Feasibility and Acceptability of Implementing a Progressive Walking Program after ACL Reconstruction: A Mixed Methods Study.

Abstract

Context: Individuals after anterior cruciate ligament reconstruction (ACLR) participate in less physical activity compared to uninjured peers. Physical activity in this population is important for both short and long-term health, particularly to reduce the risk of chronic conditions (eg, obesity, osteoarthritis).

Objective: The purpose of this study was to assess the feasibility and acceptability of implementing a walking program early after ACLR.

Design: Explanatory Mixed Methods Study.

Setting: Telehealth.

Patients or other participants: Ten individuals (60% female, mean age 20.2 ± 3.9 years old, mean BMI 22.6 ± 2.9 kg/m2 ) within 8 weeks of a unilateral ACLR.

Intervention: A 12-week personalized progressive walking program to increase daily steps utilizing weekly virtual visits with a physical therapist.

Main outcome measures: Quantitative data included rates of appointment attendance, activity monitor wear compliance, adverse events, and achievement of daily step goals. Qualitative analysis of field notebooks collected throughout the intervention and semi-structured post intervention interviews were performed to explain the quantitative feasibility metrics using a case study approach.

Results: Participants wore their activity monitor 92.3% of days, attended 94.2% of appointments, met their recommended physical activity goal 54.8% of days, and 50% of individuals reached their physical activity target at least 50% of weeks. No adverse events related to the walking program were reported. Program-level and participant-level themes that promoted successful physical activity goal achievement were identified.

Conclusions: This study demonstrated mixed feasibility and acceptability of a progressive walking program early after ACLR. Participants demonstrated high adherence to wearing an activity monitor and completing weekly virtual physical activity program sessions. However, daily physical activity goals were only met approximately half of the time. Clinicians and researchers can use the themes identified from the qualitative analysis in future program designs to promote physical activity after ACLR.