What are we measuring? Considerations on subjective ratings of perceived exertion in obese patients for exercise prescription in cardiac rehabilitation programs

2010 ◽  
Vol 140 (2) ◽  
pp. 236-238 ◽  
Author(s):  
Luca Alessandro Gondoni ◽  
Ferruccio Nibbio ◽  
Giulia Caetani ◽  
Giovanni Augello ◽  
Anna Maria Titon
Keyword(s):  
Cardiac Rehabilitation ◽  
Perceived Exertion ◽  
Exercise Prescription ◽  
Obese Patients ◽  
Subjective Ratings ◽  
Ratings Of Perceived Exertion ◽  
Rehabilitation Programs

Three-Point Method of Prescribing Exercise with Ratings of Perceived Exertion is Valid for Cardiac Patients

1996 ◽  
Vol 83 (2) ◽  
pp. 384-386 ◽  
Author(s):  
Christopher C. Dunbar ◽  
William W. Edwards ◽  
E. L. Glickman-Weiss ◽  
Patricia Conley ◽  
Antonio Quiroz
Keyword(s):  
Cardiac Rehabilitation ◽  
Phase Ii ◽  
Perceived Exertion ◽  
Exercise Prescription ◽  
Point Method ◽  
Cardiac Patients ◽  
Ratings Of Perceived Exertion ◽  
Graded Exercise Test ◽  
Standard Procedures ◽  
Graded Exercise

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.

scholarly journals Functional Translation of Exercise Responses from Exercise Testing to Exercise Training: The Test of a Model

2021 ◽  
Vol 6 (3) ◽  
pp. 66
Author(s):  
Tristan Tyrrell ◽  
Jessica Pavlock ◽  
Susan Bramwell ◽  
Cristina Cortis ◽  
Scott T. Doberstein ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Exercise Test ◽  
Perceived Exertion ◽  
Exercise Prescription ◽  
Test Results ◽  
Training Intensity ◽  
Ratings Of Perceived Exertion ◽  
Metabolic Equivalents ◽  
Cardiovascular Drift ◽  
And Training

Exercise prescription based on exercise test results is complicated by the need to downregulate the absolute training intensity to account for cardiovascular drift in order to achieve a desired internal training load. We tested a recently developed generalized model to perform this downregulation using metabolic equivalents (METs) during exercise testing and training. A total of 20 healthy volunteers performed an exercise test to define the METs at 60, 70, and 80% of the heart rate (HR) reserve and then performed randomly ordered 30 min training bouts at absolute intensities predicted by the model to achieve these levels of training intensity. The training HR at 60 and 70% HR reserve, but not 80%, was significantly less than predicted from the exercise test, although the differences were small. None of the ratings of perceived exertion (RPE) values during training were significantly different than predicted. There was a strong overall correlation between predicted and observed HR (r = 0.88) and RPE (r = 0.52), with 92% of HR values within ±10 bpm and 74% of RPE values within ±1 au. We conclude that the generalized functional translation model is generally adequate to allow the generation of early absolute training loads that lead to desired internal training loads.

A Pilot Study Comparing Physiological Responses of Phase III Cardiac Patients to Recumbent and Upright Exercise Using the RPE Scale

2005 ◽  
Vol 100 (2) ◽  
pp. 357-361 ◽  
Author(s):  
Meir Magal ◽  
Robert F. Zoeller
Keyword(s):  
Heart Rate ◽  
Pilot Study ◽  
Cardiac Rehabilitation ◽  
Perceived Exertion ◽  
Physiological Responses ◽  
Cardiac Patients ◽  
Phase Iii ◽  
Ratings Of Perceived Exertion ◽  
Physiological Differences ◽  
Stepping Exercise

Ratings of perceived exertion (RPE) are used for exercise programming of cardiac rehabilitation patients, whenever it is difficult to use heart rate to set intensity due to medication or other factors. This investigation examined the physiological responses to two stepping exercise modes (upright and recumbent) at the same RPE. Analysis indicated significant physiological differences between the modes of exercise which may be mediated by postural differences. Specifically, the physiological responses to the recumbent exercise, but not the upright exercise, had the expected relationship with RPE, with recumbent stepping requiring less physiological effort than the upright stepping at the same RPE. As such, we cannot recommend with confidence that the prescription for upright exercise be made based on data from recumbent exercise or vice-versa.

Accuracy and Reproducibility of an Exercise Prescription Based on Ratings of Perceived Exertion for Treadmill and Cycle Ergometer Exercise

1994 ◽  
Vol 78 (3_suppl) ◽  
pp. 1335-1344 ◽  
Author(s):  
Christopher C. Dunbar ◽  
Carole Goris ◽  
Donald W. Michielli ◽  
Michael I. Kalinski
Keyword(s):  
Heart Rate ◽  
Exercise Intensity ◽  
Perceived Exertion ◽  
Exercise Prescription ◽  
Treadmill Exercise ◽  
Cycle Ergometer ◽  
Ratings Of Perceived Exertion ◽  
Cycle Ergometer Exercise ◽  
Ergometer Exercise ◽  
Target Intensity

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.

Psychological Affect at Different Ratings of Perceived Exertion in High-and Low-Active Women: A Study Using a Production Protocol

1996 ◽  
Vol 82 (3) ◽  
pp. 1035-1042 ◽  
Author(s):  
Gaynor Parfitt ◽  
Roger Eston ◽  
Declan Connolly
Keyword(s):  
Steady State ◽  
Oxygen Uptake ◽  
Perceived Exertion ◽  
Exercise Prescription ◽  
Cycle Ergometer ◽  
Work Rate ◽  
Activity Levels ◽  
Ratings Of Perceived Exertion ◽  
Habitual Activity ◽  
Positive Feelings

The purpose of this study was to examine psychological affect at different ratings of perceived exertion (RPE) in 15 high- and 15 low-active women. Both groups performed three steady-state exercise bouts on a cycle ergometer at RPEs 9, 13, and 17 and reported their affect in the last 20 sec. of and 5 min. after each work rate. There were no differences between groups in percentage of maximal oxygen uptake (% VO2max) at each RPE. Low-active women reported feeling significantly more negative at RPE 17 than RPE 9 and less positive than the high-active women at RPEs 9, 13, and 17. In addition, all subjects reported more positive feelings 5 min. postexercise than in the last 20 sec. of exercising, especially at RPE 17. These results have implications for exercise prescription in groups differing in habitual activity levels.

scholarly journals Exercise Prescription Techniques in Cardiac Rehabilitation Centers in Midwest States

2018 ◽  
Vol 7 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Sean O'Neil ◽  
Andrew Thomas ◽  
Ryan Pettit-Mee ◽  
Katie Pelletier ◽  
Mary Moore ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Resistance Exercise ◽  
Perceived Exertion ◽  
Exercise Prescription ◽  
Artery Bypass ◽  
Bypass Graft ◽  
The United States ◽  
Rating Of Perceived Exertion ◽  
Rehabilitation Centers

ABSTRACT Introduction: Cardiac rehabilitation (CR) is a primary prescribed treatment for a variety of cardiovascular disease states, including: coronary artery disease, percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), myocardial infarction (MI), and heart failure. For this reason, exercise prescription guidelines for cardiac patients have been established. However, it is unclear how these guidelines are being administered at cardiac rehabilitation centers. The purpose of this study is to assess current exercise prescription techniques at cardiac rehabilitation clinics across several Midwest states in the United States. Methods: Fifty-eight CR programs from Michigan, Indiana, Illinois, Minnesota, Wisconsin, and Ohio were administered a questionnaire assessing clinic characteristics, aerobic and resistance exercise prescription techniques. Results: Most reported patient types were PCI, CABG, and MI. Clinical exercise physiologists were the primary exercise prescription writers (81%). Only 32% of the clinics required a clinical certification. Baseline stress tests prior to CR were performed in 33% of programs. Rating of Perceived Exertion (RPE) was the most commonly used indicator of exercise intensity, followed by heart rate reserve (HRR), and METs. Resistance exercise was practiced in 89% of CR programs. The most common intensity indicator was trial and error, and RPE. Conclusion: Results demonstrate exercise prescription variability among CR programs. This emphasizes the complexity and expertise among clinical exercise physiologists. These results also highlight the importance that academic programs place on training students across all prescription techniques, and utilization of research-based prescription guidelines published by professional organizations.

scholarly journals Effect of a phase 2 cardiac rehabilitation program on obese and non-obese patients with stable coronary artery disease

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Ahmed El Missiri ◽  
Walaa Adel Abdel Halim ◽  
Abdo Saleh Almaweri ◽  
Tarek Rashid Mohamed
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Stable Coronary Artery Disease ◽  
Rehabilitation Program ◽  
Obese Patients ◽  
Cardiac Rehabilitation Program ◽  
Phase 2 ◽  
Rehabilitation Programs ◽  
Artery Disease

Abstract Background Obesity is associated with significant cardiovascular morbidity and mortality effects. Cardiac rehabilitation programs cause a significant reduction in cardiovascular mortality and a reduction in all cardiovascular risk factors. Up to 80% of patients referred to cardiac rehabilitation programs are either overweight or obese. This study aimed to compare the effects of a phase 2 cardiac rehabilitation program on obese and non-obese patients with stable coronary artery disease following total revascularization by coronary angioplasty. Results This was a prospective study including 120 patients with stable coronary artery disease. Patients were enrolled in a 12-week phase 2 cardiac rehabilitation program. Patients were classified into two groups based on their body mass index (BMI): those with a BMI < 30 kg/m2 were considered non-obese (n = 58) while those with a BMI ≥ 30 kg/m2 were considered obese (n = 62). At baseline, BMI and blood pressure (BP) were recorded; fasting blood sugar, triglyceride levels, total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were assessed; and echocardiography was used to measure left ventricular ejection fraction (LVEF). These were re-assessed after completion of the program. At baseline, there were more females in the obese group 20 (32.25%) vs 6 (10.13%) (p = 0.04), more hypertensives (p = 0.023), and less smokers 32 (51%) vs 46 (79%) (p = 0.025). Obese patients achieved fewer metabolic equivalent of tasks (METs) 7.97 ± 2.4 vs 9.74 ± 2.47 (p = 0.007) and had higher LDL-C levels 121.63 ± 36.52 mg/dl vs 95.73 ± 31.51 mg/dl (p = 0.005). At the end of the program, obese patients showed more reduction in BMI − 1.78 ± 1.46 kg/m2 vs − 0. 60 ± 0.70 kg/m2 (p < 0.001) and systolic and diastolic BP (p = 0.016 and 0.038, respectively). LDL-C level was more reduced in the obese group − 25.76 ± 14.19 mg/dl vs − 17.37 ± 13.28 mg/dl (p = 0.022). Non-obese patients had more increase in LVEF (p = 0.024). There was no difference between obese and non-obese patients in the magnitude of increase in METs achieved (p = 0.21). Conclusion Cardiac rehabilitation programs lead to an improvement in cardiovascular disease risk factors with more reduction in BMI, BP, and LDL-C levels in obese patients compared to non-obese ones. LVEF was more increased in non-obese individuals. Exercise capacity in the form of METs achieved was equally improved in both groups.

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