A DIGITAL EXERCISE PROGRAMME IMPROVED PATIENT ENGAGEMENT DURING REHABILITATION FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

The purpose of this study was to evaluate patient engagement with, and acceptability of, a digital exercise program for primary anterior cruciate ligament (ACL) reconstruction during the first 6-months post-operative. A secondary purpose was to determine if engagement with the digital exercise program also improved overall patient involvement in rehabilitation. Patients that underwent primary ACL reconstructive (ACLR) surgery between 2019 and 2021 were enrolled in PhysioAid and received an email-delivered digital ACL rehabilitation exercise program. The customised ACLR PhysioAid program was provided in addition to the standard rehabilitation protocol. The digital program delivered 12 phases of exercise prescription videos every 2 & 3 weeks for 35 weeks post-operative. Patient engagement with PhysioAid was measured by the number of exercise prescriptions opened. Patient acceptability of PhysioAid was evaluated via an online questionnaire. Overall patient engagement was measured by number of email queries related to rehabilitation, completion of 6-month post-operative ACL-QOL questionnaire, and attendance at the 6-month post-operative functional testing clinic. Data was descriptively analysed using means, SD and qualitative measures. Four hundred and fifty patients were enrolled in the PhysioAid program. Two hundred and eighty-nine patients (64%) accessed at least one exercise prescription, with 49% accessing 6 or more of the 12 prescriptions. Overall, 242 patients (54%) responded to the online survey, with 221 (49%) returning completed questionnaires. Of the patients that accessed PhysioAid, 62% responded to the online questionnaire, compared with 39% that did not access any exercise prescriptions. Of those respondents, 80% responded they followed the PhysioAid exercise prescriptions. In addition, 75% of respondents indicated that they found the prescriptions helpful in someway, with 86% responding they accessed the prescriptions over the 6-month period with a frequency of about 30% or greater. Most respondents (61%) also agreed that the PhysioAid exercise prescriptions were an essential part of their rehabilitation program due to COVID-19 restrictions. Patients that accessed PhysioAid exercise prescriptions were more likely to send email queries regarding their rehabilitation compared to those that didn't access the program (24.2% versus 14.9%), were more likely to complete their 6-month post-operative ACL-QOL questionnaire (40.8% versus 28.0%), and attend their scheduled 6-month functional testing clinic (49.8% versus 39.1%). The addition of a digital rehabilitation program to the standard-of-care protocol increased patient engagement with their rehabilitation. Patients who accessed the exercise prescriptions were more likely to attend the 6-month post-operative appointment and complete the ACL-QOL. Further research is needed to determine if the incorporation of a digital exercise program during ACLR rehabilitation improves patient outcomes.