Performance of ChatGPT 4.0 on Japan's National Physical Therapist Examination: A Comprehensive Analysis of Text and Visual Question Handling.

INTRODUCTION: ChatGPT 4.0, a large-scale language model (LLM) developed by OpenAI, has demonstrated the capability to pass Japan's national medical examination and other medical assessments. However, the impact of imaging-based questions and different question types on its performance has not been thoroughly examined. This study evaluated ChatGPT 4.0's performance on Japan's national examination for physical therapists, particularly its ability to handle complex questions involving images and tables. The study also assessed the model's potential in the field of rehabilitation and its performance with Japanese language inputs. METHODS: The evaluation utilized 1,000 questions from the 54th to 58th national exams for physical therapists in Japan, comprising 160 general questions and 40 practical questions per exam. All questions were input in Japanese and included additional information such as images or tables. The answers generated by ChatGPT were then compared with the official correct answers. ANALYSIS: ChatGPT's performance was evaluated based on accuracy rates using various criteria: general and practical questions were analyzed with Fisher's exact test, A-type (single correct answer) and X2-type (two correct answers) questions, text-only questions versus questions with images and tables, and different question lengths using Student's t-test. RESULTS: ChatGPT 4.0 met the passing criteria with an overall accuracy of 73.4%. The accuracy rates for general and practical questions were 80.1% and 46.6%, respectively. No significant difference was found between the accuracy rates for A-type (74.3%) and X2-type (67.4%) questions. However, a significant difference was observed between the accuracy rates for text-only questions (80.5%) and questions with images and tables (35.4%). DISCUSSION: The results indicate that ChatGPT 4.0 satisfies the passing criteria for the national exam and demonstrates adequate knowledge and application skills. However, its performance on practical questions and those with images and tables is lower, indicating areas for improvement. The effective handling of Japanese inputs suggests its potential use in non-English-speaking regions. CONCLUSION: ChatGPT 4.0 can pass the national examination for physical therapists, particularly with text-based questions. However, improvements are needed for specialized practical questions and those involving images and tables. The model shows promise for supporting clinical rehabilitation and medical education in Japanese-speaking contexts, though further enhancements are required for a comprehensive application.

Unilateral vibration stimulation decreases F-wave persistence and F/M amplitude ratio in contralateral homonymous muscle corresponding to the stimulated muscle during stimulation.

[Purpose] This study aimed to examine the effects of unilateral vibratory stimulation on contralateral homonymous muscle. [Participants and Methods] The study included 14 participants without a history of any disease. Participants were tested under three separate conditions: vibratory stimulation, pressure stimulation, and rest. F-waves were measured at two time points for 15 seconds in the rest position under each of the testing conditions. [Results] The F/M amplitude ratio analysis showed interactions between the vibratory stimulation‒pressure stimulation and vibratory stimulation‒rest conditions. The F-wave persistence analysis demonstrated interactions between the vibratory and pressure stimulation conditions. Vibratory stimulation significantly decreased the F/M amplitude ratio and F-wave persistence at two time points, before and during the stimulation. [Conclusion] The vibratory stimulation used in this study could suppress the contralateral homonymous muscle tone.

Motor image recall ability affects the excitability of spinal nerve function in healthy participants executing mirror therapy tasks at different complexities.

[Purpose] The purpose of this study was to use Mirror Therapy to clarify the effect of the differences in image recall ability and the types of finger exercises on the excitability of spinal nerve function. This study will help establish the methodology for therapeutic intervention using Mirror Therapy. [Participants and Methods] We divided 30 healthy right-handed adults into two groups: one with high exercise image recall ability and the other with low exercise image recall ability. The participants were asked to put both hands in the Mirror Box such that the left hand was hidden behind the mirror. While looking at the mirror image of the right hand, they were instructed not to move the left hand voluntarily. We measured the F-wave from the finger abductor muscle using evoked electromyography. [Results] The comparison between the high and low image recall groups showed that the excitability of spinal nerve function increased in the low image recall group overall. [Conclusion] From the above results, we suggest that when performing mirror therapy, it is necessary to select a task that is not too simple and not difficult to move normally.

Development of the final version of the occupational adaptation questionnaire for family caregivers.

BACKGROUND: Given the growing role of family caregivers in meeting the increasing demand for ageing-related care in Japan, the occupational adaptation of family caregivers needs to be evaluated. METHODS: This study developed the Occupational Adaptation Questionnaire for Family Caregivers (OAQC) and evaluated its reliability, validity, and effectiveness. To develop the OAQC item pool, the construct 'Occupation of nursing care engaged in by family caregivers' was evaluated. Using the Delphi method, 8 experts evaluated 64 items and confirmed that 41 items adequately represented the domain. The scale was then completed by 216 family caregivers of users of outpatient service establishments affiliated with hospitals in the Chubu region. The validity of the scale items was tested, and statistical analysis was performed. The construct validity and internal consistency of the OAQC were examined using exploratory factor analysis and the ω coefficient, respectively. RESULTS: The discrimination ability and difficulty level were calculated using the item response theory. The findings showed that the scale's reliability and validity were satisfactory. Construct validity was acceptable for 16 items with 5 factors. The OAQC also had high internal consistency, reliability, and effectiveness. The item slope parameters and difficulty parameters revealed good item response, indicating that the scale could effectively measure family caregivers' occupational adaptation. CONCLUSION: The scale was compatible with the data obtained from family caregivers. Given its overall effectiveness, data obtained using the OAQC can contribute towards implementing personal care support programs for caregivers and enriching their lives by offering support from an occupational adaptation perspective.