Table 5.

Fu/Levine Exercise Training Protocol for POTS Patients

Initial Exercise Training

Avoid upright exercises

Recommend using a rowing machine, recumbent cycle or swimming.

Intensity: target heart rate equivalent to 75-80% of maximum steady state.

Duration: 3-4 sessions/week for 30-45 minutes/session.

Exercise Training Months 2-3

Can begin upright exercise using upright bike, walking, treadmill or jogging

Intensity: gradually increase intensity to maximal steady state 1/week and then 2/week.

Duration: Increase as patient becomes fit with goal of 5 to 6 hours per week.

Resistance Training

Focus on lower body

Start 1/week for 15-20 minutes/session

Gradually increase to 2/week for 45 min/session

Long Term Exercise Training

Patients encouraged to continue exercise indefinitely

Recommendations adapted from reference ¹⁴.