Abstract 16542: Gravitational Based Therapy for POTS: An International Registry Evaluating the Success of a Structured, Graduated Exercise Program Administered in a Community Setting
Postural Orthostatic Tachycardia Syndrome (POTS) is a debilitating syndrome of orthostatic intolerance resulting in lightheadedness, fatigue, and syncope leading to a dramatically reduced quality of life. POTS is defined by upright tachycardia (>120 bpm or >30 bpm change over supine) and symptoms of orthostatic intolerance; cardiac atrophy or deconditioning, is a significant underlying mechanism. Astronauts (67%), develop similar symptoms of tachycardia upon standing after the deconditioning of living in a zero gravity environment; however, exercise during space flight helps alleviate these symptoms upon return to earth. A previous small, controlled clinical trial suggested seated exercise based on astronaut-derived training might be beneficial for POTS patients. Two hundred six patients were enrolled from five countries [24 M, 182 F, age 26 ± 11 (mean ± SD)] by their personal physicians in their home environment. The 10 minute stand test, and a quality of life questionnaire (Short-Form 36 v2) were used to assess patients. A rigorous training program began with recumbent exercise and progressed to upright modalities over 3 months. Sixty-four patients already completed the program. Fifty-five patients dropped out (26.7%). Fourteen are pending due to lack of follow up data and 73 are still training. In “finishers” the HR after 10 minutes standing was significantly reduced after training ([[Unable to Display Character: ▵]]HR 42.6 ± 14.5 bpm pre vs. 21.9 ± 12.5 post, p<0.001). Patients’ physical (30 ± 9.2 pre vs. 42.6 ± 8.8 post, p<0.001), mental (41.2 ± 11.2 vs. 47.9 ± 8.7, p<0.001), and social function (28.1 ± 10.5 vs. 41.2 ± 11.3, p<0.001) scores significantly improved. Of those reporting 3 month data, 41 out of 56 patients no longer met POTS criteria after completing the training program, a 73% “cure” rate. Our data suggest this training program could be a successful non-drug treatment for POTS patients administered in a community setting.
- © 2012 by American Heart Association, Inc.