarize and implement Personal Injury case management protocols and procedures

• Recognize the importance the 5 steps represent in PI cases      
• Develop a plan to identify common PI acute injuries and conditions
• Design an in-office process to improve consistency of documentation
• Identify and evaluate several acute injuries and conditions

• Estimate the risk for an association between exposure to neck pain from a motor vehicle accident and future neck pain
• Estimate the risk for an association between exposure to neck pain from a motor vehicle accident and future back pain
• Appraise the validity of employing a biomechanical approach to assess injury risk from minimal damage traffic crashes
• Assess which factors predict the risk of developing post-traumatic headache six months following a motor vehicle collision (MVC) in adult

• Review sensory-motor control and rehabilitation
• Discuss aerobic exercise for LBP patients
• Describe muscle training of the hip, abdominal and paraspinal muscles
• Identify how aerobic exercise improves motor performance in the elderly
• Distinguish the effects of different training styles on the cross-sectional area of paraspinal muscles

• Describe the contribution of hip vs. spinal motion
• Distinguish poor motor patterns of hip and low back movements and what to do about it
• Differentiate the role of exercise for neck disorders and determine what type of exercise works
• Delineate the neural adaptations to exercise and apply towards rehabilitation
• Describe current issues in low back rehabilitation (such as can low back tissues heal within a few weeks)

• Describe the long term course of LBP
• Describe neuromuscular impairments following LBP
• Differentiate the effects of pain on the neuromuscular system
• Discuss the models that explain the nature of motor problems with pain
• Differentiate and discuss the potential sources of LBP

• Identify and describe the major factors influencing muscular strength
• Assess the chiropractic influences on strength
• Identify and discuss the strength training principles
• Illustrate components of a training session
• Apply training principles into a practical strength program

• Define proprioception and describe how it is measured
• Discuss proprioception from a rehabilitative perspective
• Examine ankle, knee and shoulder proprioception and rehabilitation
• Examine spinal proprioception and sensorimotor training
• Summarize rehabilitation recommendations for proprioceptive deficits

• Illustrate basic principles of cardiovascular exercise
• Discuss the mechanisms of cardiovascular responses to exercise
• Discuss the acute effects of exercise on the cardiovascular system
• Discuss the training effects of exercise on the cardiovascular system

• Summarize the functional anatomy of core strength training
• Discuss the principles of core strength
• Develop an assessment of spinal stabilization
• Distinguish specific evaluation tests for spinal stability

• Summarize the effect of training on the fatigue of multifidi muscles
• Discuss which muscles are involved in stabilization exercises
• Assess the relation between low back pain and clinical instability
• Describe a study implementing manipulation and stabilization exercises for chronic LBP
• Introduce the concept of functional restoration vs. physical therapy for LBP

• Describe the early health care utilization for occupational low back pain
• Determine which factors are important in predicting outcome after a spinal stabilization exercise program
• Assess lumbar disc surgery rates before and after implementation of nonsurgical spine clinics
• Determine whether kinematic compromise can be used to predict spine loading in low back pain (LBP) patients under realistic lifting efforts in a workplace
• Determine the effects of subacute LBP and limitation of the straight leg raise on lumbar and hip kinematics during sit-to-stand and its reverse

• Summarize the effect of whiplash on neck muscle strength
• Discuss the effects of manipulation vs. mobilization on head and neck pain in whiplash patients
• Assess the effects of thoracic manipulation in whiplash patients
• Describe a study predicting the response of neck pain patients to neck strengthening exercise
• Introduce the smooth pursuit neck torsion test and its application in whiplash disorders

• Identify the anatomy of upper motor neuron tract systems and discuss the functionality of upper motor neuron tract systems
• Explain the effects of a spinal cord injury
• Discuss the anatomy and functionality of regions of the brain
• Describe complications post injury of brain and spinal cord injury
• Describe standard treatment procedures prior to rehabilitation of brain and spinal cord injured patients
• Explain the difference between neurological deficit rigidity versus disuse atrophy/spasm of spinal cord and head injured patients
• Describe treatment options for rehabilitation of spinal cord and head injured patients
• Explain treatment methods to transition C curve locomotion to S curve locomotion
• Explain treatment methods for atrophy and spasm
• Discuss most current curative research for spinal cord and head injured patients

• Outline the anatomy of cervical spine proprioception
• Review clinical studies investigating cervical spine proprioception
• Assess existing literature on the reliability of cervical spine joint position sense
• Assess the effect of spinal adjustments/manipulation on cervical spine proprioception

• Summarize the central role of muscle protein in whole-body metabolism and muscle mass
• Outline the role of skeletal muscle metabolism in health and disease (such as diabetes, obesity, osteoporosis)
• Describe the role of hormones for influencing muscle metabolism and health
• Identify the catabolic and anabolic mediators of muscle metabolism
• Specify ways to maximize muscle mass and metabolism to promote wellness

• Explain the anatomical constituents of the core musculature
• Consider implications of weak or inadequate core muscles
• Emphasize the importance of the gluteal muscle group in rehabilitation
• Illustrate common compensation patterns when individuals have weak core musculature with clinical examples
• Explain the concept of neural adaptation
• Review reciprocal inhibition and it's clinical application
• Discuss physiological overflow and its clinical application

• Discuss conventional situps and their pitfalls
• Provide a logical rationale for core training
• Explain and demonstrate a logical progression of exercises for core training, emphasizing skill, then endurance and strength

• Recognize some of the common mistakes with conventional sit ups and how to correct them
• View and narrate the ideal sit up
• Recognize the importance of the brain and cortex in core training
• Discuss how inhalation and exhalation affect muscular activity, and how to utilize this in training
• Point out the pitfalls of abdominal hollowing and core training
• Examine the importance of the thoracolumbar fascia
• Analyze what cues to look for when evaluating a bench press exercise

• Demonstrate the proper patient positioning for the lunge and squat exercises
• Explain and show common problems with the lunge and squat exercises
• Explain and show Dr cues for proper patient positioning of the lunge and squat exercises
• Explain, evaluate, compare and demonstrate variations of the squat exercise, including ball squats, theraband squats, potty squats, squat shuffles
• Explore and demonstrate how foot function and shoe type impacts squat and lunge activities
• Introduce, explain and demonstrate proper and improper performance of additional, advanced gluteal activation exercises including the Texas walk, ball squats, drops, roman chair and 1 legged dead lifts

• Describe the Nordic Hamstring exercise and its potential applications for hamstring injuries
• Summarize the state of the literature on exercise interventions for adolescent scoliosis
• Integrate strength training with flexibility training to improve patient progress
• Appraise the potential role of yoga in managing spinal conditions
• Grade and recognize the state of the literature on physical and rehabilitation interventions for chronic non-specific low back pain

• Compare slower treadmill walking on a moderate incline to faster walking with no incline for moderately obese adults patients
• Summarize the current state of the literature on exercise interventions for Type 2 Diabetes Mellitus
• Explain the utility of interval training for patients with coronary artery disease
• Support the inclusion of resistance training in exercise programs for aging patients based on existing scientific research
• Appraise various types of exercise for patients with metabolic syndrome

• Outline the neuroendocrine-immune interactions and communication pertaining to exercise
• Contrast sprint training with endurance training regarding performance adaptations and cardiac output
• Identify the benefits and underlying mechanisms of agonist-antagonist paired set training for improving strength and power
• Summarize the validity of dehydration signs, compared with body weight change, in marathon runners
• Describe methods for developing maximal neuromuscular power

• Apply contemporary rehabilitation strategies for anterior cruciate ligament patients
• Illustrate the importance of proximal stability and rehabilitation in patients with patellofemoral pain syndrome
• Outline the relationship between quadriceps strength, proprioception and knee osteoarthritis
• Discuss the potential value of gait retraining for improving lower limb biomechanics in runners with patellofemoral pain
• Contrast lower extremity kinematics & muscle activation in patients with and without patellofemoral pain syndrome

• Discuss a proposed model for the logical sequence of active rehabilitation
• Review ‘the core’, its healthy functional role and how it is commonly changed in people with spinal and pelvic girdle pain syndromes
• Describe core muscle activity during physical fitness exercises
• Provide an introduction to dynamic neuromuscular (core) stabilization and athletic performance
• Introduce the basics of exercise prescription

• Illustrate the effects of external pelvic compression on the passive, active and neuromotor control systems of the lumbopelvic region and thigh
• Summarize the importance of core stability assessment and rehabilitation in lumbosacral radiculopathy cases
• Assess the differences in torso motion and muscle activity between elliptical trainer use and treadmill walking
• Discover how even small amounts of daily exercise can positively impact patients with neck and shoulder pain
• Critique and apply periodization concepts to rehabilitation for patients with non-specific low back pain

• Outline the relationship between exercise and brain health
• Describe the evidence for the links between physical activity/exercise and brain function across the lifespan
• Discuss the neurobiology of exercise
• Assess whether exercise is neuroprotective or not
• Summarize the effect of exercise on motor performance

• Identify how the sciatic nerve and adjacent nervous structures respond to tensioning and sliding techniques
• Appraise the potential benefit of adding forward head posture corrective exercise to the management of lumbosacral radiculopathy
• Compare clinical and muscle function outcomes of patients randomized to one of two early multimodal rehabilitation programs following single-level lumbar discectomy
• Analyze the influence of neck strength and muscle activation status on resultant head kinematics after impulsive loading to the head/neck
• Assess the efficacy of corrective exercise interventions for reducing thoracic hyper-kyphosis

• Recognize and document preferred outcomes that result from properly executed active care techniques
• Establish rehab protocols for both cervical and lumbar conditions with suggested core exercise recommendations
• Properly advance a patient through their customized exercise protocol in a systematized fashion
• Identify and document progress on a routine visit basis for patients participating in active care rehab

• Evaluate the long-term effect of exercise therapy in addition to patient education on a patient’s need for total hip replacement (THR)
• Integrate clinical and laboratory research on the function and assessment of abductor muscles about the hip and pelvis 
• Understand how hip weakness can potentially contribute to knee pain and altered running mechanics
• Outline the nomenclature, definition, diagnosis, imaging and management of inguinal disruption (‘Sportsman’s Groin’) 
• Assess the efficacy of exercise interventions for lateral ankle sprains, Achilles tendinopathy and plantar fasciitis 

• Recite 3 risk factors for developing rotator cuff tendonosis
• State the purpose of the scapula reposition and scapula assistance test.
• Explain how to perform the external rotation lag sign and recall the purpose of this test
• Paraphrase one evidence - based test cluster for diagnosing a rotator cuff tear.
• Recall two indications/goals for performing posterior glenohumeral joint mobilizations.
• Cite the clinical prediction rule (CPR) for favorable outcome in patients undergoing conservative management for rotator cuff disorders
• Identify two criteria for phase I rehabilitation exercises for rotator cuff disorders

• Recall 3 potential reasons, based on expert opinion, that may contribute to the high re-tear rate following rotator cuff repair.
• Recite 4 factors that impact the rehabilitation program for patients following rotator cuff repair.
• Summarize the DeOrio classification for rotator cuff tear size.
• State 3 appropriate exercises during weeks 0-2 following rotator cuff repair
• Provide 2 appropriate exercises during weeks 6-8 following rotator cuff repair
• Name 3 appropriate exercises during weeks 8-12 following rotator cuff repair

Hour 1:

• Describe common biomechanically terminology related to rehabilitation such as work, force, mass, vector, strength and power.
• Comprehend the functional biomechanics of the lunge, and squat.
• Identify regressive and progressive nature to common squat and lunge exercises.
• Describe the appropriate standard of care and the process associated with the doctor-patient encounter regarding the evaluation, and management of patients using rehabilitative exercises.   

Hour 2:

• Classify the “McGill Big 3,” and discuss their clinical significance with those with spinal pain.
• Describe an appropriate hip hinge technique for your patients.
• Describe the differences between abdominal bracing and hallowing techniques.
• Review common evidence-based exercise procedures for spinal pain.

• Apply the scientific foundations of neuromuscular re-education, and explore major guidelines and evidence-based practices for spinal pain.
• Construct a treatment plan and exercise script for patient centered care.
• Describe a case scenario involved spinal degeneration and how to create a treatment plan.
• Synthesize the justification and efficacy of evidence-based exercises for different axial spine protocols.

• Enumerate three physical / clinical examination findings associated with rupture of the quadriceps tenon.
• List 3 patient specific factors that need to be considered when following a rehabilitation program following repair of the quadriceps or patella tendon.
• Recall three goals during phase 1 (0-2 weeks) of a rehabilitation program following repair of the quadriceps or patella tendon.
• Identify three goals during phase 3 of a rehabilitation program following repair of the quadriceps or patella tendon.
• Cite five return to play criteria that need to be met following repair of the quadriceps or patella tendon.

• Summarize the key difference between the cartilage restoration vs cartilage reparation procedures.
• List 3 personal (health and demographic) factors that need to be considered when following a rehabilitation program following cartilage restoration/reparative procedures.
• Enumerate 3 lesion-specific factors that need to be considered when following a rehabilitation program following cartilage restoration/reparative procedures.
• Recall three goals during phase 1 (0-2 weeks) of a rehabilitation program following cartilage restoration/reparative procedures.
• Cite five return to play criteria that need to be met following cartilage restoration/reparative procedures.
• Summarize the evidence-based outcomes for the 3 most common cartilage restoration/reparation techniques.

Hour 1

• Recall 2 pathological pitching mechanical patterns that may lead to injury
• List 3 injury risk factors in in the overhead athlete
• Provide 4 injury prevention screening tests for the overhead athlete
• With respect to shoulder strength, cite 3 metrics  that can be used as red flags to identify players who are at higher risk for incurring an injury to the shoulder /elbow

• Recall 2 pathological pitching mechanical patterns that may lead to injury
• List 3 injury risk factors in in the overhead athlete
• Provide 4 injury prevention screening tests for the overhead athlete
• With respect to shoulder strength, cite 3 metrics  that can be used as red flags to identify players who are at higher risk for incurring an injury to the shoulder /elbow
• Describe 1 clinical test to evaluate anterior and posterior shoulder instability
• List the 3 components of an evidence -based test cluster  to assess rotator cuff pathology in the overhead athlete
• Identify 2 components in the rehabilitation program for shoulder instability
• List and define the 3 types of shoulder impingement
• Recall 2 Performance factors in pitching
• Cite 2 return to play criteria for the overhead athlete
• Identify one advantage of weighted ball holds
• Identify one disadvantage of weighted ball programs

• Recall the most common types of lumbar spine injuries among athletes participating in different sports.
• Identify one advantage and one disadvantage of the treatment-based classification system as it applies to the treatment of the athlete’s lumbar spine.
• List 3 contemporary treatment models that can be applied to the management of lower back pain in the athlete.
• Recall the definition and importance of red and yellow flags during the medical screening process.
• Identify 3 red flags that may implicate a non-mechanical source of lower back pain.
• List the difference between central and peripheral sensitization.
• List one treatment goal in phase 2 rehabilitation of the athlete’s lumbar spine.
• Cite one treatment principle in phase 3 rehabilitation of the athlete’s lumbar spine.
• Summarize two variations of the squat exercises that can be used to decrease strain on the lumbar spine.
• Recall three variations of the deadlift exercises that can be used to decrease strain on the lumbar spine.
• Summarize the McGill core endurance ratio tests that can be used to guide the return to sport decision making processes