ChatGPT y la terapia de ejercicio: lo que debes saber

File this one under “understatement”: ChatGPT has been getting a lot of buzz as of late. And if you’re like most people, you have some questions about how it fits into your life. How does ChatGPT work? What can I use it for? How is it different from Google? 

Within a few months, people have gone from using ChatGPT to write limericks and haikus to, well, just about everything: crafting speeches and work emails, creating meal plans, generating legal documents, writing code for websites, and answering health-related questions and designing workout routines. 

Got tight hip flexors? Weak hamstrings? Struggling with back pain or knee pain? You can ask ChatGPT to generate a workout designed for you. It sounds pretty cool, and in some ways it is. But is this safe or effective? When is it a good idea to consult ChatGPT for pain or injury-related help — and when should you steer clear?

Here, we’ll take a closer look at what physical therapists really think about ChatGPT when it comes to personalizing exercise and workout plans, as well as its benefits and drawbacks. 

What is ChatGPT, exactly? 

If you ask ChatGPT what it is, it will tell you the following: 

“I am ChatGPT, a large language model created by OpenAI. I am part of the GPT (Generative Pre-trained Transformer) family of models, specifically GPT-3.5 architecture. My purpose is to generate human-like text based on the input I receive. I have been trained on a vast corpus of text data and can perform a wide range of language tasks, such as answering questions, generating text, summarizing information, and more.” 

In plain language? ChatGPT is a type of artificial intelligence (AI) technology that uses a massive amount of text data to generate responses to questions on any topic you can think of, and it allows you to have human-like conversations with a chatbot. 

And it’s being used in healthcare 

ChatGPT is being used in healthcare in many different ways, such as: 

• Symptom checking: By asking people questions about their symptoms, ChatGPT can help direct them to the appropriate care setting or medical professional.

• Education: It can provide people with information about their condition, diagnosis, and symptoms, as well as treatment options. 

• Medical documentation: It’s being used to generate medical documentation, such as progress notes, discharge summaries, and referral letters in hospitals and clinics, which can save healthcare professionals time and may improve the accuracy of the documentation.

• Clinical decision-making: In some cases, it can provide healthcare professionals with information and recommendations based on patient data.

• Mental health support: By engaging in conversation with patients, ChatGPT can provide emotional support, coping strategies, and resources for further help.

This may sound obvious, but it must be said that ChatGPT is not a replacement for a medical provider. It can provide basic information about medical conditions, diagnoses, and treatment options but it’s not designed to provide personalized medical advice. 

“ChatGPT doesn’t have the ability to fact check itself,” says CJ Morrow, PT, DPT, a physical therapist and Clinical Quality Assurance Manager at Hinge Health who recently gave a presentation about AI in digital health to the American Physical Therapy Association. So just as health information from search engines like Google varies in quality, accuracy, and relevancy, ChatGPT can provide inaccurate or misleading information too. 

What about physical therapy? 

The American Physical Therapy Association (APTA) asserts that “any service labeled ‘physical therapy’ that’s delivered using digital technologies must be performed by a physical therapist” — a movement expert who helps people improve their quality of life through prescribed exercise, hands-on care, and patient education.

While no one is mistaking ChatGPT for an actual physical therapist, people are starting to "consult" it to help personalize their workouts and exercise sessions. You can ask ChatGPT for exercise recommendations based on specific criteria, such as exercises that target a particular muscle group, exercises you can do at home, or exercises that are appropriate for a certain fitness level. ChatGPT can then provide a list of exercises along with instructions on how to perform them correctly. You can ask it to try to personalize a workout based on factors such as your age, weight, height, medical history, and current fitness level. 

If you’re working with a physical therapist to achieve a specific goal, such as healing from an injury or overcoming chronic pain, ChatGPT can help with:  

• Answering questions about your diagnosis, symptoms, treatment plan, or exercises prescribed by your physical therapist. 

• Providing instructions on how to perform exercises prescribed by your PT. 

• Offering motivation, especially between appointments with your PT. Some people ask ChatGPT to provide motivational messages and encouragement to help them stay on track, for instance. 

• Tracking your progress by asking questions about your symptoms, pain level, and range of motion. This information can even be used to adjust your treatment plan to ensure you continue to make progress toward your goals. 

• Reminding you to do your exercises, schedule and attend your PT appointments, and more.

(Thanks, ChatGPT, for helping to generate the points above.)

“There are a lot of ways you can safely use ChatGPT in conjunction with a physical therapist,” says Dr. Morrow. “If you ask it for advice on something related to your exercise therapy and joint or muscle health, you can take that to your Hinge Health physical therapist or health coach — or your medical provider if you’re not a Hinge Health member — and get their take on it.” 

When it comes to any kind of health advice — whether from ChatGPT or a healthcare professional — you should always ask yourself if it’s information you feel you can trust, adds Dr. Morrow. “If not, it’s your right as a patient to get a second opinion.”  

The upsides of ChatGPT 

ChatGPT has a lot of appealing features when you ask it a question you might ask your physical therapist. 

• It’s efficient. It can answer questions in seconds, saving you from having to sift through the endless information available on the internet or reach out to a healthcare professional and wait for a response to your question. 

• You can ask follow-up questions, much like you would ask your provider or physical therapist during an in-person appointment to get more detailed and personalized answers.

• It has a conversational, approachable tone, which makes it easier to digest the advice it provides. “ChatGPT pulls data, analyzes it, and paraphrases it out in ‘natural language,’ which means it matches the tone and language you use when you enter your prompt,” says Dr. morrow.

• It helps people get started. There are a lot of different barriers to making exercise and movement a habit, whether your goal is to manage persistent joint or muscle pain, improve your fitness or body composition, or boost your balance and strength to reduce falls. For people who are just getting started with exercise, or are just getting back into it after being away for a while, the biggest barrier can be simply not knowing where to start. ChatGPT may help some people eliminate that barrier. 

Why ChatGPT is not a physical therapist 

As we saw in 2020 at the start of the COVID-19 pandemic, many healthcare processes can be more efficiently handled or aided by technology (we’re looking at you, video visits). But there are still a lot of healthcare questions and interactions that have to be — or at least should be — handled by a human being, not a chatbot. So although ChatGPT can provide information about physical therapy for pain and even offer exercises and exercise modifications, there are serious limitations to consider, including: 

Lack of context. ChatGPT generates responses to questions based on the language data it has been trained on, but it doesn’t necessarily understand the context of the information or its real-world implications. This means that ChatGPT may provide information that is technically correct but not relevant or appropriate for your needs. “Essentially, we don’t know what’s under the hood of ChatGPT,” says Jon Ide-Don, PT, DPT, a physical therapist and Director of Clinical Specialists at Hinge Health. “There are clearly filters and guard rails in place, but there’s no way to understand who built those, why the guard rails are there, and what the implications are on the advice it’s giving out.”  

Lack of relevant expertise. While ChatGPT has access to a vast amount of information across a wide range of topics, it is not a specialized expert in physical therapy or pain management so its responses may not be as accurate or comprehensive as what you would get from a qualified physical therapist or medical professional. “If you ask ChatGPT to cite its sources, it’s not able to, and it acknowledges this fact,” says Dr. Ide-Don. “This can be problematic if the answers it gives you are concerning or not clear. The most accurate information on the web has been written by or reviewed by an expert in the PT and healthcare field. It’s entirely possible that ChatGPT will pull controversial or even incorrect information into its answers.” 

Lack of consistency can be confusing. Large language models tend to generate a different answer to a question every time it’s posed. So if you asked ChatGPT to generate the “best hamstring stretches” two different times, you could get two different exercise plans. The upside to this is that it does provide variety, making some people more likely to stay engaged with exercise. “As a user, though, you have to think critically about the information you receive,” notes Dr. Morrow.

No human touch. ChatGPT has no hands-on experience in physical therapy or pain management. This means that it cannot provide practical advice, demonstrate techniques, or offer the personal touch that a human can. Although ChatGPT can give general guidance, it’s critical that a human PT be able to provide more specific and personalized information for a person to be confident in the answers, notes Dr. Ide-Don. 

Dr. Morrow adds: “As a patient, there's something comforting about sitting across from another person when you receive care  — someone with a heart that’s able to perceive things through their eyes and ears and really empathize with what you’re going through. That element isn't there with ChatGPT. When it recommends you do something, it can't perceive your reactions to that and whether you feel comfortable with that recommendation.” 

Potential bias. ChatGPT may replicate biases or inaccuracies seen in the data it’s trained on, which can be more problematic when discussing sensitive topics like chronic pain. “We do a lot of work at Hinge Health to recognize and remove bias, and that’s something that a chatbot can't do at this point,” says Dr. Morrow. 

Not able to create something new or think outside the box. “ChatGPT only has the data it's trained on. So while it can generate a lot of ideas, and very quickly, it can't think outside the box. It can’t innovate like we can from a blank slate,” says Dr. Morrow. And when it comes to personalized medicine and coming up with a care plan that’s truly tailored to each individual’s needs, this is a major shortcoming. 

What physical therapists think

ChatGPT can be a really helpful tool in many everyday situations, including providing new exercises or movement routines to try. But if you have injuries, movement restrictions, or certain medical conditions, it's best to treat ChatGPT like any other digital tool and use it in conjunction with advice and guidance from your healthcare provider.

“The potential AI has to aid and augment the medical field is infinite and profound — and it’s exciting,” says Dr. Morrow. “The reality is that some people really struggle to overcome chronic pain, despite their best efforts. AI may be able to help us as practitioners better tailor their care plan to their needs and get them the pain relief they need. And that’s truly exciting. The thing, though, is that it’s never going to replace a doctor or a PT. It has the potential to make us better, but not replace humans.”

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

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2. The Digitally Enabled Physical Therapist: An APTA Foundational Paper. (2022, November). American Physical Therapy Association (APTA). https://www.apta.org/contentassets/e37aa1765cab4b1791d22717d3ac20af/apta-digital-health-foundational-paper-2022.pdf

3. Becoming a PT. American Physical Therapy Association (APTA). Retrieved from https://www.apta.org/your-career/careers-in-physical-therapy/becoming-a-pt#:~:text=Physical%20therapists%20are%20movement%20experts,at%20the%20end%20of%20life

4. Biswas, S. S. (2023). Role of Chat GPT in Public Health. Annals of Biomedical Engineering, 51, 868–869. doi:10.1007/s10439-023-03172-7

5. Luo, R., Sun, L., Xia, Y., Qin, T., Zhang, S., Poon, H., & Liu, T.-Y. (2022). BioGPT: generative pre-trained transformer for biomedical text generation and mining. Briefings in Bioinformatics, 23(6). doi:10.1093/bib/bbac409

6. Gilson, A., Safranek, C. W., Huang, T., Socrates, V., Chi, L., Taylor, R. A., & Chartash, D. (2023). How Does ChatGPT Perform on the United States Medical Licensing Examination? The Implications of Large Language Models for Medical Education and Knowledge Assessment. JMIR Medical Education, 9, e45312. doi:10.2196/45312

7. Johnson, D., Goodman, R., Patrinely, J., Stone, C., Zimmerman, E., Donald, R., Chang, S., Berkowitz, S., Finn, A., Jahangir, E., Scoville, E., Reese, T., Friedman, D., Bastarache, J., Heijden, Y. van der, Wright, J., Carter, N., Alexander, M., Choe, J., & Chastain, C. (2023). Assessing the Accuracy and Reliability of AI-Generated Medical Responses: An Evaluation of the Chat-GPT Model. doi:10.21203/rs.3.rs-2566942/v1

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