GPT-4 outperforms junior expert physical therapists in sports medicine rehabilitation: an evaluation of AI response quality and adaptiveness

Background Artificial intelligence (AI), particularly large language models (LLMs) like ChatGPT, has demonstrated potential in healthcare applications, but its effectiveness in clinical rehabilitation contexts remains underexplored. This study investigated whether GPT-4 (accessed through its online interface ChatGPT) can deliver high-quality, adaptive responses in sports physical therapy comparable to or surpassing those of human professionals. Methods Fifty-three sports physical therapy questions were developed by senior experts and answered by GPT-4 and three junior expert physical therapists (JEPs). Responses were tailored for different target audiences: patients, physical therapists, and expert physical therapists. GPT-4 was prompted using structured engineering techniques. A blinded panel of three senior physical therapists/researchers assessed responses for quality and adaptiveness, and identified which responses were superior. Results Across all target audiences, GPT-4 outperformed JEPs in both quality and adaptiveness of responses ( p < 0.001). For responses aimed at patients, GPT-4 was rated best in 26 (55%) questions. For responses aimed at physical therapists, GPT-4 was rated best in 34 (64%) questions. Performance varied by topic, but GPT-4 consistently provided more expert-adapted and contextually appropriate information. GPT-4's responses were especially superior in areas like pain, osteoarthritis, and anterior cruciate ligament rehabilitation. Conclusion This study demonstrated that GPT-4 is capable to generate high-quality, adaptive responses in the field of orthopedic sports physical therapy, which can surpass the performance of JEPs in a controlled setting.