Management of a Patient with Postural Orthostatic Tachycardia Syndrome, A New Perspective for the Physical Therapist: A Case Report

Abstract

Background: Physical Therapy management of Postural Orthostatic Tachycardia Syndrome (POTS) symptoms is not currently well established. Purpose: To report the outcomes of a multimodal exercise program for a patient with POTS. Methods: The patient was a 25 year old female with a primary diagnosis of POTS. The patient attended 30 physical therapy sessions, approximately 60 minutes each, over 12 weeks. The patient participated in a multimodal exercise program (aerobic, functional, and strength) that utilized patient-controlled and therapist-controlled rest intervals. Outcomes were measured every 4 weeks. Outcomes: Using the SF-36 outcomes, the patient reported the largest improvements between sessions 23-30. These changes in Physical Functioning, Role limitations due to Physical Health, and Pain were 15%, 50%, and 22.5% respectfully. The largest improvements were in average subjective reports of lightheadedness, dizziness, and chest palpitations occurring between visits 1-13 and 14-22, a change of 26.2%. Conclusion: This was the first study that has investigated a multimodal exercise program (aerobic, functional, strength) that utilized rest interval management as a strategy for exercise progression in a patient diagnosed with POTS. The incorporation of multimodal training methods (aerobic, functional, strength) stimulated positive effects to the parasympathetic nervous system and thus improved average subjective reports of lightheadedness, dizziness, chest palpitations and quality of life in this patient diagnosed with POTS