Table 2 Inclusion and exclusion criteria

▪ Adults 18 to 40 years of age

▪ Confirmed diagnosis of POTS [1] and currently attending specialist out-patient clinics

▪ Able to attend a PULSE centre 1–2 times/week for 8–12 weeks for exercise training

▪ Able to provide informed consent

▪ Absolute contraindications to exercise as per international clinical guidelines [11, 12]

▪ Any serious mental health/cognitive issue that will prevent engagement with study procedures or increase the risk of exercise complications

▪ Unable to make suitable travel arrangements

▪ Currently undertaking structured exercise/physical activity equivalent to the Chief Medical Officer (CMO) guidelines (150 min moderate exercise per week or 60 min vigorous per week)

▪ Previous randomisation in the present trial

▪ Pregnancy

▪ Taken part in co-creation workshops to design the PULSE intervention/study