Monitoring External Workload With Wearable Technology After Anterior Cruciate Ligament Reconstruction: A Scoping Review

Background: Current sports medicine and rehabilitation trends indicate an increasing use of wearable technology. The ability of these devices to collect, transmit, and process physiological, biomechanical, bioenergy, and environmental data may aid in anterior cruciate ligament reconstruction (ACLR) workload monitoring and return-to-sport decision-making. In addition, their ease of use allows assessments to occur outside the clinical or laboratory settings and across a broader timeline.

Purpose: To (1) determine how wearable technology can assess external workload deficits between limbs (involved and uninvolved) and between groups (healthy controls vs patients with ACLR) during physical activity (PA) or sport and (2) describe the types of sensors, sensor specifications, assessment protocols, outcomes of interest, and participant characteristics from the included studies.

Study design: Scoping review; Level of evidence, 4.

Methods: In February 2023, a systematic search was performed in the MEDLINE, EMBASE, CINAHL, SPORTDiscus, Scopus, IEEE Xplore, Compendex, and ProQuest Dissertations and Theses Global databases. Eligible studies included assessments of PA or sports workloads via wearable technology after ACLR.

Results: Twenty articles met eligibility criteria and were included. The primary activity assessed was activities of daily living, although rehabilitation, training, and competition were also represented. Accelerometers, global positioning system units, pedometers, and pressure sensor insoles were worn to collect external workload data, which was quantified as kinetic, kinematic, and temporospatial data. Daily steps (count) and moderate to vigorous PA (min/day or week) were the most common units of measurement. A limited number of studies included outcomes related to between-limb asymmetries.

Conclusion: The findings of this scoping review highlight the versatility of wearable technologies to collect patients' kinetic, kinematic, and temporospatial data and assess external workload outcomes after ACLR. In addition, some wearable technologies identified deficits in workload compared with healthy controls and between reconstructed and unaffected limbs.