Exercise Interventions in the Management of Postural Orthostatic Tachycardia Syndrome: A Scoping Review

Objective: This review aims to identify the exercise rehabilitation approaches used for patients with POTS (Postural Orthostatic Tachycardia Syndrome). Methods: An electronic literature search was conducted using the PubMed database, covering January 2005 to October 2023. Studies were included if they reported an exercise rehabilitation intervention for POTS patients and resulting clinical outcomes. Eligible study designs included randomized and non-randomized clinical trials and case reports. Results: Initially, 34 publications were identified, but only 14 met the criteria for inclusion. After a thorough analysis, 7 studies were included in this scoping review. The majority of the studies stated aerobic exercise training significantly improves symptoms in most of the patients with orthostatic intolerance, reduces the frequency of syncope, enhances patient quality of life, and improves autonomic balance as assessed by heart rate variability analysis and cardiorespiratory endurance. Short-term exercise training was found to boost physical fitness and cardiorespiratory responses in patients with POTS. Therefore, exercise training can serve as an effective non-pharmacological therapy for managing POTS. Conclusion: This scoping review identified different approaches used for exercise rehabilitation in POTS patients. However, more research is needed to identify the optimal exercise rehabilitation program for this patient population.