Analyzing the Quality, Reliability, and Educational Value of ACL Rehabilitation Exercises on TikTok: A Cross-Sectional Study

Mikhail A Bethell; Albert T Anastasio; Kwabena Adu-Kwarteng; Troy Q Tabarestani; Brian C Lau

doi:10.1177/23259671231218668

Analyzing the Quality, Reliability, and Educational Value of ACL Rehabilitation Exercises on TikTok: A Cross-Sectional Study

Orthop J Sports Med. 2023 Dec 21;11(12):23259671231218668. doi: 10.1177/23259671231218668. eCollection 2023 Dec.

Authors

Mikhail A Bethell¹, Albert T Anastasio², Kwabena Adu-Kwarteng¹, Troy Q Tabarestani¹, Brian C Lau²

Affiliations

¹ School of Medicine, Duke University, Durham, North Carolina, USA.
² Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA.

Abstract

Background: Videos relating to rehabilitation exercises for common injuries relevant to younger populations such as anterior cruciate ligament (ACL) tear receive high view counts on social media platforms such as TikTok.

Purpose/hypothesis: The purpose of this study was to analyze the quality, reliability, and educational value of TikTok videos among the patient population for ACL injury. It was hypothesized that TikTok videos related to ACL rehabilitation exercises would lack quality, reliability, and educational value.

Study design: Cross-sectional study.

Methods: TikTok was queried for relevant videos using the hashtags "#ACLrehab" and "#ACLexercises." For each included video, the type of uploader (general user or health care professional) was identified. In addition, the number of views, likes, shares, comments, and favorites for each included video was recorded, and the content of each video was graded using the DISCERN (a well-validated informational analysis tool) and the ACL exercise education score (ACLEES - a custom-designed tool for the evaluation of ACL-related exercises).

Results: A total of 111 videos with 5,520,660 cumulative views were included; the median number of views per video was 9801.0 (interquartile range [IQR], 3583.0-28,000.0). Of these videos, 84 and 27 were created by the general public and health care professionals, respectively. The videos collectively received 335,577 likes, 2969 comments, 22,856 favorites, and 6142 shares, with a median of 439 (IQR, 111-1374), 10 (IQR, 2.5-25.5), 54 (IQR, 18-172.5), and 12 (IQR, 2-36), respectively. The tabulated scores for the DISCERN and ACLEES between general users and health care professionals were all statistically nonsignificant. Health care professionals had a higher percentage of videos with a "very poor" DISCERN score in comparison with the general public (66.67% vs 53.57%, respectively).

Conclusion: The overall educational value of the TikTok videos related to ACL rehabilitation exercises was very poor. Health care professionals should be aware of the broad distribution of ACL rehabilitation exercise videos that are accessible on TikTok and raise awareness of the deficiencies of the platform as a medium for educational medical-related information.

Keywords: ACL; TikTok; educational value; rehabilitation; reliability.