Project Description
The doctoral capstone project focused on bringing awareness to postural orthostatic tachycardia syndrome (POTS) and its impact on occupations. In partnership with Dysautonomia Support Network, I created educational materials for patients and health practitioners, highlighting the benefit of occupational therapy in the treatment of POTS. Due to the limited amount of resources on rehabilitative interventions for individuals with POTS, this project aimed to bridge the gap and positively impact a population in need.
Mission Statement
To educate health professionals and patients about POTS and provide educational materials to practitioners to guide the assessment and treatment of patients with POTS.
Vision Statement
To spread awareness about POTS and advocate for the use of occupational therapy in its treatment.
Topic Areas
Education & Advocacy
Target Population
Health practitioners and individuals with POTS
Partnered Location
Expert Mentor
Joanna Behm, EdD, MOT, OTR/L
Faculty Mentor
Reagan Bergstresser-Simpson, OTD, OTR/L, ADHD-RSP
Literature Review
A literature review of relevant research on POTS was written prior to the start of the capstone project. Although there are a limited number of scientific articles on the use of occupational therapy to treat POTS, the existing research on POTS and treatments for co-occurring conditions proved useful throughout the capstone process.
Needs Assessment
About 500,000-3 million Americans have POTS, but there is a lack of awareness about the condition. Lack of knowledge about POTS leads to diagnostic delays for many patients and makes several treatment options inaccessible (Herrera & Behm, 2021). Treatment for POTS includes lifestyle changes and medications for symptom management. Treatments such as physical therapy (PT) and occupational therapy (OT) are other options, but approximately 75% of individuals with POTS do not receive these services (Rich et al., 2021). To improve the quality of life and outcomes for individuals with POTS, increased education and advocacy for the condition is necessary.
Project Outcomes
Deliverables were completed throughout the doctoral capstone project. The resulting deliverables are summarized below:
Summaries of Applicable Sources
Annotated summaries of podcasts, webinars, journal articles, and online sources were compiled to serve as a reference while creating educational materials.
Interview Transcriptions
14 practitioners treating POTS participated in virtual interviews to discuss assessments and interventions being utilized to treat a client with POTS. 1 nutritionist, 7 physical therapists, and 6 occupational therapists across the U.S. were interviewed for this process. The Otter.ai app was utilized to transcribe speech-to-text. Transcriptions were edited and compiled for use in following portions of the project.
Patient Handout on Occupational Therapy and POTS
Impact on Occupations Handout
Practitioner Handbook
Student Presentations
PowerPoint presentations to OT and PA schools, focusing on the physiology, presentation, diagnosis, and treatment of POTS. An additional presentation on the role of occupational therapy in the treatment of POTS was given to a local POTS support group.
Social Media Posts
Certificate of Completion in the POTS Providers Course
Future Directions
The components of the capstone experience have strengthened my skills in advocacy and interprofessional collaboration. I hope to apply my OT background and personal experiences to assist individuals with chronic illness. I have a passion for educating others and talking about POTS, and I will continue to do that post-graduation in any capacity that I'm able. I plan to continue working with Dysautonomia Support Network and use the knowledge I have gained throughout capstone to promote occupational therapy as a beneficial approach to POTS treatment.
Contact Information
alyssatomcho@dysautonomiasupport.org
References
Arnold, A. C., Haman, K., Garland, E. M., Raj, V., Dupont, W. D., Biaggioni, I., Robertson, D., & Raj, S. R. (2015). Cognitive dysfunction in postural tachycardia syndrome. Clinical Science, 128(1), 39-45. http://doi.org/10.1042/CS20140251
Bourne, K. M., Chew, D. S., Stiles, L. E., Shaw, B. H., Shibao, C. A., Okamoto, L. E., Garland, E. M., Gamboa, A., Peltier, A., Biaggioni, I., Sheldon, R. S., Robertson, D., & Raj, S. R. (2021). Postural orthostatic tachycardia syndrome is associated with significant employment and economic loss. Journal of Internal Medicine, 290(1), 203-212. https://doi.org/10.1111/joim.13245
Bruce, B. K., Harrison, T. E., Bee, S. M., Luedtke, C. A., Porter, C. J., Fischer, P. R., Hayes, S. E., Allman, D. A., Ale, C. M., & Weiss, K. E. (2016). Improvement in functioning and psychological distress in adolescents with postural orthostatic tachycardia syndrome following interdisciplinary treatment. Clinical Pediatrics, 55(14), 1300-1304. https://doi.org/10.1177/0009922816638663
Cook, G. A., & Sandroni, P. 2018. Management of headache and chronic pain in POTS. Autonomic Neuroscience: Basic and Clinical, 215, 37-45. https://doi.org/10.1016/j.autneu.2018.06.004
Dochod, J. R. (2022). Enhancing health-related quality of life through occupational therapy: A case report of a client with postural orthostatic tachycardia syndrome. Occupational Therapy in Health Care, 36(3), 202-219. https://doi.org/10.1080/07380577.2022.2051218
Dochod, J. R., & Grapczynski, C. (2019). Increasing functional abilities of people with postural orthostatic tachycardia syndrome through occupational therapy. The Open Journal of Occupational Therapy, 7(1). https://doi.org/10.15453/2168-6408.1522
Fu, Q., & Levine, B. D. (2018). Exercise and non-pharmacological treatment of POTS. Autonomic Neuroscience: Basic & Clinical, 215, 20-27. https://doi.org/10.1016/j.autneu.2018.07.001
Herrera, A., & Behm, J. (2021). Using the PEOP model to understand barriers to functioning in postural orthostatic tachycardia syndrome. Occupational Therapy in Health Care, 36(3), 283-305. https://doi.org/10.1080/07380577.2021.1967548
Hollingsworth, C., Boyette, V., Rich, E. M., & Vas, A. (2021). Cognition and postural tachycardia syndrome (POTS): Participant-identified challenges and strategies, and implications for intervention. Occupational Therapy in Health Care, 36(3), 220-236. https://doi.org/10.1080/07380577.2021.2004485
Levine, D., Work, B., McDonald, S., Harty, N., Mabe, C., Powell, A., & Sanford, G. (2022). Occupational therapy interventions for clients with Ehlers-Danlos syndrome (EDS) in the presence of postural orthostatic tachycardia syndrome (POTS). Occupational Therapy in Health Care, 36(3), 253-270. https://doi.org/10.1080/07380577.2021.1975200
Pinxsterhuis, I., Hellum, L. L., Aannestad, H. H., & Sveen, U. (2015). Development of a group-based self-management programme for individuals with chronic fatigue syndrome: A pilot study. Scandinavian Journal of Occupational Therapy, 22(2), 117-125. https://doi.org/10.3109/11038128.2014.985608
Pinxsterhuis, I., Sandvik, L., Strand, E. B., Bautz-Holter, E., & Sveen, U. (2015). Effectiveness of a group-based self-management program for people with chronic fatigue syndrome: a randomized controlled trial. Clinical Rehabilitation, 31(1), 93-103. https://doi.org/10.1177/0269215515621362
Raj, V., Opie, M., & Arnold, A. C. (2018). Cognitive and psychological issues in postural tachycardia syndrome. Autonomic Neuroscience: Basic & Clinical, 215, 46-55. https://doi.org/10.1016/j.autneu.2018.03.004
Rich, E. M. & Evetts, C. L. (2021). Occupational adaptation as a model for intervention in postural orthostatic tachycardia syndrome (POTS). Occupational Therapy in Health Care, 36(3), 271-282. https://doi.org/10.1080/07380577.2021.1974643
Rich, E. M., Vas, A., Boyette, V., & Hollingsworth, C. (2020). Daily life experiences: Challenges, strategies, and implications for therapy in postural tachycardia syndrome (POTS). Occupational Therapy in Health Care, 36(3), 306-323. https://doi.org/10.1080/07380577.2020.1824303
Rich, E. M., Vas, A., Parsons, T. D., Krone, R., & Goodman, B. P. (2021). Functional status in postural tachycardia syndrome. British Journal of Occupational Therapy, 85(6), 418-426. https://doi.org/10.1177/03080226211031807
Richardson, M. V., Nordon-Craft, A., Carrothers, L. (2017). Using an exercise program to improve activity tolerance in a female with postural orthostatic tachycardia syndrome: A case report. Physiotherapy Theory and Practice, 33(8), 670-679. https://doi.org/10.1080/09593985.2017.1328719
Shaw, B. H., Stiles, L. E., Bourne, K., Green, E. A., Shibao, C. A., Okamoto, L. E., Garland, E. M., Gamboa, A., Diedrich, A., Raj, V., Sheldon, R. S., Biaggioni, I., Robertson, D., & Raj, S. R. (2019). The face of postural orthostatic tachycardia syndrome – insights from a large cross-sectional online community-based survey. Journal of Internal Medicine, 286(4), 438-448. https://doi.org/10.1111/joim.12895
Standing Up to POTS. (2023). POTS cheat sheet. https://www.standinguptopots.org/resources/cheat-sheet
Vas, A., Rich, E., Wang, W., Patterson, M., & Parsons, T. (2021). Daily functionality in adults with POTS: Predictive factors. Occupational Therapy in Health Care, 36(3), 237-252. https://doi.org/10.1080/07380577.2021.1978032
Welford, J. & McKenna, C. (2016). Postural tachycardia syndrome: A UK occupational therapy perspective. British Journal of Cardiology, 23, 141-144. https://doi.org/10.5837/bjc.2016.038
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