Autonomic Nervous System Regulation for OT Professionals
This is a one-page refresher on the autonomic nervous system (ANS). The ANS is the part of the nervous system that runs automatic body functions like heart rate and blood pressure. The handout is for OTs and OTAs who see clients with autonomic dysregulation but don’t specialize in it.
Use it when a client’s diagnosis or symptoms suggest autonomic involvement. That includes POTS and other forms of dysautonomia, conditions like Parkinson’s disease or multiple sclerosis, and times of major transition, trauma, or persistent pain. The handout lists the conditions where autonomic dysfunction often shows up, the targeted interventions available, and where everyday OT strategies fit.
The grounding and regulation tools for clients are in a separate companion handout, Grounding Techniques & Vagus Nerve Exercises for Clients.
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Clients with autonomic dysregulation turn up in almost every practice setting. Sometimes dysregulation is a core feature of the diagnosis, as in POTS, neurocardiogenic syncope, or orthostatic hypotension. Other times it appears secondarily after chemotherapy or radiation, spinal cord injury, brain injury, Guillain-Barré syndrome, complex regional pain syndrome (CRPS), or Ehlers-Danlos syndromes. Many of the therapists treating these clients don’t have specialty training in it.
The handout was created with Emily Rich, PhD, OTR/L, an occupational therapist whose research and clinical work focus on POTS. Its main message is that you don’t have to be an expert in autonomic dysfunction to support these clients and make a difference in their daily lives.
Resource Utilization
This is a clinician-facing reference. It’s most useful at evaluation and treatment planning, especially when a referral mentions dysautonomia or a client describes symptoms that get worse with position changes, stress, or fatigue. It works in outpatient, inpatient, and community settings because autonomic dysfunction crosses so many diagnoses.
The handout splits treatment into two groups:
Targeted interventions for autonomic regulation. For orthostatic hypotension, these can include fluid and sodium regulation, counterpressure maneuvers, compression garments, and exercise. Coordinate these with the client’s medical team.
General OT interventions. These include energy management, daily routines, sleep, ADL modifications, work and school accommodations, social and leisure participation, and health and stress management. Stress management can also help clients cope with changes in their bodies and find their way through the health care system.
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