Consistency of AI-Generated Exercise Prescriptions: A Repeated Generation Study Using a Large Language Model

This study compared repeated generation consistency of exercise prescription outputs across three large language models (LLMs), specifically GPT-4.1, Claude Sonnet 4.6, and Gemini 2.5 Flash, under temperature=0 conditions. Each model generated prescriptions for six clinical scenarios 20 times, yielding 360 total outputs analyzed across four dimensions: semantic similarity, output reproducibility, FITT classification, and safety expression. Mean semantic similarity was highest for GPT-4.1 (0.955), followed by Gemini 2.5 Flash (0.950) and Claude Sonnet 4.6 (0.903), with significant inter-model differences confirmed (H = 458.41, p < .001). Critically, these scores reflected fundamentally different generative behaviors: GPT-4.1 produced entirely unique outputs (100%) with stable semantic content, while Gemini 2.5 Flash showed pronounced output repetition (27.5% unique outputs), indicating that its high similarity score derived from text duplication rather than consistent reasoning. Identical decoding settings thus yielded fundamentally different consistency profiles, a distinction that single-output evaluations cannot capture. Safety expression reached ceiling levels across all models, confirming its limited utility as a differentiating metric. These results indicate that model selection constitutes a clinical rather than merely technical decision, and that output behavior under repeated generation conditions should be treated as a core criterion for reliable deployment of LLM-based exercise prescription systems.

Large language models are increasingly deployed in agentic pipelines that depend on the model evaluating its own outputs without external verification. The reliability of these pipelines depends on an implicit assumption: that the model applies relevant concepts the same way when it generates an output and later evaluates that output. We propose a new measure, generator-evaluator self-consistency, to test this assumption directly and apply it to 10 frontier models across 491 concepts. We find, first, that there is substantial variation in self-consistency. Second, we find that in a clinical setting with physician-validated mistakes (Proniakin et al., 2025), across models, those with higher self-consistency are linked to greater vulnerability to mistakes. Thus, even when models consistently apply concepts they may not be safe to deploy. This is evidence of a consistency dilemma in LLMs: self-consistency is operationally useful, but models that are more consistent are also more prone to mistakes.

Scientific Fitness Coaching (SFC) is typically delivered by human professionals, making it costly and inaccessible to many. While recent advances in Large Language Models (LLMs) show considerable promise for more inclusive fitness coaching, directly deploying prevailing general-purpose LLMs in SFC reveals critical limitations. These models often lack sufficient domain-specific knowledge integration, leading to weak performance on complex SFC scenarios. In this paper, we introduce FitOne, a series of fitness LLMs (with 8B and 32B parameters) designed to improve reliability and domain specialization for SFC applications. Built upon the Qwen3 foundation models, FitOne is developed through a three-stage post-training pipeline consisting of continual pre-training, supervised fine-tuning, and reinforcement learning, using large-scale, high-quality datasets derived from rigorous knowledge engineering. We conduct comprehensive evaluations of FitOne on professional fitness certification exams, including ACSM-EP and NSCA-CSCS, as well as general capabilities such as knowledge reasoning and instruction following. Experimental results show that, while retaining strong general capabilities, FitOne-8B/32B achieves average improvements of up to 10.09%/9.29% and 12.73%/7.01% on the ACSM-EP and NSCA-CSCS exams, respectively, compared with the Qwen3 base models. Furthermore, in-depth ablation studies confirm the necessity of each training stage, highlighting the pipeline's effectiveness in balancing domain expertise enhancement with general ability retention. We believe this research advances LLM systems toward more reliable fitness intelligence and will inspire future research on developing domain-specific LLMs.