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Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
Deconditioning in patients with orthostatic intolerance
Ajay Parsaik1, Thomas G Allison, Wolfgang Singer
1Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Neurology
|September 21, 2012
Summary
Deconditioning, indicated by reduced maximal oxygen uptake, is highly prevalent in nearly all patients with orthostatic intolerance. This finding supports exercise retraining as a key treatment strategy for this condition.
Area of Science:
- Cardiology
- Exercise Physiology
- Autonomic Neuroscience
Background:
- Orthostatic intolerance (OI) is a complex condition affecting autonomic function.
- Deconditioning is often suspected but its prevalence and impact in OI require further elucidation.
Purpose of the Study:
- To determine the frequency and severity of deconditioning in patients with OI.
- To explore clinical features and the relationship between deconditioning and autonomic parameters in OI.
- To assess the predictive value of autonomic indices for deconditioning.
Main Methods:
- Retrospective analysis of 184 patients with OI undergoing autonomic and exercise testing.
- Evaluation of deconditioning using maximal oxygen uptake (VO(2max)%).
- Correlation analysis between VO(2max)% and autonomic/laboratory parameters.
Main Results:
- 90% of patients exhibited deconditioning (VO(2max)% <85%), irrespective of age, gender, or symptom duration.
- Prevalence of deconditioning was high in both postural orthostatic tachycardia syndrome (POTS) and non-POTS OI groups (95% and 91%, respectively).
- VO(2max)% showed weak correlations with some autonomic parameters, and no reliable predictors were identified.
Conclusions:
- Reduced VO(2max)% indicative of deconditioning is nearly universal in OI patients.
- Deconditioning likely plays a central role in OI pathophysiology, supporting exercise retraining.
- Autonomic indices are not reliable predictors of deconditioning in this population.
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