L.K. Truong1, A.D. Mosewich2, M. Miciak3, A. Pajkic2, C.Y. Le3, L.C. Li1, J.L. Whittaker1
1University of British Columbia, Department of Physical Therapy, Faculty of Medicine, Vancouver, Canada, 2University of Alberta, Faculty of Kinesiology, Sport, and Recreation, Edmonton, Canada, 3University of Alberta, Faculty of Rehabilitation Medicine, Edmonton, Canada

Background: There is irrefutable evidence that exercise-based activities (i.e., exercise-therapy, physical activity, and sport) are essential for musculoskeletal health and osteoarthritis prevention after a youth anterior cruciate ligament (ACL) tear. Unfortunately, there are deleterious psychological, social, and contextual factors associated with ACL injuries that negatively impact the ability to participate and fully benefit from exercise-based activities beyond the typical rehabilitation period. An improved understanding of the attitudes, priorities, and perceptions of exercise-based activities of youth who have completed their formal rehabilitation for an ACL tear is vital for informing the development and implementation of exercise-based interventions to promote life-long mobility and health.

Purpose: Explore and identify the attitudes, priorities, and perceptions toward exercise-therapy, physical activity, and sport of youth 12-24 months after a sport-related ACL tear.

Methods: Using a qualitative (interpretative description) approach, current attitudes, priorities, and perceptions of exercise therapy, physical activity, and sport participation were explored through one-on-one semi-structured interviews. A purposive sample (i.e., age, gender, activity level) of youth (15-19 years old) who experienced an ACL tear or reconstruction (ACLR) in the past 12-24 months were included. Analyses followed an inductive approach informed by Thorne’s (2016) analytic process for interpretative description. Reflexive journaling, memoing, a detailed audit trail, and member-checking promoted data transparency and trustworthiness. A patient-partner assisted with the interview guide development and data interpretation.

Results: Six young women and four young men (median age of 17.5 (range 15-18) years) with a median of 20 (16-26) months from injury were interviewed. Seven participants had undergone an ACLR and three managed their ACL tear non-surgically. Three overarching themes were identified. ‘Balancing physical activity and future knee health’ highlighted an ongoing negotiation between what were perceived to be competing priorities for return-to-sport and future knee health. ‘Reframing the value of exercise-therapy and physical activity’ reflected the importance of reshaping exercise attitudes as positive, and was linked to prolonged adherence to exercising. ‘Overcoming unforeseen exercise challenges’ encompassed psychological (e.g., unexpected recovery timelines) and physical challenges (e.g., persistent symptoms) that remained up to two years following injury and were perceived to limit physical activity. A cross-cutting theme, ‘Timing of Injury,’ represented how the impact of an ACL tear can differ based on its timing relative to developmental milestones (i.e., transition from grade school to university).

Conclusion(s): Attitudes, priorities, and perceptions of exercise-based activities shape how youth engage in exercise-therapy, physical activity and sport 12-24 months after an ACL tear. Reshaping beliefs by putting a positive spin on these activities, and leveraging the motivation for return-to-sport and life-long knee health may be important strategies to employ when engaging youth in exercise-based activities after completing their ACL rehabilitation.

Implications: Before engaging individuals who have had an ACL tear 12-24 months earlier in exercise-based activities, it may be important to understand their beliefs about exercise and priorities for return-to-sport and long-term knee health.

Funding, acknowledgements: Project was funded by a University of Alberta Seed Grant. LKT holds a University of British Columbia Doctorate Fellowship Award.

Keywords: Anterior Cruciate Ligament, Exercise, Adolescents

Topic: Sport & sports injuries

Did this work require ethics approval? Yes
Institution: University of Alberta
Committee: Human Research Ethics Board Health Panel
Ethics number: Pro00083205

All authors, affiliations and abstracts have been published as submitted.

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