The use and effectiveness of exercise for managing postural orthostatic tachycardia syndrome in young adults with joint hypermobility and related conditions: A scoping review

IF 3.2 4区 医学 Q2 NEUROSCIENCES
Karen C. Peebles, Charl Jacobs, Logan Makaroff, Verity Pacey
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Abstract

Purpose

Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia. It may occur in isolation, but frequently co-exists in individuals with hypermobile variants of Ehlers-Danlos Syndrome (EDS) and related conditions (chronic fatigue syndrome [CFS] and fibromyalgia). Exercise is recommended for non-pharmacological POTS management but needs to be individualised. This scoping review explores the current literature on use and effectiveness of exercise-based management for POTS, with specific focus on individuals with joint hypermobility and related conditions who experience hypermobility, and/or pain, and/or fatigue.

Methods

A systematic search, to January 2023, of Medline, EMBASE, AMED, CINAHL and the Cochrane library was conducted. Studies that reported on adolescents and adults who had been diagnosed with POTS using standard criteria and underwent an exercise-based training intervention were included.

Results

Following full-text screening, 10 articles were identified (2 randomised control trials, 4 comparative studies and 4 case reports). One comparative study reported a small subset of participants with EDS and one case report included an individual diagnosed with CFS; the remainder investigated a wider POTS population. Overall, 3 months of endurance followed by resistance exercise, graduating from the horizontal-to-upright position reduced POTS symptoms and improved quality-of-life.

Conclusion

The findings highlight a paucity of higher-level studies documenting exercise for POTS management in people with joint hypermobility and related conditions. Results from the wider POTS population demonstrate exercise is safe and effective. Large, well-designed clinical studies exploring exercise for POTS management adapting to meet the complex musculoskeletal and non-musculoskeletal features of symptomatic joint hypermobility are needed.

在患有关节过度活动症及相关疾病的年轻成年人中,使用运动来控制体位性正位性心动过速综合征的方法及其有效性:范围界定综述
目的体位性正位性心动过速综合征(POTS)是一种自律神经失调症。它可能单独发生,但经常与埃勒斯-丹洛斯综合征(EDS)的高运动变异型和相关疾病(慢性疲劳综合征 [CFS] 和纤维肌痛)同时存在。建议对 POTS 进行非药物治疗,但需要因人而异。本范围综述探讨了当前有关运动疗法治疗 POTS 的使用情况和有效性的文献,尤其关注患有关节过度活动症及相关病症并伴有过度活动、和/或疼痛和/或疲劳的患者。方法:对 Medline、EMBASE、AMED、CINAHL 和 Cochrane 图书馆进行了系统检索,检索期至 2023 年 1 月。结果经过全文筛选,共发现 10 篇文章(2 项随机对照试验、4 项比较研究和 4 项病例报告)。其中一项比较研究报告了一小部分患有 EDS 的参与者,一项病例报告包括一名被诊断患有 CFS 的患者;其余研究则调查了更广泛的 POTS 患者。总的来说,3 个月的耐力锻炼后再进行阻力锻炼,从平卧位到直立位,可减轻 POTS 症状并改善生活质量。来自更广泛POTS人群的研究结果表明,运动是安全有效的。我们需要进行大型、设计良好的临床研究,探索运动对 POTS 的治疗效果,以适应症状性关节过度活动症复杂的肌肉骨骼和非肌肉骨骼特征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.80
自引率
7.40%
发文量
83
审稿时长
66 days
期刊介绍: This is an international journal with broad coverage of all aspects of the autonomic nervous system in man and animals. The main areas of interest include the innervation of blood vessels and viscera, autonomic ganglia, efferent and afferent autonomic pathways, and autonomic nuclei and pathways in the central nervous system. The Editors will consider papers that deal with any aspect of the autonomic nervous system, including structure, physiology, pharmacology, biochemistry, development, evolution, ageing, behavioural aspects, integrative role and influence on emotional and physical states of the body. Interdisciplinary studies will be encouraged. Studies dealing with human pathology will be also welcome.
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