Simon
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Now looked at that full text, and it's bizarre that Joyner should cite it as evidence that deconditioning helps POTS because the study gave no information at all about the effect of exercise training on POTS. All it found was that, as is widely found in healthy people, a sustained moderate exercise programme led to modest gains in VO2max. No mention of any effect on POTS.Few comments after reading the article:
Theory without the evidence:
..Many studies (though not all) in CFS and other illnesses have looked for deconditioning and failed to find it, though that hasn't dampened enthusiasm for the theory. Specifically, a study by Peter White of CFS patients enrolled in a Graded Exercise programme found patients were not deconditioned, and the minor gains in exercise capacity they made during the study did not correlate with improvement in their CFS.
The article specifically includes CFS:
Exercise is the answer - ALWAYS:
Again, evidence for this is lacking, or not cited by the author.
As for the specific study on training POTS patients, I've not yet read the full text, but judging by the abstract the results are not spectacular. However, says the author of the opinion piece, 'with prolonged training, even more dramatic improvement [note not cure] of symptoms is possible', citing "personal communication" - ie unpublished findings. Hardly compelling.
It's hard to see how anyone could conceive of a study on POTS that didn't measure POTS as an outcome; perhaps they did measure this and chose not to publish the findings or perhaps they just came up with a bizarre study design. We don't know (will email the authors, for fun).
Anyway, turns out a separate thread was set up the editorial last year (also turned out I had read and even contributed to that thread, but forgotten all about it..).