Clinical note
Use of Partial Body-Weight Support for Aggressive Return to Running After Lumbar Disk Herniation: A Case Report

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Abstract

Moore MN, Vandenakker-Albanese C, Hoffman MD. Use of partial body-weight support for aggressive return to running after lumbar disk herniation: a case report.

This case report demonstrates the application of partial body-weight supported treadmill running in an aggressive rehabilitation program of an ultramarathon runner who had sustained a lumbar disk herniation. Body-weight supported exercise has recognized value during rehabilitation of lower-extremity injuries. In this case we found that the reductions in vertical loading forces achieved through partial body-weight support can also be valuable in the rehabilitation of an injury above the level of support. This motivated runner successfully used weight-supported treadmill training within 1 week of an acute lumbar disk herniation when he was experiencing considerable pain with unsupported walking and lower-extremity weakness. He continued its use until he adequately improved to allow return to his regular overground running program. This case demonstrates how partial body-weight support can allow aggressive running training early after a lumbar disk injury when normal impact forces cannot be tolerated and when leg weakness is a limitation.

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Case Description

The subject of this report was a 52-year-old physical medicine and rehabilitation physician and ultramarathon runner (M.D.H.). He had been a competitive ultramarathon runner for 12 years. At the time of his injury on January 31, 2009, he was in good health and was running 110km to 130km per week and cycling 40km to 80km per week. He had no history of prior back injury or symptoms.

The injury occurred while the subject was snowmobiling. While attempting to dislodge a snowmobile from deep snow, he

Discussion

Back pain has become one of the most common medical problems in developed countries, affecting up to 8 out of 10 people at some point during their lives.7 Lumbar disk displacements are a major causal factor of acute low back pain and present with symptoms of pain, sensory disturbances, and weakness of the lower extremities. These symptoms can be severely disabling and impair performance of normal daily activities. Weight-bearing high-impact exercise such as running is often intolerable because

Conclusions

To our knowledge, this is the first clinical report on the recently developed AlterG Anti-Gravity Treadmill. While the potential use of the system for various lower-extremity disabilities is apparent, this case demonstrates a particularly novel application, because the pathology was above the level of support.

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We certify that we have a financial involvement with an entity with a financial interest in, or financial conflict with, the subject matter or materials discussed in the manuscript. Hoffman has received grant support from AlterG, Inc., the manufacturer of the partial body-weight support system used in this report.

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