Richardson Mike V, Nordon-Craft Amy, Carrothers LeeAnne
a School of Physical Therapy, University of North Texas Health Science Center , Fort Worth , TX , USA.
b Physical Therapy Program, University of Colorado Denver, Anschutz Medical Campus , Aurora , CO , USA.
Physiother Theory Pract. 2017 Aug;33(8):670-679. doi: 10.1080/09593985.2017.1328719. Epub 2017 Jun 7.
The incidence of postural orthostatic tachycardia syndrome (POTS) is estimated to be at least 500,000 in the United States and is most commonly found in premenopausal females. This syndrome shares clinical features with orthostatic hypotension (OH); however, the inclusion criteria and clinical features for POTS are not well known. The purposes of this case report are to: 1) describe the common clinical features of POTS and highlight the differences to orthostatic hypotension and 2) discuss physical therapy management of patients with POTS using exercise. A 34-year-old female with a POTS exacerbation completed a 4-week physical therapy endurance and strengthening 'reconditioning' program. Initial symptoms included the following: dyspnea with mild exertion, light-headedness, fatigue, leg "heaviness," and the inability to perform normal work duties. One-mile track walk test (1-MWT) estimated VO improved from the 45-50th percentile to the 65-70th percentile at 8 weeks post-discharge. She returned to work full-time and resumed all previous fitness activities. The patient demonstrated clinically meaningful improvements in estimated VO after the "reconditioning" training. Physical therapists should be able to recognize the clinical features and inclusion criteria for POTS as part of a differential diagnosing process for patients complaining of orthostatic symptoms.
在美国，体位性直立性心动过速综合征（POTS）的发病率估计至少为50万，且最常见于绝经前女性。该综合征与直立性低血压（OH）有共同的临床特征；然而，POTS的纳入标准和临床特征尚不为人所知。本病例报告的目的是：1）描述POTS的常见临床特征，并突出其与直立性低血压的差异；2）讨论使用运动对POTS患者进行物理治疗的管理。一名POTS病情加重的34岁女性完成了为期4周的物理治疗耐力和强化“康复”计划。初始症状包括：轻度运动时呼吸困难、头晕、疲劳、腿部“沉重感”以及无法履行正常工作职责。出院后8周，1英里跑道步行测试（1-MWT）估计的VO从第45 - 50百分位提高到了第65 - 70百分位。她恢复了全职工作，并重新开始了之前所有的健身活动。经过“康复”训练后，患者在估计的VO方面表现出了具有临床意义的改善。物理治疗师应能够识别POTS的临床特征和纳入标准，作为对主诉直立性症状患者进行鉴别诊断过程的一部分。
