Deconditioning in patients with orthostatic intolerance
Open accessAbstract
OBJECTIVE: To study the frequency and degree of deconditioning, clinical features, and relationship between deconditioning and autonomic parameters in patients with orthostatic intolerance. METHODS: We retrospectively studied all patients seen for orthostatic intolerance at Mayo Clinic between January 2006 and June 2011, who underwent both standardized autonomic and exercise testing. RESULTS: A total of 184 patients (84 with postural orthostatic tachycardia syndrome [POTS] and 100 without orthostatic tachycardia) fulfilled the inclusion criteria. Of these, 89% were women, and median age was 27.5 years (interquartile range [IQR] 22-37 years). Symptom duration was 4 years (IQR 2-7.8). Of the patients, 90% had deconditioning (reduced maximum oxygen uptake [VO(2max)%] <85%) during exercise. This finding was unrelated to age, gender, or duration of illness. The prevalence of deconditioning was similar between those with POTS (95%) and those with orthostatic intolerance (91%). VO(2max)% had a weak correlation with a few autonomic and laboratory parameters but adequate predictors of VO(2max)% could not be identified. CONCLUSION: Reduced VO(2max)% consistent with deconditioning is present in almost all patients with orthostatic intolerance and may play a central role in pathophysiology. This finding provides a strong rationale for retraining in the treatment of orthostatic intolerance. None of the autonomic indices are reliable predictors of deconditioning.
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The reported prevalence of deconditioning in POTS varies widely, from 20% to 90% of patients, depending on recruitment site and exercise protocol.
“The true prevalence of deconditioning in POTS also remains unclear, with studies showing large variations ranging from 20 to 90% of patients depending on site of patient recruitment and exercise protocols (Parsaik et al., 2012;Burkhardt et al., 2011;Arnold et al., 2013).”
From Postural tachycardia syndrome – Diagnosis, physiology, and prognosis (2018) · cites this paper as Parsaik et al., 2012
Successful outcomes of interdisciplinary pain programs have been extensively researched for adolescents and adults.
“The successful outcomes of interdisciplinary pain programs have been extensively researched for adolescents and adults.189–191”
From Sinus Tachycardia: a Multidisciplinary Expert Focused Review (2022) · cites this paper as [191]
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Treatment Updates in Postural Tachycardia Syndrome
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Autonomic Dysfunction in Hypersomnia
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- Authors
- Parsaik, A., Allison, T. G., Singer, W., Sletten, D. M., Joyner, M. J., Benarroch, E. E., Low, P. A., & Sandroni, P.
- Affiliations
- Mayo Clinic (US)
- ORCID
- Venue
- Neurology
- Published
- 2012-10-02
- Volume
- 79
- Issue
- 14
- Pages
- 1435-1439
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC3525293
- OpenAlex
- W2102895149
- Cited by
- 111
- References
- 13
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 7 · 2023: 5 · 2022: 10 · 2021: 11 · 2020: 12 · 2019: 9 · 2018: 8 · 2017: 7 · 2016: 7 · 2015: 10 · 2014: 6 · 2013: 6 · 2012: 4
- FWCI
- 8.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Georgia Clinical and Translational Science Alliance
- Rare Diseases Clinical Research Network
- National Institutes of Health (NS4 4233, NS3 2352, RR24150)
- National Institute of Neurological Disorders and Stroke (NS3 2352, P01NS044233, NS-44233, U54NS065736, K23NS075141)
- National Center for Research Resources (UL1RR024150)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- orthostatic intolerance, deconditioning, postural orthostatic tachycardia syndrome, autonomic dysfunction, VO2max, exercise capacity, autonomic function testing
- MeSH terms
- Adult, Blood Pressure, Exercise Test, Female, Heart Rate, Humans, Male, Reflex, Retrospective Studies, Valsalva Maneuver, Cardiovascular Deconditioning, Statistics, Nonparametric, Orthostatic Intolerance, Postural Orthostatic Tachycardia Syndrome, Young Adult
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