Reliability and Validity of Ratings of Perceived Exertion in Persons With Multiple Sclerosis

Published:January 30, 2016DOI:



      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).


      Nonrandomized repeated measures.


      Research laboratory.


      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.


      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 ( V ˙ o2), and physiological measures and RPE were obtained (week 1: response protocol). One week later, participants replicated the prescribed V ˙ o2 using the RPE range from week 1 (week 2: reproduction protocol). V ˙ 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, V ˙ o2, and heart rate from week 1 to week 2.


      PwMS had greater fatigue (P<.01) and disability (P<.001). Baseline measures were similar between groups and weeks. During exercise, RPE, workload, V ˙ o2, and heart rate were similar between groups. Both groups had an intraclass correlation coefficient >.86 for RPE, workload, and V ˙ 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 V ˙ o2 (r=.691, P<.001) and workload (r=.700, P<.001) for the MS group.


      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.


      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)
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