Toronto, Oct. 24-25
Two-day, 10-hour course taught to rehabilitation therapists
Day 1
(5 hours focused on theory and exam foundations)
12:00 – 1:00 P.M.
I. Neuroanatomy Review
A. Central Autonomic Network structures and functions
B. Key Brainstem nuclei
C. Networks (Default Mode Network, Salience Network and Central Executive Network
identified as being disrupted)
D. Autonomic nervous system
1:00 – 2:00 P.M.
II. Epidemiological Phenotype & Overview of Injury
A. What demographics are most commonly implicated?
B. What are common mechanisms and forces likely to result in a concussive injury?
C. Overview of the pathophysiology of the injury
- Acute
- Sub-acute
- Chronic
2:00 – 3:00 P.M.
III. The Autonomic Nervous System Impairment (ANS) as the Dominant Theory
A. Why the neurometabolic cascade directly leads to autonomic and exertional
intolerance – Connecting theory to the impairment.
B. What challenges exist regarding accurate Dx and management?
C. Differential Dx
D. Signs / symptoms suggestive of protracted recoveries and challenging cases
E. Objective biomarker tracking
3:00 – 4:00 P.M.
IV. The Subgroup Framework
A. Sub-disorder identification: Moving beyond the “concussion” label to identify the
specific drivers: Autonomic, Cervical, Vestibular, Oculo-motor, Sleep, and Mood.
B. Moser et al. Phenotypical Framework: Moving from symptom checklists to
physiological subgroups: Discussing why shifting from symptom-based
management to subgroup-informed customized rehabilitation leads to statistically
significant and clinically meaningful improvements in patient outcomes.
4:00 – 5:00 P.M.
V. Diagnostic Challenges – Psychogenic vs. Physiological
A. Differential Diagnosis: Recognizing red flags and protracted recovery indicators.
B. Psychogenic vs. Physiological: Training clinicians to distinguish symptoms driven
by autonomic/physiological dysregulation from those secondary to anxiety or mood
disorders, while noting that both may require co-management.
Day 2 (5 hours focused on clinical exam foundations and practical component)
8:00 – 9:00 A.M.
I. Key Objective Outcome Measures
A. Patient Reported Outcome Measures to use - Rivermead Postconcussion Symptom Questionnaire
- Neck Disability Index
- Patient Health Questionnaire 9
B. Buffalo Concussion Treadmill Test
C. Cardio-autonomic testing - Resting heart rate
- Supine and standing blood pressure
- Heart rate response to standing and exercise
- Heart rate recovery
- Resting 5-minute HRV
D. Cervical spine joint position error testing
E. Vestibular-oculomotor screen (VOMS)
9:00 – 10:00 A.M.
II. Autonomic Subgroup (Practical)
A. Key history signals
B. Key physical exam elements
C. How to facilitate the recovery
10:00 – 11:00 A.M.
III. Cervical and Vestibulo-Ocular Subgroups (Practical)
A. Key history signals
B. Key physical exam elements
C. How to facilitate the recovery
11:00 – 12:00 P.M.
IV. Sleep and Mood Integration / When & Why to Refer
A. Key history signals
B. Key exam elements
C. How to facilitate the recovery
12:00 – 1:00 P.M.
V. Live case demonstration
A. 10 minutes – Pertinent clinical history details reviewed
B. 30 minutes – Perform physical exam
C. 15 minutes – Discuss differential and treatment plan
D. 5 minutes – POM delivery
BIO:
Dr. Nicholas Moser is a chiropractic specialist and clinical scientist with a focus on complex rehabilitation and autonomic health. He integrates high-level academic research with clinical practice to provide evidence-based care for patients navigating persistent physical and neurological symptoms.
Dr. Moser’s academic journey began at the University of Ottawa, followed by his Doctorate at the Canadian Memorial Chiropractic College (CMCC) in 2015. He subsequently completed a formal postgraduate fellowship in Clinical Sciences, earning his Fellowship with the College of Chiropractic Sciences (Canada). Driven by a commitment to advancing thefield of rehabilitation, he recently completed his PhD in Medical Science at the University of Toronto’s Institute of Medical Science.
Clinical Expertise & Research
Dr. Moser specializes in the management of persistent post-concussion symptoms and spinal health. His doctoral research, conducted at the Toronto Rehabilitation Institute (KITE), focused on the autonomic nervous system and the use of advanced neuroimaging, including fMRI and EEG to better understand how the brain and body recover after injury. His clinical approach is rooted in a systems-based mindset, focusing on top-down autonomic regulation and exercise physiology to facilitate healing. Whether treating chronic neck pain or complex concussion cases, he applies the same rigorous, data-driven methodology used in his published research.
Professional Contributions
A recognized leader in his field, Dr. Moser’s work has been published in numerous
prestigious journals, including:
●The British Medical Journal (BMJ)
●Journal of Neurotrauma
●Journal of Head Trauma Rehabilitation
●Frontiers in Human Neuroscience
●The European Spine Journal
In 2025, he was awarded the Laidlaw Manuscript Competition for his research on concussion recovery, and his academic excellence led to a nomination for the Governor General’s Gold Medal.