Patient and Parent Perceptions of Rehabilitation Factors That Influence Outcomes After Anterior Cruciate Ligament Reconstruction and Clearance to Return to Sport in Adolescents and Young Adults

BACKGROUND: Wide variation in outcomes after anterior cruciate ligament reconstruction (ACLR) exists among adolescents and young adults. However, little evidence is available regarding key rehabilitation factors that may be driving these differences. OBJECTIVE: To explore patient and parent perceptions of key rehabilitation drivers related to outcomes after ACLR. METHODS: In this qualitative study, which used an interpretive phenomenological methodology, semi-structured interviews were conducted with patients who had returned to sport after ACLR and with their parents. The interviews asked about respondents' experience with physical therapy and how it related to their outcomes after ACLR. The interviews were recorded, transcribed, and coded. Themes were then identified using open and axial coding processes. RESULTS: There were 3 primary themes that patients and parents perceived as key factors influencing their rehabilitation outcomes after ACLR: (1) patient attributes (ie, motivation, confidence. accountability, access to resources, and social support). (2) physical therapist-patient relationship qualities (physical therapist as guide, motivator, booster of confidence, fosterer of perseverance, and coordinator of care), and (3) elements of the system (ie, availability and utilization of therapy visits, clinic environment, and coordination among care providers). CONCLUSION: Patient and parent perspectives of key drivers that influence ACLR rehabilitation outcomes include patient, therapist, and system factors. Developing specific strategies to target these factors may enhance patient and parent perceptions of the experience. The awareness gained from these results provides a foundation for future studies examining how these factors affect outcomes and how to improve rehabilitation after ACLR.