Document Detail

POTS versus deconditioning: the same or different?
MedLine Citation:
PMID:  18704621     Owner:  NLM     Status:  MEDLINE    
The 2007 Streeten Lecture focused on the idea that physical deconditioning plays a key role in the symptomology and pathophysiology of POTS. Parallels were drawn between the physiological responses to orthostatic stress seen in POTS patients and the physiological responses seen in "normal" humans after prolonged periods of bedrest, deconditioning, or space flight. Additionally, the idea that endurance exercise training might ameliorate some of these symptoms was also advanced. Finally, potential parallels between POTS, chronic fatigue syndrome, and fibromyalgia were also drawn and the potential role of exercise training as a "therapeutic intervention" in all three conditions was raised. The conceptual model for the lecture was that after some "initiating event" chronic deconditioning plays a significant role in the pathophysiology of these conditions, and these physiological changes in conjunction with "somatic hypervigilence" explain many of the complaints that this diverse group of patients have. Additionally, the idea that systematic endurance exercise training might be helpful was advanced, and data supportive of this idea was reviewed. The main conclusion is that the medical community must retain their empathy for patients with unusual conditions but at the same time send a firm but empowering message about physical activity. As always, we must also ask what do the ideas about physical activity and inactivity and the conditions mentioned above not explain?
Michael J Joyner; Shizue Masuki
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review     Date:  2008-08-12
Journal Detail:
Title:  Clinical autonomic research : official journal of the Clinical Autonomic Research Society     Volume:  18     ISSN:  1619-1560     ISO Abbreviation:  Clin. Auton. Res.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-10     Completed Date:  2009-02-09     Revised Date:  2013-09-17    
Medline Journal Info:
Nlm Unique ID:  9106549     Medline TA:  Clin Auton Res     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  300-7     Citation Subset:  IM    
Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA,
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MeSH Terms
Exercise Therapy
Fatigue Syndrome, Chronic / physiopathology
Fibromyalgia / physiopathology
Heart Rate / physiology
Hypotension, Orthostatic / physiopathology,  rehabilitation*
Physical Endurance / physiology
Postural Orthostatic Tachycardia Syndrome / etiology,  physiopathology*,  psychology,  rehabilitation*
Vasoconstriction / physiology
Grant Support
NS 32352/NS/NINDS NIH HHS; P50 NS032352-150006/NS/NINDS NIH HHS; R01 HL046493-19/HL/NHLBI NIH HHS; R01 NS022352/NS/NINDS NIH HHS; R01 NS022352-19/NS/NINDS NIH HHS
Comment In:
Clin Auton Res. 2008 Dec;18(6):298; author reply 299   [PMID:  18932009 ]

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