An Interdisciplinary Approach to Improving the Quality of Life in Postural Orthostatic Tachycardia Syndrome: A Case Study

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Carl Turner City College Plymouth

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Jonathan Rhodes University of Plymouth

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Darren Crocker City College Plymouth

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Karol Nedza University of Plymouth

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Jon May University of Plymouth

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Postural orthostatic tachycardia syndrome (POTS) is a debilitating condition affecting the autonomic nervous system that causes a series of symptoms, such as blurred vision, brain fog, chest pain, headaches, shortness of breath, fatigue, syncope, and rapid heart rate. These symptoms can lead to diminished daily activity, daytime fatigue, poor sleep quality, and increased suicidal tendencies. Among the physical symptoms, POTS patients present decreased quality of life, increased prevalence of depression, and elevated anxiety. This case study documents an interdisciplinary approach to treating a 39-year-old female POTS patient with an 8-week intervention program and a further 4-week follow-up. The intervention investigated the combined effects of Functional Imagery Training and physical exercise on the patient’s quality of life. Following completion of the program, the subject improved in all four quality-of-life components, and this change was maintained over time when compared with baseline measures. The program demonstrated that high levels of exercise adherence beyond the intervention can be achieved when combining Functional Imagery Training and exercise, regardless of the exercise-intolerant characteristics presented by a POTS patient.

Turner and Crocker are with the City College Plymouth, Plymouth, United Kingdom. Rhodes, Nedza, and May are with the School of Psychology, University of Plymouth, Plymouth, United Kingdom.

Nedza (karol.nedza@plymouth.ac.uk) is corresponding author.
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  • Agarwal, S.K. (2012). Cardiovascular benefits of exercise. International Journal of General Medicine, 5, 541. PubMed ID: 22807642 doi:10.2147/IJGM.S30113

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Anderson, J.W., Lambert, E.A., Sari, C.I., Dawood, T., Esler, M.D., Vaddadi, G., & Lambert, G.W. (2014). Cognitive function, health-related quality of life, and symptoms of depression and anxiety sensitivity are impaired in patients with the postural orthostatic tachycardia syndrome (POTS). Frontiers in Physiology, 5, 230. PubMed ID: 25009504 doi:10.3389/fphys.2014.00230

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Andrade, J., Khalil, M., Dickson, J., May, J., & Kavanagh, D.J. (2016). Functional Imagery Training to reduce snacking: Testing a novel motivational intervention based on Elaborated Intrusion theory. Appetite, 100, 256262. PubMed ID: 26877217 doi:10.1016/j.appet.2016.02.015

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bhaskar, R. (2013). A realist theory of science. London, UK: Routledge.

  • Borg, G.A. (1982). Psychophysical bases of perceived exertion. Medicine & Science in Sports & Exercise, 14(5), 377381. PubMed ID: 7154893 doi:10.1249/00005768-198205000-00012

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Campbell, A., & Hausenblas, H.A. (2009). Effects of exercise interventions on body image: A meta-analysis. Journal of Health Psychology, 14(6), 780793. PubMed ID: 19687115 doi:10.1177/1359105309338977

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Conner, R., Sheikh, M., & Grubb, B. (2012). Postural orthostatic tachycardia syndrome (POTS): Evaluation and management. British Journal of Medical Practice, 5(4), 540.

    • Search Google Scholar
    • Export Citation
  • De Moor, M.H.M., Beem, A.L., Stubbe, J.H., Boomsma, D.I., & De Geus, E.J.C. (2006). Regular exercise, anxiety, depression and personality: A population-based study. Preventive Medicine, 42(4), 273279. PubMed ID: 16439008 doi:10.1016/j.ypmed.2005.12.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Duckworth, A.L., Kirby, T.A., Gollwitzer, A., & Oettingen, G. (2013). From fantasy to action: Mental contrasting with implementation intentions (MCII) improves academic performance in children. Social Psychological and Personality Science, 4(6), 745753. PubMed ID: 25068007 doi:10.1177/1948550613476307

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Flack, T., & Fulton, J. (2018). Quality of life in postural orthostatic tachycardia syndrome (PoTS): Before and after treatment. British Journal of Cardiology, 25, 140142.

    • Search Google Scholar
    • Export Citation
  • Fu, Q., & Levine, B.D. (2018). Exercise and non-pharmacological treatment of POTS. Autonomic Neuroscience, 215, 2027. PubMed ID: 30001836 doi:10.1016/j.autneu.2018.07.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fu, Q., VanGundy, T.B., Shibata, S., Auchus, R.J., Williams, G.H., & Levine, B.D. (2011). Exercise training versus propranolol in the treatment of the postural orthostatic tachycardia syndrome. Hypertension, 58(2), 167175. PubMed ID: 21690484 doi:10.1161/HYPERTENSIONAHA.111.172262

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Galbreath, M.M., Shibata, S., VanGundy, T.B., Okazaki, K., Fu, Q., & Levine, B.D. (2011). Effects of exercise training on arterial-cardiac baroreflex function in POTS. Clinical Autonomic Research, 21(2), 7380. PubMed ID: 21103906 doi:10.1007/s10286-010-0091-5

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gholami, A., Jahromi, L.M., Zarei, E., & Dehghan, A. (2013). Application of WHOQOL-BREF in measuring quality of life in health-care staff. International Journal of Preventive Medicine, 4(7), 809. PubMed ID: 24049600

    • Search Google Scholar
    • Export Citation
  • Kavi, L., Gammage, M.D., Grubb, B.P., & Karabin, B.L. (2012). Postural tachycardia syndrome: Multiple symptoms, but easily missed. British Journal of General Practice, 62(599), 286287. PubMed ID: 22687203 doi:10.3399/bjgp12X648963

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kizilbash, S.J., Ahrens, S.P., Bruce, B.K., Chelimsky, G., Driscoll, S.W., Harbeck-Weber, C., . . . Pianosi, P.T. (2014). Adolescent fatigue, POTS, and recovery: A guide for clinicians. Current Problems in Paediatric and Adolescent Health Care, 44(5), 108133. doi:10.1016/j.cppeds.2013.12.014

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lang, P.J. (1979). A bio-informational theory of emotional imagery. Psychophysiology, 16(6), 495512. PubMed ID: 515293 doi:10.1111/j.1469-8986.1979.tb01511.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Miller, W.R., & Rollnick, S. (2012). Motivational interviewing: Helping people change. New York, NY: Guilford Press.

  • Moon, J., Kim, D.Y., Byun, J.I., Sunwoo, J.S., Lim, J.A., Kim, T.J., . . . Park, K.I. (2016). Orthostatic intolerance symptoms are associated with depression and diminished quality of life in patients with postural tachycardia syndrome. Health and Quality of Life Outcomes, 14(1), 144. PubMed ID: 27729043 doi:10.1186/s12955-016-0548-x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Paivio, A. (1985). Cognitive and motivational functions of imagery in human performance. Canadian Journal of Applied Sport Sciences, 10(4), 22S28S. PubMed ID: 4085129

    • Search Google Scholar
    • Export Citation
  • Pal, S., Radavelli-Bagatini, S., & Ho, S. (2013). Potential benefits of exercise on blood pressure and vascular function. Journal of the American Society of Hypertension, 7(6), 494506. PubMed ID: 23992766 doi:10.1016/j.jash.2013.07.004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Raj, S.R. (2013). Postural tachycardia syndrome (POTS). Circulation, 127(23), 23362342. PubMed ID: 23753844 doi:10.1161/CIRCULATIONAHA.112.144501

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Richardson, M.V., Nordon-Craft, A., & Carrothers, L. (2017). Using an exercise program to improve activity tolerance in a female with postural orthostatic tachycardia syndrome: A case report. Physiotherapy: Theory and Practice, 33(8), 670679. doi:10.1080/09593985.2017.1328719

    • Search Google Scholar
    • Export Citation
  • Rhodes, J., May, J., Andrade, J., & Kavanagh, D. (2018). Enhancing grit through functional imagery training in professional soccer. The Sport Psychologist, 32(3), 220225. doi:10.1123/tsp.2017-0093

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rorty, R. (1991). The priority of democracy to philosophy. In R. Rorty (Ed.), Objectivity, relativism, and truth: Philosophical papers (Vol. 1, pp. 175196). Cambridge, UK: Cambridge University Press.

    • Search Google Scholar
    • Export Citation
  • Sharma, A., Madaan, V., & Petty, F.D. (2006). Exercise for mental health. Primary Care Companion to the Journal of Clinical Psychiatry, 8(2), 106. PubMed ID: 16862239 doi:10.4088/PCC.v08n0208a

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Shibata, S., Fu, Q., Bivens, T.B., Hastings, J.L., Wang, W., & Levine, B.D. (2012). Short-term exercise training improves the cardiovascular response to exercise in the postural orthostatic tachycardia syndrome. The Journal of Physiology, 590(15), 34953505. PubMed ID: 22641777 doi:10.1113/jphysiol.2012.233858

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Smith, D.E., Heckemeyer, C.M., Kratt, P.P., & Mason, D.A. (1997). Motivational interviewing to improve adherence to a behavioral weight-control program for older obese women with NIDDM: A pilot study. Diabetes Care, 20(1), 5254. PubMed ID: 9028693 doi:10.2337/diacare.20.1.52

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Solbrig, L., Whalley, B., Kavanagh, D.J., May, J., Parkin, T., Jones, R., & Andrade, J. (2019). Functional imagery training versus motivational interviewing for weight loss: A randomised controlled trial of brief individual interventions for overweight and obesity. International Journal of Obesity, 43(4), 883894. PubMed ID: 30185920 doi:10.1038/s41366-018-0122-1

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tito, C., & Hess, J.B. (2017). Aquatic therapy for a patient with postural orthostatic tachycardia syndrome: A case report. Internet Journal of Allied Health Sciences and Practice, 15(3), 10.

    • Search Google Scholar
    • Export Citation
  • von Steinbüchel, N., Lischetzke, T., Gurny, M., & Eid, M. (2006). Assessing quality of life in older people: Psychometric properties of the WHOQOL-BREF. European Journal of Ageing, 3(2), 116122. doi:10.1007/s10433-006-0024-2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • WHOQOL Group. (1995). The World Health Organization quality of life assessment (WHOQOL): Position paper from the World Health Organization. Social Science & Medicine, 41(10), 14031409. doi:10.1016/0277-9536(95)00112-K

    • Search Google Scholar
    • Export Citation
  • Williams, S.E., Cooley, S.J., & Cumming, J. (2013). Layered stimulus response training improves motor imagery ability and movement execution. Journal of Sport and Exercise Psychology, 35(1), 6071. PubMed ID: 23404880 doi:10.1123/jsep.35.1.60

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Winker, R., Barth, A., Bidmon, D., Ponocny, I., Weber, M., Mayr, O., . . . Haber, P. (2005). Endurance exercise training in orthostatic intolerance: A randomized, controlled trial. Hypertension, 45(3), 391398. PubMed ID: 15699447 doi:10.1161/01.HYP.0000156540.25707.af

    • Crossref
    • Search Google Scholar
    • Export Citation
  • World Health Organization. (1997). WHOQOL Measuring quality of life: The World Health Organization quality of life instruments (the WHOQOL-100 and the WHOQOL-BREF). Washington, DC: World Health Organization.

    • Search Google Scholar
    • Export Citation
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