Orthostatic Hypotension Rehabilitation

Orthostatic hypotension is a sustained drop in blood pressure on assuming upright posture causing dizziness syncope and increased fall risk. Rehabilitation focuses on physical countermaneuvers conditioning exercises and education to improve symptom control and functional independence. The condition is common in older adults patients with autonomic dysfunction and those on antihypertensive or vasoactive medications.

Rehabilitation interventions include head up tilt sleeping at thirty degrees gradual position changes from supine to sitting to standing physical countermaneuvers like leg crossing and muscle tensing and elastic compression garments. Exercise training emphasizes recumbent or seated activities including swimming and rowing that maintain venous return without orthostatic stress.

Lifestyle modifications include adequate hydration with at least two liters of fluid daily increased dietary salt to ten grams when not contraindicated avoidance of large meals and alcohol and caution with hot environments and vasodilators. Pharmacologic adjuncts including fludrocortisone and midodrine are reserved for severe symptomatic cases. Education on fall prevention and symptom recognition is essential for caregivers and patients.