Nevada Chiropractic Assistant Education and Continuing Education

Musculoskeletal

• Explain the causes behind Musculoskeletal Injuries
• Compare the minimum/maximum times during the Acute, Repair, and Remodeling Phase of Recovery
• Summarize protocols for acute inflammation
• Demonstrate a Kinetic Chain Assessment
• Explain why indirect cause of injury can be as disabling due to tissue overuse and overload
• Contrast and compare male vs female most common extremity injuries
• Contrast the differences between high school, collegiate, and professional athletic injuries
• Summarize how gold-standard management drives lower injury rates and duration
  

Nutrition

• Develop components of a typical healthy meal plan for athletes
• Differentiate between healthy and unhealthy food choices in each category of FAT, CHO, PRO
• Identify problem foods specific to the individual athlete
• Explain CHO loading and examples of high glycemic index foods
• Describe meal plan for post-exercise "window of recovery"
• Describe benefits and sources of branched chain amino acids for athletic recovery
• Explain purpose of omega 3 fatty acids during recovery phase of athletic activity
• Define components of female athlete triad
• List vitamins and minerals required to rebuild bone health in female athlete triad
• Name ergogenic nutrients acceptable to the World Anti-Doping Agency

Dehydration

• Explain difference between dehydration and hyponatremia
• Recognize early or acute signs and symptoms of dehydration and hyponatremia
• Discuss benefits of each method of determining hydration status
• Demonstrate treatment intervention for heat cramps
• Compare energy drink to sports drink

Concussion

• Define and recognize brain concussion, second impact syndrome, and chronic traumatic encephalopathy.
• Describe frequency of sports concussion and common duration of signs and symptoms.
• Describe all possible results of head trauma, including second impact syndrome, intracranial hematoma, skull fracture, brain contusion, cervical injury (both mild and dangerous)
• Differentiate and rule out dangerous results from head trauma.
• Demonstrate proper exam procedures following head trauma on field.
• Demonstrate proper exam procedures to clear the cervical spine on field.
• Perform the SCAT 3 exam and describe how it is to be used both on field and in the office.
• Describe how and why one performs serial exams after head trauma on field.
• Describe return to play protocols for concussed athletes.
• Describe prevention procedures for sports concussion.

• Explain the phases of human walking gait
• Discuss the biomechanical events associated with stance phase of gait
• Discuss the biomechanical events associated with swing phase of gait
• Explain biomechanically what is happening during each phase of gait in the foot, ankle, knee and hip
• Discuss the 3 rockers of the foot and how they apply to the gait cycle
• Understand the calcaneocuboid locking mechanism and defend it's importance in the stance phase of gait
• Summarize the ranges of motion of the foot, ankle, knee and hip and their importance in normal gait
• Explain how stance phase abnormalities would impact the gait cycle
• Demonstrate competency in obtaining a reproducible Pedograph print
• Interpret rearfoot, midfoot and forefoot mechanics as seen on a pedograph print
• Identify and interpret problem areas in a pedograph print
• Identify stance phase abnormalities on a Pedograph print
• Extrapolate pathomechanics which would occur rostrally in the kinetic chain during pathomechanics occurring in the gait cycle
• Evaluate the impact of gait abnormalities on human locomotion

• This contains all courses with the educational objectives listed from Biomechanics 201 through Biomechanics 216

• Describe how the motor and sensory homunculus relate to the foot and are integral to training and rehabilitation
• Discuss the 3 rockers of the foot
• Give examples of problems that result from a loss of the 3 rockers of the foot
• Explain the concept of pelvis neutrality and its effect on training
• Describe and examine the tripod of the foot
• Breakdown most movement into 2 basic rules or tenets
• Give examples of the problems which can arise if the 2 basic rules or tenets of movement are not followed
• Discuss the clinical consequences of loss of the medial and lateral tripods of the foot

• Discuss the normal walking gait cycle
• Apply the biomechanics of the pelvis and lower kinetic chain during walking to clinical practice
• Predict and discuss problems and clinical strategies that can arise from altered lower extremity biomechanics
• Apply visual analysis skills
• Evaluate case studies in gait analysis
• Clinically apply solutions for gait abnormalities

• Describe and identify how the parts of a running shoe affect running biomechanics
• Compare and contrast different shoe constructions to the biomechanical needs of an individual
• Determine the appropriate last shape for different foot types
• Discuss the biomechanical consequences of improper vs. proper selection of last types
• Predict which features in a shoe are necessary to correct faulty gait patterns

• Explore barefoot running from a position of biomechanical efficiency
• Contrast the differences in shod vs unshod running
• Predict problems that can arise from shod and barefoot running
• Apply visual analysis skills to barefoot running technique
• Describe how to introduce barefoot running to your patient population

• Discuss the salient points of conducting a visual gait analysis
• Review the gait cycle and associated kinetics and kinematics
• Discuss step length, stride length and how they are affected in a case of a person with posterior compartment weakness
• Review the biomechanics associated with heel rise
• Propose rehabilitation strategies for specific cases that were reviewed

• Discuss the pitfall of video assessment of gait cases
• Review the gait cycle with respect to stance phase abnormalities in a gait case
• Differentiate between step length and stride length
• Review heel rise and the windlass mechanism
• Discuss the function of the long flexors of the toes in gait
• Evaluate pelvic posturing as it relate to a gait case
• Discuss the gait pathomechanics that result from a herniated disc

• Review the pertinent anatomy of the knee
• Review the kinematics and kinetics of knee function during the gait cycle
• View and discuss case studies involving knee function
• Predict pathomechanics that will arise from the gait abnormalities presented
• Propose remedies for the gait abnormalities seen

• Review the pertinent anatomy of the hip
• Review the kinematics and kinetics of hip function during the gait cycle
• View and discuss case studies involving hip function and common clinical scenarios
• Predict pathomechanics that will arise from the gait abnormalities presented
• Propose remedies for the gait abnormalities seen

• Review the walking gait cycle
• Review the running gait cycle
• Identify the key differences between walking and running gait
• Review the kinematics and kinetic differences between walking and running gait
• View case studies involving different walking and running gait styles
• Predict pathomechanics that may arise from gait abnormalities presented

• Review anatomical vs functional short leg
• Review the kinematics and kinetics of the short leg during the gait cycle
• View and discuss case studies looking at functional and anatomical short legs
• Predict pathomechanics that will arise from a short leg
• Propose remedies for the gait abnormalities seen

• This contains all courses with the educational objectives listed from Biomechanics 211 through Biomechanics 222

• Review fore foot to rearfoot relationships
• Review the different rear foot types
• Review the kinematics and kinetics of rear foot function during the gait cycle
• View and discuss case studies involving different rear foot types
• Predict pathomechanics that will arise from gait abnormalities presented
• Propose remedies for the gait abnormalities seen

• Breakdown the gait cycle into its component parts
• Recognize some less common gait abnormalities seen in gait analysis
• Assess actions of the lower kinetic chain during gait
• Predict pathomechanics that will arise from gait abnormalities presented

• Review how to determine foot type
• Describe and identify the five common foot types
• Explain how foot type effects gait biomechanics
• Compare and contrast different clinical examples of each foot type
• Discuss some treatments that can be utilized when a client presents with a particular foot type

• Briefly describe the history of the pedograph
• Compare pedographs with other technologies available for foot imprinting
• Explain how to obtain a reproducible pedograph
• Discuss pedograph interpretation and what it means clinically

• Review the pertinent anatomy of the foot
• Review the kinematics and kinetics of foot function during the gait cycle
• View and discuss case studies involving foot function and common pathomechanics
• Predict pathomechanics that will arise from the gait abnormalities presented
• Propose remedies for the gait abnormalities seen

• Define the crossover gait
• Visually identify the crossover gait
• Explain the biomechanical elements of the crossover gait
• Analyze the cross over gait
• Give examples of the cross over gait
• Integrate your knowledge of the cross over gait to formulate an appropriate treatment plan
• Outline some common exercises for cross over gait remediation

• Examine how arm swing correlates and integrates with the gait cycle
• Visually identify arm swing
• Explain the biomechanical elements of arm swing
• Analyze arm swing
• Give examples of normal and abnormal arm swing
• Integrate your knowledge of arm swing to formulate an appropriate treatment plan

• Define minimal vs. neutral vs. guidance vs. motion control shoes
• Contrast minimal vs. neutral vs. guidance vs. motion control shoes
• Discuss current shoe trends
• Discuss ramp delta and its implications in shoes and shoe fit

• Review the injuries associated with an improperly fitting bike frame and how to properly size a frame to a person
• Discuss how cleat position can lead to biomechanical problems and injuries related to power loss.
• Demonstrate how to properly place cleats on shoes to avoid injury and increase power transfer
• Discuss injuries that stem from inappropriate seat height, saddle for and aft position and handlebar reach and explain how to determine appropriate seat height, fore and aft saddle position and handlebar reach.

• Review static postural foot assessment as it relates to a case study
• Describe muscular compensations that may occur as the result leg length differences
• Compare muscular action vectors and their changes with aberrant foot mechanics
• Discuss the concept of flexor dominance and how it relates to the long flexors of the toes

• Discuss the gait cycle and gait cycle biomechanics
• Discuss Tetrasomy 18 and Chronic Inflammatory Demyelinating Polyneuropathy etiologies
• Discuss Tetrasomy 18 and Chronic Inflammatory Demyelinating Polyneuropathy gait abnormalities
• Propose rehabilitation strategies for abnormalities commonly seen in many neurological disorders

• Review the anatomical and functional causes of  leg length discrepancies
• Review the kinematics and kinetics of leg length discrepancies during the gait cycle.
• View and discuss several new case studies looking at anatomical leg length discrepancies and the impact of compensations to accommodate the fixed changes. 
• Discuss examination procedures to facilitate understanding of the pathomechanics resulting from a leg length discrepancy. 
• Propose intrinsic and extrinsic remedies for the gait abnormalities seen.

• Provide an overview of orthotic therapy
• Review orthotic casting processes and contrast differences and potential pitfalls in them
• Discuss common problems arising from orthotic prescription (blisters, pain during use, pressure spots, etc)
• Propose mechanisms for why problems occur biomechanically
• Present remedies for common problems that arise

• Discuss retraining CNS sensory and motor patterns
• Present several key concepts in visual gait analysis
• Introduce lesser known anatomical points of interest in the sacroiliac joint
• Discuss some rehabilitation strategies for the sacroiliac joint

• Discuss retraining CNS sensory and motor patterns
• Present several key concepts in visual gait analysis
• Introduce lesser known anatomical points of interest in the sacroiliac joint
• Discuss some rehabilitation strategies for the sacroiliac joint
• Discuss the ideal kinetics and kinematics of the walking gait cycle
• Present the normal lower extremity parameters/ontogeny surrounding the requisites for gait
• Explore the impact of lower extremity torsions on foot progression angle
• Highlight the differences between tibial and femoral leg length discrepancies
• View video examples of different aspects of gait
• Review the mechanics of the bridge exercise
• Discuss the current indexed literature surrounding the bridge exercise
• Describe potential pitfalls in performing and prescribing the bridge exercise
• Point out the differences of maintaining a "neutral spine" versus an increased or decreased lumbar lordosis
• Identify potential ways to correct faulty mechanics and optimize performance of the bridge exercise
• describe a new, novel test to diagnose gluteus medius tears
• explain the various functions of the gluteus maximus and medius
• explore the effects of a resistance band around the knees on the gluteus maximus, quadricep and valgus angles on the knees during a back barbell squat
• contrast gluteus medius resistance and rehabilitation exercises with respect to maximal recruitment
• discuss electromyographic activity in the gluteus medius, gluteus maximus, biceps femoris, vastus lateralis, vastus medialis and rectus femoris during the Monopodal Squat, Forward Lunge and Lateral Step-Up exercises

• Discuss the ideal kinetics and kinematics of the walking gait cycle
• Present the normal lower extremity parameters/ontogeny surrounding the requisites for gait
• Explore the impact of lower extremity torsions on foot progression angle
• Highlight the differences between tibial and femoral leg length discrepancies
• View video examples of different aspects of gait

• Review the mechanics of the bridge exercise
• Discuss the current indexed literature surrounding the bridge exercise
• Describe potential pitfalls in performing and prescribing the bridge exercise
• Point out the differences of maintaining a "neutral spine" versus an increased or decreased lumbar lordosis
• Identify potential ways to correct faulty mechanics and optimize performance of the bridge exercise

• describe a new, novel test to diagnose gluteus medius tears
• explain the various functions of the gluteus maximus and medius
• explore the effects of a resistance band around the knees on the gluteus maximus, quadricep and valgus angles on the knees during a back barbell squat
• contrast gluteus medius resistance and rehabilitation exercises with respect to maximal recruitment
• discuss electromyographic activity in the gluteus medius, gluteus maximus, biceps femoris, vastus lateralis, vastus medialis and rectus femoris during the Monopodal Squat, Forward Lunge and Lateral Step-Up exercises.

• Review ideal walking gait biomechanics
• Discuss the current indexed literature surrounding sandals and open back footwear relative to musculoskeletal symptoms
• Describe pathomechanics associated with wearing flip flops and open back footwear
• Contrast the ideal gait cycle with the gait cycle while wearing flip flops, sandals and open back footwear
• Identify potential ways to correct faulty mechanics associated with wearing open back footwear

• Review ideal walking gait biomechanics
• Discuss the indexed literature surrounding movement patterns, gait remodeling and therapeutic uses of a split treadmill
• Rehab gait movement patterns
• Develop a deeper understanding of arm swing, leg swing, and interlimb timing and coordination.

• Identify ideal walking gait biomechanics
• Discuss the indexed literature surrounding movement patterns, gait impairments and compensations.
• Analyze arm swing, leg swing, and interlimb timing and coordination.
• Interpret local foot biomechanics and compensations.

• Identify ideal walking gait biomechanics
• Discuss the indexed literature surrounding movement patterns, gait impairments and compensations.
• Analyze arm swing, leg swing, and interlimb timing and coordination.
• Interpret local foot biomechanics and compensations.

• Review the gait cycle and gait cycle biomechanics
• View and discuss case studies of gait pathologies
• Assess actions of the lower kinetic chain during gait
• Predict pathomechanics that will arise from gait abnormalities presented
• Propose remedies and rehabilitation strategies for the gait abnormalities seen

Hour 1

• Identify some common gait abnormalities seen in gait analysis and develop mental strategies in evaluating the 3 cardinal planes of motion and potential failures in the loading of these planes.
• Categorize the Fast and Slow phases of an imbalance asymmetrical gait and define rehabilitation strategies to remedy the gait pathology.
• Develop a conceptual overview of how step length and stride length change in a limping gait.
• Breakdown portions of the gait cycle into its component parts, including compensation patterns
• Conceptualize the gait changes oriented around a hallux (great toe) amputation and learn to predict gait compensations off of a fixed anatomic anomaly.
• Describe arm swing and how it plays out in gait, particularly asymmetrical, and develop some treatment concepts in addressing this asymmetry.

Hour 2

• Discuss the critical function of the deep neck flexors and transverse abdominus, and how they related to gait, especially the running athlete.
• Identify the 3 compartments of the thoracolumbar fascia and translate them into gait concepts and treatment concepts.
• Develop treatment concepts in addressing this asymmetry and define in-phase and out-of-phase arm and leg swing assimilation
• Discuss on a surface level the concepts of speed in gait, and how to adjust the speed of one's gait to break down gait components that might lead to better treatment directions.
• Describe central pattern generators and relate to arm swing on a neurologic level.
• Recognize some common gait abnormalities seen in gait analysis such as arm swing, step length, the cross over gait, and develop mental strategies in evaluating the 3 cardinal planes of motion and potential failures in the loading of these planes when it comes to these gait parameters.

• Present the etiology of blister and callus formation
• Review the gait cycle and the biomechanical events relevant to callus formation
• Review pronation and supination motions of the foot and how they relate to low and high gear push off
• Review the 3 rockers and how they can relate to callus formation
• Discuss the more common callus patterns in feet
• Describe the foot pathomechanics that lead to callus formation

• Discuss the anatomy of the tibialis posterior muscle
• Emphasize the importance of blood supply and the presence of watershed areas leading to tendon pathoanatomy
• Present the biomechanics associated with this muscles normal activity vs dysfunction
• Show clinical examples of posterior tibial tendon dysfunction
• Discuss orthotic intervention and exercises that are useful in remediation of posterior tibial tendon dysfunction

• Review the pertinent anatomy of the achilles tendon and adjacent structures
• Discuss watershed zones of microvascualrity and how they can be compromised 
• Discuss the mechanisms of how many achilles tendinopathies and pathologies occur
• Present some methods of treatment and remediation for achilles tendinopathies

• Discuss actual cases of problems remediated by orthotic therapy
• Discuss the pathomechanics of the problem and kinetics/ kinematics of the remediation
• Show orthotic modifications for specific issues
• Demonstrate additional therapies/exercises/modalities that assist in specific problem management

• Present the 5 basic foot types
• Discuss the biomechanics of each foot type
• Show and explain pedograph prints of each foot type
• Contrast and compare traditional vs a novel method of foot type determination
• Talk about common orthotic prescriptions for specific foot types

• Describe the biomechanics of rotation of a thoracic ring at the levels T1-T7.
• Describe the biomechanics of the Cervical spine, Thoracic spine, ribs, clavicle and manubrium with elevation of the right or left shoulder.
• Describe the biomechanics of flexion and extension at the Costotransverse joint at T9.
• Describe the differences in motion of the mobile segments between T3 -T7 with side flexion occurring first in the Thoracic spine.

• This contains all courses with the educational objectives listed from Breathing Essentials 201 through Breathing Essentials 207

• Describe the physiology of breathing and how altered pH can affect the body.
• Describe two functions of the diaphragm.
• Identify limited chest expansion and Bradcliff angles and ski jumps
• Identify limited lateral costal breathing and how to facilitate normal lateral costal breathing

• Describe how altered breathing patterns can alter pH and how this can affect the body.
• Describe the autonomic nervous system and function.
• Name three physiological consequences of respiratory alkalosis.
• Describe suboptimal breathing patterns and their effect on the cervical spine and chronic pain.

• Name and describe the different types of sleep apnea.
• Describe the three levels of Apnea-hypopnea index AHI.
• List five symptoms of sleep apnea.
• List two treatments for sleep apnea.

• Describe the physiological response of aerobic exercise on the respiratory system.
• Describe the effect of running on the viscera and the diaphragm.
• Describe the response to inspiratory muscle fatigue on the body.
• List one device than may increase endurance of the respiratory muscles.

• Describe the anatomical structure of the diaphragm including innervation and blood supply.
• List four causes that may damage the innervation to the diaphragm and effect normal function.
• Describe the factors involved in Intensive Care Unit Acquired Weakness.
• Be able to describe the pros and cons of early mobilization in the ICU.

• Discuss the theories of why aging is now seen as a disease, characterized by chronic inflammation, which could potentially be stopped or even reversed. 
• Share how persistent, low-level inflammation (inflammaging) contributes to the deterioration of cellular and systemic functions, driving the aging process and the development of age-related chronic diseases.
• Examine the role of mitochondrial dysfunction in aging, exploring how improving mitochondrial health can promote longevity and reduce age-related decline.
• Identify clinical strategies to integrate mitochondrial health and anti-inflammatory practices into patient care to enhance healthy aging and mitigate the impact of chronic diseases.
• Introduction to low-level laser therapy, its core principles, and its mechanism of action for healing and optimizing cellular function.
• Explain the role of the mitochondria in cellular energy production and overall health.
• Review evidence-based applications of low-level laser therapy in promoting mitochondrial health via evidence-based research findings and data.
• Discuss practical approaches for integrating low-level laser therapy into clinical practice to enhance patient outcomes in managing mitochondrial dysfunction and promoting cellular rejuvenation.
• Share the global impact of metabolic dysfunction and discuss the effects of obesity driving chronic inflammation and its link to chronic health conditions.
• Discuss the mechanisms through which excess body fat and underlying metabolic dysfunction contributes to inflammatory processes and hormonal/endocrine dysfunction.
• Elaborate on clinical insights into effective interventions for combating obesity, improving metabolic health, and reducing inflammation, including dietary changes, physical activity, and sleep.
• Explore emerging therapies and technologies aimed at improving metabolic function and reducing inflammation, focusing on their potential applications in clinical practice.
• Discuss mechanisms of aging and how the aging process is being challenged by both conventional and alternative medical communities. 
• Provide a comprehensive analysis of nutritional, dietary, and lifestyle-based interventions that have shown promising outcomes for improving longevity and quality of life outcomes. 
• Overview of major concepts, themes, and discussions about the importance of diet, nutrition, and controlling blood sugar to optimize metabolic capacity to maximize aging. 
• Examine emerging research on cellular regeneration and mitochondrial function as critical components in slowing the aging process and enhancing longevity.

Hour 1

• Utilize improved patient communication skills with Medicare Patients 
• Apply appropriate risk management procedures to enhance patient communication
• Identify the four elements of legal malpractice and recognize the key components to avoid a malpractice action  
• Utilize key components of good documentation and record keeping
• Integrate the legal requirements of informed consent in your informed consent process 

Hour 2

• Summarize why doctors are held to higher standards
• Discuss the Do’s and Don’ts of record keeping
• Use the 21 NCQA guidelines for appropriate medical record keeping and integrate the 3 key components of Evidence Based Practice (EBP)

Hour 3

• Assess Medicare’s mandatory Electronic Health Records (EHR) requirement        
• Discuss key items related to the Office of Inspector General (OIG) reports regarding Medicare and chiropractic services
• Summarize Executive Order issued by the White House titled reducing improper payments and eliminating waste in the Federal Programs

Hour 4

• Determine what triggers an audit and key items to consider if audited
• Utilize a step by step approach to meet all Federal Medicare Documentation guidelines 
• Summarize Medicare’s guidelines for necessity of chiropractic care and its covered services
• Prepare treatment plans per Medicare’s regulation requirements
• Recognize Medicare’s policy requirements pertaining to x-ray/diagnostic reimbursement
• Determine if ordering vs. referred services meet Medicare’s policy when performed by a chiropractic physician

Hour 1

• Demonstrate the key elements pertaining to Medicare’s documentation requirements for initial and subsequent patient encounters  
• Describe the three categories of chiropractic care covered through Medicare and the one category exempt from Medicare coverage
• Apply Medicare’s x-ray requirements for documenting a subluxation
• Utilize Medicare Advance Beneficiary Notification (ABN) form and its guidelines 
• Use Medicare’s PARTS system to document a subluxation
• Summarize the transformation of Medicare’s PARTS system utilizing the AIR S & M method               
• Include proper Medicare documentation for daily progress notes (SOAP), in order to meet insurance guidelines and meet medical necessity 

Hour 2

• Integrate a 4 step approach to meet E/M (Evaluation/Management) coding requirements to meet Medicare’s guidelines

Hour 3

• Review Medicare Access and CHIP Reauthorization Act of 2015 (MARCA) aka Medicare Quality Payment Program (QPP) and the Merit Based Incentive Payment Program (MIPS)                                                                    

Hour 4

• Apply the critical components of Chiropractic Manipulative Treatment (CMT) coding and Medicare’s requirements for documentation
• Use diagnostic codes ICD-10 (primary subluxation M-codes biomechanical lesions and secondary medical codes) to meet Medicare’s diagnosis requirements
• Recognize Current Procedure Terminology (CPT) codes and how it relates to the Medicare system
• Utilize Medicare modifiers   
• Identify some of the key items with regards to completing the Center for Medicare and Medicaid Services (CMS) 1500 claim form   
• Summarize Medicare’s mandatory claims submission policy                                   
• Explain the five levels of Medicare appeals process
• Distinguish between Medicare participating vs. non-participating provider requirements

Hour 1

• Define standard of care.
• Examine the requirements of Chiropractic documentation.
• Evaluate Chiropractic care and the functional relationship.
• Review state specific examples of documentation requirements.
• Discuss what is mean by episode of care.

 Hour 2

• Establish the baseline of care.
• Identify the inadequacies of intake forms.
• Comply with the requirements of the initial encounter report.
• Review the consultation documentation in various case scenarios.
• Apply appropriate medical decision-making processes and documentation.

 Hour 3

• Examine the Documentation Requirements of a SOAP Note.
• Utilize PART in documentation.
• Utilize outcome assessment tests in documenting medical necessity of care.
• Identify Assessment and its relationship to medical necessity.
• Solidify elements of the treatment plan to support medical necessity.
• Apprise utilization management and review analysis of documentation.

• Recognize the common pitfalls that can put your clinic at risk
• Review the difference between a mandatory ABN and a voluntary ABN
• Identify the appropriate time to initiate a mandatory ABN
• Implement customized and compliant ABNs for your clinic by following the rules

• Demonstrate understanding of the key elements of revised E/M services
• Determine the elements that count as Time-Activities and how to calculate appropriately
• Establish protocol to determine Medical Decision Making element of E/M encounter
• Apply the new algorithm to appropriately code for E/M services under the 2021 model
• Discover how to still demonstrate Medical Necessity with the revised E/M codes
• Determine why history and examination are still needed

• Develop the skills for medical documentation record-keeping for proper patient care and adherence to insurance value based parameters
• Recognize the importance, and benefits of thorough chart documentation from the standpoint of the patient, the provider, the profession and third-party payors
• Show how outcome assessment documentation benefits the patient, the provider, the profession, and third-party payors
• Demonstrate physical examination procedures that are the basis for diagnosis formulation and value based data
• Examine skills necessary to incorporate an outcomes-based, evidenced-influenced approach to patient-centered health care in bodily injuries

• Develop the skills for medical documentation record-keeping for proper patient care
• Recognize the importance and benefits of documentation methodology from the standpoint of risk management
• Identify selected documentation problems and errors
• Summarize recommendations for improving patient care documentation for those Doctors not using an EHR

• Define the Problem Oriented Medical Record (POMR).
• Demonstrate taking a complete patient history.
• Define the Evaluation and Management examination for the musculoskeletal system.
• Define Outcome Assessment.
• Illustrate the P.A.R.T. format of documentation.
• Define proper assessment for SOAP notes.
• Discuss proper documentation of treatment performed on each visit.
• Discuss proper documentation of treatment plans.

• Comprehend the reasons for transitioning from ICD9 to ICD10
• Determine the critical differences with the new ICD10 codes
• Utilize the proper alpha and numeric aspects of commonly used ICD10 codes for  Chiropractic
• Observe the practicality of combining clinical documentation and the proper use of ICD10 codes.

• Discuss the history of ICD-10-CM codes
• Discuss the Official ICD-10-CM Guidelines for Coding and Reporting
• Identify and discuss the tools needed to navigate the ICD-10 codes
• Discuss the General Equivalence Mappings (GEM’s) and their significance and how they relate to ICD-10-CM Tabular List of Diseases and Injuries
• Identify and discuss how to select the appropriate ICD-10 code to its highest specificity
• Examples to be discussed

• Recognize the key components regarding good documentation and record keeping
• Identify the legal requirements of informed consent and the key elements of the informed consent process
• Discuss why doctors are held to higher standards
• Describe the 21 NCQA guidelines for record keeping
• Document progress notes (SOAP) to meet insurance guidelines and medical necessity
• Apply the PARTS system and its transformation utilizing a new method AIR S & M
• Utilize CMT coding appropriately
• Utilize E/M (Evaluation/Management) coding appropriately to meet insurance guidelines and medical necessity
• Identify the 3 categories and 2 subcategories of E/M codes
• Identify the 5 levels of E/M services for new and established patients
• Identify the 7 components (descriptors) used to determine the level of E/M service
• Select the appropriate level of E/M services utilizing 7 simple steps

• Differentiate between active and maintenance care in clinical documentation
• Execute the use of advance notice in third party patients correctly and accurately
• Identify and implement strategies to clarify the difference between active and maintenance care in documentation
• Recognize and adopt best practices in proper notification about maintenance care vs. active treatment

• Properly document findings and recommendations around muscle therapies
• Master the documentation necessary in daily visits to verify medical necessity
• Identify and implement strategies the most important findings and rationale necessary to add muscle therapies to the treatment plan
• Recognize how to differentiate between various manual therapies to meet the requirements of third-party payers' medical review policy

• Differentiate between supervised modalities, constant attendance modalities, and therapeutic procedures
• Properly document the time and service for any physical medicine modality and procedure
• Clearly define the rationale for these services within the patient's medical record

• Recognize the varying specific requirements for documenting unique adjusting techniques in regards to compliant records and risk management
• Properly document patient encounters for medical necessity
• Discuss the Medical Review Policy insurers use in reviewing medical documentation
• Review case studies and examples to identify documentation errors during self-auditing

• Apply best practices for using abbreviations, addressing legibility, authentication of signatures, and managing the day-to-day flow of your patient records 
• Clearly delineate the beginning and end of episodes of patient care, proper recording of these episodes, and boundary discussions with patients 
• Locate and utilize the definitions of medically necessary care, and apply it as a differentiator from clinically appropriate care
• Assess documentation across the life cycle of the patient’s chart from history to discharge and on through maintenance and wellness care based on live examples demonstrated
• Identify the deficiencies that may be present in your documentation through the eyes of an auditor

• Utilize documentation requirements for the most commonly used CPT codes in the profession
• Apply coding techniques and algorithms to ensure the proper code is selected to meet E/M documentation guidelines
• Recognize the codes that carry the highest degree of risk and confirm that documentation meets the code requirements
• Identify the mandatory elements of medical review policy for selected chiropractic codes

• Compose Complete and Accurate Treatment Plans
• Formulate multiple Standard Treatment Protocols for better compliance and efficiency
• Differentiate patient care plans per Patient condition severity
• Propose recommendations based on exam findings, not third party coverage

• Know how to document exactly what’s required for initial visit treatment plans including physical medicine procedures
• Apply sample language to include in each daily visit note that will meet documentation guidelines for these modalities and procedures, including properly recording time for timed services
• Command the mechanics of how to authenticate documentation for services provided by auxiliary team members
• Tie the patient’s diagnosis to the treatment plan for tissue-specific, physical medicine solutions
• Tell a complete and coherent account of the patient’s daily visit journey, outlining the crucial language necessary to justify medical necessity for all services rendered

• Recognize and document the difference between active and maintenance care
• Use a decision-making matrix to determine the reportability of active treatment, and to be able to help the patient understand the distinction
• Apply the Medicare standard of recordkeeping to intake requirements to establish a baseline for episodes of care
• Determine whether routine visits qualify as active treatment when presented with new and updated complaints

• Describe the need for prognosis
• Summarize what a prognosis is
• Demonstrate the use of prognostic tools
• Appraise your individual patient’s outlook for recovery.
• Measure the progress
• Make evidence based clinical decisions
• Substantiate your opinion for expert testimony.
• Illustrate the evidence for care.
• Prescribe evidence based care plans.
• Properly document and code complicated cases
• Improve the patient report of findings and discharge procedures

Hour 1 - 5

• Describe the need for prognosis
• Summarize what a prognosis is
• Demonstrate the use of prognostic tools
• Appraise your individual patient’s outlook for recovery.
• Measure the progress
• Make evidence based clinical decisions
• Substantiate your opinion for expert testimony.
• Illustrate the evidence for care.
• Prescribe evidence based care plans.
• Increase your reimbursement for complicated cases.
• Improve the patient report of findings and discharge

Hour 6

• Interpret in documentation, the difference between active, medically necessary care vs. clinically appropriate but possibly maintenance adjustments
• Able to distinguish compensatory vs. primary subluxations and document them properly
• Specify proper documentation techniques as a full spine adjuster
• Demonstrate the ability to classify documentation for each chiropractic technique employed

• Interpret in documentation, the difference between active, medically necessary care vs. clinically appropriate but possibly maintenance adjustments
• Able to distinguish compensatory vs. primary subluxations and document them properly
• Specify proper documentation techniques as a full spine adjuster
• Demonstrate the ability to classify documentation for each chiropractic technique employed

• Perform functional testing to identify patients who will benefit from active care rehab
• Correlate functional testing findings with a protocol-driven care plan customized to the patient’s diagnosis
• Recognize and document preferred outcomes that result from properly executed active care techniques
• Follow clinical algorithms to best understand the beginning, middle and end points of active care rehab
• Properly document the clinical rationale for active care rehab by linking it to the diagnosis and treatment plan of initial visit documentation

• Discover all the elements necessary for appropriate documentation of an episode of care, from the initial visit through the discharge from active treatment
• Have clearer delineation of the beginning and end of episodes of patient care
• Decide when an active episode of care should turn into maintenance care, and document the decision making appropriately
• Identify the required components of documentation as they are outlined in state board documentation requirements, Medicare documentation requirements and other entities’ regulations

• Define and recognize common procedures that may be deemed unproven, investigational or experimental
• Determine how individual state boards and payers view these various treatments
• Recognize guidance or rulings from state boards that dictate the need for informed consent
• Properly document the procedures in the medical record
• Apply correct coding to describe the procedure provided
• Personalize a sample Consent to Treat for the procedure provided

• Awareness of the value of orderly documentation to you and others
• Ability to duplicate key documentation components that auditors and reviewers expect
• Steps necessary to address how poor documentation can turn a simple record review into a full audit
• Ability to identify commonly missed links connecting documentation to treatment

• Differentiate and document for the difference between medical necessity and clinical appropriateness
• Execute a complete and compliant treatment plan that includes all required elements
• Properly record the elements necessary to justify the full-spine adjustment
• Command the mechanics of properly documenting clinical rationale for ordered diagnostics and treatment
• Ensure the inclusion of diagnostic assessment and doctor’s rationale in routine daily visit notes

• Evaluate the necessary elements to properly document established patient re-evaluations of all types
• Deliver appropriate evaluation and management services to justify continued care, assess progress, and discharge from this active care when the time is right
• Report the necessary components of documenting the transitional diagnosis and treatment plan after a periodic re-evaluation
• Complete the fundamentals of documenting the assessment of change since the last evaluation as it applies to federal regulations in Medicare

• Recognize the mandatory enrollment guidelines for chiropractors.
• Distinguish between active and maintenance care.
• Employ proper procedure to administrate both active and maintenance types of care.
• Complete and document required elements of documentation of active treatment.
• Apply the Medicare standard of financial transactions with patients in order to stay within the Federal collection guideline.

• Discover how proper documentation impacts the revenue cycle and profitability of your office
• Distinguish between Medically Necessary and Clinically Appropriate Care
• Demonstrate how your office compliance program either leaves you vulnerable or reduces your risk
• Develop understanding of compliant fee systems
• Evaluate federal guidelines regarding discounting and/or hardship

• Discern Part B from Part C and know the rules for each
• Discuss mandatory enrollment necessary for Chiropractic specialty
• Master the definition of medical necessity vs. clinical appropriateness and who pays in either case
• Recognize the differences between acute, chronic, and maintenance car
• Locate and understand the Medicare Local Coverage Determination (LCD) for your state including all the rules and guidelines
• Identify CMT coding and how it is differentiated from maintenance in Medicare

• Discern Part B from Part C and know the rules for each
• Discuss mandatory enrollment necessary for Chiropractic specialty
• Master the definition of medical necessity vs. clinical appropriateness and who pays in either case
• Recognize the differences between acute, chronic, and maintenance car
• Locate and understand the Medicare Local Coverage Determination (LCD) for your state including all the rules and guidelines
• Identify CMT coding and how it is differentiated from maintenance in Medicare

• Understand the difference between clinically appropriate and medically necessary care
• Identify the clinical indications of when to initiate therapeutic withdrawal
• Execute the components of a final discharge evaluation with proper documentation and recommendations
• Learn how to transition a client from an active phase of care to maintenance as a part of your treatment plan

• Understand the difference between clinically appropriate and medically necessary care
• Identify the clinical indications of when to initiate therapeutic withdrawal
• Execute the components of a final discharge evaluation with proper documentation and recommendations
• Learn how to transition a client from an active phase of care to maintenance as a part of your treatment plan

• Cite the difference between Therapeutic Exercise and Therapeutic Activities
• Properly document all aspects required when utilizing timed therapy services
• Assimilate payer policy details to ensure proper code utilization
• Discuss common errors when documenting and billing exercise therapy services

• Demonstrate why each and every digit of the DX tells the payer something important Distinguish the nuances of specialized DX coding rules for carriers such as Medicare.
• Discover the importance of DX pointing, and which CPT codes are an absolute MUST to point to DX
• Illustrate how to diagnose with a higher level of specificity and through proper hierarchy Identify the role of the diagnosis in the documentation process'

• Identify the expected standards of a compliant and complete patient record
• Audit documentation to ensure the most important details are present
• Demonstrate how to conduct a complete baseline audit of record documentation

• Demonstrate the components of recognizing Medical Necessary Care vs. Clinically Appropriate
• Identify CMT coding trends and indicators as they relate to medical necessity
• Properly manage treatment effectiveness for exacerbations and reoccurrences
• Determine Proper Diagnosis and Assessment for Federal Patients
• Acknowledge and audit CMT coding ratios to evaluate the potential risk

• Identify Dually Eligible Individuals (QMB) and Understand How Medicare Works with Medicaid
• Ascertain the practice’s obligations for QMB patients, regardless of Medicaid participation or coverage
• Provide accurate and legal advance notice to dually eligible individuals within the new guidelines
• Recognize the differences between acute, chronic, and maintenance care and how that affects billing and charges
• Duplicate Medicare financial rules and collections guidance into a process within the practice

• Identify the key players in the patient provider relationship
• Recognize the key documentation requirements and components required to be eligible to treat Veterans
• Compose documentation that meets  required VA elements
• Locate key resources for successful referral management
• Determine key factors known to be often missing, and understand what to do to correct the deficiency
• Demonstrate the proactive steps to take in treating VA patients from clinical and financial submission

• Identify missing components before they become critical issues for your practice
• Determine the basic requirements of documentation for all payer classes
• Learn to identify payer requirements as part of your documentation standards
• Understand the key documentation components that boards, auditors and reviewers expect

• Apply the changes in the 2022 ICD-10 code set to the clinical diagnosis process
• Compare examination findings, couple with history, to select the most appropriate written diagnosis
• Document within the clinical record your thought process of selecting diagnostic codes
• Classify diagnoses in order of severity and hierarchy to match projected treatment plan

• Properly document “doctor thinking” daily in routine patient visit documentation
• Recognize the role of the PART documentation process in Routine Office Visit notes
• Identify and execute the key components of written assessment in daily documentation
• Recognize aspects of documentation and coding of Route Office Visits (ROV) whether active treatment, preventative maintenance, or wellness care.
• Distinguish the unique components of Subjective, Objective, Assessment and Plan

Hour One: Documentation and Compliance Overview, Rules and Regulations

• Recognize and avoid or correct behavior that is contrary to the rule of “no opt-out for chiropractors”
• Apply compliance rules set forth by governmental agencies that apply to providers of service to Federally insured patients
• Demonstrate day-to-day application of guidance on Federal Program and state requirements for coding, billing, and finances
• Differentiate between active and maintenance care, according to the official Medicare definitions and other third-party guidelines
• Interpret the four types of risk the Office of Inspector General (HHS) expects providers to focus on with Policy and Procedure, per the OIG Guidance for Small Practices
• Recognize the limitations of experimental, investigational, and unproven technologies

 Hour Two: Documentation of Initial Visits-New Patients, New Episodes, and New Conditions

• Identify and apply concepts that differentiate types of initial visits, from new patients to updated episodes
• Produce documentation of initial visits that comply with board requirements for chiropractors
• Summarize documentation requirements as they apply to the new initial Evaluation and Management guidelines set forth January 1, 2021
• Establish medical necessity for your care and know with surety that initial visit documentation is complete
• Rank complicating factors and contraindications according to priority and include with initial assessment
• Populate a required treatment plan for care, whether for short- or longer-term care

 Hour Three: Documentation and Case Management for Routine Visits, Preventive Maintenance, and Wellness Care

• Differentiate between requirements for medically necessary services vs. maintenance which is self-pay
• Apply primary subluxation vs secondary compensation logic to mitigate risk for the full-spine adjustment
• Reproduce the key elements of routine chiropractic visits in documentation as set forth by third-party, State and Federal guidelines
• Interpret functional data to determine stages and levels of care
• Demonstrate the ability to implement therapeutic withdrawal and to document its results
• Recognize maximum therapeutic benefit (MTB) and properly document discharge from active treatment

 Hour Four: The Risks Associated Billing and Financial Compliance Regulations

• Give examples of billing and financial compliance that cross the line of False Claims Act and Anti-Kickback Statute violations
• Apply billing and financial compliance regulations to the day-to-day operations of the practice, including payment and prepayment plans
• Execute random auditing of charges and collections to meet OIG compliance guidelines
• Recognize and apply the rules of offering financial hardship discounts
• Produce advertising that falls within the guidelines of board and federal rules

• Label the main driver is for “Medical Necessity”, how and why you must communicate this to 3^rd party payers
• List the foundation of coding and be able to apply pertinent ICD10 coding guidelines
• Discover how correct coding may dictate our strength to 3^rd parties and have national implications for our profession.
• Discuss critical questions of the benefits and risks of our Chiropractic diagnosis codes in the insurance industry.
• Identify red flags, complicating factors, and have awareness of Risk management when documenting and coding.
• Identify how insurance companies rank the importance of various diagnoses and its effect on claims’ coverage and processing

• Distinguish the meaning and implications of many important terms pertaining to the clinical practice of filiform needling therapies.
• Categorize the most common types of trigger points.
• Incorporate myofascial stress patterns into previously learned myofascial frameworks.
• Compare & contrast the legal, theoretical & practical commonalities & differences associated with the filiform needling therapies of dry needling & acupuncture.

• This contains all courses with the educational objectives listed from Dry Needling 201 through 206

• Demonstrate Clean & Safe needle handling, application, & disposal
• Recognize and reduce risks To Dry Needle Providers
• Recognize and reduce risks To Dry Needle Patients
• Integrate Dry Needling into an Existing Practice
• Document Dry Needling Diagnosis & Treatment

• Identify common filiform needle sizes and types.
• Select appropriate filiform needles for various applications.
• Integrate trigger point releasing concepts & practices.
• Apply effective trigger point releasing needle techniques.
• Outline common myofascial stress patterns.

• Identify Common Myofascial Stress Patterns.
• Discuss the differences commonalities & differences associated with myofascial stress patterns and traditional acupuncture meridians.
• Palpate & Locate Primary Points for Releasing Posterior Myofascial Stress Patterns.
• Palpate & Locate Primary Points for Releasing Anterior Myofascial Stress Patterns.
• Palpate & Locate Primary Points for Releasing Lateral Myofascial Stress Patterns.

• Diagnose & Treat Posterior Myofascial Stress Patterns & Related Trigger Points.
• Diagnose & Treat Lateral Myofascial Stress Patterns & Related Trigger Points.
• Diagnose & Treat Anterior Myofascial Stress Patterns & Related Trigger Points.
• Diagnose & Treat Head & Neck Myofascial Stress Patterns & Related Trigger Points.

• Integrate information from previous 5 classes to efficiently diagnose painful myofascial conditions, create effective treatment plans, and locate effective trigger points in the head & neck regions.
• Integrate information from previous 5 classes to efficiently diagnose painful myofascial conditions, create effective treatment plans, and locate effective trigger points in the Traps & Upper Back.
• Integrate information from previous 5 classes to efficiently diagnose painful myofascial conditions, create effective treatment plans, and locate effective trigger points in the Shoulder, Arm, Chest, Elbow, Wrist, Hand.
• Integrate information from previous 5 classes to efficiently diagnose painful myofascial conditions, create effective treatment plans, and locate effective trigger points in the Mid-Back, Lower Back, Hip/Thigh, Knee/Leg, Ankle, & Foot.

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

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

• Identify the relationship between an upper cervical - trigeminal cervical nucleus and headaches.
• Integrate headache, upper cervical spine, and the temporomandibular joint.
• Distinguish between the clinical management of compressive neuropathology v. supersensitivity nerve interference.
• Identify “red flags” associated with compressive neuropathology.
• Discuss the relationship between mechanoreceptors, the sympathetic nervous system, and neuroimmunology.
• Highlight the uniqueness of upper cervical spine mechanoreceptors and the vagus nerve.
• Describe mechanobiology and diseases of mechanotransduction.
• Explain connective tissue as a body-wide signaling network.
• Summarize some randomized controlled/clinical trials pertaining to chiropractic and/or manipulation care.
• Recall studies looking at the influence of chiropractic care on opioid use.
• Interpolate the importance of sagittal posture on pain and function.
• Examine the importance of sagittal posture on cognition.
• Integrate evolutionary biology, infection, and the existence of chiropractic subluxation.           
• Summarize studies showing the influence of joint adjusting on a variety of visceral syndromes.
• Detail the relationship between an infectious agent and host health.
• Recognize the basic details of neuroimmunology.

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

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

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

Hour 2

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

Hour 1:

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

 Hour 2:

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

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

Hours 1 - 3

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

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

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

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

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

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

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

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

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

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

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

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

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

• Define hydrotherapy, cryotherapy, spa and thermotherapy
• List 3 advantages/disadvantages of heat and cold
• Identify the Hunting Response
• List the three physical states of water
• Identify guidelines to ensure safe application of hydrotherapy methods
  Copyright 2005 Elsevier, Inc. All Rights Reserved.

   

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

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

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

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

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

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

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

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

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

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

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

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

Hour 1

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

 Hour 2

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

Hour 3

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

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

Hour 1

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

Hour 2

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

Hour 3

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

Hour 1

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

Hour 2

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

Hour 3

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

Hour 1

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

Hour 2

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

Hour 3

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

Hour 1

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

Hour 2

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

Hour 3

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

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

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

Hour 1

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

Hour 2

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

Hour 3

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

Hour 1

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

Hour 2

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

Hour 1

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

Hour 2

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

Hour 3

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

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

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

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

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

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

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

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

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

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

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

Hour 1

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

Hour 2

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

Hour 3

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

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

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

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

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

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