Tania Pizzari, Helen McBurney, Nicholas F. Taylor and Julian A. Feller
To investigate the subjective experience of anterior cruciate ligament (ACL) rehabilitation and identify variables that influence adherence as perceived by ACL-reconstructed patients.
A qualitative study using in-depth interviews to gather data and thematic coding to analyze findings.
Participants were interviewed at home or in their workplace.
Eleven patients were interviewed at an average of 4.8 months (SD = 0.8) after ACL reconstruction.
Using thematic coding of the interview data, 3 categories of variables influencing adherence emerged: environmental factors, physical factors, and psychological factors. Variables specifically affecting adherence to home exercise were perceived lack of time and a lack of self-motivation. Fear of reinjury emerged as a significant consideration for those who were nonadherent. Factors such as therapist support, the rehabilitation clinic, and the progression of exercises were identified as being important for attendance at physiotherapy appointments and adherence during appointments.
Tania Pizzari, Nicholas F. Taylor, Helen McBurney and Julian A. Feller
To investigate the relationship between adherence to rehabilitation and outcome after reconstructive surgery of the anterior cruciate ligament (ACL).
A prospective cohort study with adherence to rehabilitation evaluated over 8 weeks correlated with outcomes at 9 and 12 months postsurgery.
68 patients who had undergone ACL-reconstructive surgery.
Main Outcome Measures:
Adherence was measured to and during appointments and by a self-report diary of home exercise. Outcomes were measured by 6 knee-function scales and 2 hop tests.
There was a significant relationship between home-exercise adherence and many outcomes for participants under 30 years of age (r
s = .33-.44). For participants age 30 and over there was a negative relationship between home-exercise adherence and outcome. There were no significant relationships between adherence to and during physical therapy appointments and outcome after ACL-reconstructive surgery.
Participants under 30 years of age who adhered to their home-exercise regimen had better functional outcome, whereas adherent participants age 30 and over experienced worse outcome with better home-exercise adherence.