CHOP Modified Dallas POTS Exercise Program

Introduction

• Designed for patients with Postural Orthostatic Tachycardia Syndrome (POTS).
• Originally developed by a team in Texas, modified for ease of use.
• Commitment to the program is crucial for success.
• Requires access to gym equipment; joining a facility is recommended.

Training Calendar Structure

• Months 1-4: Horizontal position exercises (e.g., recumbent biking, rowing, swimming).
• Month 4: Introduction of upright bike.
• Month 5: Transition to further upright training (elliptical, treadmill).
• Recovery workouts are mandatory after maximal steady state workouts.
• Missed workouts require repeating the training sessions.

Strength Training Basics

• Sessions last 20-30 minutes, using body resistance or seated equipment.
• Focus on lower body and core to aid blood circulation.
• Consult a trainer for proper form; maintain a log of exercises.

Recommended Strength Exercises

• Gym Equipment: Seated leg press, leg curl, leg extension, calf raise, chest press, seated row.
• Body Resistance/Bands: Bridges, seated ball exercises, straight leg raises.

Horizontal to Upright Cardio Training

• Months 1-3: Horizontal or seated training (e.g., recumbent bike, rowing).
• Month 4: Introduction of upright bike.
• Month 5-8: Transition to elliptical/treadmill with gradual inclusion of arm motion and incline.
• Emphasis on warm-ups and cool-downs.

Heart Rate Monitoring

• Use a heart rate monitor to maintain specific heart rate zones during cardio.
• Heart rate zones are customized; RPE (Rating of Perceived Exertion) scale advised.

Long Term Maintenance

• Months 6-8: Personalized training progress, introducing high-intensity interval training.
• Encourage trying new modes and maintaining long-term exercise for health benefits.

Exercise as Therapy

• Exercise is crucial for maintaining health and quality of life for POTS patients.
• Patients often resume normal activities such as work or school.
• Exercise should become a part of daily routine, akin to personal hygiene.
• Encouragement to restart if exercise is interrupted.

Key Tips and Reminders

• Family support is crucial, but personal commitment is key.
• Symptoms may initially worsen in the first month; perseverance is important.
• New training modes might cause temporary fatigue. Adjust pace accordingly.

Conclusion

• Exercise should be maintained lifelong for continued benefits.
• Consult primary care for any sudden changes in symptoms.
• Personalized heart rate training zones provided; adjustments made as needed.

Note: The program is not a quick fix, but a long-term commitment to health improvement for POTS patients.