It is estimated that 11.4% of individuals diagnosed with postural orthostatic tachycardia (POTS) have sustained a concussion within the previous 3 months. As the symptoms of POTS include dizziness, lightheadedness, cognitive dysfunction, and fatigue, it is important to be able to distinguish 'regular' concussion symptoms from POTS.
Concussion pathophysiology is described as a metabolic process that can impact cerebral blood flow and inflammatory processes, and changes in the neural communications of the brain. These changes can impact sleep cycles, autonomic functions, and is now thought to be able to have an impact on cardiovascular autonomic dysfunction during the acute phases of concussion.
POTS is a condition of dysautonomia that occurs during standing. Patients will often experience reduced mental clarity and 'fogginess', elevated heart rate with position changes, and generalised fatigue.
This study describes a clinical training protocol that can be used to help patients who have suffered a concussion and may also be presenting with POTS.