Physical Therapy最新文献

{"title":"Patient and Clinician Perceptions of a \"People-Like-Me\" Tool for Personalized Rehabilitation After Total Knee Arthroplasty: A Qualitative Interview Study.","authors":"Laura Churchill, Jeremy Graber, Meredith Mealer, Charles A Thigpen, Dan D Matlock, Michael J Bade, Jennifer E Stevens-Lapsley","doi":"10.1093/ptj/pzaf058","DOIUrl":"10.1093/ptj/pzaf058","url":null,"abstract":"<p><strong>Objective: </strong>The author team developed a decision support tool to help physical therapists address the varied expectations and recoveries of the total knee arthroplasty (TKA) population. The purpose of this study was to explore patients' and clinicians' perceptions and experiences with the tool during rehabilitation after TKA.</p><p><strong>Methods: </strong>The tool was piloted in 2 outpatient physical therapy clinics. An in-depth semi-structured interview was conducted with patients who underwent TKA and were exposed to the tool during rehabilitation, and with clinicians who used the tool with patients after TKA. Two members of the research team coded the interview data using a descriptive content analysis.</p><p><strong>Results: </strong>Sixteen patients and 10 clinicians were interviewed. Four common themes were identified: (1) expectations: most patients and clinicians felt the tool provided patients with valuable feedback for managing recovery expectations; (2) motivation: patients and clinicians felt the tool motivated patients to participate in rehabilitation by providing positive reinforcement and/or a form of competition; (3) influence on practice: some patients and clinicians indicated that the tool helped guide treatment decisions or provided opportunities for patient education, but most felt it did not influence clinical decision making; and (4) clarity and comprehension: the majority of patients understood the tool's \"take-home\" message, however, some patients and clinicians felt the use of percentiles, line graphs, and medical jargon decreased patients' clarity and comprehension of the tool.</p><p><strong>Conclusions: </strong>Overall, participants reported that the tool helped to shape patients' expectations for postoperative recovery and increase patient motivation to participate in rehabilitation. Participants had mixed perceptions on how the tool influenced clinical care. Finally, participants identified some limitations in patient comprehension of the tool, which will inform future revisions to the tool to accommodate varying levels of health literacy.</p><p><strong>Impact: </strong>A clinical decision support tool that provided individualized projections of TKA recovery was helpful to patients and clinicians during TKA rehabilitation to set expectations and increase patient motivation. Revisions to the tool and how it is implemented may enhance its future utility and potential to impact clinical practice.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Experiences of a Group Intervention Integrating Vestibular Rehabilitation, Body Awareness, and Cognitive Behavioral Therapy for Long-Lasting Dizziness: A Focus Group Study.","authors":"Liv Heide Magnussen, Kjersti Thulin Wilhelmsen, Målfrid Råheim","doi":"10.1093/ptj/pzaf062","DOIUrl":"https://doi.org/10.1093/ptj/pzaf062","url":null,"abstract":"<p><strong>Objective: </strong>Long-lasting dizziness is a distressing and disabling condition frequently accompanied by psychological and physical discomfort, and if untreated, could evolve into a complex, self-perpetuating condition challenging treatment. A treatment approach addressing psychological, physical, and social ailments in connection with long-term dizziness has been developed. The objective of this study was to explore experiences and perceptions of participants with long-lasting dizziness who have engaged in a group-based intervention approach that combines principles from vestibular rehabilitation (VR), body awareness therapy (BA), and cognitive behavioral therapy (CBT) in primary care.</p><p><strong>Methods: </strong>The study is rooted in an interpretative approach. Fifteen participants, 10 women and 5 men, aged 38 to 71 years, were interviewed in 3 focus groups. Data were analyzed by systematic text condensation, a 4-step thematic cross-case strategy suitable for exploratory investigations.</p><p><strong>Results: </strong>Four main themes emerged from the analyses: 1) To share and feel understood when struggling with dizziness, 2) The exercises: body perceptions and challenging one's own limits to control dizziness, 3) Increased self-knowledge helps to process anxiety and challenge avoidance behavior, 4) Changing habits is hard work, but necessary to recover from dizziness.</p><p><strong>Conclusions: </strong>This novel group-based VR-BA-CBT treatment for individuals with long-lasting dizziness offered valuable peer support, shared learning, and learning in action providing new understanding. The VR-BA-CBT treatment includes a comprehensive and holistic approach addressing physical, psychological, and social challenges.</p><p><strong>Impact: </strong>Through knowledge about dizziness triggers, participants learn new strategies to confront previously avoided activities. The approach holds promise to be implemented in primary care physical therapy settings.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Function Differences by COVID-19 Status: A Cross-Sectional Analysis from the RECOVER Adult Cohort.","authors":"Grace L Kulik Née Ditzenberger, Tianyu Zheng, Sarah E Jolley, Hassan Ashktorab, Hassan Brim, Elen M Feuerriegel, John W Hafner, Rachel Hess, Benjamin D Horne, Mady Hornig, Brandon Johnson, C Kim, Adeyinka O Laiyemo, Grace A McComsey, Janko Ž Nikolich, Kayleigh Reid, John Scherry, Zaki A Sherif, Huong G Tran, Monica Verduzco-Gutierrez, Shelby West, Kristine M Erlandson","doi":"10.1093/ptj/pzaf063","DOIUrl":"https://doi.org/10.1093/ptj/pzaf063","url":null,"abstract":"<p><strong>Importance: </strong>Many adults with prior SARS-CoV-2 infection have persistent limitations, but few studies have examined objective physical function impairment that persist longer than 3 months after infection.</p><p><strong>Objective: </strong>The objective was to characterize physical function impairment among adults with and without SARS-CoV-2 infection.</p><p><strong>Design: </strong>This study was a retrospective, cross-sectional analysis.</p><p><strong>Setting: </strong>Researching COVID to Enhance Recovery (RECOVER) initiative, a multi-site observational study in the United States (ClinicalTrials.gov: NCT05172024).</p><p><strong>Participants: </strong>Participants were adults ≥18 years old with and without SARS-CoV-2 infection.</p><p><strong>Exposures: </strong>Groups were defined based on COVID-19 status at enrollment: never diagnosed (control), diagnosed with COVID-19 ≤ 12 weeks (recent COVID-19), or > 12 weeks prior to enrollment (remote COVID-19). The RECOVER-Adult Long COVID Index was used to further characterize by Index ≥12 versus 0.</p><p><strong>Main outcomes/measures: </strong>Physical function (main outcome) was assessed by number of repetitions on a 30-second sit-to-stand test (30STS).</p><p><strong>Results: </strong>30STS assessments at enrollment were available from 11,578 participants. 30STS repetitions were lowest in the remote COVID-19 group (n = 4942) with 11.5 (SD = 4.2) repetitions compared to 12.5 (SD = 4.7) repetitions among controls (n = 1887) or 12.2 (SD = 4.5) in recent COVID-19 (n = 4698). Remote COVID-19, but not recent COVID-19, was associated with lower physical function in the adjusted model (-0.61 repetitions; SD = 0.21). Those with RECOVER Long COVID Research Index ≥12 performed 1.6 (SD = 0.2) fewer repetitions than those with an Index equal 0.</p><p><strong>Conclusions: </strong>Physical function impairment did not show clinically meaningful group differences between RECOVER Adult Cohort participants by COVID-19 status, or by Long COVID Index. Individual responses over time or in response to an intervention may be more clinically relevant.</p><p><strong>Relevance: </strong>In the RECOVER adult cohort, overall physical function differences by time since COVID-19 or by Long COVID Index were small. Individualized assessments are needed to determine functional impairment following COVID-19 diagnosis and subsequent steps for rehabilitation interventions.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Beliefs, Perceptions, and Experiences of Individuals with Tendinopathy: A Systematic Review and Meta-Ethnography of Qualitative Studies.","authors":"Mark S Mesiha, Steven J Obst, Samantha Randall, Amanda Rebar, Cassandra K Dittman, Luke J Heales","doi":"10.1093/ptj/pzaf060","DOIUrl":"https://doi.org/10.1093/ptj/pzaf060","url":null,"abstract":"<p><strong>Importance: </strong>This study systematically examines the effects of tendinopathy on patients' quality of life and investigates their experiences with rehabilitation.</p><p><strong>Objective: </strong>This study aims to synthesize qualitative research exploring the beliefs, perceptions, and experiences of individuals living with tendinopathy by employing a systematic review with meta-ethnography.</p><p><strong>Data sources: </strong>Studies were identified from 4 databases (CINAHL, EMBASE, Scopus, and ProQuest One Academic).</p><p><strong>Study selection: </strong>Studies were included if they utilized qualitative methods to investigate beliefs, perceptions, and/or experiences of participants with clinically diagnosed tendinopathy.</p><p><strong>Data extraction and synthesis: </strong>Data synthesis was completed using the 7 phases of meta-ethnography and reported using the eMERGe guidelines. Risk of bias was assessed using the Joanna Briggs Checklist for Qualitative Studies. Confidence in the findings was assessed using the Grading of Recommendations Assessment, Development and Evaluation Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual).</p><p><strong>Main outcomes(s) and measure(s): </strong>Twenty-three studies were included (rotator cuff [n = 12]; Achilles [n = 6]; gluteal [n = 2]; lateral elbow [n = 2]; and mixed tendinopathies [n = 1]). Methodological quality of included studies varied. Moderate confidence in review findings 1 and 2, and high confidence in review finding 3.</p><p><strong>Results: </strong>Qualitative synthesis identified 3 themes: (1) I need to understand why my tendon hurts (participants wanted clarity regarding the cause of symptoms); (2) I want to fix my tendon, but I don't know how (participants had varied beliefs regarding optimal management and how to reduce their pain); and (3) I am uncertain whether my lifestyle will return to normal (participants felt frustrated with the negative impact that tendinopathy had on their life).</p><p><strong>Conclusion and relevance: </strong>This review provides insights into the lived experiences of individuals with tendinopathy. The review advocates for clearer communication and education regarding causes and optimal management of tendinopathy. Participants' varied beliefs and uncertainties about treatment efficacy suggest that health care providers consider individualized evidence-based guidance to improve patient outcomes.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Barriers to the Use of a Low Back Pain Clinical Practice Guideline in Physical Therapist Practice: A Mixed-Methods Approach.","authors":"Matthew R Schumacher, Kyle A Cottone, Laura M Siviter, Casey J Rentmeester, Daniel I Rhon, Jodi L Young","doi":"10.1093/ptj/pzaf059","DOIUrl":"https://doi.org/10.1093/ptj/pzaf059","url":null,"abstract":"<p><strong>Importance: </strong>Low adherence rates to low back pain (LBP) clinical practice guidelines (CPGs) by physical therapists have been reported in the United States (US); however, no studies have explored barriers to their use.</p><p><strong>Objective: </strong>The aim of this study was to explore perceived barriers physical therapists face for implementing the most recent LBP CPG from American Physical Therapy Association Orthopaedic.</p><p><strong>Design: </strong>This was a convergent parallel mixed-methods design.</p><p><strong>Setting: </strong>This was completed virtually.</p><p><strong>Participants: </strong>A total of 173 US outpatient physical therapists completed the survey, with 20 participating in focused interviews.</p><p><strong>Intervention(s) or exposure(s): </strong>Participants completed an online survey and semi-structured virtual interviews.</p><p><strong>Main outcome(s) and measure(s): </strong>The primary outcomes were the top barriers identified through survey data and thematic analysis of interviews. A thematic analysis was implemented for the qualitative analysis. A binary logistic regression was used to model relationships between demographic variables, barriers, and CPG use.</p><p><strong>Results: </strong>Six themes related to barriers to CPG implementation were identified through interviews including a lack of individualized care, a lack of skills/confidence, patient expectations/perceptions, previous experience, time limitations, and proper understanding of the guidelines. Participants who completed an orthopaedic residency program were more likely to report the barrier of \"difficulties with 1-on-1 care\" (OR = 8.70, 95% CI = 2.12-39.22). Individuals practicing between 1 to 5 years (OR = 7.49, 95% CI = 1.39-52.75) compared to 20+ years and those reporting regular use of the CPG (OR = 5.81, 95% CI = 1.99-21.51) were more likely to report the barrier of \"concern for patient's response.\"</p><p><strong>Conclusion: </strong>Novice clinicians and those who completed orthopaedic residency reported barriers to CPG use. Six major themes related to barriers for implementing the CPG were identified, consistent with majority of the barriers reported in the survey, demonstrating the convergence of analyses. The most common barrier was the perception of sacrificing individualized care.</p><p><strong>Impact: </strong>This study may help improve adoption and implementation of CPGs in real-world clinical practice settings.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On \"Effectiveness of Cognitive Functional Therapy Versus Core Exercises and Manual Therapy in Patients With Chronic Low Back Pain After Spinal Surgery: Randomized Controlled Trial.\" Avila L, da Silva M, Neves M, et al. Phys Ther. 2024;104:pzad105. https://doi.org/10.1093/ptj/pzad105.","authors":"Wei-Chun He, Jing Luo","doi":"10.1093/ptj/pzaf055","DOIUrl":"https://doi.org/10.1093/ptj/pzaf055","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author response to Luo and He.","authors":"Leonardo Avila, Morgana Duarte Silva, Marcos Lisboa Neves, Andre Rogerio Abreu, Cibelle Ramos Fiuza, Leandro Fukusawa, Arthur Sá Ferreira, Ney Meziat-Filho","doi":"10.1093/ptj/pzaf056","DOIUrl":"https://doi.org/10.1093/ptj/pzaf056","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Whole-Body Vibration Therapy on Physical Function in Children With Cerebral Palsy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.","authors":"Chi-Hung Huang, Chi-Ying Chen, Ho-Wei Lin, Yu-Fen Chiu, Li-Fong Lin, Ka-Wai Tam, Tung-Wu Lu, Shih-Wen Chiang, Yi-Chun Kuan","doi":"10.1093/ptj/pzaf052","DOIUrl":"https://doi.org/10.1093/ptj/pzaf052","url":null,"abstract":"<p><strong>Objective: </strong>Although whole-body vibration (WBV) is often employed alongside traditional physical therapies to treat cerebral palsy, its effects on motor function remain unclear. Therefore, this study investigated the effects of WBV either alone or in combination with other therapies in children with cerebral palsy, compared with control groups that underwent traditional physical therapy or remained untreated.</p><p><strong>Methods: </strong>We analyzed randomized controlled trials published up to September 2024 that assessed motor function in WBV and control groups, including those receiving conventional physical therapy or no intervention. Articles were retrieved from PubMed, EMBASE, Scopus, and the Cochrane Library. The random-effects model was used to analyze the outcomes of these trials.</p><p><strong>Results: </strong>Our search yielded 23 studies involving 729 participants. Compared with the control group, the WBV group exhibited significantly greater improvements in walking speed (pooled mean difference: 14.26 cm/s [95% CI = 6.45 to 22.08 cm/s]), Timed \"Up & Go\" Test results (pooled mean difference = -2.52 seconds [95% CI = -3.66 to -1.37 seconds]), Gross Motor Function Measure scores (total score: pooled mean difference = 0.69 [95% CI = 0.30 to 1.08]; dimension D: pooled mean difference = 3.41 [95% CI = 0.53 to 6.29]; dimension E: pooled mean difference = 3.28 [95% CI = 1.36 to 5.20]), and overall stability index values (standardized mean difference = -1.20 [95% CI = -2.28 to -0.11]). The Modified Ashworth Scale results varied between the muscle groups, and no intolerable adverse effects of WBV were reported.</p><p><strong>Conclusion: </strong>WBV improves postural control and motor performance in children with cerebral palsy by enhancing walking speed, Timed \"Up & Go\" Test performance, and gross motor function without causing intolerable adverse effects. However, the certainty of the current evidence on the topic is very low or low. Additional well-structured trials are required to determine the optimal intensity of WBV treatment.</p><p><strong>Impact: </strong>Given its therapeutic benefits and safety, WBV may be considered as an adjunctive therapy for managing cerebral palsy, particularly for children with spastic cerebral palsy.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between Fear of Movement and Physical Activity in Patients with Cardiac, Rheumatologic, Neurologic, Pulmonary, or Pain Conditions: A Systematic Review and Meta-Analysis.","authors":"Miriam Goubran, Ataallah Farajzadeh, Ian M Lahart, Martin Bilodeau, Matthieu P Boisgontier","doi":"10.1093/ptj/pzaf050","DOIUrl":"https://doi.org/10.1093/ptj/pzaf050","url":null,"abstract":"<p><strong>Objective: </strong>Physical activity contributes to the primary, secondary, and tertiary prevention of multiple diseases. However, in some patients, fear of movement may induce avoidance behaviors and reduce engagement in physical activity. This study aims to examine whether this fear of movement is negatively associated with physical activity across several health conditions, and what factors may influence this relationship.</p><p><strong>Methods: </strong>Five databases were searched for studies including both a measure of fear of movement and physical activity. Two reviewers screened articles for inclusion, assessed risk of bias, and extracted data from each study. Pearson product-moment correlations were pooled from eligible studies using the generic inverse pooling and random effects method to examine the relationship between fear of movement and physical activity.</p><p><strong>Results: </strong>Seventy-four studies were included in the systematic review and 63 studies (83 estimates, 12,278 participants) in the main meta-analysis. Results showed a negative correlation between fear of movement and physical activity (r = -0.19 [95% CI = -0.26 to -0.13]; I2 = 85.5%). Funnel plot analysis showed evidence of publication bias, but p-curve analysis suggested that our results could not be caused by selective reporting. A subgroup meta-analysis showed that the correlation was statistically significant in patients with cardiac, rheumatologic, neurologic, or pulmonary conditions, but not in patients with chronic or acute pain.</p><p><strong>Conclusions: </strong>Our results suggest that higher levels of fear of movement are associated with lower levels of physical activity in several health conditions that are not necessarily painful.</p><p><strong>Impact: </strong>Fear of movement should be dissociated from pain and considered in relation to specific health conditions when implementing exercise therapy. Fear of movement may have prognostic and therapeutic implications in patients for whom physical activity contributes to prevent recurrence or worsening of their condition.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Potential of Large Language Models for Vestibular Rehabilitation Education: A Comparison of ChatGPT, Google Gemini, and Clinicians.","authors":"Yael Arbel, Yoav Gimmon, Liora Shmueli","doi":"10.1093/ptj/pzaf010","DOIUrl":"10.1093/ptj/pzaf010","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the performance of 2 large language models, ChatGPT (Generative Pre-trained Transformer) and Google Gemini, against experienced physical therapists and students in responding to multiple-choice questions related to vestibular rehabilitation. The study further aimed to assess the accuracy of ChatGPT's responses by board-certified otoneurologists.</p><p><strong>Methods: </strong>This study was conducted among 30 physical therapist professionals experienced with vestibular rehabilitation and 30 physical therapist students. They were asked to complete a vestibular knowledge test (VKT) consisting of 20 multiple-choice questions that were divided into 3 categories: (1) Clinical Knowledge, (2) Basic Clinical Practice, and (3) Clinical Reasoning. ChatGPT and Google Gemini were tasked with answering the same 20 VKT questions. Three board-certified otoneurologists independently evaluated the accuracy of each response using a 4-level scale, ranging from comprehensive to completely incorrect.</p><p><strong>Results: </strong>ChatGPT outperformed Google Gemini with a 70% score on the VKT test, while Gemini scored 60%. Both excelled in Clinical Knowledge scoring 100% but struggled in Clinical Reasoning with ChatGPT scoring 50% and Gemini scoring 25%. According to 3 otoneurologic experts, ChatGPT's accuracy was considered \"comprehensive\" in 45% of the 20 questions, while 25% were found to be completely incorrect. ChatGPT provided \"comprehensive\" responses in 50% of Clinical Knowledge and Basic Clinical Practice questions, but only 25% in Clinical Reasoning.</p><p><strong>Conclusion: </strong>Caution is advised when using ChatGPT and Google Gemini due to their limited accuracy in clinical reasoning. While they provide accurate responses concerning Clinical Knowledge, their reliance on web information may lead to inconsistencies. ChatGPT performed better than Gemini. Health care professionals should carefully formulate questions and be aware of the potential influence of the online prevalence of information on ChatGPT's and Google Gemini's responses. Combining clinical expertise and clinical guidelines with ChatGPT and Google Gemini can maximize benefits while mitigating limitations. The results are based on current models of ChatGPT3.5 and Google Gemini. Future iterations of these models are expected to offer improved accuracy as the underlying modeling and algorithms are further refined.</p><p><strong>Impact: </strong>This study highlights the potential utility of large language models like ChatGPT in supplementing clinical knowledge for physical therapists, while underscoring the need for caution in domains requiring complex clinical reasoning. The findings emphasize the importance of integrating technological tools carefully with human expertise to enhance patient care and rehabilitation outcomes.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}