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Assessment of the talk test and rating of perceived exertion for exercise intensity prescription in persons with paraplegia

Rachel E Cowan, Kelly L Ginnity, Jochen Kressler, Mark S Nash, Mark S Nash
Topics in Spinal Cord Injury Rehabilitation 2012, 18 (3): 212-9
23459216

BACKGROUND: Physical activity recommendations require accurate estimations of exercise intensity. Rating of Perceived Exertion (RPE) and talk test (TT) are 2 commonly recommended techniques to gauge intensity. It is not known whether these are valid to select an exercise intensity that would elicit a training effect for persons with spinal cord injury (SCI).

OBJECTIVE: To define the exercise intensity of each TT stage and RPE exercise intensity category and assess whether persons with paraplegia are able to use the TT to select a "comfortable" exercise workload they could maintain for 15 minutes.

METHODS: Twelve participants with paraplegia completed 2 arm crank exercise tests on nonconsecutive days within 14 days. Test 1 was an incremental peak effort assessment. Test 2 was a 15-minute simulated exercise session at a participant-selected fixed workload. During each test, participants reported their RPE and performed a TT at 2-minute intervals.

RESULTS: The intensity of the first negative TT stage was vigorous (75 ± 15 %VO2R); at low and moderate intensities, perceived effort was greater than measured intensity; at vigorous and maximal intensities, perceived effort matched measured intensity. Individuals successfully used the TT to select an exercise workload they could maintain for 15 minutes. RPE, but not exercise intensity, increased during the 15-minute session.

CONCLUSIONS: During arm crank exercise when speaking is not comfortable (ie, first negative TT), persons with paraplegia are exercising at vigorous intensity, which is sufficient to elicit training effects. During incremental peak exercise testing, RPE does not appear to accurately index low-moderate exercise intensities. During the simulated exercise session, RPE appeared to index peripheral fatigue.

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