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.

Lori Quinn, PT, EdD, FAPTA has been named the next editor-in-chief of the Journal of Neurologic Physical Therapy (JNPT), the official, Medline indexed, quarterly publication of the Academy of Neurologic Physical Therapy. Quinn will serve as a deputy editor during a transition period before assuming the role of editor-in-chief in January 2025 when the term of the current chief, George D. Fulk, PT, PhD, FAPTA, is completed.

Do you work with patients who have had a concussion and want to use the most up to date evidence in your clinical practice? This new ANPT course will help you understand and implement the information of the concussion CPG to guide your clinical practice. This course takes 4 clinical cases from across the lifespan and uses the CPG to guide clinical reasoning related to each case. Presented in a grand rounds format these real world scenarios will help you feel confident in implementing the evidence based content of the CPG in your daily practice. You can earn .15 CEU for completing this course. Register for this course on the ANPT Education Center: https://anpteducationcenter.org/products/application-of-concussion-cpg-across-clinical-cases