Cardiac Patientsʼ Perception of Work Intensity During Graded Exercise Testing

Abstract

Purpose . Ratings of perceived exertion (RPE) have been proposed as an alternative to regulate exercise training intensity in a variety of populations; however, this method has not been adequately studied for application to cardiac patients. Methods In the first of two studies (Study 1), we examined the relationship between heart rate and RPE in patients with cardiac disease (n = 15) during graded exercise testing (GXT) on a treadmill and during exercise training in a gymnasium setting. Subjects were asked to estimate RPEs during each two minute stage of the GXT and then to produce three different levels of perceived exertion (RPE = low ∼10, moderate ∼12, hard ∼14) during exercise training. Results For each of the three levels of exertion, HRs (mean \pm SEM) were significantly (P < 0.01) higher during GXT than during exercise training in a gym (106.0 \pm 5.7 vs. 89.7 /Pm 4.1, 119.4 /Pm 3.4 vs. 95.1 /Pm 3.4, 130.7 /Pm 5.9 vs. 103.1 /Pm 3.9 beats min-1. Study II compared estimated RPEs of patients with cardiac disease (n = 25) during both a GXT and during an exercise training session (ETS). At matched HRs, patients' RPEs (mean /Pm SEM) were significantly higher (P < 0.01) during the exercise training session than GXT (12.6 /Pm 0.5 vs. 10.4 /Pm 0.3). Conclusions.The findings from both studies indicate that patients with cardiac discase perceive exercise to be more difficult in the context of exercise training compared to exercise testing, possibly explaining why many patients with cardiac disease find it difficult to attain the intensities established for exercise prescriptions.