Exercise Intensity In Patients Research Articles

THE RELATIONSHIP OF HEART RATE AND PERCEIVED EXERTION IS ALTERED BY SEVERITY OF PARKINSON??S DISEASE

Exercise training can improve aerobic capacity, movement initiation, and quality of life in individuals with Parkinson's disease (PD). The Borg rating of perceived exertion (RPE) scale has been used to help prescribe and monitor intensity of aerobic exercise regimens in healthy adults. In PD, motor and subclinical autonomic nervous system dysfunction may influence the heart rate (HR) response to exercise and thus the relationship between HR and RPE. This influence may limit the usefulness of RPE-based intensity prescriptions in PD. PURPOSE To examine the effects of parkinsonian motor disability score (Hoenh & Yahr) (H&Y) on the relationship between HR and RPE during exercise. METHODS Distance walked, maximum HR (HRmax), and RPE were recorded in 19 patients in H&Y stages 1.5–2.0 and in 12 patients in H&Y stages 2.5–3.0 during a standard 6-minute walk test. Patients were optimally medicated and were evaluated within 1–2 hours of taking antiparkinsonian medication. Group comparisons were made using independent t-tests, and regression analysis was used to evaluate the relationship between HR and RPE. RESULTS HRmax and distance walked were significantly greater in H&Y 1.5–2.0 compared to HY 2.5–3.0 (p < 0.05). A significant relationship between RPE at HRmax and HRmax was observed in patients with H&Y 1.5–2.0 (r = 0.47,p > < 0.05). However, this relationship was not observed in patients with H&Y 2.5–3.0 (r = 0.02,p = 0.94). This discrepancy indicates that the association between RPE at HRmax and HRmax depends on H&Y (Fig 1). CONCLUSIONS The HR-RPE relationship may be maintained in patients with early PD, but not by patients in whom ambulation is affected. These preliminary results would imply that using RPE to prescribe and monitor exercise intensity in patients with PD may have important limitations. Further study is necessary to elucidate the nature of the evolving relationship between RPE and disability in PD. Supported by NIH grant # RO-1AT00612–01.Figure: No Caption Available

Use of ratings of perceived exertion for predicting maximal work rate and prescribing exercise intensity in patients taking atenolol.

OBJECTIVE: The purpose of this study was to assess the efficacy of Borg's rating of perceived exertion (RPE) scale to predict maximal exercise levels to control exercise intensity in patients...

Dyspnea Ratings for Prescribing Exercise Intensity in Patients with COPD

Dyspnea Ratings for Prescribing Exercise Intensity in Patients with COPD

Dyspnea Ratings for Prescribing Exercise Intensity in Patients With COPD

We tested the hypothesis that patients with COPD can use dyspnea ratings obtained from a prior graded exercise test as a target to reliably produce specific exercise intensities. Four visits over a 7-week period. Pulmonary function and cardiorespiratory exercise laboratory at a university hospital. Fifteen symptomatic patients with stable COPD. Age was 68 +/- 7 (mean +/- SD) years. FEV1 was 1.12 +/- 0.22 L (45 +/- 8% predicted). At each visit, patients estimated the heaviness of weights to evaluate their magnitude estimation of a nonrespiratory task; after pulmonary function testing was completed, patients were tested on the cycle ergometer. At estimation trial 1 (day 0), patients estimated the intensity of dyspnea using the 0 to 10 category-ratio scale during an incremental exercise test. Estimation trial 2 (day 5 to 7) was the same as the previous trial. At production trials 1 (day 10 to 14) and 2 (day 40 to 44), patients were instructed to produce specific intensities of dyspnea (ie, dyspnea targets) at 50% and at anaerobic threshold (AT) or 80% of peak oxygen consumption (Vo2) as calculated from results at estimation trial 2. Lung function was stable at all visits. Dyspnea ratings were 1.8 +/- 0.9 (range, 1 to 3) at 50% of peak Vo2 and 5.5 +/- 1.5 (range, 4 to 8) at AT/80% of peak Vo2 (17.0 +/- 3.4 mL/kg/min) at estimation trial 2. The individual percent changes in Vo2 at the lower dyspnea target were 12 +/- 19% and 11 +/- 19% for production trials 1 and 2, respectively, compared with estimation trial 2. At the higher dyspnea target, the corresponding individual percent changes in Vo2 were -4 +/- 9% and -7 +/- 11%, respectively. For all 15 patients, there were borderline statistical differences for the Vo2 values at the lower (p = 0.04 and p = 0.07) and at the higher (p = 0.04 for each production trial) dyspnea targets for production trials 1 and 2 compared with estimation trial 2. Two patients showed 50% or greater variability in the calculated exponent for magnitude estimation of weights. In a subgroup analysis of the 13 patients with reproducible magnitude estimation of the heaviness of weights, there were no significant differences in Vo2 for the two production trials compared with estimation trial 2 at both exercise intensities. Dyspnea ratings obtained from an incremental exercise test can be used as a target for patients with COPD to regulate/monitor the intensity of exercise training. The ability of patients with COPD to achieve a desired Vo2 based on an individual dyspnea target was generally more accurate at the higher exercise level (AT/80% of peak Vo2) compared with the lower intensity (50% of peak Vo2). Acceptable accuracy was maintained over a 5-week time period.

Ratings of Perceived Exertion in Chronic Obstructive Pulmonary Disease

The purpose of this study was to evaluate the usefulness of ratings of perceived exertion (RPE) as an indicator of exercise intensity in patients with chronic obstructive pulmonary disease (COPD). The subjects were ten male patients with COPD, whose mean forced expiratory volume in 1 s was 1.09 1, SD 0.41, and ten healthy middle-aged men. Ramp incremental exercise on a cycle-ergometer was performed and RPE was determined by the Borg 15-point scale. The absolute oxygen uptake at each RPE was significantly greater in the healthy subjects than in the patients with COPD. However, oxygen uptake calculated as a percentage of maximal at any RPE did not differ significantly between the two groups. Arterial blood lactate concentration at points 15 to 19 on the RPE scale was increased in healthy subjects (P less than 0.05-P less than 0.001), while the dyspnoea index at points 11 to 19 on the RPE scale was higher in patients with COPD (P less than 0.05-P less than 0.001). The main complaints on stopping exercise were dyspnoea in the patients with COPD and fatigue in the healthy subjects. Although the nature of RPE may have been different in the two groups, RPE could be a possible indicator of exercise intensity when physicians prescribe exercise to patients with COPD.

Ratings of perceived exertion in chronic obstructive pulmonary disease ? a possible indicator for exercise training in patients with this disease

The purpose of this study was to evaluate the usefulness of ratings of perceived exertion (RPE) as an indicator of exercise intensity in patients with chronic obstructive pulmonary disease (COPD). The subjects were ten male patients with COPD, whose mean forced expiratory volume in 1 s was 1.09 1, SD 0.41, and ten healthy middle-aged men. Ramp incremental exercise on a cycle-ergometer was performed and RPE was determined by the Borg 15-point scale. The absolute oxygen uptake at each RPE was significantly greater in the healthy subjects than in the patients with COPD. However, oxygen uptake calculated as a percentage of maximal at any RPE did not differ significantly between the two groups. Arterial blood lactate concentration at points 15 to 19 on the RPE scale was increased in healthy subjects (P less than 0.05-P less than 0.001), while the dyspnoea index at points 11 to 19 on the RPE scale was higher in patients with COPD (P less than 0.05-P less than 0.001). The main complaints on stopping exercise were dyspnoea in the patients with COPD and fatigue in the healthy subjects. Although the nature of RPE may have been different in the two groups, RPE could be a possible indicator of exercise intensity when physicians prescribe exercise to patients with COPD.