Link To “10-Minute NASA Lean Test (a standardized passive stand test)” For Orthostatic Intolerance From The Bateman Horne Center

In this post, I link to and excerpt from the four-page PDF,  “10-Minute NASA Lean Test (a standardized passive stand test)” For Orthostatic Intolerance From The Bateman Horne Center.

I include the first page of the four-page protocol [See the link to the complete protocol, June 12, 2022].

10-Minute NASA Lean Test (a standardized passive stand test)

Clinician Instructions

Orthostatic intolerance (OI) is an umbrella term used to describe the development of symptoms induced byupright posture that  are relieved by reclining or supine posture. Orthostatic hypotension (OH), neurallymediated hypotension (NMH) [or  neurogenic orthostatic hypotension/NOH] and postural orthostatic tachycardia syndrome (POTS) are terms used to describe several subtypes of OI.

The 2015 National Academy of Medicine (NAM) clinical diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) establishes that orthostatic intolerance is a common and often overlooked feature of illness that is objectively measurable.

OI may contribute to dizziness, fatigue, headache, cognitive dysfunction, chest discomfort (palpitations, shortness of breath), abdominal discomfort (nausea), tremor, anxiety, various pain manifestations, and even non-epileptic seizure activity. We recommend that all ME/CFS and fibromyalgia syndrome (FMS)
patients undergo the standardized 10-Minute NASA Lean Test* to assess for orthostatic intolerance.

A baseline diagnostic test will be most revealing if therapeutic measures that reduce orthostatic intolerance are withheld upon the day of testing. For example, patients are encouraged to limit extra fluid and sodium intake, remove compression socks, and adjust medications that might influence the test (see examples
below). These treatments can be resumed immediately after the test.

Tools needed:

• Bed, wall, blood pressure cuff, and finger or ear pulse oximeter.
• The test is most safely done with two observers: one to obtain blood pressure (BP) and heart rate
(HR) values, and one to scribe, observe, and instruct.

General baseline pre-test preparation instructions (directed by a medical provider, as appropriate for each patient):

• Ideally, taper, stop or hold medications, supplements, or substances (including extra fluids and sodium), that might affect BP or HR, with timing based on the drug half-life and patient safety. Patient should be normally hydrated, and not dehydrated.
• Examples of medications to consider withholding or modifying:

      • Midodrine or Northera
      • Fludrocortisone
      • Beta blockers: propranolol, metoprolol, bisoprolol or atenolol
      • Stimulants: methylphenidate, dexadrine, or caffeine
      • Tricyclic antidepressants (TCA): amitriptyline, doxepin, or cyclobenzaprine
      • Serotonin-norepinephrine reuptake inhibitors (SNRI): duloxetine (Cymbalta) or
        venlafaxine (Effexor)
      • Tizanidine
This entry was posted in Autonomic Dysfunction, Autonomic Medicine, Autonomic Nervous System, Fibromyalgia, Medical News, Myalgia Encephalomyelitis, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Orthostatic Intolerance. Bookmark the permalink.