Oklahoma Chiropractic Continuing Education

• 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.

• 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.

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

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

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

Hour 1

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

Hour 2

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

Hour 3

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

Hour 1

• 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

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

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

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

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

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

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

Hour 1

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

Hour 2

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

Hour 3

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

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

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

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

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

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

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

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

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

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

Hour One:

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

 Hour Two:

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

 Hour Three:

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

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

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

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

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

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

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

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

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

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

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

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

Introduction

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

Examination

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

Mobilization and Adjusting

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

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

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

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

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

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

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

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

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

Hour 1

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

 Hour 2

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

 Hour 3

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

 Hour 4

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

Hour 1

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

Hour 2

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

Hour 3

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

Hour 4

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

Hour 1

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

Hour 2

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

Hour 3

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

Hour 4

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Hour 1: Evolutionary Biology Influence on Clinical Physiology

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

 Hour 2: Summarize Inflammation in both Pain and Disease

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

Hour 3: Justification of Sleep Hygiene

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

Hour 4: Define the Recently Discovered Glymphatic System

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

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

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

Hour 6: Analyze the Science of a Healthy Diet

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

Hour 7: Appraise Chiropractic Clinical Practice and Pain Management

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

Hour 8: Detail the Benefits of Exercise

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

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

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

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

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

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

Hour 1

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

 Hour 2 

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

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

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

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

Hour 1

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

Hour 2

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

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

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

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

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

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

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

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

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

Hour 1

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

Hour 2

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

Hour 3

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

Hour 4

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