Paper Title
Intensive Pain/Exercise Programs Are Not Beneficial For Most Pots Patients
Abstract
Intensive, hospital-based rehabilitation programs are recommended for many POTS patients. Electronic surveys
were taken by 1,130 POTS patients to assess the long-term effects of these programs, including a demographic
questionnaire, the Malmö POTS Symptom Score (MAPS), Functional Assessment of Chronic Illness Therapy Fatigue Scale
(FACIT), Gastrointestinal Symptom Rating Scale (GSRS), and Self-Management Assessment Scale (SMAS). Only 80
(54.1%) POTS patients completed an entire rehabilitation program while 68 (45.9%) left early. One-way ANOVAs revealed
that POTS patients who began a rehabilitation program had significantly more diagnoses (p < 0.001), higher incidence of
CFS/ME (p = 0.026), EDS (p = 0.002), MCAS (p < 0.001), and disability (p = 0.049), and higher scores on the MAPS (p =
0.043), GSRS (p = 0.039), and SMAS Knowledge (p < 0.001), Goals for Future (p = 0.002) and Daily Routines (p = 0.016)
than those who never started. Participants who left rehabilitation early had a significantly higher incidence of disability (p =
0.026) and scored significantly lower on SMAS Daily Routines (p = 0.004) and Emotional Adjustment (p = 0.001) domains
than those who completed the program. A significantly lower incidence of EDS (p = 0.005) was found in the 46.2% of
participants that felt better after rehabilitation than those who stayed the same or felt worse. The remaining 53.8% of
enrollees reported no benefit from these programs, with those who felt worse after starting rehabilitation having a
significantly higher incidence of MCAS than those who stayed the same (p = 0.043).
Keywords: Postural orthostatic tachycardia syndrome (POTS), rehabilitation, pain program, exercise program