Background: This study aimed to compare the effectiveness of artificial intelligence (AI)-generated, personalized video-based exercise instructions with traditional paper-based leaflets in improving exercise adherence and accuracy among patients with Achilles tendinitis and plantar fasciitis, and to evaluate whether this approach can serve as a practical tool for home exercise education that enables physicians and physiotherapists to easily create customized exercise programs without the need for advanced technical expertise or external resources. Methods: 159 patients diagnosed with Achilles tendinitis or plantar fasciitis were randomized into 2 groups, with 103 completing the study in the paper exercise group (n = 47) and video exercise group (n = 56). The video group received exercise instructions created using the Google Veo 3 AI platform, whereas the paper group received standard AAOS/OrthoInfo leaflets. Exercise adherence was assessed using the Exercise Adherence Rating Scale (EARS), and exercise accuracy was evaluated through a 3-stage scoring system for 4 specific foot stretching exercises. Results: There was no significant difference between the groups in overall exercise adherence rates (71% vs 73%, P = .276). The mean EARS scores were 18.4 ± 3.1 for the paper group and 18.9 ± 3.4 for the video group ( P = .412). However, the video group demonstrated significantly higher accuracy in complex exercises, particularly the Towel Curls (2.82 ± 0.27 vs 2.23 ± 0.31, P < .001). Subgroup analysis revealed that educational level affected adherence in the paper group ( P = .012), whereas no such difference was observed in the video group ( P = .624). Conclusion: AI-generated video instructions demonstrate comparable effectiveness to traditional printed leaflets in supporting short-term exercise adherence and may enhance exercise accuracy, particularly for complex, multistep movements. This low-cost approach may enable health care professionals to readily create personalized exercise programs without copyright concerns or the need for advanced technical skills - offering a practical and scalable adjunct to conventional home exercise education. Level of Evidence: Level II, randomized controlled trial.
Ülgen et al. (Wed,) studied this question.