The nature of rehabilitation programs to improve musculoskeletal, biomechanical, functional, and patient-reported outcomes in athletes with ACL reconstruction: A scoping review

Context: Following anterior cruciate ligament (ACL) reconstruction, athletes commonly undergo prolonged rehabilitation (e.g., 9-12 months), but few individuals actually return to pre-injury sports activities. The nature (composition, configuration) of an ACL rehabilitation program (ACL-RP) is an important factor in determining rehabilitation outcomes; however, details about the nature of ACL-RPs are inconsistently reported in research studies. To guide future research reporting to support clinical translation and implementation of ACL-RPs, it is necessary to describe the nature, reporting, and outcomes of ACL-RPs in the current literature. Objective: The purpose of this scoping review was to understand the nature and reporting of various rehabilitation programs that address musculoskeletal, biomechanical, functional, or patient-reported outcome measures in adult and pediatric athletes with ACL reconstruction (ACL-R). Data Sources: Articles were selected from searches in five electronic databases (PubMed, EbscoHost (MEDLINE, SportDiscus, CINAHL Plus), PROQuest, Cochrane, and Embase). Study Selection: Studies were included if they evaluated a post-ACL-RP that implemented strength, balance, plyometric, change of direction running, and/or agility running and included self-reported physical function, quality of life, or pain outcomes. Study Design: Scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines. Level of Evidence: 4 Data Extraction: Data was extracted and synthesized to evaluate the reporting of acute program variables (APVs) and exercise descriptors (EDs). Seventeen studies were included in the final synthesis. Results: Studies reported between 0-67% of the APVs and EDs combined. Only two studies were considered to have adequate reporting of both APVs and EDs. Conclusions: Inadequate reporting of APVs and EDs in past studies restricts the translation and implementation of existing research-based ACL-RPs to present-day clinical contexts.