Integration of an Adjunct Digital Exercise Program for Anterior Cruciate Ligament Reconstruction Rehabilitation: Patient Use and Acceptability

Purpose To evaluate patient use and acceptability of an adjunct digital exercise program for anterior cruciate ligament (ACL) reconstruction rehabilitation, as well as overall patient engagement with rehabilitation. Methods Consecutive patients who underwent primary ACL reconstruction were enrolled in a digital ACL rehabilitation exercise program (PhysioAid, Canada) as an adjunct to usual postoperative care for 35 weeks after surgery. Patient use was measured by the number of digital exercise prescriptions opened. Patient acceptability was evaluated via an online questionnaire. Overall patient engagement was assessed by the number of rehabilitation‐related queries submitted, completion of patient‐reported outcomes, and attendance at the 6‐month postoperative functional testing clinic. Results A total of 450 patients were enrolled. Of these, 289 patients (64.2%) opened at least 1 digital exercise prescription. Completed questionnaires were returned by 221/450 patients (49.1%). Of the respondents, 176 (79.6%) reported using the digital exercise prescriptions, and 165 respondents) (74.6%) indicated these were helpful. A greater proportion of patients who opened the digital exercise prescriptions submitted queries regarding their rehabilitation (24.2% vs 14.9%), completed their 6‐month postoperative ACL‐quality of life questionnaire (40.8% vs 28.0%), and attended their 6‐month functional testing visit (49.8% vs 39.1%). However, none of these differences reached statistical significance. Conclusions The adjunct digital exercise program showed meaningful patient uptake and was considered helpful by most respondents. Clinical Relevance About one‐third of patients fail to complete evidence‐based rehabilitation within 6 months after ACL reconstruction, with barriers being multifactorial. This study may provide a method to overcome some of these barriers, which is crucial for improving rehabilitation outcomes.