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Data from 25 participant periods for RTUS with manual facilitation and data from 26 participant periods for manual facilitation only were analyzed. The predicted marginal mean difference between interventions was 55.5% (95% CI = 13.9% to 97.1%) in favor of the addition of RTUS feedback. No adverse effects occurred. RTUS visual feedback increases SA activation in adults with painful shoulders compared with manual facilitation alone. Determining if RTUS can improve SA muscle activation may help clinicians improve physical ther