Exercise for POTS

This weeks question

What do you think about the CHOP/Levine protocols for POTS.

My answer

The CHOP and Levine protocols are probably the best available protocols that have been well researched in treatment of POTS. HOWEVER the majority of the research on these protocols did not focus on patients with EDS or HSD. While there have been modifications of the protocols for patients with these conditions, they have not been well researched. Also, as is my comment on almost any EDS "protocol" it is nearly impossible to come up with a protocol that covers the spectrum of EDS patients. 

Also, these protocols require an hour + of exercise per day at times, up to 5 days per week. In order to "successfully" complete them as written, any missed time must be made up/ re-started. For many of my patients, I do not see this as feasible. When we take into account all medical conditions including POTS, EDS, MCAS and then add in life "conditions" (work, children, families, sleep, etc) completing this much exercise this frequently for months becomes very difficult. 

To be clear, I think these are very well written, well meaning protocols, and the idea of progressive cardiovascular exercise is a MUST in the treatment of POTS, I have not had many, if any patients successfully complete either of these protocols. Generally what happens is a patient tries several times, is unable to, and then feels like a "failure" for not completing them, even though it may be nearly impossible or inappropriate to complete as written for them as an individual.

If you need help developing a specific, graded, cardiovascular exercise program specific to you reach out to us at info@perfecttenpt.com!