ReviewJournal of neurologic physical therapy : JNPT2018
Activity and Exercise Intolerance After Concussion: Identification and Management of Postural Orthostatic Tachycardia Syndrome.
Review in Journal of neurologic physical therapy : JNPT, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Faintly tired: a systematic review of fatigue in patients with orthostatic syncope.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2022Pooled it
- Role of anxiety in exercise intolerance and autonomic nervous system dysfunction post-concussion.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Trial
- Transcranial low-frequency pulsating electromagnetic fields (T-PEMF) as post-concussion syndrome treatment.Acta neurologica Scandinavica · 2020Trial
- Concussion: A Comprehensive Review of Current Evidence.Current reviews in musculoskeletal medicine · 2026Review
- Assessment of internal consistency reliability and concurrent validity of PROMISJournal of patient-reported outcomes · 2026Article
- Comorbidities Across Functional Neurological Disorder Subtypes: A Comprehensive Narrative Synthesis.Life (Basel, Switzerland) · 2025Review
- Article
- Commentary: are postconcussive symptoms and exercise testing appropriate tools to identify autonomic impairment after mild traumatic brain injury?The Clinical neuropsychologist · 2025Review
- Concussion and the Autonomic, Immune, and Endocrine Systems: An Introduction to the Field and a Treatment Framework for Persisting Symptoms.Journal of personalized medicine · 2025Review
- Adaptive Approaches to Exercise Rehabilitation for Postural Tachycardia Syndrome and Related Autonomic Disorders.Archives of rehabilitation research and clinical translation · 2024Article
- Orthostatic Vital Signs After Sport-Related Concussion: A Cohort Study.The American journal of sports medicine · 2024Article
- Functional neurological disorder, physical activity and exercise: What we know and what we can learn from comorbid disorders.Epilepsy & behavior reports · 2024Review
- The role of the physiotherapist in concussion.The South African journal of physiotherapy · 2024Article
- Review
- Sub-occipital muscle pressure pain thresholds correlate to direction of symptomatic active comfortable sustained neck rotation testing in post-concussive headache: a retrospective observational cross-sectional study.The Journal of manual & manipulative therapy · 2023Observational
- Autonomic dysfunction and exercise intolerance in concussion: a scoping review.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023Article
- Narrative Review of Postural Orthostatic Tachycardia Syndrome: Associated Conditions and Management Strategies.US cardiology · 2023Review
- From Provider to Advocate: The Complexities of Traumatic Brain Injury Prompt the Evolution of Provider Engagement.Journal of clinical medicine · 2021Review
- Pain Management In Pediatric Patients With Postural Orthostatic Tachycardia Syndrome: Current Insights.Journal of pain research · 2019Review
- Postural Orthostatic Tachycardia Syndrome (POTS): A critical assessment.Progress in cardiovascular diseasesReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposePostural orthostatic tachycardia syndrome (POTS) is increasingly recognized as a complication affecting recovery from concussion. Individuals with POTS demonstrate refractory dizziness, lightheadedness, cognitive dysfunction, fatigue, headache, chronic pain, nausea and gastrointestinal dysmotility, activity and exercise intolerance, syncope, and tachycardia. Subtypes of POTS may include hypovolemia, hyperadrenergic states, autonomic neuropathy, and underlying autoimmunity, which may variably impact response to rehabilitation in varying ways. The subtle presentation of POTS postconcussion is often mistaken for underlying anxiety, conversion disorder, or lack of motivation for recovery. This article will present clinical features of POTS that may arise after concussion, and propose a role for physical therapists in the diagnosis and management of POTS during concussion recovery. SUMMARY OF KEY POINTS: Data recorded and entered into a database during clinic visits from a large pediatric institution indicate that 11.4% of individuals diagnosed with POTS report onset of symptoms within 3 months of sustaining a concussion. Activation of the sympathetic nervous system can result in lightheadedness, shortness of breath, chest pain, tachycardia, palpitations on standing or with exertion, and activity and exercise intolerance. Identified comorbidities in people with POTS such as joint hypermobility and autoimmune disorders can further influence recovery. RECOMMENDATIONS FOR CLINICAL PRACTICE: Physical therapists may identify signs and symptoms of POTS in a subset of individuals who remain refractory to typical interventions and who exhibit symptom exacerbation with orthostatic activity. Incorporation of an individualized POTS exercise program into current established concussion interventions may be useful, with emphasis on initial recumbent exercises and ongoing physical therapy assessment of exercise tolerance for dosing of activity intensity and duration.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A211).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.