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Evaluating change in self-reported function and pain in patients with musculoskeletal concerns attending a physiotherapy student-led service 评估参加物理治疗学生主导服务的肌肉骨骼问题患者自我报告功能和疼痛的变化
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2026-06-01 Epub Date: 2025-12-08 DOI: 10.1016/j.physio.2025.101866
Andrea Hams , Chloe Prudden , Emmah Baque , Tyler Collings , Sandy Edwards , Renae Shepherd , Taryn Jones

Background

Musculoskeletal conditions contribute significantly to global health burden through impaired function and pain. Physiotherapy student-led services provide a model for addressing community healthcare needs while offering clinical training experiences. Despite their prevalence, description of patient demographics and clinical outcomes (function and pain) remains under-explored.

Objectives

To evaluate changes in self-reported function and pain and describe patient demographics and presenting musculoskeletal conditions of patients accessing a student-led service.

Design setting and participants

Observational pre-post study at a student-led musculoskeletal physiotherapy service in Australia involving ninety-nine community-dwelling participants (Mdn age = 29 years, IQR = 22–40).

Methods

Final-year physiotherapy students managed patient care under senior physiotherapist supervision. Demographic and presenting condition data were collected at the initial appointment, while self-reported outcome measures of function (Patient Specific Functional Scale: PSFS) and pain (Numeric Pain Rating Scale: NPRS) were recorded at all appointments.

Results

A significant positive correlation was observed between appointment frequency and PSFS scores. At each appointment, the PSFS score increased by 0.8 units (95% CI 0.4 to 1.1, p < .001). There was a significant negative correlation between appointment frequency and NPRS scores, with each appointment associated with a 0.6 unit decrease in NPRS scores (95% CI: -0.8 to -0.4, p < 0.001).

Conclusions

This study adds to growing evidence describing patient-reported outcomes within student-led physiotherapy services, showing that patients attending reported improvement in self-reported function and pain. Limitations of a pragmatic service evaluation are acknowledged; further multi-site longitudinal research is recommended.

Contribution of the Paper

  • Patients attending a physiotherapy student-led service reported improvement in self-reported function and reduction in pain.
  • Student-led services may support addressing the community need for musculoskeletal care while providing meaningful clinical learning for students.
肌肉骨骼疾病通过功能受损和疼痛对全球健康负担做出了重大贡献。理疗学生主导的服务为解决社区医疗保健需求提供了一种模式,同时提供临床培训经验。尽管它们很普遍,但对患者人口统计学和临床结果(功能和疼痛)的描述仍未得到充分探讨。目的评估自我报告的功能和疼痛的变化,描述患者的人口统计学特征,并呈现学生主导服务的患者的肌肉骨骼状况。设计环境和参与者:澳大利亚一项由学生主导的肌肉骨骼物理治疗服务的观察性前后研究,涉及99名社区居民参与者(Mdn年龄= 29岁,IQR = 22-40)。方法:高年级物理治疗学生在高级物理治疗师的监督下管理患者护理。在初次预约时收集人口统计学和表现状况数据,同时在所有预约时记录自我报告的功能(患者特定功能量表:PSFS)和疼痛(数字疼痛评定量表:NPRS)的结果测量。结果就诊次数与PSFS评分呈显著正相关。每次就诊时,PSFS评分增加0.8个单位(95% CI 0.4 ~ 1.1, p < 0.001)。预约频率与NPRS评分之间存在显著的负相关,每次预约与NPRS评分下降0.6个单位相关(95% CI: -0.8至-0.4,p < 0.001)。结论:本研究增加了越来越多的证据,描述了学生主导的物理治疗服务中患者报告的结果,表明参加治疗的患者报告自我报告的功能和疼痛有所改善。认识到实用服务评价的局限性;建议进一步开展多地点纵向研究。•参加物理治疗学生主导服务的患者报告自我报告的功能改善和疼痛减轻。•学生主导的服务可以支持解决社区对肌肉骨骼护理的需求,同时为学生提供有意义的临床学习。
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引用次数: 0
The ExtRA Capacity Test: Reliability, validity and normative data of a new clinical tool for assessing shoulder muscle performance 额外的能力测试:可靠性,有效性和规范性数据的一个新的临床工具评估肩肌肉的表现
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2026-06-01 Epub Date: 2025-12-11 DOI: 10.1016/j.physio.2025.101868
Harry Ford , Jeremy Lewis , Vasileios Tyros , Daniel C. Low , William R. Bateman , Youmin Lee , Raj Sakadasariya , Joshua Rex , Matthew Oldfield , Marco Davare , Aliah Faisal Shaheen
<div><h3>Objectives</h3><div>Introduce The ExtRA Capacity Test, a measure for assessing shoulder muscle performance. Assess its reliability, validity and present normative scores in a large sample of asymptomatic adults.</div></div><div><h3>Design</h3><div>Cross-sectional observational study with test–retest.</div></div><div><h3>Setting</h3><div>Community.</div></div><div><h3>Participants</h3><div>Volunteers (<em>n</em> = 344, age 20–90 years).</div></div><div><h3>Interventions</h3><div>The ExtRA Capacity Test involves two capacity tests completed to a 30 beats per minute metronome: maximal scapular plane lateral raises to 90° abduction with 2.5 kg of external load, and maximal external rotations in unsupported prone lying with the shoulder at 90° abduction.</div><div>Reliability was assessed in 30 asymptomatic participants, tested by two raters over two sessions, one week apart, using Bland–Altman analysis to determine mean bias and 95 % limits of agreement (LoA) as measures of error. Criterion validity was evaluated in 20 participants using Pearson correlation to examine the relationship between ExtRA and isokinetic dynamometry measures. A normative dataset was also established from 344 asymptomatic individuals across a range of ages, physical activity levels, and both sexes.</div></div><div><h3>Results</h3><div>The intra-rater and inter-rater agreement for the ExtRA Capacity Test was assessed in a sample of 30 participants. The 95 % LoA for abduction and external rotation measurements ranged from 2.9 to 13.1 repetitions. In a sample of 20 participants, the abduction test showed good/moderate correlation with muscle strength measures but not with the external rotation test. Older age, female sex and not achieving the WHO activity guidelines have a negative impact on ExtRA performance.</div></div><div><h3>Conclusions</h3><div>Within the caveats discussed in this paper, ExtRA can be considered a reasonably reliable tool for assessing shoulder strength and control in a clinical setting. The normative database will help clinicians set rehabilitation or return-to-play targets based on sex, age, and physical activity level.</div></div><div><h3>Contributions of Paper</h3><div><ul><li><span>•</span><span><div>This study introduces the ExtRA Capacity Test as a reliable tool for assessing shoulder muscle performance in both sporting and non-sporting populations.</div></span></li><li><span>•</span><span><div>The test demonstrates clinically acceptable intra- and inter-rater reliability, with the abduction component showing a strong correlation with strength measures from Isokinetic Dynamometry.</div></span></li><li><span>•</span><span><div>The normative database established in this study facilitates the evaluation of shoulder performance relative to reference values stratified by age, sex, and physical activity level.</div></span></li><li><span>•</span><span><div>Given its high reliability, the ExtRA Capacity Test can be used to monitor performance change
目的介绍额外能力测试,一种评估肩部肌肉性能的方法。在大量无症状成人样本中评估其信度、效度和目前的规范分数。设计:横断面观察性研究,再测试。参与者:志愿者(n = 344,年龄20-90岁)。干预措施额外能力测试包括两个能力测试,以每分钟30次节拍器完成:最大肩胛骨平面外侧抬高至90°外展,外加2.5 kg的外负荷;最大外旋无支撑俯卧,肩部外展90°。在30名无症状参与者中评估可靠性,由两名评分员在两个疗程中进行测试,间隔一周,使用Bland-Altman分析确定平均偏差和95%的一致限度(LoA)作为误差测量。对20名参与者进行标准效度评估,使用Pearson相关性来检验ExtRA与等速动力学测量之间的关系。还从344名无症状个体中建立了一个规范的数据集,这些个体跨越了年龄、身体活动水平和性别的范围。结果在30名参与者的样本中评估了额外容量测试的内部评分者和内部评分者协议。外展和外旋测量的95% LoA范围为2.9至13.1次。在20名参与者的样本中,外展测试显示与肌肉力量测量有良好/中等的相关性,但与外旋测试没有相关性。年龄较大、女性和未达到世卫组织活动指南对ExtRA的表现产生负面影响。结论:在本文讨论的注意事项中,ExtRA可以被认为是临床环境中评估肩部力量和控制的合理可靠的工具。规范数据库将帮助临床医生根据性别、年龄和身体活动水平设定康复或恢复目标。论文贡献•本研究介绍了额外能力测试作为评估运动和非运动人群肩部肌肉表现的可靠工具。•该测试显示出临床可接受的内部和内部可靠性,外展成分显示出与等速动力学强度测量的强相关性。•本研究中建立的规范数据库有助于评估肩部表现相对于按年龄、性别和身体活动水平分层的参考值。•由于其高可靠性,额外容量测试可用于监测性能随时间的变化,为临床实践和康复计划提供有价值的见解。
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引用次数: 0
Development of a virtual reality game for rehabilitation of patients with lower extremity musculoskeletal disorders 开发用于下肢肌肉骨骼疾病患者康复的虚拟现实游戏
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2026-06-01 Epub Date: 2025-12-18 DOI: 10.1016/j.physio.2025.101870
Shamim Kiani , Iman Rezaei , Naghmeh Ebrahimi , Sanaz Abasi , Azita Yazdani

Introduction

Exercise therapy is a commonly recommended intervention for managing musculoskeletal disorders. Utilizing virtual reality (VR) could prove effective in enhancing exercise therapy. Consequently, the objective of this study is to design and develop a prototype of a VR-based therapeutic exercise game called Vitality, which is suitable for patients with lower limb musculoskeletal disorders.

Methods

This development-applied study was conducted in three phases, determining the identification and confirming requirements, development, and performance evaluation. In the first phase, functionality was extracted by the Delphi technique. In the second phase, the prototype was developed using the Unity 2018 reconstruction engine. Finally, the Vitality was evaluated using the ISO/IEC 25010:2011 product quality model.

Results

The implementation of the first phase led to the extraction of therapeutic practice and the selection of 54 information items during two Delphi rounds for the VR game. A game prototype was then developed, focusing on each of the 16-step therapy exercises in an avatar-based fashion. The evaluation results showed that the functional suitability of the Vitality was 88% and its usability was 94%.

Conclusions

This research presents the VR game for the rehabilitation of different types of musculoskeletal disorders by considering more exercises and a customizable user interface that allows for game difficulty adjustment.
运动疗法是治疗肌肉骨骼疾病的常用干预方法。利用虚拟现实(VR)可以有效地增强运动治疗。因此,本研究的目的是设计和开发一款名为Vitality的基于vr的治疗性运动游戏原型,该游戏适用于下肢肌肉骨骼疾病患者。方法本开发应用研究分三个阶段进行:确定和确认需求、开发和性能评价。在第一阶段,通过德尔菲技术提取功能。在第二阶段,使用Unity 2018重建引擎开发原型。最后,使用ISO/IEC 25010:2011产品质量模型对Vitality进行评估。结果第一阶段的实施导致在两轮德尔菲游戏中提取治疗实践和选择54个信息项目。然后开发了一个游戏原型,专注于以虚拟形象为基础的16步治疗练习中的每一步。评估结果显示,Vitality的功能适宜性为88%,可用性为94%。本研究通过考虑更多的练习和可定制的用户界面,允许游戏难度调整,提出了用于不同类型肌肉骨骼疾病康复的VR游戏。
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引用次数: 0
Red flags to screen for tumours in patients with neck pain: A scoping review 颈部疼痛患者肿瘤筛查的危险信号:范围综述
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2026-06-01 Epub Date: 2025-12-13 DOI: 10.1016/j.physio.2025.101869
Beatrice Occhetto , Martina Ballesio , Firas Mourad , Marco Trucco , Filippo Maselli , Alessandro Chiarotto , Daniel Feller

Introduction

Neck pain is a prevalent condition that can occasionally indicate serious underlying pathologies, such as tumours. Red flags are clinical indicators used to identify patients at risk of such conditions. This scoping review systematically maps and summarizes the literature on red flags for tumours in patients presenting with neck pain in primary care, highlighting evidence gaps and priorities for future research.

Methods

A comprehensive search across four databases up to June 2025 targeted studies on patients of any age or gender presenting with neck pain as the primary complaint and a final diagnosis of a tumour. Only studies conducted in primary care were included, with no time or geographical restrictions. Data were synthesized quantitatively and thematically.

Results

From 10,211 initial records, 25 studies met the inclusion criteria, all being case reports. The most frequently reported red flags were severe neck pain, which may become progressive and constant, neurological signs and symptoms, and nocturnal neck pain. However, inconsistencies in reporting were observed: many commonly discussed red flags were absent from case reports, while some red flags highlighted in case reports are not extensively covered in the literature.

Conclusion

Evidence on red flags for tumours in patients with neck pain in primary care remains fragmented. While certain red flags were frequently reported, their clinical utility is limited by inconsistent reporting and a lack of robust evidence. Further research is needed to standardize red flags and assess their diagnostic accuracy to improve early tumour detection in patients with neck pain.

Contribution of paper

  • Evidence regarding red flags for tumours in patients with neck pain in primary care is fragmented, underscoring the need for comprehensive history-taking and thorough clinical examination.
  • Key red flags, such as progressive pain, neurological symptoms, and nocturnal pain, are frequently reported, though inconsistencies in their documentation across studies are evident.
颈部疼痛是一种普遍的疾病,有时可能表明严重的潜在病理,如肿瘤。红旗是临床指标,用于识别有此类疾病风险的患者。本综述系统地绘制和总结了初级保健中颈部疼痛患者肿瘤危险信号的文献,突出了证据差距和未来研究的重点。方法对截至2025年6月的4个数据库进行综合检索,针对以颈部疼痛为主诉并最终诊断为肿瘤的任何年龄或性别的患者进行研究。仅纳入在初级保健中进行的研究,没有时间或地域限制。数据按数量和主题进行综合。结果10211份初始记录中,25项研究符合纳入标准,均为病例报告。最常见的危险信号是严重的颈部疼痛,这可能会成为进行性和持续性的,神经体征和症状,以及夜间颈部疼痛。然而,在报告中观察到不一致:许多经常讨论的危险信号在病例报告中没有出现,而病例报告中强调的一些危险信号在文献中没有广泛涉及。结论:在初级保健中关于颈部疼痛患者肿瘤危险信号的证据仍然不完整。虽然某些危险信号经常被报道,但由于报道不一致和缺乏强有力的证据,它们的临床应用受到限制。需要进一步的研究来标准化危险信号并评估其诊断准确性,以提高颈部疼痛患者的早期肿瘤检测。•关于初级保健中颈部疼痛患者肿瘤危险信号的证据是碎片化的,强调需要全面的病史记录和彻底的临床检查。•关键的危险信号,如进行性疼痛、神经系统症状和夜间疼痛,经常被报道,尽管不同研究的文献明显不一致。
{"title":"Red flags to screen for tumours in patients with neck pain: A scoping review","authors":"Beatrice Occhetto ,&nbsp;Martina Ballesio ,&nbsp;Firas Mourad ,&nbsp;Marco Trucco ,&nbsp;Filippo Maselli ,&nbsp;Alessandro Chiarotto ,&nbsp;Daniel Feller","doi":"10.1016/j.physio.2025.101869","DOIUrl":"10.1016/j.physio.2025.101869","url":null,"abstract":"<div><h3>Introduction</h3><div>Neck pain is a prevalent condition that can occasionally indicate serious underlying pathologies, such as tumours. Red flags are clinical indicators used to identify patients at risk of such conditions. This scoping review systematically maps and summarizes the literature on red flags for tumours in patients presenting with neck pain in primary care, highlighting evidence gaps and priorities for future research.</div></div><div><h3>Methods</h3><div>A comprehensive search across four databases up to June 2025 targeted studies on patients of any age or gender presenting with neck pain as the primary complaint and a final diagnosis of a tumour. Only studies conducted in primary care were included, with no time or geographical restrictions. Data were synthesized quantitatively and thematically.</div></div><div><h3>Results</h3><div>From 10,211 initial records, 25 studies met the inclusion criteria, all being case reports. The most frequently reported red flags were severe neck pain, which may become progressive and constant, neurological signs and symptoms, and nocturnal neck pain. However, inconsistencies in reporting were observed: many commonly discussed red flags were absent from case reports, while some red flags highlighted in case reports are not extensively covered in the literature.</div></div><div><h3>Conclusion</h3><div>Evidence on red flags for tumours in patients with neck pain in primary care remains fragmented. While certain red flags were frequently reported, their clinical utility is limited by inconsistent reporting and a lack of robust evidence. Further research is needed to standardize red flags and assess their diagnostic accuracy to improve early tumour detection in patients with neck pain.</div></div><div><h3>Contribution of paper</h3><div><ul><li><span>•</span><span><div>Evidence regarding red flags for tumours in patients with neck pain in primary care is fragmented, underscoring the need for comprehensive history-taking and thorough clinical examination.</div></span></li><li><span>•</span><span><div>Key red flags, such as progressive pain, neurological symptoms, and nocturnal pain, are frequently reported, though inconsistencies in their documentation across studies are evident.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"131 ","pages":"Article 101869"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reply to comment on “socio-cultural associates of pain, disability and health-related quality of life in 1350 primary care physiotherapy patients with non-specific musculoskeletal pain” 回复关于“ 1350名接受初级保健物理治疗的非特异性肌肉骨骼疼痛患者的疼痛、残疾和健康相关生活质量的社会文化关联”的评论。
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2026-03-01 Epub Date: 2025-07-02 DOI: 10.1016/j.physio.2025.101819
Renske Annevelink , Sanneke Don , Jo Nijs , David Beckwée , Kelly Ickmans , Wilfried Cools , Lennard Voogt
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引用次数: 0
Unpacking the “black box” of safe respiratory physiotherapy interventions delivered in the home for children with cerebral palsy and medical complexity 打开在家中为患有脑瘫和医疗复杂性的儿童提供的安全呼吸物理治疗干预措施的“黑匣子”
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2026-03-01 Epub Date: 2025-07-31 DOI: 10.1016/j.physio.2025.101835
B. Caird , N. McGowan , J. Depiazzi , R. Marpole , N. Gibson

Objective

To describe the physiotherapy interventions provided to children with cerebral palsy (CP) at risk of respiratory illness and determine criteria for safe in-home treatment.

Design

Descriptive study of physiotherapy interventions received by children enrolled in the treatment arm of a 12-month feasibility randomised controlled trial between March 2022 and July 2023.

Setting

Tertiary hospital, community and in-home.

Participants

Ten children with CP aged 28 months to 12 years.

Interventions

All types of respiratory physiotherapy interventions.

Main outcome measures

Types of physiotherapy interventions, the number, location, and duration of occasion of service (OOS), patient symptoms at baseline and post intervention, stability of participant during treatment sessions.

Results

There were 159 physiotherapy intervention OOS, median (range) 15.5 (4 to 27). All 10 children had at least one new or worsened symptom at a follow up visit that was present before physiotherapy commenced and was not present at their initial baseline assessment on entry to the study. Nine children received individualised respiratory action plans, seven received airway clearance-based plans and two exercise-based plans. The most frequently used airway clearance techniques were manual techniques and positioning. Lung health education was delivered to all participants on every visit. No negative events related to physiotherapy interventions occurred. Criteria for children deemed unsuitable for respiratory physiotherapy interventions outside the hospital were developed.

Conclusion

Airway clearance, positioning and lung health education were the most frequently used respiratory physiotherapy interventions in the community. These were safe when children had clear action plans and were delivered by a skilled respiratory paediatric physiotherapist with tertiary experience.

Contribution of the Paper

  • Types of, and responses to respiratory physiotherapy interventions for children with cerebral palsy and respiratory illness, at risk of deterioration are described in detail.
  • Respiratory physiotherapy interventions are safe when guided by clear safety criteria and respiratory action plans.
  • Skilled paediatric physiotherapists with tertiary experience are vital to the safe delivery of these interventions.
目的探讨脑瘫患儿存在呼吸系统疾病风险的物理治疗干预措施,确定安全的家庭治疗标准。设计对2022年3月至2023年7月期间参加为期12个月的可行性随机对照试验治疗组的儿童接受的物理治疗干预进行描述性研究。设置三级医院、社区和家庭。参与者为28个月至12岁的CP患儿。干预措施所有类型的呼吸物理治疗干预措施。主要结果测量:物理治疗干预的类型、数量、地点和服务时间(OOS)、患者在基线和干预后的症状、治疗期间参与者的稳定性。结果物理治疗干预OOS 159例,中位(范围)15.5例(4 ~ 27例)。所有10名儿童在随访访问中至少有一种新的或恶化的症状,这些症状在物理治疗开始之前就存在,而在他们进入研究时的初始基线评估中没有出现。9名儿童接受个性化呼吸行动计划,7名接受基于气道通畅的计划,2名接受基于运动的计划。最常用的气道清除技术是手动技术和定位技术。每次访问时向所有参与者提供肺部健康教育。未发生与物理治疗干预相关的负面事件。制定了被认为不适合在医院外进行呼吸物理治疗干预的儿童标准。结论社区呼吸物理治疗中最常用的干预措施是气道清扫、定位和肺部健康教育。当儿童有明确的行动计划并由具有三级经验的熟练呼吸儿科物理治疗师提供时,这些是安全的。•对脑瘫和呼吸系统疾病患儿呼吸物理治疗干预的类型和反应进行了详细描述。•在明确的安全标准和呼吸行动计划的指导下,呼吸物理治疗干预是安全的。•具有高等教育经验的熟练儿科物理治疗师对这些干预措施的安全交付至关重要。
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引用次数: 0
Evaluation of ChatGPT accuracy and reliability in answering questions about exercise recommendations for breast cancer survivors 评价ChatGPT在回答乳腺癌幸存者运动建议问题中的准确性和可靠性
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2026-03-01 Epub Date: 2025-08-16 DOI: 10.1016/j.physio.2025.101838
C. Bernal-Utrera , A. Bravo-Vázquez , F.J. Montero-Bancalero , A. Suárez-Vega , M.J. Casuso-Holgado , E. Anarte-Lazo

Objective

To assess the accuracy and reliability of an artificial intelligence (AI) chatbot (ChatGPT) in providing answers about exercise recommendations for breast cancer survivors.

Design

Cross-sectional study.

Methods

We extracted recommendations from recent systematic reviews of clinical practice guidelines (CPGs) on therapeutic physical exercise in breast cancer survivors. Clinical questions were developed and queried to ChatGPT-4. We evaluated the performance of ChatGPT-4 as a counseling tool by assessing the accuracy of responses (percentage of agreement with CPGs recommendations, weighted Cohen’s kappa and the percentage of text wording similarity) and the intra-rater and inter-rater reliability in grading ChatGPT answers (kappa value).

Results

We tested 15 clinical questions. The accuracy of the AI chatbot´s responses was considered unacceptable, with only 7% of responses being reasonably accurate (1/14), 64% of responses being partially accurate (9/14) and 29% being completely incorrect (4/14). It was observed a low Kappa coefficient (k = 0.244, CI: 0.089 to 0.577) and the similarity of responses was also considered unacceptable, with 27.2% of overlapping text wording. Intra and inter-rater reliability showed moderate to good values in all cases.

Conclusions

ChatGPT does not appear to be an accurate counselling tool for answering questions about exercise recommendations for breast cancer survivors. Compared to CPG´s recommendations, the accuracy of ChatGPT responses was considered poor, with moderate to good reliability. It is important to make patients know that they should not only base their decisions on information coming from ChatGPT.

Contribution of the Paper

  • ChatGPT is not an accurate tool for answering questions about exercise recommendations for breast cancer survivors.
  • Breast cancer survivors should not make decisions about exercise based on ChatGPT information alone.
  • The feasibility of therapeutic exercise in breast cancer survivors needs to be supported by expert advice.
目的评估人工智能(AI)聊天机器人(ChatGPT)为乳腺癌幸存者提供运动建议答案的准确性和可靠性。DesignCross-sectional研究。方法:我们从最近的临床实践指南(CPGs)中提取了关于乳腺癌幸存者治疗性体育锻炼的建议。制定临床问题并向ChatGPT-4查询。我们通过评估回答的准确性(与CPGs建议的一致性百分比,加权科恩kappa和文本措辞相似度百分比)和评分者内部和评分者之间对ChatGPT答案评分的可靠性(kappa值)来评估ChatGPT-4作为咨询工具的性能。结果共测试了15个临床问题。AI聊天机器人的回答的准确性被认为是不可接受的,只有7%的回答是合理准确的(1/14),64%的回答是部分准确的(9/14),29%的回答是完全错误的(4/14)。Kappa系数很低(k = 0.244, CI: 0.089 ~ 0.577),回复的相似性也被认为是不可接受的,有27.2%的文本措辞重叠。在所有情况下,评级内和评级间的信度显示中等到良好的值。结论:schatgpt似乎不是回答乳腺癌幸存者运动建议问题的准确咨询工具。与CPG的建议相比,ChatGPT回答的准确性被认为是差的,具有中等到良好的可靠性。重要的是要让患者知道,他们不应该仅仅根据ChatGPT提供的信息来做决定。•ChatGPT不是回答乳腺癌幸存者运动建议问题的准确工具。•乳腺癌幸存者不应仅根据ChatGPT信息来决定是否锻炼。•乳腺癌幸存者进行治疗性运动的可行性需要得到专家建议的支持。
{"title":"Evaluation of ChatGPT accuracy and reliability in answering questions about exercise recommendations for breast cancer survivors","authors":"C. Bernal-Utrera ,&nbsp;A. Bravo-Vázquez ,&nbsp;F.J. Montero-Bancalero ,&nbsp;A. Suárez-Vega ,&nbsp;M.J. Casuso-Holgado ,&nbsp;E. Anarte-Lazo","doi":"10.1016/j.physio.2025.101838","DOIUrl":"10.1016/j.physio.2025.101838","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the accuracy and reliability of an artificial intelligence (AI) chatbot (ChatGPT) in providing answers about exercise recommendations for breast cancer survivors.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>We extracted recommendations from recent systematic reviews of clinical practice guidelines (CPGs) on therapeutic physical exercise in breast cancer survivors. Clinical questions were developed and queried to ChatGPT-4. We evaluated the performance of ChatGPT-4 as a counseling tool by assessing the accuracy of responses (percentage of agreement with CPGs recommendations, weighted Cohen’s kappa and the percentage of text wording similarity) and the intra-rater and inter-rater reliability in grading ChatGPT answers (kappa value).</div></div><div><h3>Results</h3><div>We tested 15 clinical questions. The accuracy of the AI chatbot´s responses was considered unacceptable, with only 7% of responses being reasonably accurate (1/14), 64% of responses being partially accurate (9/14) and 29% being completely incorrect (4/14). It was observed a low Kappa coefficient (k = 0.244, CI: 0.089 to 0.577) and the similarity of responses was also considered unacceptable, with 27.2% of overlapping text wording. Intra and inter-rater reliability showed moderate to good values in all cases.</div></div><div><h3>Conclusions</h3><div>ChatGPT does not appear to be an accurate counselling tool for answering questions about exercise recommendations for breast cancer survivors. Compared to CPG´s recommendations, the accuracy of ChatGPT responses was considered poor, with moderate to good reliability. It is important to make patients know that they should not only base their decisions on information coming from ChatGPT.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>ChatGPT is not an accurate tool for answering questions about exercise recommendations for breast cancer survivors.</div></span></li><li><span>•</span><span><div>Breast cancer survivors should not make decisions about exercise based on ChatGPT information alone.</div></span></li><li><span>•</span><span><div>The feasibility of therapeutic exercise in breast cancer survivors needs to be supported by expert advice.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"130 ","pages":"Article 101838"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clarifying the concept of advanced practice in physiotherapy for global model development 阐明物理治疗先进实践的概念,促进全球模式发展。
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2026-03-01 Epub Date: 2025-09-15 DOI: 10.1016/j.physio.2025.101846
Lalit E. Braem , Fanny Lacour , Antoine Fourré , Etienne Panchout , Grégory Reychler , Joachim Van Cant
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引用次数: 0
Perceptions and use of behaviour change interventions for physical activity in chronic respiratory disease in The Republic of Ireland 爱尔兰共和国慢性呼吸道疾病患者对身体活动行为改变干预措施的认识和使用情况
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2026-03-01 Epub Date: 2025-09-09 DOI: 10.1016/j.physio.2025.101841
Ciara Hanrahan , Joseph G. McVeigh , Terence M. O’Connor , Thierry Troosters , Julie Broderick
<div><h3>Objectives</h3><div>Behaviour change interventions may support physical activity behaviour in people with chronic respiratory disease. The most effective interventions for long-term physical activity behaviour change in this cohort remains unclear. This aim of this study was to explore the use and perceptions of behaviour change interventions by both providers of physical activity programmes for people with chronic respiratory disease and by people living with chronic obstructive pulmonary disease (COPD) in The Republic of Ireland.</div></div><div><h3>Design</h3><div>Two anonymous online and paper-copy cross-sectional surveys, piloted and mapped to the COM-B model of behaviour change, were distributed via social media and relevant gate-keepers (e.g Irish Society of Chartered Physiotherapists, COPD Support Ireland) between November 2023 and April 2024. Findings were summarised using descriptive statistics including frequencies, percentages, means and medians. Relationships between variables were investigated using Chi<sup>2</sup> (<em>p</em> = 0.05).</div></div><div><h3>Results</h3><div>The response rate to the provider survey was 71% (107/150), and 112 participants responded to the COPD cohort survey. Providers perceived encouragement, pertaining to theoretical constructs such as self-confidence, optimism and reinforcement to be the most effective techniques influencing physical activity behaviour. People with COPD perceived social support, pertaining to theoretical constructs such as interpersonal skills and social identity, to be the most effective interventions influencing their physical activity behaviour. Motivation was frequently identified as a common COM-B component, suggesting important links to this mechanism of action in influencing behaviour.</div></div><div><h3>Conclusions</h3><div>Interventions with motivational components are perceived as effective influencers of physical activity behaviour by providers of physical activity programmes and by those living with chronic respiratory disease.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>Providers of physical activity programmes for people with chronic respiratory disease in The Republic of Ireland perceive that they are using encouragement, education, goal setting, education and social support as effective interventions to support behaviour change in chronic respiratory disease.</div></span></li><li><span>•</span><span><div>People with COPD perceive social support and one-to-one interaction with trainers as effective interventions to support their physical activity behaviour.</div></span></li><li><span>•</span><span><div>There may be discrepancies between male and female perceptions of effective interventions in the COPD cohort, and this warrants further research.</div></span></li><li><span>•</span><span><div>Interventions containing motivational components are perceived by both providers and people living with chronic respiratory dise
目的行为改变干预措施可能支持慢性呼吸道疾病患者的身体活动行为。在这一队列中,最有效的长期体育活动行为改变干预措施尚不清楚。本研究的目的是探讨爱尔兰共和国慢性呼吸系统疾病患者和慢性阻塞性肺疾病(COPD)患者的身体活动方案提供者对行为改变干预措施的使用和看法。在2023年11月至2024年4月期间,两项匿名在线和纸质横断面调查通过社交媒体和相关守门者(如爱尔兰特许物理治疗师协会、爱尔兰慢性阻塞性肺病支持协会)进行了试点和映射到COM-B行为改变模型。使用包括频率、百分比、平均值和中位数在内的描述性统计对研究结果进行总结。采用Chi2分析变量间的关系(p = 0.05)。结果对提供者调查的响应率为71%(107/150),112名参与者对COPD队列调查有响应。提供者认为鼓励是影响身体活动行为的最有效的技术,这与自信、乐观和强化等理论结构有关。COPD患者认为社会支持(与人际交往能力和社会认同等理论结构有关)是影响其身体活动行为的最有效干预措施。动机经常被确定为共同的COM-B组成部分,这表明在影响行为方面与这一作用机制有重要联系。结论:具有动机成分的干预措施被体育活动计划提供者和慢性呼吸系统疾病患者认为是体育活动行为的有效影响因素。•爱尔兰共和国慢性呼吸道疾病患者身体活动方案的提供者认为,他们正在利用鼓励、教育、目标设定、教育和社会支持作为有效干预措施,支持改变慢性呼吸道疾病患者的行为。•COPD患者认为社会支持和与教练的一对一互动是支持其体育活动行为的有效干预措施。•在COPD队列中,男性和女性对有效干预措施的看法可能存在差异,这值得进一步研究。•提供者和慢性呼吸道疾病患者都认为,包含动机成分的干预措施最有效地影响慢性呼吸道疾病患者的身体活动行为。
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引用次数: 0
Exploring the validity of smartphone based single camera markerless motion capture technology to quantify knee range of motion in patients with knee osteoarthritis 探索基于智能手机的单摄像头无标记运动捕捉技术量化膝骨关节炎患者膝关节运动范围的有效性。
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2026-03-01 Epub Date: 2025-10-15 DOI: 10.1016/j.physio.2025.101850
B. Langley , M. Greig , T.N. Board

Background

Single camera markerless motion capture technology offers a potential means of assessing joint function in patients with musculoskeletal disorders/diseases. The aim of this study was to determine the validity and within-session reliability of sagittal plane knee joint kinematics quantified using the Deep Vision platform in patients with knee osteoarthritis.

Methods

Sagittal plane knee joint kinematics were quantified using a 3D motion capture system, the msk.ai Deep Vision platform and Kinovea in fifteen patients with knee osteoarthritis. Bland Altman plots with 95 % limits of agreement were used to assess validity and within-session reliability, with mean differences and limits of agreement explored relative to ± 5° and 10° clinically meaningful thresholds, respectively. This is based on the assumption that changes in joint angles greater than 5° are clinically meaningful.

Results

Mean differences and 95 % limits of agreement were within the clinically meaningful thresholds when using the Deep Vision platform to quantify peak knee flexion and extension, and range of motion. Mean differences were within the clinically meaningful threshold for Kinovea based assessments, but 95 % limits of agreement exceeded the ± 10° clinically meaningful threshold for peak flexion and range of motion. All assessment methods displayed mean differences and 95 % confidence intervals within the clinically meaningful thresholds on average when comparing across repetitions to quantify within-session reliability.

Conclusion

The findings of the study demonstrate that the msk.ai Deep Vision platform provides a valid and reliable means of quantifying peak knee flexion, extension and range of motion.

Contribution of the Paper

  • The Deep Vision platform, a smartphone based markerless motion capture technology, provides a valid means of measuring knee range of motion.
  • The Deep Vision platform displays high reliability when measuring knee range of motion.
背景:单摄像头无标记运动捕捉技术为评估肌肉骨骼疾病/疾病患者的关节功能提供了一种潜在的手段。本研究的目的是确定使用深度视觉平台量化的膝关节矢状面运动学在膝关节骨性关节炎患者中的有效性和会话内可靠性。方法:采用三维运动捕捉系统msk对膝关节矢状面运动学进行量化。ai深度视觉平台和Kinovea在15例膝关节骨关节炎患者中的应用。使用95%一致性限的Bland Altman图来评估效度和会话内信度,分别相对于±5°和10°临床意义阈值探讨了平均差异和一致性限。这是基于关节角度变化大于5°具有临床意义的假设。结果:当使用深度视觉平台量化峰值膝关节屈伸和活动范围时,平均差异和95%的一致性限制在临床有意义的阈值范围内。基于Kinovea评估的平均差异在临床有意义的阈值范围内,但95%的一致性界限超过了峰值屈曲和活动范围的±10°临床有意义的阈值。所有的评估方法显示平均差异和95%的置信区间在临床有意义的阈值内,当通过重复比较来量化疗程内的可靠性。结论:本研究结果表明,msk是一种有效的抗肿瘤药物。ai深度视觉平台提供了一种有效可靠的量化膝关节屈曲、伸展和运动范围的方法。论文贡献。
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引用次数: 0
期刊
Physiotherapy
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