Christopher C. Dunbar

The validity of regulating exercise intensity by ratings of perceived exertion.

DUNBAR, C. C., R. J. ROBERTSON, R. BAUN, M. F. BLANDIN, K. METZ, R. BURDETT, and F. L. GOSS. The validity of regulating exercise intensity by ratings of perceived exertion. Med. Sci. Sports Exerc., Vol. 24, No. 1, pp. 94–99, 1992. The purpose of this investigation was to examine the regulation of ex

ACCURACY AND REPRODUCIBILITY OF AN EXERCISE PRESCRIPTION BASED ON RATINGS OF PERCEIVED EXERTION FOR TREADMILL AND CYCLE ERGOMETER EXERCISE

The accuracy of regularing exercise intensity by Ratings of Perceived Exertion (RPE) was examined. Subjects underwent 4 production trials, 2 on a treadmill (PIA, P1B) and 2 on a cycle ergometer (P2A, P2B). 9 untrained subjects used only their perceptions of effort to regulate exercise intensity. Target intensity was the RPE equivalent to 60% VO2mx. Exercise intensity (VO2) during P1A, P1B, and P2A did not differ from the target, but during P2B was lower than target. During P1A and P1B heart rate did not differ from the target but was lower than target during P2A and P2B. RPE seems a valid means of regulating exercise intensity during repeated bouts of treadmill exercise at 60% VO2max; however, exercise intensity during repeated bouts on the cycle ergometer may be lower than target.

Using RPE to regulate exercise intensity during a 20-week training program for postmenopausal women: a pilot study.

Feelings of effort sense quantified via the Borg Rating of Perceived Exertion (RPE) scale have been validated for regulating exercise intensity. Most studies validating RPE for exercise prescription have used young, male subjects and only a few exercise sessions. As part of a larger study we examined the accuracy of RPE for regulating exercise intensity in a group of postmenopausal women. Six women (70.0 ± 7.1 yr.) were given a maximal graded exercise test. Target RPEs equivalent to 40%, 50% and 60% VO2 max were developed from this test using standard techniques. These RPEs were used to regulate intensity during a 20-wk. training program. During the initial 5 wk. of training target intensity was increased from 40% to 60% VO2 max and exercise duration from 15 to 30 min. Accuracy of exercise intensity regulation was determined by comparing the heart rate during exercise to a target heart rate equivalent to the desired %VO2 max. At Week 2 of training (target 40% VO2 max) the mean intensity produced did not differ from target. During Weeks 4 (target 50% VO2 max), 6 and 10 of training (target 60% VO2 max) the mean exercise intensity was below target. At Week 20 the mean intensity produced was not different from target. This suggests that elderly women can accurately use RPE to regulate exercise intensity, but at intensities above 40% VO2 max an acclimation period is needed.

The Slope Method for Prescribing Exercise with Ratings of Perceived Exertion (RPE)

The Borg Ratings of Perceived Exertion scale (RPE) has been shown to be a valuable tool for prescribing exercise; however, use of RPE-based exercise prescriptions in field settings has often been problematic because RPE data derived from maximal exercise testing are needed. We describe a simple method for obtaining target RPEs for exercise training from submaximal exercise data. Target RPEs for 50%, 60%, 70%, and 85% VO2peak exercise intensities obtained using the new method did not differ significantly from those obtained using data from a maximal graded exercise test. The mean difference was less than one RPE unit and was not significant (p<.05). Therefore, the Slope Method appears to be valid for developing RPE-based exercise prescriptions.

A SUBMAXIMAL TREADMILL TEST FOR DEVELOPING TARGET RATINGS OF PERCEIVED EXERTION FOR OUTPATIENT CARDIAC REHABILITATION

For patient populations whose heart rates cannot be used to regulate exercise intensity, the Borg Rating of Perceived Exertion (RPE) Scale is the preferred way to prescribe exercise intensity. Individual perceptual variations are best quantified by measuring perceptual intensity during maximal exercise testing; however, many situations require a submaximal protocol. Here, a submaximal treadmill procedure for establishing individualized target Ratings of Perceived Exertion is described. Target ratings of exertion were developed for outpatient cardiac rehabilitation patients using the new method and compared to target Ratings of Perceived Exertion obtained using standard techniques. A total of 144 target ratings at intensities ranging from 50% to 85% VO2max were compared. Over-all, the average difference between the two methods was 0.27 units and was not significant at any intensity. Therefore, the Treadmill Slope Method appears to be a valid submaximal test for generating target Ratings of Perceived Exertion for outpatient cardiac rehabilitation patients.

A New Method for Prescribing Exercise: Three-Point Ratings of Perceived Exertion

An accurate exercise prescription for ratings of perceived exertion has previously depended on data from a maximal graded exercise test during which RPE was measured. In many clinical settings RPE is not measured; in many fitness settings maximal testing is not feasible. A new method using treadmill speed or power output of a cycle ergometer at an RPE of 13 from a submaximal test which can be used in these situations is described. We evaluated the accuracy of this method at 50%, 60%, 70%, and 85% VO2max. A total of 160 target RPEs were developed using traditional procedures and the new method. No significant differences between RPEs obtained with the two techniques were found. The mean difference was less than one unit of RPE. It appears that the new method is valid for intensities of 50% to 85% VO2max and that data from either the cycle ergometer or the treadmill can be used to prepare exercise prescriptions.

Three-point method of prescribing exercise with ratings of perceived exertion is valid for cardiac patients.

It is often difficult to use heart rate to prescribe exercise for cardiac patients due to the effects of medications and procedures such as cardiac transplantation. Ratings of Perceived Exertion (RPE) is the preferred method of regulating exercise intensity in these situations. An RPE-based exercise prescription has previously depended on perceptual data from a maximal Graded Exercise Test (GXT). Recently, using 13 healthy subjects, we validated a Three-point RPE for prescribing exercise using RPE which can be used when ratings from a GXT are not available. Currently, we examined the accuracy of this method for developing target RPEs for patients in Phase II cardiac rehabilitation. Such target RPEs did not differ from those obtained using standard procedures. We conclude that the Three-point Method is valid for preparing RPE-based exercise prescriptions for Phase II cardiac rehabilitation patients.

Is exercise indicated for the patient diagnosed as anorectic

1. Anorexia nervosa is a disorder characterized by voluntary decreases in food intake resulting in negative caloric balance and dramatic loss of body weight. 2. Aerobic exercise may be contraindicated in patients diagnosed with anorexia because of the high caloric cost and the possibility of overindulgence. 3. Calorically modest weight lifting exercises to increase lean body mass might be useful in increasing compliance with therapy by ensuring that the weight gained is distributed in a more aesthetically appealing manner.

Cardiovascular and Metabolic Responses to Vinyasa Yoga and Paced Surya Namaskar B

Objectives: The purpose of this study is to assess cardiovascular response to a thirty-minute continuous and uniformly paced session of Surya Namaskar B. The metabolic response to the yoga protocol is compared to the maximum cardiovascular response assessed utilizing a Bruce Protocol treadmill test to determine whether or not the a vinyasa flow yoga practice, including frequent paced Surya Namaskar B, meets the guidelines for moderate intensity activity as outlined by the American College of Sports Medicine (ACSM). Methods: Four healthy men and women (37 - 62 years) who have practiced vinyasa yoga for at least six months participated in the study. Participants completed a Bruce Protocol treadmill test to assess maximum cardiovascular and metabolic response. In a subsequent session, participants completed thirty minutes of a paced Surya Namaskar B yoga protocol. Results: Participants exhibited an average 50% or more of their VO2 max and between 5-8 METS during the course of the thirty-minute yoga protocol. Conclusion: The practice of Surya Namaskar B, paced at approximately one sequence completed over 45 seconds, can elicit a moderate intensity cardiovascular response and meets the guidelines of moderate intensity activity.

The Accuracy of the Electrocardiogram during Exercise Stress Test Based on Heart Size

Background Multiple studies have shown that the exercise electrocardiogram (ECG) is less accurate for predicting ischemia, especially in women, and there is additional evidence to suggest that heart size may affect its diagnostic accuracy. Hypothesis The purpose of this investigation was to assess the diagnostic accuracy of the exercise ECG based on heart size. Methods We evaluated 1,011 consecutive patients who were referred for an exercise nuclear stress test. Patients were divided into two groups: small heart size defined as left ventricular end diastolic volume (LVEDV) <65 mL (Group A) and normal heart size defined as LVEDV ≥65 mL (Group B) and associations between ECG outcome (false positive vs. no false positive) and heart size (small vs. normal) were analyzed using the Chi square test for independence, with a Yates continuity correction. LVEDV calculations were performed via a computer-processing algorithm. SPECT myocardial perfusion imaging was used as the gold standard for the presence of coronary artery disease (CAD). Results Small heart size was found in 142 patients, 123 female and 19 male patients. There was a significant association between ECG outcome and heart size (χ2 = 4.7, p = 0.03), where smaller hearts were associated with a significantly greater number of false positives. Conclusions This study suggests a possible explanation for the poor diagnostic accuracy of exercise stress testing, especially in women, as the overwhelming majority of patients with small heart size were women.