J Orthop Sports Phys Ther. 2019 Aug;49(8):576-583. doi: 10.2519/jospt.2019.8608. Epub 2019 Feb 13.
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.
To explore patient and parent perceptions of key rehabilitation drivers related to outcomes after ACLR.
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.
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).
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.
Therapy, level 3. .
前交叉韧带重建（ACLR）后，青少年和年轻成年人的结局存在广泛差异。然而，关于可能导致这些差异的关键康复因素的证据很少。
探讨患者和家长对 ACLR 后与结局相关的关键康复驱动因素的看法。
本研究采用解释性现象学方法，对重返运动的 ACLR 患者及其家长进行了半结构化访谈。这些访谈询问了受访者对物理治疗的体验，以及这些体验如何与他们的 ACLR 后结果相关。对访谈进行了记录、转录和编码。然后使用开放式和轴向编码过程确定主题。
患者和家长认为有 3 个主要因素会影响 ACLR 后的康复结局：（1）患者特征（即动机、信心、责任感、获取资源的机会和社会支持）；（2）物理治疗师与患者的关系质量（物理治疗师作为指导者、激励者、信心增强者、毅力培养者和护理协调者）；（3）系统要素（即治疗就诊的可用性和利用情况、诊所环境以及护理提供者之间的协调）。
影响 ACLR 康复结局的关键驱动因素包括患者、治疗师和系统因素。制定针对这些因素的具体策略可能会增强患者和家长对治疗体验的看法。这些结果所获得的认识为未来研究如何影响这些因素以及如何改善 ACLR 后的康复提供了基础。
疗法，3 级。
