Abstract
Objective
To test the reliability and validity of using the Borg rating of perceived exertion
(RPE) scale (ratings 6–20) in persons with multiple sclerosis (PwMS).
Design
Nonrandomized repeated measures.
Setting
Research laboratory.
Participants
Volunteer sample (N=27) comprised of 16 PwMS (10 women) and 11 age-matched persons
without multiple sclerosis (MS) (6 women). Clinical measures included symptomatic
fatigue, depression, and MS functional capacity.
Interventions
A submaximal cycling test was performed to estimate maximal capacity. Participants
then pedaled for 2 minutes at 50% and 60% of predicted maximal oxygen consumption
per unit time (o2), and physiological measures and RPE were obtained (week 1: response protocol). One
week later, participants replicated the prescribed o2 using the RPE range from week 1 (week 2: reproduction protocol). o2, heart rate, and respiratory quotient were measured continuously; RPE and workload
were measured every minute; and blood lactate and mean arterial pressure were measured
after exercise.
Main Outcome Measures
RPE, workload, o2, and heart rate from week 1 to week 2.
Results
PwMS had greater fatigue (P<.01) and disability (P<.001). Baseline measures were similar between groups and weeks. During exercise,
RPE, workload, o2, and heart rate were similar between groups. Both groups had an intraclass correlation
coefficient >.86 for RPE, workload, and o2. The intraclass correlation coefficient was comparatively lower for heart rate for
both groups (MS group: .72, non-MS group: .83). RPE was highly correlated with o2 (r=.691, P<.001) and workload (r=.700, P<.001) for the MS group.
Conclusions
Results suggest that RPE can be reliably reproduced, is valid, and may be used in
exercise prescription in mildly to moderately impaired PwMS during cycling exercise.
Keywords
List of abbreviations:
MAP (mean arterial pressure), MS (multiple sclerosis), MSFC (Multiple Sclerosis Functional Composite), PwMS (persons with multiple sclerosis), RPE (rating of perceived exertion), RQ (respiratory quotient), V˙o2 (oxygen consumption per unit time)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- American College of Sports Medicine. ACSM's resources for clinical exercise physiology: musculoskeletal, neuromuscular, neoplastic, immunologic, and hematologic conditions.2nd ed. Wolters Kluwer Health/Lippincott Williams & Wilkins Health, Philadelphia2010
- Physical activity and multiple sclerosis: a meta-analysis.Mult Scler. 2005; 11: 459-463
- Quantitation of lower physical activity in persons with multiple sclerosis.Med Sci Sports Exerc. 1997; 29: 517-523
- Symptomatic fatigue in multiple sclerosis.Arch Phys Med Rehabil. 1984; 65: 135-138
- Exercise and multiple sclerosis: physiological, psychological, and quality of life issues.J Sports Med Phys Fitness. 2001; 41: 421-432
- The effects of home-based resistance exercise on balance, power, and mobility in adults with multiple sclerosis.Arch Phys Med Rehabil. 2004; 85: 290-297
- Resistance training improves strength and functional capacity in persons with multiple sclerosis.Mult Scler. 2004; 10: 668-674
- A systematic review and meta-analysis of strength training in individuals with multiple sclerosis or Parkinson disease.Medicine (Baltimore). 2015; 94: e411
- Impact of aerobic training on fitness and quality of life in multiple sclerosis.Ann Neurol. 1996; 39: 432-441
- Change in aerobic fitness of patients with multiple sclerosis during a 6-month training program.Sports Med Train Rehabil. 1997; 7: 265-272
- Effects of a short-term exercise training program on aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis.Mult Scler. 2002; 8: 161-168
- Aerobic exercise in people with multiple sclerosis: its feasibility and secondary benefits.Int J MS Care. 2013; 15: 138-145
- Comparison of the influence of different rehabilitation programmes on clinical, spirometric and spiroergometric parameters in patients with multiple sclerosis.Mult Scler. 2006; 12: 227-234
- Effects of an aquatic fitness program on the muscular strength and endurance of patients with multiple sclerosis.Phys Ther. 1984; 64: 653-657
- ACSM's guidelines for exercise testing and prescription.9th ed. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia2014
- Submaximal exercise testing: clinical application and interpretation.Phys Ther. 2000; 80: 782-807
- Cardiovascular autonomic function in multiple sclerosis.J Neurol Sci. 1991; 104: 129-134
- Autonomic dysfunction in multiple sclerosis: correlation with disease-related parameters.Eur Neurol. 2002; 48: 1-5
- Cardiovascular dysfunction in multiple sclerosis.Acta Neurol Scand. 2000; 101: 85-88
- Evidence for cardiovascular autonomic nerve dysfunction in multiple sclerosis.J Neurol Neurosurg Psychiatry. 1984; 47: 947-952
- On the current status of rated perceived exertion.Percept Mot Skills. 1997; 84: 799-808
- American College of Sports Medicine. ACSM's exercise management for persons with chronic diseases and disabilities.3rd ed. Human Kinetics, Champaign2009
- Exercise and multiple sclerosis.Sports Med. 2004; 34: 1077-1100
- Perceived exertion.Human Kinetics, Champaign1996
- Central motor drive is increased during voluntary muscle contractions in multiple sclerosis.Muscle Nerve. 1997; 20: 1213-1218
- Central motor drive and perception of effort during fatigue in multiple sclerosis.J Neurol. 2006; 253: 1048-1053
- Fatigue in multiple sclerosis.Arch Neurol. 1988; 45: 435-437
- Multiple sclerosis and depression.Mult Scler. 2011; 17: 1276-1281
- Imbalance in multiple sclerosis: a result of slowed spinal somatosensory conduction.Somatosens Mot Res. 2008; 25: 113-122
- Defective sensorimotor integration in preparation for reaction time tasks in patients with multiple sclerosis.J Neurophysiol. 2015; 113: 1462-1469
- Psychometric properties of the Center for Epidemiologic Studies-Depression scale in multiple sclerosis.Neuroepidemiology. 2001; 20: 262-267
- Indices of cognitive dysfunction in relapsing-remitting multiple sclerosis: intra-individual variability, processing speed, and attention network efficiency.J Int Neuropsychol Soc. 2013; 19: 551-558
- Ratings of perceived exertion during aerobic exercise in multiple sclerosis.Arch Phys Med Rehabil. 2008; 89: 1570-1574
- Blunted pressor and intramuscular metabolic responses to voluntary isometric exercise in multiple sclerosis.J Appl Physiol. 2000; 88: 871-880
- Sample size requirements for estimating intraclass correlations with desired precision.Stat Med. 2002; 21: 1331-1335
- Measuring the functional impact of fatigue: initial validation of the fatigue impact scale.Clin Infect Dis. 1994; 18: S79-S83
- Validity and reliability of the MSQLI in cognitively impaired patients with multiple sclerosis.Mult Scler. 2003; 9: 621-626
- Multiple sclerosis quality of life inventory: a user's manual.National Multiple Sclerosis Society, New York1997
- The CES-D scale: a self-report depression scale for research in the general population.Appl Psychol Meas. 1977; 1: 385-401
- The use of psychological testing for treatment planning and outcomes assessment.3rd ed. Lawrence Erlbaum Associates, Mahwah2004
- Development of a multiple sclerosis functional composite as a clinical trial outcome measure.Brain. 1999; 122: 871-882
- The Multiple Sclerosis Functional Composite Measure (MSFC): an integrated approach to MS clinical outcome assessment. National MS Society Clinical Outcomes Assessment Task Force.Mult Scler. 1999; 5: 244-250
- Multiple sclerosis functional composite (MSFC). Administration and scoring manual.National Multiple Sclerosis Society, New York2001
- Y's Way to physical fitness: the complete guide to fitness testing and instruction.3rd ed. Human Kinetics, Champaign1989
- Statistics in kinesiology.4th ed. Human Kinetics, Champaign2012
- Maximal aerobic exercise in persons with multiple sclerosis.Clinical Kinesiology. 1993; 46: 12-21
- Pressor response to isometric exercise in patients with multiple sclerosis.Med Sci Sports Exerc. 1996; 28: 656-660
- Autonomic nervous system function in multiple sclerosis.J Neurol Sci. 2003; 215: 79-85
Article Info
Publication History
Published online: January 30, 2016
Footnotes
Current affiliation for Woo, OhioHealth Marion Area Physicians, Marion, OH.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
