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识别人工智能为肌肉骨骼疾病患者推荐的运动的风险。

Identifying the risk of exercises, recommended by an artificial intelligence for patients with musculoskeletal disorders.

机构信息

Department of Physiotherapy, Institute of Health Sciences, Universität zu Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.

Faculty Business Management and Social Sciences, University of Applied Science Osnabrueck, Albrechtstraße 30, 49076, Osnabrück, Germany.

出版信息

Sci Rep. 2024 Jun 24;14(1):14472. doi: 10.1038/s41598-024-65016-1.

Abstract

Musculoskeletal disorders (MSDs) impact people globally, cause occupational illness and reduce productivity. Exercise therapy is the gold standard treatment for MSDs and can be provided by physiotherapists and/or also via mobile apps. Apart from the obvious differences between physiotherapists and mobile apps regarding communication, empathy and physical touch, mobile apps potentially offer less personalized exercises. The use of artificial intelligence (AI) may overcome this issue by processing different pain parameters, comorbidities and patient-specific lifestyle factors and thereby enabling individually adapted exercise therapy. The aim of this study is to investigate the risks of AI-recommended strength, mobility and release exercises for people with MSDs, using physiotherapist risk assessment and retrospective consideration of patient feedback on risk and non-risk exercises. 80 patients with various MSDs received exercise recommendations from the AI-system. Physiotherapists rated exercises as risk or non-risk, based on patient information, e.g. pain intensity (NRS), pain quality, pain location, work type. The analysis of physiotherapists' agreement was based on the frequencies of mentioned risk, the percentage distribution and the Fleiss- or Cohens-Kappa. After completion of the exercises, the patients provided feedback for each exercise on an 11-point Likert scale., e.g. the feedback question for release exercises was "How did the stretch feel to you?" with the answer options ranging from "painful (0 points)" to "not noticeable (10 points)". The statistical analysis was carried out separately for the three types of exercises. For this, an independent t-test was performed. 20 physiotherapists assessed 80 patient examples, receiving a total of 944 exercises. In a three-way agreement of the physiotherapists, 0.08% of the exercises were judged as having a potential risk of increasing patients' pain. The evaluation showed 90.5% agreement, that exercises had no risk. Exercises that were considered by physiotherapists to be potentially risky for patients also received lower feedback ratings from patients. For the 'release' exercise type, risk exercises received lower feedback, indicating that the patient felt more pain (risk: 4.65 (1.88), non-risk: 5.56 (1.88)). The study shows that AI can recommend almost risk-free exercises for patients with MSDs, which is an effective way to create individualized exercise plans without putting patients at risk for higher pain intensity or discomfort. In addition, the study shows significant agreement between physiotherapists in the risk assessment of AI-recommended exercises and highlights the importance of considering individual patient perspectives for treatment planning. The extent to which other aspects of face-to-face physiotherapy, such as communication and education, provide additional benefits beyond the individualization of exercises compared to AI and app-based exercises should be further investigated.Trial registration: 30.12.2021 via OSF Registries, https://doi.org/10.17605/OSF.IO/YCNJQ .

摘要

肌肉骨骼疾病(MSD)在全球范围内影响着人们,导致职业疾病并降低生产力。运动疗法是 MSD 的黄金标准治疗方法,可由物理治疗师提供,也可通过移动应用程序提供。除了物理治疗师和移动应用程序在沟通、同理心和身体接触方面的明显差异外,移动应用程序提供的个性化运动可能较少。人工智能(AI)的使用可以通过处理不同的疼痛参数、合并症和患者特定的生活方式因素来克服这个问题,从而实现个性化的运动疗法。本研究旨在通过物理治疗师的风险评估和对患者对风险和非风险运动的反馈的回顾性考虑,来调查 AI 推荐的力量、灵活性和释放运动对 MSD 患者的风险。80 名患有各种 MSD 的患者接受了 AI 系统的运动建议。物理治疗师根据患者信息(如疼痛强度(NRS)、疼痛质量、疼痛位置、工作类型)将运动评为风险或非风险。基于提到的风险的频率、百分比分布和 Fleiss-或 Cohens-Kappa 分析了物理治疗师的一致性。在完成运动后,患者对每项运动都在 11 分制的李克特量表上进行了反馈。例如,释放运动的反馈问题是“伸展运动对您的感觉如何?”,答案选项从“疼痛(0 分)”到“不明显(10 分)”。三种类型的运动分别进行了统计分析。为此,进行了独立 t 检验。20 名物理治疗师评估了 80 个患者示例,共收到 944 个运动。在物理治疗师的三方协议中,有 0.08%的运动被认为有增加患者疼痛的潜在风险。评估显示 90.5%的运动没有风险。被物理治疗师认为对患者有潜在风险的运动也收到了患者的较低反馈评分。对于“释放”运动类型,风险运动收到的反馈较低,表明患者感到更疼痛(风险:4.65(1.88),非风险:5.56(1.88))。该研究表明,AI 可以为 MSD 患者推荐几乎无风险的运动,这是创建个性化运动计划的有效方法,而不会使患者面临更高的疼痛强度或不适的风险。此外,该研究表明,物理治疗师在 AI 推荐运动的风险评估方面具有显著的一致性,并强调了在治疗计划中考虑患者个体观点的重要性。与 AI 和基于应用程序的运动相比,面对面物理治疗的其他方面(如沟通和教育)在个性化运动之外提供额外益处的程度应进一步研究。试验注册:2021 年 12 月 30 日通过 OSF 注册处,https://doi.org/10.17605/OSF.IO/YCNJQ。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cfd/11196744/3341290328e0/41598_2024_65016_Fig1_HTML.jpg

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