Scientific Abstract

Postural Orthostatic Tachycardia Syndrome (POTS) is an autonomic nervous system disorder causing an abnormal cardiovascular response to upright posture. Prevalence is estimated at 0.2 – 1.0%, most commonly affecting women aged 13 to 50. POTS is frequently misdiagnosed, thus prevalence is likely to be higher than reported. POTS can be a debilitating condition; prolonged, episodes of pre-syncope and fatigue can severely affect activities of daily living and quality of life (QoL). The condition presents a significant challenge to the people affected, and the healthcare system. Medical treatment for POTS is limited; pharmacotherapy is not supported by RCT evidence. Active living interventions are first line treatment, including increased fluid and salt intake, compression tights, and isometric counter-pressure manoeuvres to prevent fainting. Observational studies and small RCTs suggest exercise training may improve symptoms and QoL, but evidence is not sufficient to warrant the inclusion of people with POTS in supervised exercise rehabilitation programmes.

The aim of this study is to assess the feasibility of a supervised exercise rehabilitation intervention with behavioural and motivational support, compared to usual care, for people with POTS. After three months of co-production development work we will enrol people with POTS on a randomised feasibility study, investigating process related measures, physiological and health-related outcomes, and participant experience.