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Perceived Exertion Relationships and Prediction of Peak Oxygen Uptake in Able-bodied and Paraplegic Individuals
Al-Rahamneh, Harran Qoblan Mefleh
Thesis or dissertation
University of Exeter
Rating of Perceived Exertion (RPE) relates to how ‘hard’ or ‘easy’ an exercise feels. The Borg 6-20 RPE scale is the most widely used scale to estimate the overall, peripheral and central perception of effort. To date, there are a limited number of studies on the use and efficacy of perceived exertion in persons with spinal cord injury and/or disease. The findings from these studies are also equivocal. Therefore, the aims of this thesis were to assess: i) the relationship between the RPE and physical and physiological markers of exercise intensity during arm cranking exercise in able-bodied and individuals with spinal cord disease, ii) the efficacy of sub-maximal RPE values to predict peak oxygen uptake during arm cranking exercise in able-bodied and paraplegic individuals using different exercise protocols, iii) the scalar property of the RPE during arm cranking exercise in able-bodied and paraplegic individuals. To achieve these goals, the thesis has been broken down to a series of seven studies. In each of these studies, except study 6, a group of able-bodied and a group of paraplegic participants were recruited to asses these hypotheses. Paraplegic individuals had spinal cord injury with neurological levels at or below the sixth thoracic vertebra (T6) or flaccid paralysis as a result of poliomyelitis infection. These individuals were physically active and participated in sports like wheelchair basketball, weightlifting, wheelchair racing and table tennis at both professional and recreational levels. Able-bodied participants were healthy and free from pre-existing injuries and physically active but not arm-trained. There were strong relationships between the RPE and each of the physiological and physical indices of exercise intensity during arm cranking exercise regardless of group or gender. Peak oxygen uptake can be predicted with reasonable accuracy from sub-maximal oxygen uptake values elicited during a sub-maximal perceptually-guided, graded exercise test for paraplegic individuals but not for able-bodied participants. It has also been shown that peak oxygen uptake can be predicted from power output using the equation prescribed by the American College of Sports Medicine (ACSM, 2006). Furthermore, for able-bodied participants using estimation procedures, a passive process in which an individual is asked to rate how ‘hard’ or ‘easy’ an exercise feels, the ramp exercise test provided more accurate prediction of peak oxygen uptake compared to the graded exercise test. For paraplegic persons using estimation procedures, the graded exercise test provided more accurate prediction of peak oxygen uptake compared to the ramp exercise test. Finally, the scalar property of the RPE (i.e., similar proportions of time at a given RPE) was evident during arm cranking exercise regardless of group. In conclusion, the prediction of peak oxygen uptake from sub-maximal exercise tests would provide a safer environment of exercise testing. In addition, using a sub-maximal protocol would make peak oxygen uptake more available for sedentary and clinical population compared to the graded exercise test to volitional exhaustion. Prediction of peak oxygen uptake from power output using the ACSM equation would make the estimation of peak oxygen uptake more available for large groups of people. Similar proportions of time were observed at a given RPE regardless of group or exercise intensity. The early RPE responses will give an indicator for how long a participant is going to exercise. This has important implications for rehabilitation settings. Based on the RPE responses the tester or the observer can increase or decrease the work rate to enable the participant to exercise for the desired duration.
The University of Jordan, Amman, Jordan
PhD in Sport and Health Sciences