Sutcliffe, K, Gray, J, Tan, M P et al. · European journal of clinical investigation · 2010 · DOI
Some ME/CFS patients experience sudden drops in blood pressure when standing up, which may worsen fatigue. This study tested whether daily tilting exercises done at home could help stabilize blood pressure and improve symptoms. Over 6 months, patients who did the tilting exercises showed slightly better blood pressure control compared to those doing fake exercises, though fatigue improvements were modest.
Orthostatic intolerance is common in ME/CFS and contributes to disability. This feasibility study demonstrates that a simple, home-based intervention is well-tolerated and produces measurable physiological improvements in blood pressure regulation, providing preliminary evidence that a larger trial is justified and could lead to an accessible treatment option for patients.
This feasibility study was not adequately powered to determine whether HOT significantly reduces fatigue or improves clinical outcomes; the trend toward fatigue improvement at 6 months requires confirmation in a larger trial. The study does not establish causation between orthostatic intolerance and CFS symptoms, only that HOT can modulate haemodynamic responses. Compliance was variable, and optimal training protocols and patient selection criteria remain undefined.
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
Sutcliffe, K, Gray, J, Tan, M P, Pairman, J, Wilton, K, Parry, S W, et al. (2010). Home orthostatic training in chronic fatigue syndrome--a randomized, placebo-controlled feasibility study.. European journal of clinical investigation. https://doi.org/10.1111/j.1365-2362.2009.02225.x
BibTeX
@article{mecfsatlas-sutcliffe-2010-home-orthostatic,
author = {Sutcliffe, K and Gray, J and Tan, M P and Pairman, J and Wilton, K and Parry, S W and Newton, J L},
title = {Home orthostatic training in chronic fatigue syndrome--a randomized, placebo-controlled feasibility study.},
journal = {European journal of clinical investigation},
year = {2010},
doi = {10.1111/j.1365-2362.2009.02225.x},
note = {PubMed: 19912315},
url = {https://www.mecfsatlas.com/evidence/sutcliffe-2010-home-orthostatic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/sutcliffe-2010-home-orthostatic
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