Physical Therapy Management of a Young Woman with Postural Orthostatic Tachycardia Syndrome: A Case Report

Background: Postural orthostatic tachycardia syndrome (POTS) is estimated to affect anywhere from 500,000 to 1,000,000 people in the U.S. Most of those affected are young females between the ages of 15 and 25 years old. Because of the lack of objective outcome measures for POTS and the etiology being relatively unknown, treatment of this condition can be challenging. The purpose of this case report is to discuss the signs and symptoms of POTS and examine physical therapy management of a patient with POTS using an exercise program. Case Description: The patient was a 22-year-old female, presenting to an outpatient orthopedic clinic with a chief complaint of decreased activity tolerance and fatigue due to POTS. Intervention: The intervention consisted of an endurance program and progressive strength program. The strength and endurance programs were made to target the patient’s impairments found on evaluation and build tolerance to being in the upright position for longer periods of time. Outcome Measures: The primary outcome measures used to assess this patient were the 10-minute active stand test, heart rate, and blood pressure. The Malmo pots score could have been used to track symptom severity. Discussion: This case report outlines the physical therapy approaches for the treatment of POTS, including an endurance and strength program based on patient tolerance. This report highlights possible outcome measures to track patient progress and the role that the physical therapist has in the care of patients with Postural Orthostatic Tachycardia Syndrome.