Document Detail

Diagnostic management of orthostatic intolerance in the workplace.
MedLine Citation:
PMID:  12733087     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Orthostatic intolerance (OI) is a syndrome that is characterised by headache, concentration difficulties, palpitation of the heart, dizziness associated with postural tachycardia and plasma norepinephrine concentrations that are disproportionately high when the sufferer is in the upright posture. In contrast to other forms of orthostatic dysregulation - orthostatic hypotension (OH) and postural orthostatic tachycardia syndrome (POTS) - OI, hitherto, could be diagnosed only by a tilt table examination, with high expenditure. In this paper we examine the reliability and validity of a questionnaire as a screening instrument for OI. METHODS: We studied 138 young men (mean age 21.6 years) who were undergoing military service. After a medical check and filling in the questionnaire, the participants underwent a tilt table test including monitoring of blood pressure, heart rate and plasma catecholamines, in the supine position and during 30 min of standing. The questionnaire consisted of ten items registering presence and frequency of typical OI symptoms. RESULTS: Probands (104) showed normal tilt table test results. OI was diagnosed in 14 probands, OH in 6 and POTS in 14. The OI participants scored significantly higher in the questionnaire than the healthy subjects did: the mean score of the OI group was 22.6, the healthy participants had a mean score of 3.9. Participants with POTS had a mean score of 13.5 and subjects with OH had a mean score of 17.0. Reliability analysis showed a Cronbach's alpha of 0.888. Validity analysis showed that 93.5% of the probands with any kind of orthostatic dysregulation can be detected. CONCLUSIONS: We were able to establish a short questionnaire as a reliable and valid screening instrument for OI. Usage of this questionnaire can simplify enormously the diagnostic management of patients with suspected OI.
R Winker; A Barth; W Dorner; O Mayr; A Pilger; S Ivancsits; I Ponocny; A Heider; C Wolf; H W Rüdiger
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Publication Detail:
Type:  Journal Article; Validation Studies     Date:  2002-10-30
Journal Detail:
Title:  International archives of occupational and environmental health     Volume:  76     ISSN:  0340-0131     ISO Abbreviation:  Int Arch Occup Environ Health     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-05-06     Completed Date:  2003-07-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7512134     Medline TA:  Int Arch Occup Environ Health     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  143-50     Citation Subset:  IM    
Division of Occupational Medicine, University of Vienna, Währinger Gürtel 18-20, Vienna 1090, Austria.
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MeSH Terms
Catecholamines / blood
Hypotension, Orthostatic / diagnosis*,  etiology,  physiopathology
Military Personnel
Occupational Diseases / diagnosis*,  etiology,  physiopathology
Reproducibility of Results
Tilt-Table Test
Reg. No./Substance:

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