NASA 10-minute lean test: Testing for orthostatic intolerance (OI) in ME/CFS patients (video)

[Lolinda]

Is this it? https://ichgcp.net/clinical-trials-...arison-of-tilt-testing-compared-with-standing

Edit: I just noticed the date on the one I posted so I don't think it is the right one. I'm sorry.

Here might be a longer version but confusing how they keep putting boxes with different topics down the whole page. It made me think it was just the shortened version.
And still only 2012: https://www.researchgate.net/public..._testing_compared_with_standing_haemodynamics

The problem with the paper you have found is that it does not feature at all the NASA test. Patients are not required to reduce water and salt intake for 2 days. also they do not lean against the wall but stand. Free standing activates the muscles more. The smartness of the NASA test is to exclude these things that help POTS people to avoid the increase of heart rate.

having said that, IMO The wisest thing is to think about what your purpose with testing is:
- if you want to file for disability then do the test as tough as you can. I guess for this purpose probably the best would be: reduce water and salt intake as in the NASA test for 2 days. Get a doctor to do for you until the table test for a long duration and don't tell him that you are water and salt deprived. This should be the toughest test possible and get you the money
- if wanting to know whether your life is affected by POTS, then I would do the test as a real world-like as possible, that is, no tilt table but plain simple standing, for as long as it is relevant for your life. Here the paper you found is useful as it specifies a heart rate difference of 29 for 10 min standing and a heart rate difference of 34 for 30 minutes standing. The paper is useful in my opinion because it helps finding good cut-off values.

 

[Judee]

So I went for the NASA lean test today. I was so worried it wouldn't show anything that my resting pulse was 93 and bp 110/73. I really did try to relax and breathe.

However, I asked the nurse to show me the sheet when we finished (at 9 minutes). I think she wanted me to stop sooner. My pulse went as high as 130 and my bps went as low as 83(?) over something. My watch alarm went off 3x during the standing portion.

Anyway, I'm hopeful that it showed POTS but have to wait til my doctor looks at the results as she was out of the office today and tomorrow.

Edit: I do think the going down to 1Ltr of water per day and normal salt intake helped as well as cutting out caffeine. I know caffeine is supposed to make our heart rates increase but for some reason I also feel like it must help me with my orthostatic issues. Too tired to research it right now.

I also used the guidelines for TTT prep in what I did. (See attachment below.)

 

[pattismith]

I don't know if this paper was already on PR​

​

Orthostatic Challenge Causes Distinctive Symptomatic, Hemodynamic and Cognitive Responses in Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome​

2022
Methods: We evaluated whether a simple, standardized, office-based test of OI, the 10-min NASA Lean Test (NLT), would aggravate symptoms and produce objective hemodynamic and cognitive abnormalities, the latter being evaluated by a simple smart phone-based app.

Participants: People with Long COVID (N = 42), ME/CFS (N = 26) and healthy control subjects (N = 20) were studied just before, during, immediately after, 2 and 7 days following completion of the NLT.

Results: The NLT provoked a worsening of symptoms in the two patient groups but not in healthy control subjects, and the severity of all symptoms was similar and significantly worse in the two patient groups than in the control subjects (p < 0.001). In the two patient groups, particularly those with Long COVID, the NLT provoked a marked and progressive narrowing in the pulse pressure. All three cognitive measures of reaction time worsened in the two patient groups immediately following the NLT, compared to the healthy control subjects, particularly in the Procedural Reaction Time (p < 0.01).

Conclusions: A test of orthostatic stress easily performed in an office setting reveals different symptomatic, hemodynamic and cognitive abnormalities in people with Long COVID and ME/CFS, compared to healthy control subjects.
Thus, an orthostatic challenge easily performed in an office setting, and the use of a smart phone app to assess cognition, can provide objective confirmation of the orthostatic intolerance and brain fog reported by patients with Long COVID and ME/CFS.
https://www.frontiersin.org/articles/10.3389/fmed.2022.917019/full