Episode 52 Brain Immune Gut Axis
Shoot me any comments or questions @Rotation2ptoh on X
Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025
Outro Music: Trap Beat (Dripin’ Sauce) by Alex Grohl
Courtesy of Pixabay under Creative Commons non-commercial use.
Produced by: Todd Fredricks DO MSS
Edited by: Todd Fredricks DO MSS
Answers for Episode 51 Sprains and Strains
1) Acute management and expected outcome
A 24‑year‑old recreational basketball player presents 36 hours after an inversion injury. Examination is consistent with a grade II lateral ankle sprain; Ottawa ankle rules are negative. He asks what intervention is most likely to reduce his pain at rest over the next 1–2 weeks. Which is the best evidence‑based recommendation?
A. Early, supervised physical therapy using a multimodal program (e.g., progressive exercise, stretching, thermotherapy/ultrasound or hydrotherapy, and functional training)
2) Outcome interpretation
A 19‑year‑old soccer player undergoes early physical therapy after a grade I ankle sprain. At follow‑up, the clinician reviews expected benefits from the literature. Which outcome did not show a significant difference between physical therapy and conventional treatment in the pooled analysis?
C. Dorsiflexion range of motion (ROM)
3) Evidence synthesis and methodology
In the same review, Trial Sequential Analysis (TSA) showed the Z‑curve crossed the monitoring boundary and reached the required information size for the primary pain outcome. What is the best interpretation of this finding?
A. The cumulative evidence is sufficient to conclude that physical therapy reduces pain versus conventional care while controlling for type I and type II errors
Paper for Next Week:
Jonathan J. Molina, Ana L. Flores-Mireles, CAUTIon – not all UTIs are the same, Nat Rev Urol. 2025 December ; 22(12): 799–814
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