The Levine Protocol is a reconditioning programme recommended by cardiologists for PoTS patients to help them get fitter in a way that overcomes exercise intolerance and limits the exacerbation of symptoms.
Below are instructions for the 8-month programme, but first you will need to calculate your personal heart rate zones for training. Instructions for doing that is also below.
Remember that you should always consult a medical professional before exercising, and stop if you feel that your symptoms are being exacerbated or you experience pain.
Calculating your heart rate training zones*
The order of each pace in ascending order of intensity is: recovery pace, base pace, MSS pace, race pace, and interval pace.
Step 1: Find your Max Heart Rate (MaxHR): 220 – your age
Example: MaxHR = 220 – 25 = 195 bpm
Step 2: Find Heart Rate Reserve (HRR): MaxHR – supine resting HR
Example: HRR = 195 bpm – 65 bpm = 130 bpm
Step 3: Multiple HRR by .75 (75% of HRR)
Example: 130 bpm x .75 = 97.5 bpm (round up to 98 bpm)
Step 4: Find Mid-Maximal Steady State (MSS) HR: 75% of HRR + Resting HR
Example: 98 bpm + 65 bpm = 163 bpm
Step 5: Find MSS pace: 5 bpm +/- MSS HR
Example: 163 bpm +/- 5 = 158-168 bpm
Step 6: Find base pace: Subtract 20 bpm from low end of MSS pace range
Example: 158 bpm – 20 bpm = 138 bpm
Step 7: Find recovery pace: Less than your lowest base pace HR
Example: 138 – 157 bpm is my base pace range
Step 8: Find race pace: Multiply .95 by MaxHR
Example: .95 x 195 bpm = 185.25 (round down to 185 bpm); 168 is upper limit of MSS pace
Step 9: Find Interval Pace: Anything higher than your greatest race pace value (but not more than your MaxHR!).
Example: My greatest race pace value is 185 bpm; my max HR is 195 bpm
Below is the guidance that is commonly issued in the UK for patients. Remember that the heart rate numbers listed here should be replaced by your numbers, worked out using the method above. At the bottom of the document you’ll see a ↓ symbol, click on this to download the document for easier use.
Don’t feel confident to do the strength training workouts? No problem! In the video below Beth takes us through two workouts suitable for month one of the protocol to get you started. You can find more of our awesome workouts specially designed for the chronic illness community at www.patreon.com/chronicallyawesome.
* Thank you to Better By The Beat for laying out medical guidance so clearly.
