Exercise and non-pharmacological treatment of POTS.
Exercise and non-pharmacological treatment of POTS.
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DOI：
10.1016/j.autneu.2018.07.001
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发表时间：
2018-12
期刊：
影响因子：
--
通讯作者：
Levine BD
中科院分区：
文献类型：
--
作者：
Fu Q;Levine BD
最近的研究表明，心血管失调（即，心脏萎缩和血容量不足）显著地导致体位性心动过速综合征（POTS）及其功能性残疾。因此，如果可能，POTS患者应在治疗过程的早期开始通过运动训练和通过增加盐和液体摄入量进行容量扩张进行身体恢复。水平运动的使用（例如，划船、游泳、斜卧自行车等）在开始时是一个关键的策略，让病人锻炼，同时避免直立的姿势，加剧他们的POTS症状。随着患者身体状况的改善，运动的持续时间和强度应逐渐增加，并在耐受范围内逐渐增加直立运动。最好进行有监督的培训，以最大限度地提高功能能力。其他非药物干预，包括：1）通过头高位睡眠进行慢性容量扩张; 2）通过至少延伸至剑突的下体加压衣或使用腹带减少体位期间的静脉淤积;以及3）物理对抗措施，如挤压橡胶球、交叉腿、肌肉泵送、蹲下、负压呼吸等，也可有效预防POTS患者的立位不耐受和控制急性临床症状。然而，需要随机临床试验来评估这些POTS非药物治疗的疗效。
Recent research has demonstrated that cardiovascular deconditioning (i.e., cardiac atrophy and hypovolemia) contributes significantly to the Postural Orthostatic Tachycardia Syndrome (POTS) and its functional disability. Therefore, physical reconditioning with exercise training and volume expansion via increased salt and fluid intake should be initiated early in the course of treatment for patients with POTS if possible. The use of horizontal exercise (e.g., rowing, swimming, recumbent bike, etc.) at the beginning is a critical strategy, allowing patients to exercise while avoiding the upright posture that elicits their POTS symptoms. As patients become increasingly fit, the duration and intensity of exercise should be progressively increased, and upright exercise can be gradually added as tolerated. Supervised training is preferable to maximize functional capacity. Other non-pharmacological interventions, which include: 1) chronic volume expansion via sleeping in the head-up position; 2) reduction in venous pooling during orthostasis by lower body compression garments extending at least to the xiphoid or with an abdominal binder; and 3) physical countermeasure maneuvers, such as squeezing a rubber ball, leg crossing, muscle pumping, squatting, negative-pressure breathing, etc., may also be effective in preventing orthostatic intolerance and managing acute clinical symptoms in POTS patients. However, randomized clinical trials are needed to evaluate the efficacies of these non-pharmacological treatments of POTS.
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影响因子：
8.3
作者：
Fu, Qi;VanGundy, Tiffany B.;Levine, Benjamin D.
通讯作者：
Levine, Benjamin D.
影响因子：
5.8
作者：
Galbreath, M. Melyn;Shibata, Shigeki;Levine, Benjamin D.
通讯作者：
Levine, Benjamin D.
影响因子：
5.5
作者：
Baggish, Aaron L.;Hale, Andrew;Chan, Stephen Y.
通讯作者：
Chan, Stephen Y.
影响因子：
120.7
作者：
CRILEY, JM;BLAUFUSS, AH;KISSEL, GL
通讯作者：
KISSEL, GL
影响因子：
--
作者：
Fu, Qi;Levine, Benjamin D
通讯作者：
Levine, Benjamin D