Is home orthostatic self-training effective in preventing neurally mediated syncope?
Open accessAbstract
BACKGROUND: Repeated orthostatic stress may prove to be of benefit in the regulation of neurally mediated syncope. But the role of home orthostatic self-training is not established to prevent symptoms in patients with neurally mediated syncope. We performed a prospective and randomized study to evaluate the effectiveness of repeated home orthostatic self-training in preventing tilt-induced neurally mediated syncope. METHODS AND RESULTS: Fourty-two consecutive patients (24 males and 18 females, mean age 39 years, 16-68 years) with recurrent neurally mediated syncope were randomized into the tilt training and control groups. The home orthostatic self-training program consisted of daily sessions for 7 days a week for 4 weeks. In order to determine the effects of home orthostatic self-training, we repeated the head-up tilt test in both groups 4 weeks later. Among the tilt-training group, 9 of 16 patients (56%) had a positive response on follow-up head-up tilt test. Among the untreated control group, 9 of 17 patients (53%) had a positive response on follow-up head-up tilt test. In subgroup analyses according to the number of tilt-training sessions or the classified type, we found no differences in the follow-up head-up tilt test responses. Spontaneous syncope or presyncope over mean follow-up of 16.9 months were observed in 42.9% versus 47.1% in the tilt-training and control group, respectively. CONCLUSIONS: Home orthostatic self-training was ineffective in reducing the positive response rate of head-up tilt test in patients with recurrent neurally mediated syncope.
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Most controlled trials reported no significant effect of tilt training.
“most controlled trials reported no significant effect. 268-272”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [270]
The Clinical Follow-Up section reports no significant benefit of home tilt training in this controlled study (P = 0.815 for syncope or presyncope). The Clinical Perspective says two controlled studies found no change in tilt-test responses, but also notes that some controlled studies suggest a benefit against spontaneous relapse. The paper therefore supports a null finding in its own trial, not the broader claim that most controlled trials reported no significant effect. (LLM, conf=0.84)
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References 20 · Cited by 78
Research works printed but not linked: 1
- Grubb BP. Pathophysiology and differential diagnosis of neurocar- diogenic syncope. Am J Cardiol 1999; 84:3Q-9Q.
- Authors
- ON, Y. K., PARK, J., HUH, J., & SOO KIM, J.
- Affiliations
- Samsung Medical Center (KR)
- Corresponding author
- HUH, JUNE
- Venue
- Pacing and Clinical Electrophysiology
- Publisher
- Wiley
- Published
- 2007-04-24
- Volume
- 30
- Issue
- 5
- Pages
- 638-643
- ISSN
- 0147-8389 (ISSN-L)
- 1540-8159
- OpenAlex
- W2138113824
- Cited by
- 78
- References
- 20
- Citations by year
- 2025: 3 · 2024: 5 · 2023: 2 · 2022: 5 · 2021: 2 · 2020: 2 · 2019: 4 · 2018: 5 · 2017: 8 · 2016: 4 · 2015: 3 · 2014: 6 · 2013: 3 · 2012: 2
- FWCI
- 5.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Pacing and Clinical Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Samsung
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Keywords
- neurally mediated syncope, home-based exercise training, head-up tilt, orthostatic stress, presyncope
- MeSH terms
- Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Posture, Self Care, Chi-Square Distribution, Treatment Outcome, Tilt-Table Test, Statistics, Nonparametric, Syncope, Vasovagal
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