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

Journal of athletic training
April 16, 2025
David Werner et al. (6 authors)
Journal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to assess the feasibility and acceptability of implementing a progressive walking program early after anterior cruciate ligament reconstruction (ACLR).

Results Summary

Participants showed high adherence to activity monitoring and virtual sessions but met daily step goals only about half the time. No adverse events were reported, and qualitative themes identified factors promoting successful physical activity.

Population

Ten individuals (60% female, mean age 20.2 ± 3.9 years, mean BMI 22.6 ± 2.9 kg/m²) within 8 weeks of unilateral ACLR.

Effective Dosage

12-week personalized progressive walking program with weekly virtual physical therapist visits.

Duration

12 weeks

Interactions

None mentioned

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
A 12-week personalized progressive walking program to increase daily steps utilizing weekly virtual visits with a physical therapist
no change
feasibility and acceptability
individuals within 8 weeks of a unilateral ACLR
mixed
demonstrated mixed feasibility and acceptability
#1
A 12-week personalized progressive walking program to increase daily steps utilizing weekly virtual visits with a physical therapist
increase
wearing an activity monitor
individuals within 8 weeks of a unilateral ACLR
92.3% of days
demonstrated high adherence
#2
A 12-week personalized progressive walking program to increase daily steps utilizing weekly virtual visits with a physical therapist
increase
completing weekly virtual physical activity program sessions
individuals within 8 weeks of a unilateral ACLR
94.2% of appointments
demonstrated high adherence
#3
A 12-week personalized progressive walking program to increase daily steps utilizing weekly virtual visits with a physical therapist
no change
daily physical activity goals
individuals within 8 weeks of a unilateral ACLR
54.8% of days
were only met approximately half of the time
#4
A 12-week personalized progressive walking program to increase daily steps utilizing weekly virtual visits with a physical therapist
increase
physical activity target
50% of individuals
at least 50% of weeks
reached
#5
A 12-week personalized progressive walking program to increase daily steps utilizing weekly virtual visits with a physical therapist
no change
adverse events related to the walking program
individuals within 8 weeks of a unilateral ACLR
no
were not reported
#6
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.

Study Links
Quality Scores
Safety100
Efficacy60/10
Quality75/10
Research Impact Scores
APT Score0.05
Weight Score2.50
Normalized Score0.79
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