A web-support intervention to promote recovery following Anterior Cruciate Ligament Reconstruction

INTERVENTION: Three months Internet‐based intervention (web resource information and text messaging). The Internet‐based resource comprises of two elements – information and communication. Information about ACL reconstruction, expected milestones during the recovery process, strategies to overcome distress associated with the injury, and recommended physiotherapy exercises. Communication using frequent text messages to the participants via SMS (to their personal mobile phones) or emails. Participants can choose their preferred method of communication (SMS or emails) Participants will be able to access the web‐support resource as often as they wish and were encouraged to access it at least: *On a daily basis for the first week following the surgery *Three times per week for weeks 2‐4 following the surgery *Once a week for weeks 4‐12 following the surgery The SMS messages and emails encouraged the participants to access the web‐support resource and check their progress by answering a set of questions each time. Based on the participant’s response, specific recommendations were suggested. The SMS followed the rehabilitation guidelines and recommendation of accessing the website and included: *A daily reminder for the first week following the surgery *A reminder 3 times a week for weeks 2‐4 *A reminder once a week for weeks 4‐12 The SMS messages and emails included a statement or a question regarding a specific aspect of recovery, with a link to the website. The set of questions were based on certain goals or outcomes that are expected to be achieved during the rehabilitation phases following the surgery. Participants in the intervention group will be advised to continue with the standard care their health care provider institutes. The Internet‐based intervention group was differ from the standard care control group only by the inclusion of the interactive web‐support resource as part of their rehabilitation phases following the surgery. CONDITION: ACL reconstruction PRIMARY OUTCOME: Function assessed by The Knee Injury and Osteoarthritis Outcome Score (KOOS) sub score Pain related fear of movement assessed by The Tampa Scale for Kinesiophobia Self efficacy assessed by Knee Self Efficacy Scale INCLUSION CRITERIA: (1) aged 18‐45 years (2) able to speak English and give informed consent (3) had Internet access on a daily basis via mobile phone or a computer. (4) Only patients undergoing Anterior Cruciate Ligament Reconstraction SECONDARY OUTCOME: Fear about physical activity and work related activities assessed by Fear‐Avoidance Beliefs Questionnaire (FABQ). A composite secondary outcome Feasibility ‐ website access (number of times and duration) Phone interview. Questions that discuss patients perception of their readiness to return to physical and sports activities (questions for both groups). Phone interview. Questions that discuss factors related to patients’ perception about the practicalities of the website and how they found it (questions for the intervention group only). Physical activity using The short form International Physical Activity Questionnaires (IPAQ) The Knee Injury and Osteoarthritis Outcome Score (KOOS) ‐ symptoms subscore The Knee Injury and Osteoarthritis Outcome Score (KOOS) pain subscore The Knee Injury and Osteoarthritis Outcome Score (KOOS)‐ knee‐related quality of life subscore The Knee Injury and Osteoarthritis Outcome Score (KOOS)‐ knee‐related sports and recreational activities subscore