Michael Major, DC FIACN, DIBCN.

Covered Engineering Mechanics, both static and dynamic needed to reconstruct automobile crash scenarios. (Both colinear and oblique collisions were covered). A comprehensive review of vehicle dynamic and vehicle behavior in collisions. Principle Direction of Force was covered with regard to momentum. Conservation of momentum calculation and techniques for post-collision drag factors were covered. An introduction to human factors was also included. All skills required to reconstruct crash situations using momentum and mechanics.

Mathematical basis for Traffic Crash Reconstruction, including Newton’s Laws of Motion and application in the traffic crash scenario. Velocity, time, acceleration and distance of travel concepts were covered, as well as vehicle braking and drag factors/coefficient of friction were covered.

Explanation of the role that the traffic crash investigator plays within the police mission of traffic safety was presented. Five levels of crash investigation were outlined along with the implementation of each distinct phase. Detailed review of planning the different stages of the traffic crash investigation was reviewed. Defining the elements necessary to classify situations beyond a traffic crash, such as suicide, homicide or leaving the scene was presented. Detailed individual projects with instructor grading were required including post-collision questioning, roadway analysis, intersection measurements, vehicle damage analysis on live models, crash scene photographic analysis, influence of drag factor in crash investigation and final project incorporating all learned material in an intersection crash diagram to scale.

Detailed review of Crash Investigation 1 was presented and discussed in group setting. Outline of next phases of crash investigation with detailed instruction of tire mark identification and evaluation with focus on tire inflation status and tire damage with reference to pre and post-crash. Methodology pertaining to crash investigation format was outlined in a scientific process. Instruction in analysis of vehicle lamps was given including pre and post-crash presentations, scientific process and understanding of lamp engineering and manufacturing was detailed. Vehicle crash physics and crush measurements was given and practices in a project scenario using scientific processes to document vehicle damage. Relationship to vehicular behavior, analysis and crash dynamics was presented with analysis using perspective grid photogrammetry. Specifi investigation of crash analysis in hit and run events was presented. Final projects included complete technical report writing, discussion of emerging crash investigation technology and crash dynamics related to real world crash analysis

Neurodiagnostics, Imaging Protocols and Pathology of the Trauma Patient, An in-depth understanding of the protocols in triaging and reporting the clinical findings of the trauma patient. Maintaining ethical relationships with the medical-legal community.

Diagnostics, Risk Factors, Clinical Presentation and Triaging the Trauma Patient, An extensive understanding of the injured with clinically coordinating the history, physical findings and when to integrate neurodiagnostics. An understanding on how to utilize emergency room records in creating an accurate diagnosis and the significance of “risk factors” in spinal injury.

Crash Dynamics and Its Relationship to Causality, An extensive understanding of the physics involved in the transference of energy from the bullet car to the target car. This includes G's of force, newtons, gravity, energy, skid marks, crumple zones, spring factors, event data recorder and the graphing of the movement of the vehicle before, during and after the crash. Determining the clinical correlation of forces and bodily injury.

MRI, Bone Scan and X-Ray Protocols, Physiology and Indications for the Trauma Patient, MRI interpretation, physiology, history and clinical indications, bone scan interpretation, physiology and clinical indications, x-ray clinical indications for the trauma patient.

Neurodiagnostic Testing Protocols, Physiology and Indications for the Trauma Patient, Electromyography (EMG), Nerve Conduction Velocity (NCV), Somato Sensory Evoked Potential (SSEP), Visual Evoked Potential (VEP), Brain Stem Auditory Evoked Potential (BAER) and Visual-Electronystagmosgraphy (V-ENG) interpretation, protocols and clinical indications for the trauma patient.

Documentation and Reporting for the Trauma Victim, Understanding the necessity for accurate documentation and diagnosis utilizing the ICD-9 and the CPT to accurately describe the injury through diagnosis. Understanding and utilizing state regulations on reimbursement issues pertaining to healthcare.

Documenting Clinically Correlated Bodily Injury to Causality, Understanding the necessity for accurate documentation, diagnosis and clinical correlation to the injury when reporting injuries in the medical-legal community. Documenting the kinesiopathology, myopathology, neuropathology, and pathophysiology in both a functional and structural paradigm.

Spinal Biomechanical Engineering: Cartesian System, The Cartesian Coordinate System from the history to the application in the human body. Explanation of the x, y and z axes in both translation and rotations (thetas) and how they are applicable to human biomechanics.

Spinal Biomechanical Engineering: Cervical Pathobiomechanics, Spinal biomechanical engineering of the cervical and upper thoracic spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine.

Spinal Biomechanical Engineering: Lumbar Pathobiomechanics, Spinal biomechanical engineering of the lumbar spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine.

Spinal Biomechanics in Trauma, To utilize whiplash associated disorders in various vectors of impact and whiplash mechanisms in determining pathobiomechanics. To clinically correlate annular tears, disc herniations, fractures, ligament pathology and spinal segmental instability as sequellae to pathobiomechanics from trauma. The utilization of digital motion x-ray in diagnoising normal versus abnormal facet motion along with case studies to understand the clinical application.

Spinal Biomechanical Engineering & Organizational Analysis, Integrating spinal biomechanics and pathobiomechanics through digitized analysis.The comparison of organized versus disorganized compensation with regional and global compensation. Correlation of the vestibular, occular and proprioceptive neurological integration in the righting reflex as evidenced in imaging. Digital and numerical algorithm in analyzing a spine.

Spinal Biomechanical Engineering: Cervical Digital Analysis, Digitizing and analyzing the cervical spine in neutral, flexion and extension views to diagnose pathobiomechanics. This includes alteration of motion segment integrity (AMOSI) in both angular and translational movement. Ligament instability/failure/pathology are identified all using numerical values and models. Review of case studies to analyze pathobiomechanics using a computerized/numerical algorithm.

Spinal Biomechanical Engineering: Lumbar Digital Analysis, Digitalizing and analyzing the lumbar spine images to diagnose pathobiomechanics. This includes anterior and posterior vertebral body elements in rotatioal analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines.

Spinal Biomechanical Engineering: Full Spine Digital Analysis, Digitalizing and analyzing the full spine images to diagnose pathobiomechanics as sequellae to trauma in relation to ligamentous failure and disc and vertebral pathology as sequellae. This includes anterior and posterior vertebral body elements in rotatioal analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines.

Interprofessional Spine Care, Clinical analysis of anatomic versus biomechanical spine pain and clinical triage protocols. Relating current research trends in the Whole Spine Model of patient including normal versus abnormal sagittal curvature in the adolescent and adult spine, pelvic incidence as a parameter for sagittal balance in the human spine and current methods of assessment. Patient centered approach to Evidenced Based Spine care with a focus on diagnosis, prognosis and triage of the spine pain patient

Epidemiology of Spine Pain, Review of the current Centers for Disease Control [CDC} data on the frequency of musculoskeletal pain in the United States population with emphasis on pain of spinal origin. CDC guidelines on opioid medication were discussed and correlated to persistent pain syndromes. Research was reviewed showing the importance of managing the spine pain patient properly from the entry point of care with a concentration on maintenance of spinal biomechanics

Course presents the theoretical aspects and concepts of the McKenzie Method in Mechanical Diagnosis and Therapy, as applied in the examination and treatment of patients with complaints of neck, upper back and related referred pain. Through lectures and patient demonstrations the derangement, dysfunction and postural syndromes are described in detail and appropriate treatment plans are outlined with emphasis on the use of patient self-treatment procedures.   The clinical efficacy and limitations of the McKenzie approach as applied to the cervical and thoracic spine, are illustrated by follow-up patient demonstrations.

Magnetic fields, T1 and T2 relaxations, nuclear spins, phase encoding, spin echo, T1 and T2 contrast, magnetic properties of metals and the historical perspective of the creation of NMR and MRI.

Normal anatomy of axial and sagittal views utilizing T1, T2, 3D gradient and STIR sequences of imaging. Standardized and desired protocols in views and sequencing of MRI examination to create an accurate diagnosis in MRI.

MRI interpretation of bulged, herniated, protruded, extruded, sequestered and fragmented disc pathologies in etiology and neurological sequelae in relationship to the spinal cord and spinal nerve roots.

MRI interpretation of bone, intradural, extradural, cord and neural sleeve lesions. Tuberculosis, drop lesions, metastasis, ependymoma, schwanoma and numerous other spinal related tumors and lesions.

MRI interpretation sequencing of the cervical, thoracic and lumbar spine inclusive of T1, T2, STIR and 3D gradient studies to ensure the accurate diagnosis of the region visualized.

The clinical application of the results of space occupying lesions. Disc and tumor pathologies and the clinical indications of manual and adjustive therapies in the patient with spinal nerve root and spinal cord insult as sequelae.

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images. Clinical indication for the utilization of MRI and pathologies of disc in both trauma and non-trauma sequellae, including bulge, herniation, protrusion, extrusion and sequestration.

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar degeneration. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Central canal and cauda equina compromise interpretation with management.

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar herniations. With the co-morbities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Central canal and cauda equina compromise interpretation with management.

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of cervical degeneration. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Spinal cord and canal compromise interpretation with management.

MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of lumbar herniations. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Spinal cord and canal compromise interpretation with management.

MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of degenerative spondylolesthesis, spinal canal stenosis, Modic type 3 changes, central herniations, extrusions, compressions, nerve root compressions, advanced spurring and thecal sac involvement from an orthopedic, emergency room, chiropractic, neurological, neurosurgical, physical medicine perspective.

Comprehensive training in whiplash and brain injury traumatology, emphasizing the biomechanics of injury mechanisms, occupant kinematics, automobile crash reconstruction methods, our most current knowledge of soft tissue, endocinological, bony, and nervous system disorders, advanced imaging techniques, and the comprehensive case management of whiplash and related disorders.

Material covered includes; Theoretical aspects and concepts of the McKenzie Method in Mechanical Diagnosis and Therapy, as applied in the examination and treatment of patients with complaints of low back and related referred pain. Through lectures and patient demonstrations the derangement, dysfunction and postural syndromes are described in detail and appropriate treatment plans are outlined with emphasis on the use of patient self-treatment procedures. The clinical efficacy and limitations of the McKenzie approach as applied to the lumbar spine are illustrated by follow-up patient demonstrations.

Included didactic lectures on the Electro-diagnosis and its practical uses in the field of rehabilitation. Sports related injuries to the shoulder and appropriate rehabilitation while maintaining an active lifestyle. Sports related injuries of the ankle and appropriate rehabilitation strategy while maintaining an active lifestyle. All joints covered included normal biomechanics along with the alteration of biomechanics in injury and alteration of adjacent joint biomechanics due to compensation. Functional clinical assessment of the injury and diagnosis for appropriate clinical protocol. Fundamentals of office ergonomic evaluation and workplace trends in efficiency. Electro-diagnosis and Rehabilitation: The Diagnosis and Management of Radiculopathy.

The purpose of the PSSR training program is to provide in—depth instruction to DCs in post-surgical spine rehabilitation of patients who have undergone spine surgery, including minimally invasive spine surgery. This program emphasizes a continuum model of quality treatment and care for the patient.

Program training in clinical neurology for use in a chiropractic setting.

Introduction to the Electromyographic instrument and overview of functions. Operation of the Cadwell Wave instrument, software and hardware. Introduction to norminative data along with bioinstrumentation exercises. Median, Ulnar and Radial nerve conduction velocity, sensory and motor review. Specialized secondary nerve conduction techniques for carpal tunnel syndrome confirmation. Median nerve H reflex performed. Peroneal nerve motor conduction study performed. Artifacts and common technical difficulties/troubleshooting reviewed.

Comprehensive review of the lower extremity neuromusculoskeletal anatomy relative to electrodiagnostic applications. Anatomy and motor nerve conduction studies of Tibial, Peroneal, Femoral, and Obturator nerves. Anatomy and sensory nerve conduction studies of the Sural, Superficial Peroneal and Saphenous nerves. Lumbar radiculopathy and electrodiagnostic protocols. Review of common neuropathies of the lower and introduction to polyneuropathy. Tibial nerve H-reflex pathay, theory and technique.

Lab review of the Tibial. Peroneal, and Femoral nerves and nerve conduction techniques exerccises. Review of pathways and lab exercises for Tibial nerve H-reflex and F-waves of Tibial and Peroneal nerves. Lab review of pathways and technique of Sural, Superfical Peroneal and Saphenous sensory nerve conduction techniques with lab exercises.

Introduction to the principles of motor unit action potentials and needle EMG including morphology, (normal/abnormal). Review of anatomy of commonly sampled muscles. Introduction to spontaneous potentials with waveform recognition. Clinical correlation and case presentation, overview and employing the use of nerve conduction studies, late responses and needle EMG in a clinical setting.

Review of the motor unit potentials and spontaneous potentials, anatomy review of commonly sampled muscles. Introduction to the bioinstumentation of EMG and use of the software with laboratory exercises. Needle technique with limitation of risks to the patient and the practitioner. Common artifacts and pitfalls of EMG waveform analysis.

Eletrodiagnostic report writing, medio-legal issues in electrodiasgnosis and coding. Substantiating medical necessity, utilization reviews, evidence based rebuttals to denials. How to handle peer issues. Case based practical exercises. Open lab of all techniques.

Overview of the field of electrodiagnosis; Nerve conduction studies, (motor and sensory concepts), late responses, (H reflex and F wave), overview of needle electromyography principles. Introduction to the bioinstrumentation used in electrodiagnosis. Review of the micro and macro anatomy and physiology of the peripheral nervous system, including pathophysiology. Principles of electrodiagnostic interpretation, and case reviews.

Comprehensive review of the upper extremity neuromuscular anatomy including the brachial plexus, median ulnar and radial nerves with emphasis on the electrodiagnostic application. Overall review of the common nerve conduction techniques and clinical applications, (upper extremities). Upper extremity brachial plexus lesions and correlative nerve conduction techniques. Overview of upper extremity neuropathy and review of muscle selection for region.

Covered the AMA Guides to Permanent Impairment, Sixth Edition with regards to musculoskeletal conditions.

The fundamentals of the Pettibon technique of spinal correection including the neurospinal biomechanics and its application in posture correction.

Specifically deals with ancient and modern concepts to include theory, philosophy, history, diagnostic methods and specific acupuncture techniques and practices. The program incorporates procedures and techniques from a variety of countries to include Japan, Korea, Taiwan, Southeast Asia as well as the People's Republic of China. In addition, special emphasis is placed on acupuncture point location of the major meridians, the fundamentals of acupuncture physiology, the concepts of Five Elements, auriculotherapy, scalp acupuncture and hand acupuncture. The program also focuses special emphasis on specific needling techniques, electroacupuncture, laser acupuncture along with precautions, complications and contraindications of an acupuncture practice. Clinical competence, safety to the public and academic excellence is paramount.

Procedures and techniques, indications and contraindicatrions of manipulation under anesthesia were reviewed. Hands on techn ique was reviewed as well as hospital/surgical room protocol was covered.