Theory Driven and Evidence-Informed Chiropractic: A Three Hour Survey

This course from author Robert A. Leach, DC, MS, MCHES, provides a brief introduction to the science of chiropractic for the busy clinician or student, explaining how a questioning philosophy supports a modern theory-based clinical practice. The course focuses on five promising theories for evidence-informed practice, including: inflammation, segmental dysfunction, postural distortion and immobilization degeneration, stress and neurodystrophy/neuroplasticity, and the wellness and psychosocial model. This course provides the knowledge and skills necessary to enable the busy clinician to understand possible scientific explanations for chiropractic and how the research has informed practice guidelines, discuss ways to communicate these topics with patients and other healthcare partners, and incorporate them into practice behaviors and collaborative care. 

This course is worth a total of 3 CE credits.  

Learning Objectives:

Module 1: Introduction to the Science of Chiropractic: Inflammation

• Explain how the philosophy and clinical questions of a mature healthcare profession impacts   private, public and government attitudes, guidelines, reimbursement schedules, and ultimately clinical practice. 
• Describe the role of inflammation in disease and health, markers of inflammation associated with spine pain, changes in inflammation in experimental and clinical subjects after spinal manipulation, and the role of inflammation within the larger context of whole-body or wholistic treatment. 

Module 2: Clinical Correlates of Spinal Dysfunction

• Distinguish between “subluxation” as a theoretical construct as opposed to segmental dysfunction that may be associated with painful range of motion restriction, abnormal pressure pain thresholds, and other clinical predictors such as quality of life measures such as activities of daily living disability.
• Explain some of the research regarding “misalignment,” how it varies with radiation guidelines and with some common clinical practices. 
• Explain recent research on postural distortion such as forward head tilt, immobilization degeneration and the role of imaging in the larger context of ruling out disease to provide a safe platform for chiropractic, as opposed to determining where and when to adjust the spine.

Module 3: Effects of Dysfunction and Spinal Manipulative Treatment: Evidence for a Wholistic Chiropractic Treatment Approach

• Define how stress may both influence and proceed from back pain, the body’s response including neuroplasticity, and how this neurodystrophy per the models of Selye and McEwen may influence immunity and brain aging, in addition to influencing brain centers. 
• Describe the positive influence of spinal manipulation on these changes. 
• Recognize the role of lifestyle and smoking cessation, increasing activity levels, counseling and improving coping skills for addictions and illness behaviors, and improved dietary habits in overall health and wellness. 
• Compare and contrast the role of a chiropractic practice limited to spine care, as opposed to a practice that also offers wellness care counseling, advice and referral.