Evidence map›Paper›PMID 39987007›Full record

Trial reportBMJ open2025

Exercise rehabilitation for people with postural tachycardia syndrome at two secondary care centres in the UK: the PULSE feasibility randomised controlled trial.

Gordon McGregor, Becky Evans, Harbinder Kaur Sandhu, Julie Bruce, Gita Devi, Sajad Hayat, Siew Wan Hee, Peter Heine, Nikki Holliday, Shivam Joshi and 12 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Gordon McGregorCoventry University, Coventry, UK gordon.mcgregor@uhcw.nhs.uk.ORCID http://orcid.org/0000-0001-8963-9107
Becky EvansUniversity Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Harbinder Kaur SandhuUniversity of Warwick, Coventry, UK.ORCID http://orcid.org/0000-0003-1522-8078
Julie BruceUniversity of Warwick, Coventry, UK.ORCID http://orcid.org/0000-0002-8462-7999
Gita DeviCoventry University, Coventry, UK.
Sajad HayatQatar Heart Hospital, Doha, Qatar.
Siew Wan HeeUniversity Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Peter HeineUniversity of Warwick, Coventry, UK.
Nikki HollidayCoventry University, Coventry, UK.
Shivam JoshiUniversity Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Lesley KaviPoTS UK, London, UK.
Lim BoonImperial College Healthcare NHS Trust, London, UK.
Angela NoufailyUniversity of Warwick, Coventry, UK.
Nicholas ParsonsUniversity of Warwick, Coventry, UK.
Shilpa PatelUniversity Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Gemma PearceCoventry University, Coventry, UK.
Richard PowellCoventry University, Coventry, UK.
Eva SchultzCoventry University, Coventry, UK.
Jane SimmondsUniversity College London, London, UK.
Albiona ZhupajUniversity Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Helen Eftekhari *University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Sandeep Panikker *University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe aim of the study was to assess the feasibility of conducting a definitive multicentre randomised controlled trial (RCT) testing an online exercise rehabilitation and behavioural/motivational support intervention for people with postural tachycardia syndrome (PoTS).

designFeasibility RCT.

settingTwo secondary care centres.

participantsAdults aged 18 to 60 years with PoTS. Exclusions were serious mental health/cognitive problem preventing safe participation; currently undertaking physical activity equivalent to the Chief Medical Officer guidelines; pregnancy.

interventionsParticipants were randomly assigned (1:1) to best-practice usual care (a single 1:1 session of advice) or the 'postural tachycardia syndrome exercise' (PULSE) intervention: (1) individual online consultation, (2) 12 weeks of supervised online group exercise and behavioural/motivational support, and (3) home exercise programme with recumbent exercise bike. OUTCOMES: The primary outcome was feasibility: (1) patients screened, eligible, recruited, randomised, withdrawn; (2) adherence; (3) physiological, clinical and patient-reported outcomes (4 and 7 months); and (4) embedded qualitative study to evaluate acceptability.

results209 patients screened between 5 May 2021 and 1 December 2022, 44 (female 98%; age 29.9 SD, 7.5) were randomised to usual care (n=21) or PULSE (n=23) (71% of target). Follow-up at 4 months was n=12 and n=17 respectively (66% of target). Median live exercise/support session attendance was 15 (IQR 12 to 17) of 18 sessions. Home exercise bike usage was highly variable. There were two serious adverse events in each treatment arm, both unrelated to the trial. Exercise rehabilitation was considered important by participants, and trial procedures, outcomes and interventions were acceptable.

conclusionsThe PULSE trial procedures and interventions were acceptable, and important design considerations were identified. A definitive RCT testing a remotely supervised exercise rehabilitation and behavioural/motivational support intervention for people with PoTS is feasible in the UK National Health Service. TRIAL REGISTRATION NUMBER: ISRCTN45323485.

Indexed as

Exercise TherapyPostural Orthostatic Tachycardia SyndromeAdultFeasibility StudiesFemaleHumansMaleMotivationSecondary Health CareUnited KingdomYoung AdultCARDIOLOGYPhysical Therapy ModalitiesREHABILITATION MEDICINE

Identifiers

PMID39987007
PMCPMC11848665

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.