United Kingdom Chiropractic Continuing Education

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Hour 1

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

 Hour 2

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

 Hour 3

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

 Hour 4

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

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

Hour 1

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

Hour 2

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

Hour 3

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

Hour 4

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

Hour 1

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

Hour 2

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

Hour 3

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

Hour 4

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

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

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

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

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

• Identify neurological, arterial and venous causes of Thoracic Outlet Syndrome and associated disorders.
• Assess between Thoracic Outlet Syndrome, Hyperabduction Syndrome and Costoclavicular Syndrome (as associated disorders) and their symptoms.
• Diagnose the neurological, muscular and bony structures associated with the cause of Thoracic Outlet Syndrome and associated disorders.
• Apply manual methods to the soft tissue structures in the treatment of Thoracic Outlet Syndrome and associated disorders.
• Apply the use of modalities to the soft tissue structures in the treatment of Thoracic Outlet Syndrome and associated disorders.

• 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.