Efficacy of stairclimber versus cycle ergometry in postoperative anterior cruciate ligament rehabilitation.

Objective: To examine the effective use of stair climbing as an alternative to cycling for knee rehabilitation in an actual injured sport population.

Design: Repeated-measures multivariate analyses with data collected during anterior cruciate ligament (ACL) rehabilitation.

Setting: Clinical rehabilitation setting following ACL reconstruction.

Participants: 46 athletes with ACL reconstruction (32 males, 14 females; age 25.5 +/- 8.9 yrs) were randomly assigned to either cycle or stairclimber programs previously matched by metabolic equivalents (METs) and heart rate.

Main Outcome Measures: Isokinetic testing was performed at 4 and 12 weeks postoperatively on the uninjured knee to safely determine mean and peak concentric quadriceps, eccentric quadriceps, concentric hamstring, and eccentric hamstring peak torques. Pre/post leg girths were also measured bilaterally (+7.6, +15.2, +22.9, -7.6, -15.2, -22.9 cm) proximal/distal to the patella.

Results: Multivariate analysis of variance indicated no differences (Wilks' Lambda F(8,37) = 1.461; p = 0.21; eta(2) = 0.240; Power = 0.556) in strength gains (NM) between cycle and stair climbing groups, respectively, in mean concentric quadriceps (58.4 +/- 12.0 vs. 37.1 +/- 13.2), peak concentric quadriceps (77.0 +/- 14.7 vs. 36.8 +/- 16.2), mean eccentric quadriceps (57.2 +/- 12.7 vs. 79.2 +/- 14.0), peak eccentric quadriceps (78.6 +/- 19.3 vs. 105.5 +/- 21.3), mean concentric hamstring (14.3 +/- 3.9 vs. 6.5 +/- 4.3), peak concentric hamstring (24.0 +/- 6.7 vs. 22.2 +/- 7.4), mean eccentric hamstring (22.6 +/- 8.6 vs. 23.8 +/- 9.5), or peak eccentric hamstring (23.5 +/- 11.2 vs. 36.7 +/- 12.3) response. A significant stair climbing effect (Wilks' Lambda F(6,37) = 2.95; p = 0.02; eta(2) = 0.324; Power = 0.843) was observed in gastrocnemius girth (-15.2 cm) in both injured (0.5 +/- 0.1 cm vs. 0.3 +/- 0.1 cm, p < 0.04) and non-injured (0.3 +/- 0.1 cm vs. 0.0 +/- 0.1 cm, p < 0.008) legs.

Conclusions: In conclusion, the results of the data suggest no deleterious effect of stair climbing on knee isokinetic performance or limb girth measurements, and confirms the use of stair climbing as a viable adjunct/alternative to cycle ergometry in ACL-injured athletes.