One symptom commonly reported by patients with ME/CFS is orthostatic intolerance, which is characterised by fainting or a loss in consciousness when standing up, and is caused by abnormalities in the body’s neurological system. An individual with orthostatic intolerance is unable to compensate for the changes in blood pressure that occur on standing, and this leads to a temporary lack of blood flow to the upper body and head.

Home orthostatic (or tilt) training (HOT) is a technique which has proved to be effective for the treatment of orthostatic intolerance in patients withUK neurally mediated hypotension, which may share other features with ME/CFS. Patients are asked to stand and lean with their upper back against a wall and their feet placed 15 cm away from the wall. They do this for up to 30 or 40 minutes, or until they experience symptoms, and then repeat the procedure once or twice a day for several weeks. The idea is that this repetition conditions them over time.

A research team from the National Institute for Health Research in Newcastle wondered whether HOT may be a simple, non-invasive treatment for the symptoms of orthostatic intolerance in patients with ME/CFS. A total of 38 patients completed either a regime of HOT (40 minutes once a day for 6 months), or a sham regime in which they stood for only 10 minutes while exercising their calf muscles.

The results showed that patients who completed HOT did not experience such a big drop in blood pressure while standing as those who completed the sham treatment. They also tended to show an improvement in their fatigue at the end of six months. The investigators concluded that a course of HOT may well be an effective strategy for improving the quality of life of patients with ME/CFS, although a large-scale clinical trial is needed to confirm this, and individuals should probably not undertake the therapy by themselves without the advice of their doctors.

Reference: Home orthostatic training in chronic fatigue syndrome–a randomized, placebo-controlled feasibility study. Sutcliffe K et al. Eur J Clin Invest 2010 Jan; 40(1): 18-24.