Oefeningen bij POTS — progressie liggend → staand, zout + vocht + compressie

Fu 2010 + Shibata 2012 + the CHOP/Levine protocol + AHA 2015 consensus established the modern framework: structured recumbent → upright progression (typically recumbent bike, rowing, or swimming for months → semi-recumbent → upright over 3-6 months) improves POTS outcomes meaningfully. The Vanderbilt + Mayo + Stanford POTS programs apply this framework. Salt 8-10 g/day (under cardiologist clearance for BP) + fluid 2.5-3 L/day + compression stockings (waist-high 20-30 mmHg or higher per cardiologist) are foundational. hEDS overlap (Hakim 2017), ME/CFS overlap, and long COVID overlap (Bisaccia 2021) are common. Medication adjuncts (midodrine, propranolol, ivabradine, fludrocortisone) per autonomic cardiology. The exercise priorities are therefore: recumbent + semi-recumbent + supine work first, calf-pump + ankle-pump emphasis (skeletal muscle pump supports venous return), gentle progression over months, breath/parasympathetic regulation, posture support. AVOID upright high-intensity start (worsens orthostatic symptoms); AVOID Valsalva-heavy lift; AVOID prolonged standing without compression.

Volya's catalogue carries the foundation moves chosen for recumbent + POTS-friendly progression: diaphragmatic-breathing for parasympathetic regulation + autonomic support, supported-glute-bridge (recumbent) for posterior chain + venous return, supine-knee-to-chest (recumbent) for low-back release, wall-push-up for upper-body strength without sustained upright cardiovascular demand, scapular-retraction for posture, cat-cow for spinal mobility, calf-raise-rehab for posterior-chain + skeletal muscle pump support, ankle-pump for venous return (CRITICAL for POTS — frequent ankle pumps during prolonged standing), sit-to-stand for progressive upright transitions when ready. The AI coach also knows the nutrition side — Vanderbilt + AHA 2015 sodium 8-10 g/day target (under cardiologist clearance) + fluid 2.5-3 L/day, small frequent meals 4-6/day tolerated better than 3 large (large meals trigger postprandial blood shunting to gut), carbohydrate-modest meals (high-CHO can amplify postprandial hypotension), AVOID caffeine spike timing (individual response varies), alcohol AVOID excess (vasodilation worsens orthostatic), iron + B12 + vitamin D + magnesium monitoring (often low in fatigue subsets), compression stockings + abdominal binders as medical adjuncts, AVOID low-sodium 'heart healthy' diet (worsens POTS) + standing-still prolonged without compression + sudden upright transitions. CRITICAL: autonomic cardiologist + POTS-specialty programs (Vanderbilt, Mayo, Stanford) + Dysautonomia International + 988 if mental health crisis. POTS multidisciplinary care often includes PT (graded recumbent → upright protocol) + cardiology + neurology. This is NEVER a replacement for autonomic cardiology care.