AI-Powered Physiotherapy: Evaluating LLMs Against Students in Clinical Rehabilitation Scenarios

Abstract

Generative artificial intelligence (GenAI), particularly large language models (LLMs) such as ChatGPT and DeepSeek, is transforming healthcare by enhancing clinical decision-making, education, and patient interaction. This exploratory study compares the responses of ChatGPT (GPT-4.1) and DeepSeek-V2 against 90 final-year physiotherapy students in Greece on the quality of the responses to 60 clinical questions across four rehabilitation domains: low back pain, multiple sclerosis, frozen shoulder, and knee osteoarthritis (15 questions per domain). The questions spanned basic knowledge, diagnosis, alternative treatments, and rehabilitation practices. The responses were evaluated for their relevance, accuracy, clarity, completeness, and consistency with clinical practice guidelines (CPGs), emphasizing conceptual understanding. This study provides novel contributions by (i) benchmarking LLMs in physiotherapy-specific domains (low back pain, multiple sclerosis, frozen shoulder, and knee osteoarthritis) underrepresented in prior AI-health evaluations; (ii) directly comparing the LLM written response quality to student performance under exam constraints; and (iii) highlighting the improvement potential for education, complementing ChatGPT’s established role in physician decision support. The results indicate that the LLMs produced higher-quality written responses than students in most domains, particularly in the global response quality and the conceptual depth of written responses, highlighting their potential as educational aids for knowledge-based tasks, although not equivalent to clinical expertise. This suggests AI’s role in physiotherapy as a supportive tool rather than a replacement for hands-on clinical skills and asks whether GenAI could transform physiotherapy practice by augmenting, rather than threatening, human-centered care, for its potential as a knowledge support tool in education, pending validation in clinical contexts. This study explores these findings, compares them with the related work, and discusses whether GenAI will transform or threaten physiotherapy practice. Ethical considerations, limitations, and future directions, including AI voice assistants and AI characters, are addressed.

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