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Education and the Controlled Act of Spinal Manipulation

Chiropractic is a regulated health profession with particular expertise in the care of the spine and extremity articulations. The legislated scope of practice of the profession includes the controlled act of spinal manipulation, a therapy that is central to the delivery of care by chiropractors.

Spinal manipulation requires a high degree of skill. The clinical decision to utilize manipulation is determined based on a thorough patient assessment and diagnosis requiring the clinical acumen to determine an appropriate course of treatment.

To ensure that the chiropractic profession is competent to assess, diagnose and provide spinal manipulation, the Council on Chiropractic Education of Canada (CCEC) requires that accredited chiropractic degree programs provide a minimum of 4,200 hours of education encompassing an approved curriculum. The World Health Organization (WHO) has also established 4,200 hours of training for chiropractic education in countries where is there is legislation governing the profession.

As well, the WHO has established a minimum of 2,200 hours of additional training for any other regulated health care professional, whose scope of practice includes the controlled act of manipulation, and who wishes to become proficient in the assessment and diagnosis of neuromusculoskeletal conditions and the application of spinal manipulation to address those conditions.

Therefore, it is the position of the Canadian Chiropractic Association (CCA), that chiropractors be educated in compliance with CCEC standards, and that other health professionals whose scope of practice includes the controlled act of spinal manipulation obtain a minimum of 2,200 hours of additional training that meets CCEC and WHO standards in order to be sufficiently qualified to assess and diagnose neuromusculoskeletal conditions and provide spinal manipulation.

The CCA cautions that public safety is at risk when spinal manipulation is performed by any health professional whose training and education do not meet CCEC and WHO standards.


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