Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia. It may occur in isolation, but frequently co-exists in individuals with hypermobile variants of Ehlers-Danlos Syndrome (EDS) and related conditions (chronic fatigue syndrome [CFS] and fibromyalgia). Exercise is recommended for non-pharmacological POTS management but needs to be individualised. This scoping review explores the current literature on use and effectiveness of exercise-based management for POTS, with specific focus on individuals with joint hypermobility and related conditions who experience hypermobility, and/or pain, and/or fatigue. A systematic search, to January 2023, of Medline, EMBASE, AMED, CINAHL and the Cochrane library was conducted. Studies that reported on adolescents and adults who had been diagnosed with POTS using standard criteria and underwent an exercise-based training intervention were included. Following full-text screening, 10 articles were identified (2 randomised control trials, 4 comparative studies and 4 case reports). One comparative study reported a small subset of participants with EDS and one case report included an individual diagnosed with CFS; the remainder investigated a wider POTS population. Overall, 3 months of endurance followed by resistance exercise, graduating from the horizontal-to-upright position reduced POTS symptoms and improved quality-of-life. The findings highlight a paucity of higher-level studies documenting exercise for POTS management in people with joint hypermobility and related conditions. Results from the wider POTS population demonstrate exercise is safe and effective. Large, well-designed clinical studies exploring exercise for POTS management adapting to meet the complex musculoskeletal and non-musculoskeletal features of symptomatic joint hypermobility are needed.

中文翻译：

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运动治疗关节过度活动和相关疾病年轻人体位性直立性心动过速综合征的使用和有效性：范围综述


体位性直立性心动过速综合征 （POTS） 是自主神经功能障碍的一种形式。它可能单独发生，但经常共存于患有 Ehlers-Danlos 综合征 （EDS） 过度活动变异和相关疾病（慢性疲劳综合征 [CFS] 和纤维肌痛）的个体中。建议将运动用于非药物 POTS 管理，但需要个体化。本范围综述探讨了当前关于基于运动的 POTS 管理及其有效性的文献，特别关注患有关节过度活动和相关疾病的个体，这些个体经历过度活动和/或疼痛和/或疲劳。对 Medline、EMBASE、AMED、CINAHL 和 Cochrane 图书馆进行了系统检索，检索时间截至 2023 年 1 月。纳入了使用标准标准报告被诊断患有 POTS 并接受基于运动的训练干预的青少年和成人的研究。经过全文筛选，确定了 10 篇文章 （2 项随机对照试验、4 项比较研究和 4 篇病例报告）。一项比较研究报告了一小部分患有 EDS 的参与者，一项病例报告包括一名被诊断患有 CFS 的个体;其余研究调查了更广泛的 POTS 人群。总体而言，3 个月的耐力训练，然后进行阻力运动，从水平到直立姿势毕业，减少了 POTS 症状并改善了生活质量。研究结果突出了缺乏更高级别的研究来记录运动对关节过度活动和相关疾病患者进行 POTS 管理。更广泛的 POTS 人群的结果表明，运动是安全有效的。 需要大型、精心设计的临床研究，探索运动对 POTS 管理进行调整以满足有症状关节过度活动的复杂肌肉骨骼和非肌肉骨骼特征。