The DOI matches its Crossref record; 88 of the 88 references it cites were found in a registry or an index.
Exercise and non-pharmacological treatment of POTS
Open accessAbstract
Recent research has demonstrated that cardiovascular deconditioning (i.e., cardiac atrophy and hypovolemia) contributes significantly to the Postural Orthostatic Tachycardia Syndrome (POTS) and its functional disability. Therefore, physical reconditioning with exercise training and volume expansion via increased salt and fluid intake should be initiated early in the course of treatment for patients with POTS if possible. The use of horizontal exercise (e.g., rowing, swimming, recumbent bike, etc.) at the beginning is a critical strategy, allowing patients to exercise while avoiding the upright posture that elicits their POTS symptoms. As patients become increasingly fit, the duration and intensity of exercise should be progressively increased, and upright exercise can be gradually added as tolerated. Supervised training is preferable to maximize functional capacity. Other non-pharmacological interventions, which include: 1) chronic volume expansion via sleeping in the head-up position; 2) reduction in venous pooling during orthostasis by lower body compression garments extending at least to the xiphoid or with an abdominal binder; and 3) physical countermeasure maneuvers, such as squeezing a rubber ball, leg crossing, muscle pumping, squatting, negative-pressure breathing, etc., may also be effective in preventing orthostatic intolerance and managing acute clinical symptoms in POTS patients. However, randomized clinical trials are needed to evaluate the efficacies of these no…
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“Along with increased water and salt intake, a progressive exercise program with recumbent aerobic exercise and leg resistance training transitioning to upright exercise has been shown to improve quality of life and reduce orthostatic HR in many patients (Fu and Levine, 2018, 2015; George et al., 2016; Sheldon et al., 2015; Shibata et al., 2012).”
From Postural orthostatic tachycardia syndrome (POTS): State of the science and clinical care from a 2019 National Institutes of Health Expert Consensus Meeting - Part 1 (2021) · cites this paper as Fu and Levine, 2018
In the citing paper
“The combination of abdominal binders and lower extremity compression stockings is thought to be more effective than lower extremity compression alone due to the disproportionally greater volume in the splanchnic circulation than in the legs (51).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [51]
In the citing paper
“Up to 25% of adult patients with POTS were found to be unable to work182”
From Sinus Tachycardia: a Multidisciplinary Expert Focused Review (2022) · cites this paper as [182]
Citations
Cites
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“Exercise and non-pharmacological interventions should be considered for most patients if tolerated (Sheldon et al. 2015), because they are simple and cost-effective and have no or minimal side effects.”
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Cited by
Sorted by citations
Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments
Yong, S. J. (2021) · Infectious Diseases · doi:10.1080/23744235.2021.1924397 · Cited by 1,339
Gluckman, T. J., Bhave, N. M., Allen, L. A., Chung, E. H., Spatz, E. S., Ammirati, E., Baggish, A. L., Bozkurt, B., Cornwell, W. K., Harmon, K. G., et al. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2022.02.003 · Cited by 431
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Postural tachycardia syndrome – Diagnosis, physiology, and prognosis
Arnold, A. C., Ng, J., & Raj, S. R. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.02.005 · Cited by 186
Postural orthostatic tachycardia syndrome as a sequela of COVID-19
Ormiston, C. K., Świątkiewicz, I., & Taub, P. R. (2022) · Heart Rhythm · doi:10.1016/j.hrthm.2022.07.014 · Cited by 154
Metadata
- Authors
- Fu, Q., & Levine, B. D.
- Affiliations
- Texas Health Dallas (US)
- Corresponding author
- Fu, Qi
- Venue
- Autonomic Neuroscience
- Publisher
- Elsevier BV
- Published
- 2018-12
- Volume
- 215
- Pages
- 20-27
- ISSN
- 1566-0702 (ISSN-L)
- PMC
- PMC6289756
- OpenAlex
- W2810136578
- Cited by
- 174
- References
- 88
- Citations by year
- 2026: 24 · 2025: 25 · 2024: 32 · 2023: 23 · 2022: 31 · 2021: 15 · 2020: 14 · 2019: 7 · 2018: 2
- FWCI
- 2.11
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Autonomic Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (K23 HL075238)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Keywords
- postural orthostatic tachycardia syndrome, exercise training, cardiovascular deconditioning, cardiac atrophy, hypovolemia, volume expansion, supervised exercise, orthostatic intolerance, non-pharmacological treatment
- MeSH terms
- Exercise Therapy, Humans, Postural Orthostatic Tachycardia Syndrome
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