Adding Multimedia Animations to Exercise Therapy Provides No Additional Benefit for Rotator Cuff–Related Shoulder Pain: A Randomized Clinical Trial

<b>Background:</b> Exercise therapy is essential in managing rotator cuff-related shoulder pain. Multimedia tools may enhance adherence and engagement, but their added value over traditional materials remains uncertain. <b>Objective:</b> To compare an exercise program delivered through paper-based materials with or without addition of multimedia animations in individuals with rotator cuff-related shoulder pain. <b>Method:</b> A single-center open-label randomized clinical trial was conducted in [Blinded] between April 2023 and December 2024 Patients with rotator cuff-related shoulder pain were included. Both groups received seven face-to-face exercise sessions with a physical therapist and were randomized into receiving or not multimedia animations. The main outcome measure was Shoulder Pain and Disability Index at 6-week follow-up. Other outcomes were pain intensity (rest, during movement and at night), patients' satisfaction, perceived improvement and expectations and patients' adherence to the exercise program. Furthermore, patients' perceived usability, usefulness and satisfaction with multimedia animations were also measured. Subjects were followed for 24 weeks. Adequate multilevel regression models were implemented. <b>Results:</b> A total of 154 subjects were included (80 in the control group and 74 in the experimental group). Both groups improved over time, but there were no significant between-group differences regarding Shoulder Pain and Disability Index, pain intensity, patients' satisfaction, perceived improvement or expectations. Subjects showed a decrease in adherence to exercise over time, without significant between-group differences. <b>Conclusions:</b> The implementation of multimedia animations may not provide additional benefits when a well-designed paper-based program and therapist support are already established.