Division of Cardiovascular Diseases, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA.
Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.
Clin Auton Res. 2023 Dec;33(6):659-672. doi: 10.1007/s10286-023-00970-w. Epub 2023 Aug 20.
Exercise like any medication requires the correct dose; to be effective the appropriate frequency, duration, and intensity are necessary. This study aimed to assess if a semi-supervised exercise training (ET) program would be more effective at improving aerobic fitness (VO), exercise tolerance, and symptoms in individuals with postural orthostatic tachycardia syndrome (POTS) compared to the standard of care (SOC).
Subjects were randomized to either the ET or SOC groups (n 26 vs. 23; age 33 ± 11 vs. 37 ± 10 years; VO 66 ± 15 vs. 62 ± 15% predicted, ET vs. SOC respectively, p > 0.05). Composite Autonomic Symptom Score (COMPASS 31), 10 min stand test, and cardiopulmonary exercise test were performed at baseline and following 12 weeks. The ET group received an exercise consultation and eight semi-supervised in-person or virtual exercise sessions.
The ET group demonstrated a greater improvement in VO, higher or longer tolerance for baseline peak workload, and more often had a delayed symptom onset with exercise than the SOC group (ΔVO 3.4 vs. - 0.2 mL/min/kg, p < 0.0001, ΔWorkload 19 ± 17 vs. 0 ± 10 W; Workload time 63 ± 29 vs. 22 ± 30 s; onset-delay 80% vs. 30%, p < 0.05). Individuals in the ET group reported a significant improvement in orthostatic intolerance domain score (p = 0.02), but there was not a significant difference in the improvement in total COMPASS score (- 11.38 vs. - 6.49, p = 0.09).
Exercise training was more effective with greater improvements in aerobic fitness, orthostatic symptoms, and exercise tolerance for individuals with POTS when intensity and progression were personalized and delivered with minimal supervision compared to the SOC.
与任何药物一样，运动也需要正确的剂量；为了达到效果，需要适当的频率、持续时间和强度。本研究旨在评估与标准治疗（SOC）相比，半监督运动训练（ET）方案是否更能有效提高体位性心动过速综合征（POTS）患者的有氧健身（VO）、运动耐量和症状。
受试者随机分为 ET 组或 SOC 组（n 26 对 23；年龄 33±11 对 37±10 岁；VO 66±15 对 62±15%预测，ET 对 SOC 分别，p>0.05）。基线和 12 周后进行综合自主症状评分（COMPASS 31）、10 分钟站立试验和心肺运动试验。ET 组接受运动咨询和八次半监督的面对面或虚拟运动课程。
与 SOC 组相比，ET 组的 VO 改善更大，基线峰值工作负荷的耐受性更高或更长，且运动时症状发作更晚（VO 变化 3.4 对 -0.2 mL/min/kg，p<0.0001，Workload 变化 19±17 对 0±10 W；Workload time 变化 63±29 对 22±30 s；onset-delay 变化 80%对 30%，p<0.05）。ET 组的直立不耐受域评分显著改善（p=0.02），但 COMPASS 总分改善无显著差异（-11.38 对 -6.49，p=0.09）。
与 SOC 相比，当强度和进展个性化并进行最小监督时，ET 更能有效提高 POTS 患者的有氧健身、直立症状和运动耐量，且改善程度更大。
