The 19 contributors had been aged between 17 and 30 years, imply age 21.6 years (SD 3.5). There have been 7 males and 12 ladies; all had been performing contact or non-contact pivoting sport previous to their ACL damage. The contributors performed soccer (n = 8), handball (n = 7), each soccer and handball (n = 1), floorball (n = 1), American soccer (n = 1), or observe and area (n = 1), respectively. Three of the contributors had been national-level athletes, the opposite 16 participated at sub-elite stage. Interviews had been on common 17 min lengthy (vary 7–33 min) and the transcripts contained a imply of 11 068 characters with out areas (vary 5062–24,544 characters).
The qualitative content material evaluation generated three most important classes, with 19 related subcategories. The classes and subcategories are described in textual content beneath and illustrated in Fig. 1.
Overview of the athletes´ experiences of utilizing the BANG app throughout rehabilitation following ACL reconstruction
Interacting with the app
The class Interacting with the app refers to how, when, or why the contributors had been engaged with the app, and consists of seven subcategories. Selecting app content material from personal curiosity and wish illustrates how contributors allowed themselves to make use of particular content material of curiosity or repeated useful elements of the fabric. This included, selecting to revisit a video, training self-reflection workout routines, or listening to rest audio. Utilizing the app when idle or free illustrates that the contributors selected to make use of the app when it suited them; they primarily used the app early in rehabilitation—when on sick depart and sedentary. Individuals used the app once they felt like they’d the time and curiosity all through your entire intervention interval.
It was nice to have a psychological assist. Within the app menu I used to be in a position to decide on primarily based by myself wants. (ID 2)
I used the app particularly to start with of my rehab; once I was at house and on sick depart. (ID 3)
Utilizing the app along with physiotherapy illustrates that the contributors perceived the app as a useful resource for psychological assist, selling development and complementing physiotherapy classes. Drifting out of focus when different issues name for consideration describes that the contributors stopped utilizing the app when different points of life took priority (e.g., work or college). Being reminded to make use of the app by notifications means that reminders helped contributors to interact with the content material; with out notifications contributors would have forgotten to make use of the app.
I feel the app was a great further assist in my rehabilitation, to make sure I obtained as a lot out of it as doable. (ID 4)
In my busy life, I prioritize different issues than the app. (ID 15)
I used the app once I acquired the notifications. (ID 5)
Fading out of use when now not wanted, refers to how contributors’ use of the app stopped for causes comparable to now not needing it or one’s wants have been met. Individuals described being primarily occupied with ideas and worries concerning the injured knee-joint early in rehabilitation and felt supported by the app content material on the time. As rehabilitation progressed, the app was not thought of essential to succeed. Not utilizing the app, however comforted by its existence, represents how the contributors shared that they managed their rehabilitation with out the app; the contributors valued the app, and its availability ‘on-demand’. Additional on, the app was not thought of vital to reach rehabilitation.
I used the app to start with of my rehabilitation, however after some time I didn’t want it any extra. (ID 12)
I didn’t want the assist from the app, but it surely was good to have. It confirmed the following section of my rehabilitation. (ID 19)
Difficult experiences with the app
The class Difficult experiences with the app depicts the difficulties contributors skilled with the BANG app, and encompasses 5 subcategories. Struggling to navigate the app primarily describes that the contributors couldn’t simply navigate the aim setting content material as a result of it was not straightforward to find when navigating the app. Discovering the notifications technically incomplete or receiving too many describes how the contributors skilled technical issues and didn’t obtain notifications about new app materials. Individuals described that notifications had been delivered to start with, but when they modified their cellphone, they didn’t obtain additional notifications. At instances, they skilled too many notifications, which was notably aggravating in the event that they had been at school or busy with different duties.
I couldn’t find all the pieces within the app. (ID 7)
I used to be irritated once I acquired notifications and didn’t have the time to interact with the app. (ID 9)
Missing content material that was tailor-made to 1’s sport and rehabilitation section refers to how the contributors had recognized an absence of alignment between the app materials and their very own timeline post-ACLR; they felt the content material was both too early or too late. When the app content material didn’t seem with the appropriate timing, it was troublesome to interact with the fabric. Individuals additionally described that the app lacked materials that was tailor-made to 1’s personal sport, and so they couldn’t relate to some predefined multiple-choice alternate options within the app or to watching movies with athletes in sports activities apart from their very own. Respiration and rest workout routines within the app had been perceived as troublesome and difficult to interact in.
It was troublesome to narrate to different varieties of sports activities than mine. (ID 1)
In Lacking particular person suggestions, contributors wished that somebody may have learn their responses from surveys, offering particular person suggestions. Individuals felt that the app would have helped them extra if it included personalised choices in ready-made questions. Additional, the contributors described Discovering it exhausting to make use of the app when not making any progressions with rehabilitation: it was much less motivating to make use of the app throughout a plateau of development or setbacks, dropping their incentives to interact with the app.
I didn’t obtain any suggestions on my aim setting within the app. (ID 18)
Early in my rehabilitation I used to be actually struggling. I couldn’t get wherever with my bodily workout routines; that was a troublesome time for me to make use of the app. (ID 8)
Supportive experiences with the app
The class Supportive experiences with the app displays how the app facilitated the contributors’ rehabilitation progress; it encompasses seven subcategories, together with optimistic points of the app content material and navigation, boosting their confidence to return to sport, and motivation to proceed with rehabilitation. The app format promotes entry and has straightforward navigation highlights how contributors appreciated the accessibility of the app and that the navigation was intuitive: easy to make use of, logical and with a pedagogy to the content material. The app didn’t require loads of writing for the contributors as most app content material had ready-made solutions and the menu was straightforward to navigate. Studying extra about damage and concern represents that the contributors gained data from the app content material; the app grew to become a useful further info useful resource, along with the physician and the physiotherapist.
To have entry to an app is a lot better than an internet site. (ID 14)
In addition to the data I obtain from my physician and physiotherapist, it’s good to have the additional tutoring [that comes with the app]. (ID 16)
The tutorial content material of the app helped contributors perceive the method of being in rehabilitation; it was comforting to learn and watch (textual content and movies) that concern is widespread throughout return to sport. Individuals described that Being supported by watching different athlete’s movies and/or training visualization workout routines assisted them in understanding that others have had related accidents and experiences. Studying about different athletes’ ups and downs in rehabilitation supplied a practical expectation for their very own expertise. Figuring out that obstacles can happen in or throughout rehabilitation validated their worries about setbacks, as did understanding {that a} lack of motivation may also occur to others. When different athletes shared (by way of the app content material) how they started their rehabilitation post-surgery on the sofa after which later returned to sport, contributors had been impressed: they described how the tales gave hope that they too would succeed. Additional, training visualization workout routines was supportive to organize for upcoming motion expertise of their rehabilitation.
It was a studying expertise watching different athletes speaking about the identical kind av damage as I’ve. (ID 6)
The subcategory Enabling reflection, illustrated an inspiration to take a seat down, and take into consideration how one feels in a specific second. The contributors described how the app helped them to mirror about returning to sport and whether or not they trusted their injured knee. Whereas reflection may very well be scary, it helped keep motivation. But, if the workout routines with reflections occurred too usually within the app, with not sufficient time in between, it was much less useful: one wanted to have made some progress earlier than one may tackle the following perspective. Utilizing the app for reflections was notably useful attributable to its format: the participant was protected and undisturbed of their personal area.
Reflections are useful; I get an opportunity to ask myself ‘how do I actually really feel’? (ID 17)
Selling setting objectives refers back to the act of phrasing one’s ambition with regards to rehabilitation and returning to sports activities: the app helped with a number of objectives to select from. With the advantage of hindsight, contributors may return to their earlier objectives and observe their rehabilitation development, no matter how small the steps had been. The app was Serving to to simply accept emotions and sensations, and contributors had been supported when it comes to self-compassion and physique consciousness. Individuals described that in setbacks of their rehabilitation, the app helped them navigate feeling low; the app bolstered that it’s okay to have such emotions. When being inspired to not suppress feeling low, a way of normalization may seem, and contributors felt much less lonely of their rehabilitation. Workout routines with respiration and rest helped to entry physique consciousness. Transferring data to different instances in life, illustrates that the contributors discovered of such points from the app, and applied them in different life conditions not associated to sports activities.
Setting objectives has helped me to remain centered on what’s most essential in my rehabilitation. (ID 10)
The app made me conscious of my knee and my concern. It helped me to grasp extra about my emotions and settle for them. (ID 11)
I feel I might use the expertise from the app if I might have a brand new damage. (ID 13)