Autonomic dysfunction is a rapidly evolving area in medicine due to improved understanding of its role in persistent post-concussion symptoms (PPCS) and long-COVID. Approximately 70 million people worldwide are affected by autonomic disorders. The umbrella term dysautonomia is inclusive of more than 15 subtypes associated with dysfunction of the autonomic nervous system (ANS), with three of the most prevalent being Orthostatic Intolerance (OI), Postural Orthostatic Tachycardia Syndrome (POTS), and Orthostatic Hypotension (OH). Dysautonomia is often triggered by various neurological conditions or immune system responses such as brain injury, Multiple Sclerosis, and Parkinson’s Disease, as well as viral infections including COVID-19. As recognition improves, some patients will be identified as having autonomic dysfunction and may present with only mild symptoms. However, the majority of patients experience impairment across multiple domains impacting quality of life and community participation with the level of disability being compared to CHF and COPD. Although there is no known cure, prescribed symptom-guided progressive physical exercise is currently accepted as the most effective treatment to improve ANS regulation, regardless of clinical presentation or reported symptoms. Strategies for identifying and managing dysautonomia have been proposed in the literature, with recent updates providing clearer guidelines to physical therapists in clinical management of this evolving condition.

Course Recorded June 2024