Peebles, Karen C, Jacobs, Charl, Makaroff, Logan et al. · Autonomic neuroscience : basic & clinical · 2024 · DOI
This review looked at 10 studies examining whether exercise helps people with POTS (a condition causing dizziness and fast heart rate when standing) who also have joint hypermobility, chronic fatigue, or fibromyalgia. The research found that 3 months of gradually increasing exercise—starting lying down and progressing to standing—reduced POTS symptoms and improved quality of life. However, very few studies have specifically tested exercise in people with the combination of POTS and joint hypermobility problems.
Many people with ME/CFS also experience POTS and hypermobility, making this review directly relevant to understanding safe and effective exercise approaches in this overlap population. The findings underscore an urgent need for well-designed clinical trials specifically testing exercise protocols in ME/CFS patients with POTS, since current evidence barely addresses this common comorbidity.
This review does not establish that the exercise protocols found effective in general POTS populations are safe or effective for ME/CFS patients with concurrent POTS and hypermobility—the very populations most needing evidence. The small number of studies directly examining hypermobile POTS means findings cannot definitively guide clinical practice for this subgroup, and case reports alone are insufficient to establish causation or generalizability.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Peebles, Karen C, Jacobs, Charl, Makaroff, Logan, & Pacey, Verity (2024). The use and effectiveness of exercise for managing postural orthostatic tachycardia syndrome in young adults with joint hypermobility and related conditions: A scoping review.. Autonomic neuroscience : basic & clinical. https://doi.org/10.1016/j.autneu.2024.103156
BibTeX
@article{mecfsatlas-peebles-2024-use-effectiveness,
author = {Peebles, Karen C and Jacobs, Charl and Makaroff, Logan and Pacey, Verity},
title = {The use and effectiveness of exercise for managing postural orthostatic tachycardia syndrome in young adults with joint hypermobility and related conditions: A scoping review.},
journal = {Autonomic neuroscience : basic & clinical},
year = {2024},
doi = {10.1016/j.autneu.2024.103156},
note = {PubMed: 38401460},
url = {https://www.mecfsatlas.com/evidence/peebles-2024-use-effectiveness},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/peebles-2024-use-effectiveness
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