The DOI matches its Crossref record; 35 of the 36 references it cites were found in a registry or an index.
The international POTS registry: Evaluating the efficacy of an exercise training intervention in a community setting
Abstract
Background Postural orthostatic tachycardia syndrome (POTS) affects primarily young women and impairs quality of life. We found that in a research setting, exercise training along with lifestyle intervention is effective as a nondrug therapy for POTS. Objective To evaluate the efficacy of our exercise training/lifestyle intervention in POTS patients in a community environment. Methods We established a POTS registry and enrolled 251 patients (86% women, aged 26 ± 11 [SD] years) through their physicians. A 3-month program involving mild- to moderate-intensity endurance training (progressing from semirecumbent to upright, 3-5 times/wk, 30-45 min/session) plus strength training was implemented along with increasing salt/water intake. The program was delivered to the physicians, who oversaw training in their patients. A 10-minute stand test was performed at the physician's office and patient quality of life was assessed using the 36-Item Short Form Health Survey. Results One hundred and three patients completed the program. Of those that completed, 71% no longer qualified for POTS and were thus in remission. The increase in heart rate from supine to 10-minute stand was markedly lower (23 ± 14 vs. 46 ± 17 beats/min before intervention; P Conclusions A training/lifestyle intervention program can be implemented in a community setting with physician supervision and is effective in the treatment of POTS. It remains to be determined whether exercise can be an effective long-term treatme…
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“the positive response these patients have to exercise training, which has been demonstrated to expand blood volume and increase cardiac size and mass in POTS patients and result in a prominent decrease in symptoms (4,63,64).”
From Postural Orthostatic Tachycardia Syndrome (2019) · cites this paper as [64]
In the citing paper
“Research has demonstrated that physical reconditioning with a short-term (3 month) progressive exercise training program leads to improvement or remission of POTS in the majority of patients (4,64).”
From Postural Orthostatic Tachycardia Syndrome (2019) · cites this paper as [64]
In the citing paper
“Exercise therapy is most successful when the program is supervised by experienced trainers or physical therapists that understand the pathophysiology of POTS, though it has also been demonstrated to be highly effective when administered in a community setting (64).”
From Postural Orthostatic Tachycardia Syndrome (2019) · cites this paper as [64]
In the citing paper
“In a follow-up of a small number of patients who participated in the exercise program in a community setting, the effectiveness persisted for at least 1 year (64).”
From Postural Orthostatic Tachycardia Syndrome (2019) · cites this paper as [64]
In the citing paper
“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 George et al., 2016
In the citing paper
“Unfortunately, only 41% of POTS patients in the community setting are able to complete a standardized 3-month program involving mild-moderate intensity endurance training 3-5 times per week at 30-45 min per session (63).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [63]
In the citing paper
“In fact, 50-70% of POTS patients who complete 3 months of endurance training exhibit hemodynamic changes that no longer meet criteria for POTS (42, 62, 63).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [63]
In the citing paper
“Exercise training may be very effective and has been shown to alleviate the symptoms of POTS-related deconditioning [66,67].”
From Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management (2019) · cites this paper as [67]
In the citing paper
“The two most common forms of sinus tachycardia for which the underlying condition is not well understood are POTS 49,50,170 and IST49,55.”
From Sinus Tachycardia: a Multidisciplinary Expert Focused Review (2022) · cites this paper as [170]
In the citing paper
“Clinically, ‘Idiopathic sinus tachycardia’ comprises two principal diagnostic categories, POTS and IST.49,50,75,167,170”
From Sinus Tachycardia: a Multidisciplinary Expert Focused Review (2022) · cites this paper as [170]
In the citing paper
“Exercise is an HRS Class IIA indication for POTS but remains a target of study49,50,125,170,173; its value in IST is unknown.49,50,125”
From Sinus Tachycardia: a Multidisciplinary Expert Focused Review (2022) · cites this paper as [170]
Citations
Cites
Ware, J. E. (2000) · Spine · doi:10.1097/00007632-200012150-00008 · Cited by 4,455
O'Connor (2009) · doi:10.1001/jama.2009.454 · Cited by 2,173
Interventions to Enhance Patient Adherence to Medication Prescriptions: Scientific Review
McDonald, H. P., Garg, A. X., & Haynes, R. B. (2002) · JAMA · doi:10.1001/jama.288.22.2868 · Cited by 1,176
Sheldon, R. S., Grubb, B. P., Olshansky, B., Shen, W.-K., Calkins, H., Brignole, M., Raj, S. R., Krahn, A. D., Morillo, C. A., Stewart, J. M., et al. (2015) · Heart Rhythm · doi:10.1016/j.hrthm.2015.03.029 · Cited by 1,013
Response to Exercise After Bed Rest and After Training.
(1969) · Annals of Internal Medicine · doi:10.7326/0003-4819-71-2-444_1 · Cited by 914
Suaya, J. A., Shepard, D. S., Normand, S. T., Ades, P. A., Prottas, J. M., & Stason, W. B. (2007) · Circulation · doi:10.1161/circulationaha.107.701466 · Cited by 827
Flynn, K. E., Piña, I. L., Whellan, D. J., Lin, L., Blumenthal, J. A., Ellis, S. J., Fine, L. J., Howlett, J. G., Keteyian, S. J., Kitzman, D. W., et al. (2009) · JAMA · doi:10.1001/jama.2009.457 · Cited by 737
Cardiac Remodeling in Response to 1 Year of Intensive Endurance Training
Arbab‐Zadeh, A., Perhonen, M. A., Howden, E. J., Peshock, R. M., Zhang, R., Adams-Huet, B., Haykowsky, M. J., & Levine, B. D. (2014) · Circulation · doi:10.1161/circulationaha.114.010775 · Cited by 365
Self-citationPostural tachycardia syndrome (POTS)
LOW, P. A., SANDRONI, P., JOYNER, M., & SHEN, W. (2009) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2008.01407.x · Cited by 358
Exercise is medicine and physicians need to prescribe it!
Sallis, R. E. (2008) · British Journal of Sports Medicine · doi:10.1136/bjsm.2008.054825 · Cited by 338
Cardiac origins of the postural orthostatic tachycardia syndrome
Fu, Q., VanGundy, T. B., Galbreath, M. M., Shibata, S., Jain, M., Hastings, J. L., Bhella, P. S., & Levine, B. D. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.02.043 · Cited by 329
Self-citationBlumenthal, J. A., Babyak, M. A., O’Connor, C., Keteyian, S., Landzberg, J., Howlett, J., Kraus, W., Gottlieb, S., Blackburn, G., Swank, A., et al. (2012) · JAMA · doi:10.1001/jama.2012.8720 · Cited by 305
Postural tachycardia syndrome (POTS)
Lamotte, G., & Low, P. A. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-85492-4.00118-6 · Cited by 301
The epidemic of orthostatic tachycardia and orthostatic intolerance
Robertson, D. (1999) · The American Journal of the Medical Sciences · doi:10.1016/s0002-9629(15)40480-x · Cited by 293
Raj, S. R., Biaggioni, I., Yamhure, P. C., Black, B. K., Paranjape, S. Y., Byrne, D. W., & Robertson, D. (2005) · Circulation · doi:10.1161/01.cir.0000160356.97313.5d · Cited by 286
Response to Exercise After Bed Rest and After Training
Vries, H. A. D. (1969) · Journal of Gerontology · doi:10.1093/geronj/24.2.219a · Cited by 268
Strategies for promoting physical activity in clinical practice.
Sallis, R., Franklin, B., Joy, L., Ross, R., Sabgir, D., & Stone, J. (2015) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2014.10.003 · Cited by 265
Postural tachycardia syndrome—current experience and concepts
Mathias, C. J., Low, D. A., Iodice, V., Owens, A. P., Kirbis, M., & Grahame, R. (2012) · Nature Reviews Neurology · doi:10.1038/nrneurol.2011.187 · Cited by 251
Exercise is medicine: a call to action for physicians to assess and prescribe exercise
Sallis, R. (2015) · The Physician and Sportsmedicine · doi:10.1080/00913847.2015.1001938 · Cited by 198
Cardiac atrophy in women following bed rest
Dorfman, T. A., Levine, B. D., Tillery, T., Peshock, R. M., Hastings, J. L., Schneider, S. M., Macias, B. R., Biolo, G., & Hargens, A. R. (2007) · Journal of Applied Physiology · doi:10.1152/japplphysiol.01162.2006 · Cited by 189
Self-citationFu, Q., VanGundy, T. B., Shibata, S., Auchus, R. J., Williams, G. H., & Levine, B. D. (2011) · Hypertension · doi:10.1161/hypertensionaha.111.172262 · Cited by 175
Self-citationExercise therapy – the public health message
Blair, S. N., Sallis, R. E., Hutber, A., & Archer, E. (2012) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/j.1600-0838.2012.01462.x · Cited by 165
Endurance Exercise Training in Orthostatic Intolerance
Winker, R., Barth, A., Bidmon, D., Ponocny, I., Weber, M., Mayr, O., Robertson, D., Diedrich, A., Maier, R., Pilger, A., et al. (2005) · Hypertension · doi:10.1161/01.hyp.0000156540.25707.af · Cited by 156
Idiopathic Orthostatic Intolerance and Postural Tachycardia Syndromes
Jacob, G., & Biaggioni, I. (1999) · The American Journal of the Medical Sciences · doi:10.1097/00000441-199902000-00003 · Cited by 136
Deconditioning in patients with orthostatic intolerance
Parsaik, A., Allison, T. G., Singer, W., Sletten, D. M., Joyner, M. J., Benarroch, E. E., Low, P. A., & Sandroni, P. (2012) · Neurology · doi:10.1212/wnl.0b013e31826d5f95 · Cited by 111
Shibata, S., Fu, Q., Bivens, T. B., Hastings, J. L., Wang, W., & Levine, B. D. (2012) · The Journal of Physiology · doi:10.1113/jphysiol.2012.233858 · Cited by 109
Self-citationLechín, F., van der Dijs, B., Orozco, B., Lechin, M. E., Báez, S., Lechin, A. E., Rada, I., Acosta, E., Arocha, L., Jiménez, V., et al. (1995) · Biological Psychiatry · doi:10.1016/0006-3223(94)00258-5 · Cited by 107
POTS versus deconditioning: the same or different?
Joyner, M. J., & Masuki, S. (2008) · Clinical Autonomic Research · doi:10.1007/s10286-008-0487-7 · Cited by 90
Laliberté, F., Bookhart, B., Nelson, W. W., Lefèbvre, P., Schein, J. R., Rondeau-Leclaire, J., & Duh, M. S. (2013) · Patient · doi:10.1007/s40271-013-0020-5 · Cited by 83
Effects of exercise training on arterial-cardiac baroreflex function in POTS
Galbreath, M. M., Shibata, S., VanGundy, T. B., Okazaki, K., Fu, Q., & Levine, B. D. (2011) · Clinical Autonomic Research · doi:10.1007/s10286-010-0091-5 · Cited by 54
Self-citationGeest, S. D., Ruppar, T. M., Berben, L., Schönfeld, S., & Hill, M. N. (2014) · EuroIntervention · doi:10.4244/eijv9i9a185 · Cited by 51
Standing up for exercise: should deconditioning be medicalized?
Joyner, M. J. (2012) · The Journal of Physiology · doi:10.1113/jphysiol.2012.238550 · Cited by 34
Lemstra, M., Alsabbagh, M. W., Rajakumar, R. J., Rogers, M., & Blackburn, D. F. (2013) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2013.08.011 · Cited by 32
Cardiac rehabilitation uptake following myocardial infarction: cross-sectional study in primary care
Cupples, M., Tully, M. A., Dempster, M., Corrigan, M., McCall, D. O., & Downey, B. (2010) · British Journal of General Practice · doi:10.3399/bjgp10x502155 · Cited by 24
Exercise Training in Postural Orthostatic Tachycardia Syndrome
Joyner, M. J. (2011) · Hypertension · doi:10.1161/hypertensionaha.111.173872 · Cited by 5
Research works printed but not linked: 1
- 2004, Strategies to accelerate medical research progress, Funct Neurol, 19, 165
Cited by
Sorted by citations
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
Self-citationPostural orthostatic tachycardia syndrome: clinical presentation, aetiology and management
Fedorowski, A. (2019) · Journal of Internal Medicine · doi:10.1111/joim.12852 · Cited by 352
Vernino, S., Bourne, K. M., Stiles, L. E., Grubb, B. P., Fedorowski, A., Stewart, J. M., Arnold, A. C., Pace, L. A., Axelsson, J., Boris, J. R., et al. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102828 · Cited by 304
Postural Orthostatic Tachycardia Syndrome
Bryarly, M., Phillips, L. T., Fu, Q., Vernino, S., & Levine, B. D. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.11.059 · Cited by 245
Self-citationRaj, S. R., Guzman, J. C., Harvey, P., Richer, L., Schondorf, R., Seifer, C., Thibodeau-Jarry, N., & Sheldon, R. S. (2020) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2019.12.024 · Cited by 223
Metadata
- Authors
- George, S. A., Bivens, T. B., Howden, E. J., Saleem, Y., Galbreath, M. M., Hendrickson, D., Fu, Q., & Levine, B. D.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Texas Health Dallas (US)
- Corresponding author
- Levine, Benjamin D.
- Venue
- Heart Rhythm
- Publisher
- Elsevier BV
- Published
- 2016-04
- Volume
- 13
- Issue
- 4
- Pages
- 943-950
- ISSN
- 1547-5271 (ISSN-L)
- OpenAlex
- W2195983391
- Cited by
- 127
- References
- 36
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 20 · 2023: 12 · 2022: 16 · 2021: 10 · 2020: 16 · 2019: 9 · 2018: 13 · 2017: 9 · 2016: 1
- FWCI
- 8.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Heart Rhythm (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- postural orthostatic tachycardia syndrome, exercise training, lifestyle intervention, endurance training, resistance training, community-based intervention, quality of life, heart rate response to standing, long-term treatment efficacy
- MeSH terms
- Adult, Blood Pressure, Postural Balance, Exercise Therapy, Female, Humans, Male, Quality of Life, Registries, Treatment Outcome, Tilt-Table Test, Postural Orthostatic Tachycardia Syndrome
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