Adherence to anterior cruciate ligament rehabilitation: A qualitative analysis

Objective: To investigate the subjective experience of anterior cruciate ligament (ACL) rehabilitation and identify variables that influence adherence as perceived by ACL-reconstructed patients. Design: A qualitative study using in-depth interviews to gather data and thematic coding to analyze findings. Setting: Participants were interviewed at home or in their workplace. Participants: Eleven patients were interviewed at an average of 4.8 months (SD = 0.8) after ACL reconstruction. Results: Using thematic coding of the interview data, 3 categories of variables influencing adherence emerged: environmental factors, physical factors, and psychological factors. Variables specifically affecting adherence to home exercise were perceived lack of time and a lack of self-motivation. Fear of reinjury emerged as a significant consideration for those who were nonadherent. Factors such as therapist support, the rehabilitation clinic, and the progression of exercises were identified as being important for attendance at physiotherapy appointments and adherence during appointments.