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Degenerative Knee DiseaseLLM-RehabKneeNCT07267962

LLM-Guided Rehabilitation in Degenerative Knee Disease

A study testing Supervised conventional physiotherapy, ChatGPT-5-assisted exercise planning and DeepSeek V3.1-assisted exercise planning in people with Degenerative Knee Disease, run by Kirsehir Ahi Evran Universitesi at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This randomized, four-arm clinical trial will investigate the effects of large language model (LLM)-assisted exercise prescriptions integrated with conventional physiotherapy on pain, function and quality of life in adults with degenerative knee disease. Read more about this study

Who is it for?
Ages 40 to 65 years
Conditions the study is for
Degenerative Knee Disease
What is being tested?
Supervised conventional physiotherapy, ChatGPT-5-assisted exercise planning and DeepSeek V3.1-assisted exercise planning
Could I receive a placebo?
No, everyone receives an active treatment
How many people
84 participants
Where
1 siteTurkey (Türkiye)
Study dates
26 Nov 2025to 15 May 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age between 40 and 65 years.
  • Clinical and radiographic diagnosis of degenerative knee disease in the target knee.
  • Knee pain in the target knee for at least 3 months.
  • Ability to bear weight on the target limb and perform the planned functional tests.
  • Sufficient cognitive and physical capacity to participate in an 8-week supervised exercise program.
  • Willingness to participate and ability to provide written informed consent.

Who cannot join

  • Intra-articular corticosteroid or similar injection to the target knee within the previous 3 months.
  • Knee surgery on the target knee within the previous 6 months.
  • Severe malalignment of the knee or concomitant severe neurological disease and/or balance disorder that would interfere with safe testing or exercise.
  • Pregnancy or any systemic disease that would contraindicate participation in the rehabilitation program according to the physician.

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site

  • Kırşehir Ahi Evran University

    Kırşehir, Merez, 40100

Other trials in Turkey (Türkiye)

About this study

Official title: The Effect of ChatGPT-5, Gemini 2.5 Pro, and DeepSeek V3.1 Guided Rehabilitation on Clinical Outcomes in Individuals With Degenerative Knee Disease

This randomized, four-arm clinical trial will investigate the effects of large language model (LLM)-assisted exercise prescriptions integrated with conventional physiotherapy on pain, function and quality of life in adults with degenerative knee disease. Participants will be randomly assigned to conventional physiotherapy alone or to conventional physiotherapy plus an exercise program planned with the assistance of ChatGPT-5, Gemini 2.5 Pro, or DeepSeek V3.1. All participants will receive supervised outpatient physiotherapy two times per week for 8 weeks (16 sessions in total). Outcomes will be assessed at baseline and at the end of the 8-week intervention period by physiotherapists blinded to group allocation.

Read the detailed description

Degenerative knee disease, including knee osteoarthritis, is a common cause of pain, disability and loss of independence in middle-aged and older adults. Exercise-based rehabilitation is a core component of evidence-based management, but the content and progression of exercise programs often vary between clinicians. Large language models (LLMs) such as ChatGPT-5, DeepSeek V3.1 and Gemini 2.5 Pro can generate exercise suggestions based on clinical information and may support physiotherapists in designing and progressing individualized programs. However, their impact on clinical outcomes in degenerative knee disease has not been evaluated in randomized controlled trials.

This single-center, randomized, parallel-group clinical trial will be conducted in adults with degenerative knee disease referred to the physiotherapy clinic of Kirsehir Ahi Evran University. After written informed consent and baseline assessments, participants will be randomly assigned (1:1:1:1) to one of four groups. All groups will receive a standardized outpatient physiotherapy program including hot pack, conventional TENS, therapeutic ultrasound and strengthening, range of motion, proprioceptive and functional exercises for the knee joint. In the three experimental groups, the content and progression of the exercise program will be planned with the assistance of standardized prompts to ChatGPT-5, DeepSeek V3.1 or Gemini 2.5 Pro, and all LLM-generated suggestions will be reviewed for safety and appropriateness by physiotherapists before being implemented. Sessions will be delivered two times per week for 8 weeks (16 supervised visits) under the supervision of a physical medicine and rehabilitation specialist and physiotherapists.

Outcomes will be evaluated at baseline (week 0) and after the 8-week intervention by a physiotherapist blinded to group allocation. Main outcome domains include knee pain, knee-related patient-reported outcomes, objective functional performance tests, isometric muscle strength, knee range of motion, psychosocial factors and health-related quality of life. Data will be analyzed according to CONSORT guidelines for randomized trials.

Being tested
Supervised conventional physiotherapy, ChatGPT-5-assisted exercise planning, DeepSeek V3.1-assisted exercise planning, Gemini 2.5 Pro-assisted exercise planning
Keywords
Degenerative knee disease, physiotherapy, rehabilitation, large language model, ChatGPT, DeepSeek, Gemini

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Supervised conventional physiotherapyBehavioural

    Supervised outpatient physiotherapy including hot pack (20 minutes), conventional TENS (100 Hz, 60 µs, 20 minutes), therapeutic ultrasound (1 MHz, 1.5 W/cm², 5 minutes) and a standardized knee exercise program (strengthening, range of motion, proprioceptive and functional exercises), delivered two times per week for 8 weeks (16 sessions in total).

  • ChatGPT-5-assisted exercise planningBehavioural

    Exercise selection and progression for the knee rehabilitation program supported by standardized prompts to the ChatGPT-5 large language model. All LLM-generated suggestions are reviewed for safety and appropriateness by physiotherapists before being implemented in supervised sessions.

  • DeepSeek V3.1-assisted exercise planningBehavioural

    Exercise selection and progression for the knee rehabilitation program supported by standardized prompts to the DeepSeek V3.1 large language model. All LLM-generated suggestions are reviewed for safety and appropriateness by physiotherapists before being implemented in supervised sessions.

  • Gemini 2.5 Pro-assisted exercise planningBehavioural

    Exercise selection and progression for the knee rehabilitation program supported by standardized prompts to the Gemini 2.5 Pro large language model. All LLM-generated suggestions are reviewed for safety and appropriateness by physiotherapists before being implemented in supervised sessions.

Study groups in NCT07267962
Study groupRoleWhat they receive
Conventional physiotherapyActive comparatorParticipants receive supervised conventional physiotherapy including hot pack, TENS, ultrasound and a standardized knee exercise program two times per week for 8 weeks (16 sessions).
Receives: Behavioral: Supervised conventional physiotherapy
Conventional physiotherapy plus ChatGPT-5-assisted exercise planningExperimentalParticipants receive supervised conventional physiotherapy plus an exercise program whose content and progression are planned with the assistance of the ChatGPT-5 large language model, under physiotherapist supervision, two times per week for 8 weeks (16 sessions).
Receives: Behavioral: ChatGPT-5-assisted exercise planning
Conventional physiotherapy plus DeepSeek V3.1-assisted exercise planningExperimentalParticipants receive supervised conventional physiotherapy plus an exercise program whose content and progression are planned with the assistance of the DeepSeek V3.1 large language model, under physiotherapist supervision, two times per week for 8 weeks (16 sessions).
Receives: Behavioral: DeepSeek V3.1-assisted exercise planning
Conventional physiotherapy plus Gemini 2.5 Pro-assisted exercise planningExperimentalParticipants receive supervised conventional physiotherapy plus an exercise program whose content and progression are planned with the assistance of the Gemini 2.5 Pro large language model, under physiotherapist supervision, two times per week for 8 weeks (16 sessions).
Receives: Behavioral: Gemini 2.5 Pro-assisted exercise planning

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in KOOS total score

    Knee Injury and Osteoarthritis Outcome Score (KOOS) total score (0-100), calculated as the mean of the five KOOS subscales (Pain, Symptoms, Activities of Daily Living, Sport/Recreation, and knee-related Quality of Life). Higher scores indicate better knee-related health. The primary analysis will compare change in KOOS total score from baseline to week 8 between the four groups.

    Measured: Baseline (week 0) to end of treatment (week 8)

Secondary outcomes (12)

  1. Change in knee pain intensity at rest, at night and during activity (Numeric Pain Rating Scale)

    Numeric Pain Rating Scale (0-10) scores for knee pain at rest, at night and during activity. Higher scores indicate more severe pain. Mean change in each pain condition from baseline to week 8 will be compared between groups.

    Measured: Baseline (week 0) to week 8

  2. Change in IKDC subjective knee score

    International Knee Documentation Committee (IKDC) subjective knee form score (0-100). Higher scores indicate better symptoms, sports activity and knee function. Change from baseline to week 8 will be compared between groups.

    Measured: Baseline (week 0) to week 8

  3. Change in Lysholm knee score

    Lysholm knee score (0-100). Higher scores indicate better knee function. Change from baseline to week 8 will be analyzed between the four groups.

    Measured: Baseline (week 0) to week 8

  4. Change in 30-second chair stand test performance

    Number of full stands completed in 30 seconds from a standard chair. Higher numbers indicate better lower limb functional performance. Change in repetitions from baseline to week 8 will be compared between groups.

    Measured: Baseline (week 0) to week 8

  5. Change in Four Square Step Test performance

    Four Square Step Test (FSST): the time (seconds) taken to step sequentially over four canes arranged in a cross, moving forward, sideways, and backward. Lower times indicate better dynamic balance and functional mobility. Change in completion time from baseline to week 8 will be compared between groups.

    Measured: Baseline (week 0) to week 8

  6. Change in stair climb test time

    Time (seconds) needed to ascend and/or descend a standardized set of stairs. Lower times indicate better functional performance. Change from baseline to week 8 will be compared between groups.

    Measured: Baseline (week 0) to week 8

  7. Change in maximal isometric quadriceps strength

    Maximal voluntary isometric strength of the quadriceps muscle of the target knee, measured with a handheld dynamometer. Higher values (e.g., Newtons) indicate greater muscle strength. Change from baseline to week 8 will be compared between groups.

    Measured: Baseline (week 0) to week 8

  8. Change in maximal isometric hamstring strength

    Maximal voluntary isometric strength of the hamstring muscles of the target limb, measured with a handheld dynamometer. Higher values indicate greater muscle strength. Change from baseline to week 8 will be compared between groups.

    Measured: Baseline (week 0) to week 8

  9. Change in knee range of motion

    Active knee flexion and extension range of motion measured with a universal goniometer in degrees. Higher flexion and closer-to-zero extension deficit indicate better joint mobility. Changes in range of motion from baseline to week 8 will be analyzed.

    Measured: Baseline (week 0) to week 8

  10. Change in Pain Catastrophizing Scale score

    Pain Catastrophizing Scale total score (0-52). Higher scores indicate greater levels of pain catastrophizing. Change from baseline to week 8 will be compared between groups.

    Measured: Baseline (week 0) to week 8

  11. Change in Tampa Scale for Kinesiophobia score

    Tampa Scale for Kinesiophobia total score (17-68). Higher scores indicate greater fear of movement or re-injury. Change from baseline to week 8 will be analyzed between groups.

    Measured: Baseline (week 0) to week 8

  12. Change in SF-12 physical and mental component summary scores

    Short Form-12 (SF-12) physical and mental component summary scores (0-100). Higher scores indicate better health-related quality of life. Change from baseline to week 8 will be compared between groups.

    Measured: Baseline (week 0) to week 8

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Dec 2025
  2. Study start26 Nov 2025
  3. Primary completion15 May 2026
  4. Study completion15 May 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Four-arm, parallel-group randomized controlled trial in adults with degenerative knee disease.
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
84 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07267962
Sponsor's protocol ID
2025/1056
Acronym
LLM-RehabKnee
Status last verified
May 2026
First submitted
25 Nov 2025
Last updated
7 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be shared because the ethics approval and informed consent did not cover external data sharing.

Questions about this trial

What is this clinical trial studying?

A study testing Supervised conventional physiotherapy, ChatGPT-5-assisted exercise planning and DeepSeek V3.1-assisted exercise planning in people with Degenerative Knee Disease, run by Kirsehir Ahi Evran Universitesi at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 7 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in KOOS total score (time frame: Baseline (week 0) to end of treatment (week 8)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07267962.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Oct 2026.

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