POTS versus deconditioning: the same or different?
Open accessAbstract
The 2007 Streeten Lecture focused on the idea that physical deconditioning plays a key role in the symptomology and pathophysiology of POTS. Parallels were drawn between the physiological responses to orthostatic stress seen in POTS patients and the physiological responses seen in "normal" humans after prolonged periods of bedrest, deconditioning, or space flight. Additionally, the idea that endurance exercise training might ameliorate some of these symptoms was also advanced. Finally, potential parallels between POTS, chronic fatigue syndrome, and fibromyalgia were also drawn and the potential role of exercise training as a "therapeutic intervention" in all three conditions was raised. The conceptual model for the lecture was that after some "initiating event" chronic deconditioning plays a significant role in the pathophysiology of these conditions, and these physiological changes in conjunction with "somatic hypervigilence" explain many of the complaints that this diverse group of patients have. Additionally, the idea that systematic endurance exercise training might be helpful was advanced, and data supportive of this idea was reviewed. The main conclusion is that the medical community must retain their empathy for patients with unusual conditions but at the same time send a firm but empowering message about physical activity. As always, we must also ask what do the ideas about physical activity and inactivity and the conditions mentioned above not explain?
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These findings suggest that the orthostatic tachycardia in POTS is a physiological compensatory response to the smaller stroke volume in the setting of cardiac atrophy and reduced blood volume.
“These findings suggest that the orthostatic tachycardia in POTS is a physiological compensatory response to the smaller stroke volume (61,62) in the setting of cardiac atrophy and reduced blood volume (Figure 2B).”
From Postural Orthostatic Tachycardia Syndrome (2019) · cites this paper as [62]
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References 24 · Cited by 90
Research works printed but not linked: 17
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- Authors
- Joyner, M. J., & Masuki, S.
- Affiliations
- Mayo Clinic (US)
- Shinshu University (JP)
- Corresponding author
- Joyner, Michael J.
- Venue
- Clinical Autonomic Research
- Published
- 2008-08-12
- Volume
- 18
- Issue
- 6
- Pages
- 300-307
- ISSN
- 0959-9851 (ISSN-L)
- 1619-1560
- PMC
- PMC3770293
- OpenAlex
- W1967290453
- Cited by
- 90
- References
- 24
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 10 · 2021: 6 · 2020: 7 · 2019: 6 · 2018: 5 · 2017: 3 · 2016: 2 · 2015: 5 · 2014: 5 · 2013: 4 · 2012: 6
- FWCI
- 5.63
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Clinical Autonomic Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01ns032352-003)
- National Heart, Lung, and Blood Institute (R01HL046493)
- National Institute of Neurological Disorders and Stroke (NS3 2352, P50NS032352, N01 NS032352, R01NS022352)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- postural orthostatic tachycardia syndrome, deconditioning, orthostatic stress, prolonged bed rest, spaceflight, endurance training, chronic fatigue syndrome, fibromyalgia, physical activity, pathophysiology
- MeSH terms
- Exercise Therapy, Fibromyalgia, Heart Rate, Humans, Hypotension, Orthostatic, Physical Endurance, Vasoconstriction, Fatigue Syndrome, Chronic, Postural Orthostatic Tachycardia Syndrome
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