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While there’s no cure for POTS, Dysautonomia, or Long Covid, what if there were a treatment shown to improve symptoms for 77% of patients?

There is: a specific, structured exercise program. While “exercise more” may seem like one of the most banal pieces of health advice, this isn’t that—instead, it’s an exercise program that’s been carefully designed around the unique characteristics and needs of POTS patients.

Empirical Health’s POTS exercise program is rooted in the foundational research of the CHOP / Levine protocol. But we’ve updated it to use the latest technology and research, including iOS 17’s new WorkoutKit feature to preload workouts with pre-calculated heart rate zones to your watch.

Here’s how it works.

The science behind the CHOP / Levine protocol for POTS

My co-founder Dr Raquel Rodriguez wrote about the science behind the CHOP and Levine protocols in the CHOP protocol and the science behind it.

While the details of these two protocols vary a bit, they all involve these common characteristics:

• They begin with horizontal exercise, such as rowing, recumbent biking, or swimming. These horizontal exercises allow you to build cardiovascular endurance without exacerbating POTS symptoms.

• Start with low intensity exercise, guided by heart rate zones, for short durations (about 3 minutes initially). Strength training is incorporated twice a week. For those using beta blockers, an exertion scale is used instead of heart rate zones.

• Over the course of several months, graduate to longer durations, higher intensities, and upright exercise.

How we used iOS 17’s new WorkoutKit feature to build a POTS exercise program

iOS 17 and watchOS 10 introduced WorkoutKit, which lets developers create iPhone apps that preload workouts onto the Apple Watch. These workouts can be structured to include multiple segments, each of which have custom heart rate zones.

When you add today’s workout onto your watch, it will guide you through each segment. Segments generally guide you to reach a certain heart rate zone (or exertion level, for those on beta blockers) for a certain period of time. In the initial levels of the program, you might spend 3 minutes at a time at your base pace, with recovery in between:

As you advance in the program, the active periods adapt to become longer and more intense, with upright exercises typically being introduced after about two months.

How to start the CHOP protocol for POTS on your Apple Watch

Download Empirical Health on the App Store, then start the POTS exercise program. Let us know what you think!