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

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.