Tailored physical exercise plus standard care resulted in no significant between-group differences in self-rated health compared to standard care alone at 16 weeks (within-group improvements p<0.05).
RCT (n=60)
randomized
Does tailored physical exercise added to standard care improve self-rated health in adults with COVID-19-induced POTS?
In patients with COVID-19-induced POTS, a 16-week tailored physical exercise program did not yield significant between-group differences in self-rated health compared to standard care alone, though both groups improved.
Abstract Background/introduction About 30% of patients with Post-COVID-19 Condition (PCC) develop postural orthostatic tachycardia syndrome (POTS). Exercise is a commonly recommended treatment for both PCC and POTS, although the supporting scientific evidence is limited. Purpose This study aimed to evaluate the effectiveness of tailored physical exercise as a treatment for COVID-19-induced POTS and to assess its effects on self-rated health, physical functions, symptom burden, and mental well-being. Methods Adults diagnosed with POTS following COVID-19 and referred to physiotherapy were eligible. The primary outcome was self-rated health measured by EQ-VAS. Secondary outcomes included physical function (heart rate after 10 minutes of the Active Standing Test and walking distance during the 6-minute walking test), mental health (anxiety and depression assessed by questionnaires), and symptom burden (fatigue, insomnia, orthostatic and autonomic symptoms, all evaluated by questionnaires). Assessments were conducted at baseline and after 16 weeks. Participants were randomised to either standard care alone (n=30) or standard care plus tailored exercise with weekly physiotherapist support (n=30). Data was analysed using linear mixed models. Results Of the 60 included participants, 54 completed the study; two withdrew, and four did not complete the post-intervention assessment. At inclusion, 85% of the participants were women, the mean age was 37 years (SD 11.8), and the mean BMI was 24.9 (SD 5.8). More than 60% had post-secondary education, and 52% were on sick leave to some extent. At baseline, both groups reported high symptom burden and low self-rated health, with mean EQ-VAS scores of 35 and 37, respectively (Table 1). After 16 weeks, both groups showed significant improvements in self-rated health (p0.05), with no between-group differences (Figure 1). Walking distance and orthostatic symptoms showed similar patterns, with significant within-group improvements but no group differences. The remaining secondary outcomes showed small, non-significant improvements. Overall, there was considerable within-group variability across all measures. Conclusion(s) There were significant improvements in self-rated health, walking distance, and orthostatic symptoms regardless of group allocation. At the group level, exercise appeared safe, with no evidence of deterioration in the assessed outcomes. Tailored exercise may still be considered a relevant treatment option for PCC-related POTS; however, further analyses are needed to identify responders and non-responders and to determine how individual exercise tolerance and achieved exercise dose influence outcomes.Table 1 Figure 1
Svensson et al. (Wed,) conducted a rct in COVID-19-induced postural orthostatic tachycardia syndrome (POTS) (n=60). Tailored physical exercise with weekly physiotherapist support vs. Standard care alone was evaluated on self-rated health measured by EQ-VAS. Tailored physical exercise plus standard care resulted in no significant between-group differences in self-rated health compared to standard care alone at 16 weeks (within-group improvements p<0.05).