In order to test for POTS, a clinician takes the baseline heart rate (HR) and blood pressure (BP) after the patient has been sitting for 10 minutes. BP and HR are then re-tested after 3, 5, 7, and 10 minutes of standing.
In the case of POTS, symptoms such as headache, dizziness, nausea, sweating may increase during prolonged standing, and are accompanied by elevated HR and BP levels. Tilt Table testing is needed for a true diagnosis of POTS, but monitoring changes in vitals with a progressed standing test can support a suspected diagnosis of POTS.
One of the main challenges with patients who have a concussion and POTS is to find an exercise training programme that will not excessively increase their symptoms. It is adviced to calculate the training effect by multiplying the HRR with 0.75: this is the maximum HR that should be achieved during training.
This calculation is applied to a training programme using a recombinant bike (to prevent symptoms evoked with standing) and is suggested to start with a maximum of five minutes of exercise at a time and completed over several weeks.