NWHSU logo
Chiropractic Methods V: Practicum 1 - #34150


 

 

Thomas Bergmann, DC
Clinical Sciences Faculty Offices, 2nd Floor
952-888-4777 Ext. 279 or faculty secretaries

2.0
45.00
1.0
2.0
Continued development of phychomotor skills introduced in previous methods courses, with emphasis on modifications necessary to fit specific doctor and/or patient needs. Management strategies of common axial and appendicular conditions are discussed and practiced.
Please select from the list on the right.

The Institution-wide learning goals define the common ground that unites the programs within the university. They are purposefully broad so that the various colleges and schools can continue to develop their unique identities through varying ways in which the goals are met.

  1. Effective Communication
    Graduates will demonstrate effective verbal, non-verbal, and written communication skills in a wide variety of contexts, including collaborative activities.
  2. Self Directed and Lifelong Learning
    Graduates will be aware of the limits of one’s personal knowledge and experience and have an intellectual interest in scholarly and creative endeavors. Graduates will actively set appropriate learning goals, pursue them, and apply the knowledge gained.
  3. Ethical Reasoning
    Graduates will demonstrate a willingness to recognize the values of others while maintaining one’s own integrity, and act ethically and professionally in all endeavors.
  4. Individuals, Communities and Cultures
    Graduates will demonstrate awareness and sensitivity to the cultural and health practices of individuals and communities. Graduates will be able to identify appropriate health related resources.
  5. Service to the Community
    Graduates will understand and value the benefits of service to the community.
  6. Influence of Mind, Body and Spirit on Health
    Graduates will recognize the inter-relationship of the mind, body and spirit and the influence of extrinsic factors on an individual’s health.
  7. Critical Thought and Knowledge Acquisition
    Graduates will acquire, appraise and apply scientific information. Graduates will contextually organize and synthesize relevant information to address an issue or problem.
  8. Competence in one's Discipline
    Graduates will demonstrate competence of appropriate depth and scope for one's discipline.

Course Objectives
Top

  1. Describe the natural history and presenting complaints of several common conditions of the neuromusculoskeletal system;
  2. Understand the importance and interpret the subjective history assisting in the assessment of a patient;
  3. Coordinate relevant physical, laboratory, and imaging evaluations to meet the needs of the clinical presentation;
  4. Interpret radiographic manifestations of subluxation (malposition);
  5. Synthesize subjective and objective information into a diagnostic impression;
  6. Discuss differing mechanisms in the application of thrusting techniques;
  7. Determine how to incorporate, apply or modify manual therapies into treatment plans for common conditions of the neuromusculoskeletal system;
  8. Demonstrate continued improvement in the application of the HVLA thrust as well as other forms of manual therapy.
Materials
Top
A. Required Text(s):
  • Peterson, Bergmann. Chiropractic Technique, 2nd edition, Mosby, 2002.
  • Bergmann, Davis. Mechanically Assisted Manual Procedures, Mosby, 1997.
  • Sousa. Differential Diagnosis and Management for the Chiropractor, 2nd edition. Aspen, 2001.

    B. Recommended Text(s):


    Additional Sources:
    Plaugher. Textbook of Clinical Chiropractic
    Gatterman. Chiropractic Management of Spine Related Disorders
    Kirkaldy-Willis. Managing Low Back Pain
    Grieve. Common Vertebral Joint Problems
    Grieve. Modern Manual Therapy
    Kirk, Lawrence, Valvo. States Manual of Spinal, Pelvic and Extravertebral Technics, 2 ed.


    C. Required Materials for Lab:

  • Lecture Notes by Thomas Bergmann - available in the bookstore
  • Printed Case Studies - handed out in class
    		•
    Assignments
    Top

    A. Reading cases before lecture.
    B. Review psychomotor skills and procedures taught in previous Methods classes at Northwestern Health Sciences University.
    C. Proper attire is expected in the laboratory sessions - department policy will be followed. Please review the outline prior to class to ensure reasonable access to the scheduled body region.
    Attendance
    Top
    Attendance is expected.
    Grading Criteria
    Top
    1. Quizzes: 100 points, 10 unannounced in lecture and lab, 10 points each.
    2. Midterm: 100 points; multiple choice.
    3. Practical: 100 points, 3 adjusting stations: (cervical/thoracic - 20 points; lumbar/pelvic - 20 points; upper/lower extremity - 20 points); 1 x-ray station - 20 points; and 1 exam station (pdx, ortho, neuro - 20 points.
    4. Final: 100 points, multiple choice, cumulative (in the style of NBCE Part 2 Chiropractic Practice and Part 3 Written Clinical Competency)
    5. Portfolio: 110 points; continuation of methods portfolio with the following criteria and points: Examination form - 15; Cervical/Thoracic Video Critique - 15; Lumbar/Pelvic Video Critique - 15; Extremity Video Critique - 15; Narrative Report - 20, Case Interpretations - 20; Overall Organization - 10.
    6. Adjusting Competencies Pass/Fail. Supervised adjustments of the upper cervical (C0-C1, C1-C2), lower cervical (C2-C7), thoracic/ribs (C7-T12), lumbar/pelvic (T12-S1, S1), upper/lower extremity) to be completed in lab or supervised open labs.

    Guaranteed grades are as follows:

    A = 92 - 100% of Total Possible Points
    B = 83 - 91% of Total Possible Points
    C = 74 - 82% of Total Possible Points
    D = 65 - 73% of Total Possible Points
    F =

    Failure to accrue at least 65% of the Total Possible Points

    Grading: The assignment of and changes to course grades are the sole responsibility of the instructor of record. A grade may be changed only if there was an error in calculation. If you believe there has been an error in the calculation of a grade, contact me for an explanation of the grade within the first week of classes the following term. If a grade is determined to be in error, a grade change report will be issued to the Deparment of Student Records. The changed grade can be checked on eNorthwestern as soon as it is made available.

    Grade Appeals: The instructor is responsible for evaluation of student performance and for determining a student's course grade. The student is responsible for fulfiling the academic requirements for the course, as established by the insturctor, in the course syllabus. A student may appeal a grade only through an informal resolution process. The student should first talk with the instructor.

    Course Competencies
    Top
    -

    COGNITIVE DOMAIN


    Students will be able to construct and follow a rational diagnostic process in evaluating patients who present with the following musculoskeletal symptoms:

    a. low back pain g. elbow pain
    b. neck pain h. wrist/hand pain
    c. headache i. hip pain
    d. midback pain j. knee pain
    e. jaw pain k. ankle/foot pain
    f. shoulder pain l. radiating pain

    In addition, students will be familiar with the following symptoms, which sometimes accompany certain musculoskeletal conditions as well as conditions related to other body systems:

    a. dizziness, vertigo d. muscle aches
    b. anorexia, weight loss e. bowel or bladder changes
    c. fever, chills, night sweats f. malaise, fatigue, prostration

    Students will be able to explain the clinical utility and indications for the following laboratory, imaging and other diagnostic tests in patients with suspected musculoskeletal disease:

    a. CT scan d. EMG
    b. MRI e. Alkaline phosphatase
    c. Plain film x-ray f. Acid phosphatase

    Musculoskeletal Conditions
    Students will be able to make case management decisions regarding common musculoskeletal conditions based on their understanding of the following information regarding each condition:

    A. Definition F. Natural history/Clinical course
    B. Epidemiology G. Management
    C. Etiology --1. Chiropractic
    D. Pathophysiology --2. Physiological Therapeutics
    E. Manifestations --3. Nutrition and/or supplementation
    --1. Symptoms --4. Exercise
    --2. History findings --5. Lifestyle Management
    --3. Exam findings --6. Medical
    --4. Chiropractic findings --7. Other
    --5. Lab findings H. Management Guidelines (where available
    --6. Diagnostic imaging findings  
    --7. Findings from special tests  


    Conditions:
    a. Sacroiliac sprain/strain j. Cervical sprain/strain
    b.Maigne's syndrome (cluneal nerve entrapment) k. Lumbar disc syndrome
    c. Barre-Lieou syndrome (cervicalcranial syndrome) l. Cervicogenic headache
    d. Temporomandibular joint conditions (extracapsular, capsular, intracapsular) m. Lumbar facet syndrome - sprain/strain
    e. Piriformis syndrome n. Shoulder tendonitis, bursitis, capsulitis
    f. Thoracic sprain/strain o. Lateral epicondylitis
    g. Intercostal neuralgia p. Cubital tunnel syndrome
    h. Scoliosis  
    i. Bell's Palsy  


    PSYCHOMOTOR DOMAIN


    Students will be able to conduct an appropriate joint function assessment using the following procedures and/or criteria (PARTS assessment):


    a. Pain location, character and description of reported pain correlated to pain produced by percussive palpation;
    b.


    		 Asymmetry


    		 interpretation of postural distortion, static palpation findings for joint position, and interpretation of static radiographic findings of joint position;
    c.





    		 Range of Motion





    		 Evaluation of gait, interpretation of changes in global or regional active ranges of joint motion (inclinometers, goniometers), evaluation of passive joint motion and overpressure for accessory joint movement (joint play, end feel), use of stress x-ray for segmental active motion changes (hyper- or hypomobility);
    d.

    Tone, Texture, Temperature

     

    		Palpatory evaluation of the soft tissues for changes in tone (hyper- hypotonicity, spasm) and texture (ropiness, cords, bands, nodules), evaluation of the skin for temperature changes using the dorsum of the hand and/or a temperature detecting instrument;
    e.


    		 Special tests


    		 Use of any other evaluation procedures that may relate characteristics of joint dysfunction (leg length inequality, correlation with visceral findings)

    Students will be able to select and properly employ the following adjustive techniques:

    a. supine, prone and side posture adjustments to the sacroiliac articulation
    b. side posture and knee chest adjustments to the lumbar spine (and TL junction)
    c. prone and supine blocking techniques, apex contact from Logan
    d. distraction techniques using manual means and mechanical assistance
    e. prone and supine thoracic/rib techniques
    f. supine, seated, prone and side posture cervical techniques
    g. distractive and translational TMJ techniques
    h. AC, SC, GH, and ST adjustments
    i. elbow, wrist and hand adjustments
    j. hip, knee, ankle, foot adjustments

    In addition, students will be able to modify techniques for the following:

    a. hyperflexible patients
    b. elderly patients
    c. acute or hypersensitive patients
    d. unresponsive patients

    AFFECTIVE DOMAIN


    Students will demonstrate integrity, sensitivity, respect, courtesy, compassion and professionalism at all times, both in lectures and labs; and will be able to apply the history, physical examination and treatment techniques learned in this course to any patient while demonstrating those same qualities.
    Weekly Calendar of Learning Objectives
    Top
    Week Dates Topics/Learning objectives
    Week 1 -- Lec: Introduction: Syllabus, Joint assessment.
    Lab: Sacroiliac evaluation, side posture positioning.
    Week 2 -- Lec: Case 1 - DDX/TX Pelvic Conditions (piriformis syndrome, POS, coccygodynia, S1 sprain/strain, pubic symphysis dysfunction).
    Lab: Side posture adjustments of S1.
    Week 3 -- Lec: Case 2 - DDX/TX Lumbar conditions (facet syndrome, disc syndrome, lumbar sprain/strain, myofascial syndromes, epidural hematoma, synovial cyst, compartment syndrome, spondylolisthesis, lumbar instability, DJD/DDD/stenosis).
    Lab: Pubic and Sacrococcygeal adjustments. Lumbar assessment. Side posture adjustments lumbar spine (R, LF).
    Week 4 -- Lec: Lumbar conditions - continued.
    Lab: Other low back adjustive procedures (blocking, Logan basic, genu extensions, flexible patient modifications). Distraction techniques, drop piece techniques, motion-assisted thrust techniques.
    Videotape side posture adjustment.
    Week 5 -- Lec: Memorial Day - No Class
    Lab:T-L junction considerations and knee-chest adjustments of TL and lumbar regions. Review.
    Week 6 -- Lec: Thoracic/Rib Conditions (thoracic sprain/strain, intercostal neuralgia, middle trapezius strain, visceral reflex phenomenon).
    Lab: Prone, supine, and knee-chest adjustments of the thoracic spine. CT junction techniques, rib techniques.
    Week 7 -- Lec: MIDTERM (100 points: true/false, multiple choice)Case
    Lab: NO LABS - MIDTERMS
    Week 8 -- Lec: Case 3 - Cervical Conditions (torticollis, cervical sprain/strain, headache of cervical origin, Barre-Lieou syndrome).
    Lab: Side posture, supine, seated, and prone adjustments of the cervical spine.
    Week 9 -- Lec: DDX/TX Temporomandibular Joint Conditions (extracapsular, capsular, intracapsular dysfunction).
    Lab: TMJ Evaluation, TMJ Manipulation.
    Videotape cervical/thoracic adjustment
    Week 10 -- Lec:4TH OF JULY - NO CLASS
    Lab: Shoulder Evaluation and Adjustments.
    Week 11 -- Lec: Case 4 - DDX/TX Upper Extremity Conditions (shoulder impingement, teres syndrome, tendonitis/bursitis/capsulitis, epicondylitis, ulnar/median/radial entrapment syndromes.
    Lab: Elbow, Wrist, and Hand evaluation and adjustments.
    Week 12 -- Lec: Case 5 - DDX/TX Lower Extremity Conditions (trochanteric bursitis, meralgia paresthetica, paresthetica, patellar tracking, meniscus dysfunction, hip/knee/ankle sprain/strain, plantar fascitis, shin splints).
    Lab: Hip, Knee, Ankle, Foot evaluation and adjustments
    Week 13 -- Lec: Extremity conditions - continued. Misc. cases.
    Lab: Review
    Videotape extremity adjustment
    Week 14 -- FINAL EXAMS - Exam Dates TBA
    Written Final:     100 points, multiple choice;
    Practical FinalL 100 points; 5 stations, 20 points each
    Week 15 -- FINAL EXAMS
    Please Note
    This schedule of lecture and lab topics and quizzes and exams may be changed during the course of the trimester as circumstances require. Whenever possible, such changes will be announced in class before the date and time in question. You are responsible for anything that transpires during lectures and labs, even when you are unable to attend. In the event that you miss a class session, make sure you check with a classmate about any announcements or schedule changes which may have been made. Makeup exams are allowed only according to the policies described in the current student handbook, which is available in the Student Affairs office.
    Maintained by Northwestern College of Chiropractic
    Last updated: 27 April 2006
     

    Copyright ©2006 Northwestern Health Sciences University, 2501 W. 84th St., Bloomington, MN 55431, (952) 888-4777.
    Send your questions/comments about the website to Northwestern Health Sciences University Web Coordinator.