Can patients and clinicians find conservative management protocols of anterior cruciate ligament injuries online? A systematic review

Arianne P Verhagen; Poonam Mehta; Chiara Hildenbrand; Jarrod Pace; Anthony Nasser; Alana B McCambridge

doi:10.1016/j.msksp.2023.102754

Can patients and clinicians find conservative management protocols of anterior cruciate ligament injuries online? A systematic review

Musculoskelet Sci Pract. 2023 Jun:65:102754. doi: 10.1016/j.msksp.2023.102754. Epub 2023 Apr 10.

Authors

Arianne P Verhagen¹, Poonam Mehta², Chiara Hildenbrand², Jarrod Pace², Anthony Nasser², Alana B McCambridge³

Affiliations

¹ Discipline of Physiotherapy, Graduate School of Health, University of Technology Sydney, Sydney, Australia. Electronic address: [email protected].
² Discipline of Physiotherapy, Graduate School of Health, University of Technology Sydney, Sydney, Australia.
³ Discipline of Physiotherapy, Graduate School of Health, University of Technology Sydney, Sydney, Australia; Public Health Association of New Zealand, New Zealand.

PMID: 37098282
DOI: 10.1016/j.msksp.2023.102754

Abstract

Objective: To systematically search the internet for conservative rehabilitation protocols for people with an anterior cruciate ligament (ACL) injury and critically appraise the websites and exercise protocols.

Design: Systematic review of online rehabilitation protocols.

Search: We searched four online search-engines (Google, Yahoo, Bing, DuckDuckGo).

Selection criteria: Rehabilitation protocols on active, English language websites aimed at conservative (non-surgical) management of an ACL injury.

Data synthesis: We extracted descriptive information and assessed quality of the websites using the Journal of the American Medical Association (JAMA) benchmark criteria, the Health on the Net Code (HONcode) certificate, and the Flesch-Kincaid Reading Ease (FKRE). We assessed completeness of exercise protocol reporting using the Consensus on Exercise Reporting Template (CERT). We performed a descriptive analysis.

Results: We found 14 websites that met our selection criteria. The protocols varied between 10 and 26 weeks duration, nine were from the United States, five targeted patients, and 13 used multiple phases with a variety of different criteria for progression. Three protocols scored good quality with the JAMA, two were HonCode certified, and ten had good readability according to the FKRE. Completeness of exercise protocol reporting in all but one protocol was poor according to the CERT.

Conclusion: Few rehabilitation protocols for conservative management of ACL injuries were available online. Most of the websites showed good readability, but poor quality and credibility with inadequate description of exercise protocols.

Keywords: Exercise protocols; Knee injury; Quality assessment websites.

Publication types

Review
Systematic Review

MeSH terms

Anterior Cruciate Ligament Injuries* / therapy
Comprehension
Conservative Treatment
Humans
Internet
Patients