Rupa was referred to CP+R with a condition called Postural Orthostatic Tachycardia Syndrome (PoTS). This is a relatively rare condition that is often misdiagnosed and on average takes 12 years for a confirmed diagnosis. The condition is not completely understood in the medical world, but it results in severe fatigue, dizziness, breathlessness, and other symptoms upon small amounts of activity, particularly when changing posture, such as standing up.

Our action plan

PoTS is not known to be curable and therefore the plan for Rupa was to minimise and manage symptoms as much as possible.

In order to not exacerbate her symptoms but also allow for enough work to be completed for physiological change, our plan for Rupa had to be very carefully constructed. Exercises were chosen that involved minimal postural change and reduced the workload on her heart, this included multiple floor-based exercises and activating isolated muscle groups. Rupa’s heart rate and blood pressure were monitored closely through each exercise session to determine early signs of symptoms being triggered.

Nutrition also played a significant part in Rupa’s plan as this can impact blood volume levels and heart rhythm, both of which have considerable impact on PoTS.

Rupa’s results

Rupa performed extremely well, and through joint decision making and discussion we were able to navigate her care with minimal symptom exacerbation. She also improved her overall functionality.

Rupa’s work with us also facilitated better health for her generally, with her body mass reducing by 5.9 kg (3.9 kg fat mass) and her resting heart rate reducing from 86 to 66 bpm. The resting heart rate in particular relates to a reduced excitability of the heart rhythm, which will help to minimise Rupa’s PoTS symptoms longer term.