Winker Robert, Barth Alfred, Bidmon Daniela, Ponocny Ivo, Weber Michael, Mayr Otmar, Robertson David, Diedrich André, Maier Richard, Pilger Alex, Haber Paul, Rüdiger Hugo W
Division of Occupational Medicine, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
Hypertension. 2005 Mar;45(3):391-8. doi: 10.1161/01.HYP.0000156540.25707.af. Epub 2005 Feb 7.
Orthostatic intolerance is a syndrome characterized by chronic orthostatic symptoms of light-headedness, fatigue, nausea, orthostatic tachycardia, and aggravated norepinephrine levels while standing. The aim of this study was to assess the protective effect of exercise endurance training on orthostatic symptoms and to examine its usefulness in the treatment of orthostatic intolerance. 2768 military recruits were screened for orthostatic intolerance by questionnaire. Tilt-table testing identified 36 cases of orthostatic intolerance out of the 2768 soldiers. Subsequently, 31 of these subjects with orthostatic intolerance entered a randomized, controlled trial. The patients were allocated randomly to either a "training" (3 months jogging) or a "control" group. The influence of exercise training on orthostatic intolerance was assessed by determination of questionnaire scores and tilt-table testing before and after intervention. After training, only 6 individuals of 16 still had orthostatic intolerance compared with 10 of 11 in the control group. The Fisher exact test showed a highly significant difference in diagnosis between the 2 groups (P=0.008) at the end of the study. Analysis of the questionnaire-score showed significant interaction between time and group (P=0.001). The trained subjects showed an improvement in the average symptom score from 1.79+/-0.4 to 1.04+/-0.4, whereas the control subjects showed no significant change in average symptom score (2.09+/-0.6 and 2.14+/-0.5, respectively). Our data demonstrate that endurance exercise training leads to an improvement of symptoms in the majority of patients with orthostatic intolerance. Therefore, we suggest that endurance training should be considered in the treatment of orthostatic intolerance patients.
直立不耐受是一种综合征，其特征为慢性直立症状，如头晕、疲劳、恶心、直立性心动过速以及站立时去甲肾上腺素水平升高。本研究的目的是评估耐力运动训练对直立症状的保护作用，并检验其在治疗直立不耐受中的有效性。通过问卷调查对2768名新兵进行直立不耐受筛查。倾斜试验在2768名士兵中确定了36例直立不耐受病例。随后，其中31例直立不耐受受试者进入随机对照试验。患者被随机分配到“训练”组（3个月慢跑）或“对照组”。通过干预前后问卷评分和倾斜试验来评估运动训练对直立不耐受的影响。训练后，16人中只有6人仍有直立不耐受，而对照组11人中有10人仍有直立不耐受。费舍尔精确检验显示，研究结束时两组在诊断上有高度显著差异（P = 0.008）。问卷评分分析显示时间和组间存在显著交互作用（P = 0.001）。训练组受试者的平均症状评分从1.79±0.4改善至1.04±0.4，而对照组受试者的平均症状评分无显著变化（分别为2.09±0.6和2.14±0.5）。我们的数据表明，耐力运动训练可使大多数直立不耐受患者的症状得到改善。因此，我们建议在治疗直立不耐受患者时应考虑耐力训练。
