PM&R最新文献

{"title":"Artificial intelligence versus physical medicine and rehabilitation residents: Can ChatGPT compete in clinical exam performance?","authors":"Aylin Ayyıldız, Selda Çiftci İnceoğlu, Banu Kuran, Kadriye Öneş","doi":"10.1002/pmrj.70032","DOIUrl":"https://doi.org/10.1002/pmrj.70032","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence has begun to replace human power in many areas today.</p><p><strong>Objective: </strong>To assess the performance of Chat Generative Pretrained Transformer (ChatGPT) on examinations administered to physical medicine and rehabilitation (PM&R) residents.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Tertiary-care training and research hospital, department of physical medicine and rehabilitation.</p><p><strong>Participants: </strong>ChatGPT-4o and PM&R residents.</p><p><strong>Intervention: </strong>ChatGPT was presented with questions from the annual nationwide in-training exams administered to PM&R residents at different postgraduate years. The exam is a national requirement for the majority of PM&R residents in Turkey and is administered annually.</p><p><strong>Main outcome measures: </strong>The responses to these multiple-choice questions were evaluated as correct or incorrect, and ChatGPT's performance was then compared to that of the residents of each postgraduate year (PGY) term. The time taken by ChatGPT to answer each question was also recorded. Additionally, its learning ability was assessed by reasking the questions it initially answered incorrectly, this time providing the correct answers to evaluate improvement.</p><p><strong>Results: </strong>ChatGPT received a score of 88 out of 100 points in the PGY1 exam, 84 points in the PGY2 exam, 78 points in the PGY3 exam, and 80 points in the PGY4 exam. When compared with the performance distribution of residents, ChatGPT ranked in the 40th-50th percentile for PGY1, 70th-80th percentile for PGY2, 30th-40th percentile for PGY3, and 40th-50th percentile for PGY4. It has been demonstrated that ChatGPT has achieved a learning rate of 65%.</p><p><strong>Conclusion: </strong>Despite the potential of ChatGPT to surpass PM&R physicians in terms of learning capabilities and extensive knowledge network, several functional limitations remain. In its current form, it is not capable of replacing a physician, especially in the field of PM&R, where clinical examination and patient interaction play a critical role.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213386","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 use of dalfampridine (4-aminopyridine) for treatment of ataxia in cerebellar stroke.","authors":"Arjun Kotwal, Prashant Yadav, Veyola Rezkalla, Alison Mautner, Gilbert Siu","doi":"10.1002/pmrj.70036","DOIUrl":"https://doi.org/10.1002/pmrj.70036","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207257","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":"Response to Letter Re: Comment on \"Assessing knowledge about the Americans with Disabilities Act and comfort level in treating persons with disabilities among fourth-year medical students following a clerkship in physical medicine and rehabilitation\".","authors":"Rachel Murray, Einat Engel-Haber, Brittany Snider, Steven Kirshblum","doi":"10.1002/pmrj.70031","DOIUrl":"https://doi.org/10.1002/pmrj.70031","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207333","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":"Ultrasonographic evaluation of ulnar innervated muscles in ulnar neuropathy at the elbow.","authors":"Emmanuel Ogalo, Lee Bauer, Christopher Doherty, Sean G Bristol, Kristine M Chapman, Bc Neuromuscular Disease Group, Emily Krauss, Michael J Berger","doi":"10.1002/pmrj.70020","DOIUrl":"https://doi.org/10.1002/pmrj.70020","url":null,"abstract":"<p><strong>Background: </strong>Quantitative muscle ultrasound (qMUS) provides morphological measurements that can support clinical observation of muscle atrophy and weakness. As the use of qMUS continues to expand, and its potential for broader implementation in neuromuscular evaluation grows, there is a clear need for further validation, particularly in pathologies frequently encountered in electrodiagnostic laboratories, such as cubital tunnel syndrome caused by ulnar neuropathy at the elbow (UNE).</p><p><strong>Objective: </strong>To evaluate the validity of qMUS evaluation of ulnar-innervated intrinsic hand muscles.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Participants: </strong>Individuals 18 years or older with chronic UNE and healthy controls (HC).</p><p><strong>Main outcome measurement: </strong>qMUS parameters (muscle thickness [MT], cross-sectional area [CSA], echogenicity) were measured in the first dorsal interosseous (FDI) and abductor digiti minimi (ADM) and were correlated to corresponding negative peak amplitude of the compound muscle action potential measured (CMAP) and key pinch grip strength.</p><p><strong>Results: </strong>Sixteen adults (8 HC, 8 UNE) participated in the study. Key pinch strength was significantly correlated with FDI MT (r = 0.45, p = .03 [95% CI, 0.05-0.73]) and echogenicity (rho = -0.60, p = .002 [95% CI, -0.82 to -0.24]). FDI MT and echogenicity explained 20% and 36% of pinch strength variance, respectively. Echogenicity was significantly correlated with corresponding CMAP amplitudes (FDI: rho = -0.59, p = .004 [95% CI, -0.81 to -0.21]; ADM: rho = -0.62, p = .002 [95% CI, -0.83 to -0.26]). No statistically significant relationship was found between key pinch strength and FDI CSA (r = 0.35 p = .104 [95% CI, -0.08-0.67]). Furthermore, FDI CMAP was not significantly associated with FDI MT (rho = 0.14, p = .55 [95% CI, -0.32-0.54]) or FDI CSA (rho = 0.041, p = .86 [95% CI, 0.04-0.47]).</p><p><strong>Conclusion: </strong>qMUS measures of echogenicity and MT (indicators of muscle fibrosis and size, respectively), correlated with key pinch strength and CMAP amplitudes in the FDI and ADM, in a heterogenous group including UNE and HC limbs. qMUS parameters may provide useful complementary markers and deeper insight into neuromuscular health in entrapment neuropathy.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200854","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":"Comment on \"Assessing knowledge about the Americans with Disabilities Act and comfort level in treating persons with disabilities among fourth-year medical students following a clerkship in physical medicine and rehabilitation\".","authors":"Rachana Mehta, Ranjana Sah","doi":"10.1002/pmrj.70026","DOIUrl":"https://doi.org/10.1002/pmrj.70026","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207252","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":"Extensor indicis proprius rupture mimicking dorsal wrist ganglion: Role of dynamic ultrasound in diagnosis.","authors":"Wei-Ting Wu, Ke-Vin Chang, Levent Özçakar","doi":"10.1002/pmrj.70011","DOIUrl":"https://doi.org/10.1002/pmrj.70011","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191917","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":"Relief of pain associated with spasticity in adult patients after treatment with onabotulinumtoxinA: Post hoc observational results from the ASPIRE study.","authors":"Jörg Wissel, Cassandra List, Marc Schwartz, Mariana Nelson, Tiziana Musacchio, Esther Duarte","doi":"10.1002/pmrj.70013","DOIUrl":"https://doi.org/10.1002/pmrj.70013","url":null,"abstract":"<p><strong>Background: </strong>Pain is often observed in patients with spasticity, but little is known about the relationship between pain and spasticity and the effectiveness of treating pain with botulinum toxins in these patients.</p><p><strong>Objective: </strong>To explore onabotulinumtoxinA (onabotA) use and pain relief in patients with spasticity with pain at baseline.</p><p><strong>Design: </strong>Subanalysis of a 2-year multicenter, prospective, observational study (ASPIRE [Adult Spasticity International Registry], NCT01930786).</p><p><strong>Setting: </strong>Fifty-four international clinical sites.</p><p><strong>Participants: </strong>Adults with spasticity (N = 494) and pain at baseline (Numeric Pain Rating Scale [NPRS]>0) across multiple etiologies and age groups.</p><p><strong>Intervention: </strong>OnabotA administered at clinician's discretion.</p><p><strong>Main outcomes: </strong>OnabotA use, pain measured with the NPRS and Disability Assessment Scale (DAS), patient- and physician-reported satisfaction, and safety.</p><p><strong>Results: </strong>Of 730 patients who received ≥1 onabotA dose in ASPIRE, 494 (68%) had baseline pain (mean age, 54 years; stroke, 56%; naïve to onabotA, 38%; NPRS ≥5, 65%). Average onabotA dose per treatment session (Tx) ranged from 345 to 463 U. Pain reduction from baseline was observed across all Tx; mean NPRS decreased from 5.4 to 2.6 at Tx8, model estimated mean NPRS was significantly reduced after each Tx (Tx1-7, p ≤ .001; Tx8, p ≤ .005), and a high proportion achieved clinically meaningful pain reductions across Tx1-4 (mean NPRS decreased by ≥30% for 49%-59%, by ≥50% for 40%-49%, and by ≥70% for 24%-34% of patients). Relief of pain was supported by significant improvements from baseline on the DAS pain subscale across most Tx with most patients/physicians being satisfied with onabotA treatment. Overall, 15 patients (3%) reported 17 treatment-related adverse events (TRAEs), and 2 patients (0.4%) reported 3 serious TRAEs.</p><p><strong>Conclusion: </strong>In patients with spasticity experiencing pain, long-term onabotA treatment demonstrated consistent clinically meaningful reductions in pain, reduced pain disability on DAS, and high patient and physician satisfaction with no new safety signals identified, regardless of prior onabotA treatment or age groups.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192312","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":"Visual disorder and sensory integration in 3- to 6-year-old children with cerebral visual impairment and cerebral palsy.","authors":"Mustafa Cemali, Sümeyye Belhan Çelik","doi":"10.1002/pmrj.70001","DOIUrl":"https://doi.org/10.1002/pmrj.70001","url":null,"abstract":"<p><strong>Background: </strong>Sensory and behavioral difficulties are frequently observed in children with cerebral palsy (CP), and these challenges may intensify when cerebral visual impairment (CVI) co-occurs. However, the extent and nature of these combined effects remain underexplored.</p><p><strong>Objective: </strong>The aim of this study is to compare sensory processing skills and behavior of children with CP and CVI, CP without CVI, and typically development (TD) and to examine the relationship between sensory processing skills and behavior in children in these groups.</p><p><strong>Design: </strong>Prospective, cross-sectional study with control group.</p><p><strong>Setting: </strong>Special education and rehabilitation center.</p><p><strong>Participants: </strong>A total of 120 children aged 3-6 years, consisting of three groups, were included in the study: 40 children with CP and CVI, 40 children with CP without CVI, and 40 children with TD.</p><p><strong>Main outcomes measures: </strong>The Sensory Profile (SP) was used to assess sensory skills and the Child Behavior Rating Scale (CBRS) was used to assess behavior.</p><p><strong>Results: </strong>There were significant differences in all pairwise comparisons between the three groups and between SP subdomains and CBRS scores (p < .05). Children with CP and CVI had the lowest median scores (SP: 7-78.5; CBRS: 26), followed by those with CP without CVI (SP: 9-95; CBRS: 33), whereas TD children had the highest scores (SP: 12-129; CBRS: 49). These findings suggest a trend toward worsening sensory and behavioral outcomes in the presence of CVI in addition to CP and in CP alone. Furthermore, moderate to strong positive correlations were observed between SP and CBRS scores in all groups (rho = 0.468-0.872; p < .001), suggesting that behavioral problems increase with decreased sensory processing skills.</p><p><strong>Conclusions: </strong>This study reveals that children with CP have more problems in sensory processing and behavioral functioning compared to their peers with TD and that these problems are exacerbated in the presence of CVI accompanying CP. In addition, the significant relationship observed between the decrease in sensory processing skills and the increase in behavioral problems emphasizes the importance of evaluating these two areas together and adopting a holistic approach in intervention planning.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192479","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":"Are psychological factors associated with patient-reported pain and function in individuals with hip joint-related pain? A systematic review.","authors":"Kate N Jochimsen, James D Doorley, Jennifer Monnin, Joshua E Cohen, Hunter Robinson, William K Vasileff, Cale A Jacobs, Stephanie Di Stasi, Ana-Maria Vranceanu","doi":"10.1002/pmrj.70015","DOIUrl":"https://doi.org/10.1002/pmrj.70015","url":null,"abstract":"<p><strong>Objective: </strong>To examine associations between (1) baseline psychological factors and pain and function, (2) baseline psychological factors and postintervention (nonoperative or surgery) pain and function, and (3) how psychological factors change following intervention in patients with hip joint-related pain.</p><p><strong>Literature survey: </strong>In July 2021 and June 2023, PubMed, Scopus, Web of Science Core Collection, CINAHL with Full Text, and SPORTDiscus were searched. Search strategies are available in our institutional repository. Quantitative research studies (observational, interventional, case-series/case-control) on hip joint--related pain were included if one psychological and one pain or functional patient-reported outcome measure were reported. Qualitative methods, non-hip joint-related pain pathologies, nonoriginal/non-peer-reviewed, review papers, dissertation/thesis, conference proceedings, book chapters, and protocols were excluded.</p><p><strong>Methodology: </strong>Two authors screened titles/abstracts and read all articles to confirm eligibility. Results were reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk of bias was assessed using National Institutes of Health Study Quality Assessment Tools. Data (demographics, diagnosis, psychological factors, pain/function, intervention) were extracted. A quantitative analysis was not performed due to lack of study homogeneity and outcome data. Descriptive data and Grading of Recommendations Assessment, Development, and Evaluation ratings were reported.</p><p><strong>Synthesis: </strong>A total of 6040 abstracts/titles and 93 full texts were screened. Sixty articles published between 2007 and 2023 were included. Most were observational, with acceptable quality and moderate-to-low-level bias. Nineteen studies examined baseline associations between psychological factors and pain and function. Of those, 17 studies (89.5%) identified at least one association. Twenty-six studies examined the association between baseline psychological factors and postintervention pain and function. Twenty of these studies (76.9%) identified an association. It is unclear whether or how psychological factors change following intervention.</p><p><strong>Conclusions: </strong>There is consistent, low- to moderate-grade evidence supporting an association between psychological factors and pain and function in patients with hip joint-related pain at baseline and following intervention. There is inconsistent, very low-grade evidence on whether psychological factors improve following intervention.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186505","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":"Platelet-rich plasma outcomes in knee osteoarthritis are associated with the amount of total deliverable platelets: A systematic review and meta-analysis.","authors":"Nicholas Hooper, Shane Shapiro, Vineet Paidsetty, Aydin Azarpey, Alexa Jindal, Kenneth Mautner, Kirk Easley, Don Buford, Walter Sussman, Prathap Jayaram","doi":"10.1002/pmrj.13455","DOIUrl":"https://doi.org/10.1002/pmrj.13455","url":null,"abstract":"<p><strong>Objective: </strong>The goal of this study was to examine if differing platelet counts in platelet-rich plasma (PRP) formulations affected overall pain and function outcomes when compared to hyaluronic acid or placebo control saline injections.</p><p><strong>Design/methods: </strong>We conducted a systematic review and meta-analysis (International Prospective Register of Systematic Reviews CRD42022340057) evaluating randomized controlled trials comparing injections of PRP to hyaluronic acid (HA) or saline (NS) control in patients with mild or moderate knee osteoarthritis. All studies used a validated outcome measure that examined pain, function, or overall patient global assessment. Study PRP interventions were subclassified as investigating the total number of platelets delivered in a low dose (1-5 billion total deliverable platelets), moderate dose (5-10 billion total deliverable platelets), or high dose (greater than 10 billion total deliverable platelets) injected into the joint.</p><p><strong>Results: </strong>A total of 32 trials met inclusion criteria. All three PRP groups had significant improvements in validated patient-reported outcomes when compared to HA. Both the \"low\" and \"high\" platelet count groups resulted in a moderate effect size, respectively (standardized mean difference [SMD] = .47; 95% confidence interval [CI] .05-0.89, p < .01; SMD = .68; 95% CI .26-1.09, p < .01). Only the \"moderate\" (SMD = 1.48; 95% CI .71-2.58 p < .01) platelet count group resulted in large effect size on validated patient-reported outcomes. When compared to NS, all three PRP groups resulted in significant large effect sizes when examining pain reduction.</p><p><strong>Conclusions: </strong>When compared to HA, PRP with platelet counts between 1 and 10 billion total deliverable platelets may result in a larger decrease in pain symptoms when compared to platelet counts greater than 10 billion at 6 months. In addition, platelet counts between 5 and 10 billion total deliverable platelets may be associated with greater improvement in functional outcomes.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113967","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}