Influence of physical activity status, gender, age and type of ergometry on ratings of perceived exertion during exercise testing

Einleitung: Die Borg Skala ist eine einfache und weit verbreitete Möglichkeit zur Einschätzung der subjektiv empfundenen Anstrengung und der Steuerung von Trainingsintensitäten bei sportlicher Aktivität. Die American College of Sports Medicine empfiehlt hierfür die RPE- Werte 9 – 11 für leichte Intensität, 12 – 13 für moderate Intensität und 14 – 17 für hohe Intensität, wobei keine Empfehlungen für interindividuelle Unterschiede ausgegeben werden. Zielsetzung: Ziel dieser Studie ist die Untersuchung des Einflusses von Fitnesslevel, Geschlecht, Alter und Ergometrieart auf die subjektive empfundene Anstrengung anhand der 15-stufigen Borg- Skala bei sportlicher Aktivität. Methode: In der Querschnittsstudie wurden 2096 retrospektive, pseudonymisierte Belastungsuntersuchungen weiblicher und männlicher Probanden, bei denen im Rahmen von Stufentests die Parameter Laktat, Herzfrequenz und Borg-Skala (6 bis 20) gemessen wurden, statistisch ausgewertet. Dabei wurden vorab RPE- Werte an definierten Laktatkonzentrationen 2 mmol/l, 3 mmol/l und 4 mmol/l und individuellen Laktatschwellen LT und IAS mit Hilfe quadratischer Regressionen errechnet und in Form von Subgruppenanalysen für die genannten Einflussfaktoren auf signifikante Unterschiede untersucht und Effektstärken (d nach Cohen) berechnet. Ergebnisse: Bei Probanden mit dem höchsten Fitnesslevel 1 konnten gegenüber Probanden mit schlechterer Fitness höhere RPE- Werte am deutlichsten bei Laktatkonzentration 2 mmol/l (RPE 13.44 (± 1.79) Fitnesslevel 1 vs. 11.67 (± 2.77) Fitnesslevel 4, p < .001, d = 0.60) beobachtet werden. Altersspezifische Unterschiede waren am deutlichsten zwischen Probanden im hohen Erwachsenenalter (> 60 Jahre) und Probanden im frühen Erwachsenenalter (18 – 39.9 Jahre) bei der Laktatschwelle IAS (RPE 15.04 (± 1.71) vs. 14.42 (± 1.57), p < .001, d = 0.38) zu sehen. Geschlechtsspezifische Unterschiede konnten nicht beobachtet werden (alle p > .05). Bei der Fahrradergometrie gaben die Probanden höhere RPE- Werte an, mit dem stärksten Effekt bei der Laktatschwelle LT (RPE 12.31 (± 1.87) Fahrrad vs. 11.28 (± 2.01) Laufband, p < .001, d = 0.51). Zusammenfassung: Wir konnten zeigen, dass signifikante Unterschiede der RPE- Werte bei der Stratifizierung in Subgruppen nach Fitnesslevel, Alter und Ergometrieart zu beobachten waren, nicht jedoch für das Geschlecht. Nach unseren Ergebnissen empfehlen wir leichte Intensität bei RPE 12 – 13, moderate Intensität bei RPE 14 – 15 und hohe Intensität bei RPE > 15. Für die Empfehlungen aus der Laufbandergometrie leichte Intensität bei RPE 11 – 12, moderate Intensität RPE 13 – 14 und hohe Intensität bei RPE > 14.Introduction: The Borg`s Scale is an easy and widely used tool to assess subjective perceived exertion and to regulate training intensities during physical activity and exercise testing. The American College of Sports Medicine recommends RPE (rating of perceived exertion) values of 9 – 11 for light intensity training, 12 – 13 for moderate intensity training and 14 – 17 for high intensity training without any individual recommendations. Objectives: The aim was to investigate the influence of the level of fitness, gender, age and type of ergometry on ratings of perceived exertion using the Borg´s Scale during physical activity. Methods: In the retrospective cross sectional study we statistically analyzed 2096 exercise tests of male and female participants performed in routine outpatient diagnostics. During the incremental tests blood lactate concentration, heart rate and RPE (Borg´s Scale 6 to 20) values were measured. Quadratic regression was used to calculate RPE values for/at defined blood lactate concentrations 2 mmol/l, 3 mmol/l and 4 mmol/l and individual lactate thresholds LT (lactate threshold) and IAT (individual anaerobic threshold). Differences in subgroups of physical activity status, gender, age and type of ergometry were analysed and values of effect sizes (Cohen’s d) were calculated. Results: Participants with the highest fitness level had significant higher RPE than participants with lower fitness levels, strongest influence at blood lactate concentration 2 mmol/l (RPE 13.44 (± 1.79) fitness level 1 vs. 11.67 (± 2.77) fitness level 4, p < .001, d = 0.60). The highest age related difference on RPE had participants aged over 60 compared to participants aged 18 to 39.9 at IAT (RPE 15.04 (± 1.71) vs. 14.42 (± 1.57), p < .001, d = 0.38). Gender had no significant influence on RPE (all p > .05). Exercise testing had high influence on RPE with significant higher RPE on bicycle ergometer versus treadmill ergometer, especially at LT (RPE 12.31 (± 1.87) bicycle vs. 11.28 (± 2.01) treadmill, p < .001, d = 0.51). Conclusion: The results suggests that there is an influence of fitness level, age and type of ergometry on RPE values. In general, we recommend a RPE of 12 – 13 for light intensity training, for moderate intensity training a RPE of 14 – 15 and for high intensity training RPE values > 15. Furthermore, for treadmill ergometry we propose RPE values of 11 – 12 for light intensity training, for moderate intensity training a RPE of 13 – 14 and for high intensity training RPE values > 14

Rating of Perceived Exertion: A Large Cross-Sectional Study Defining Intensity Levels for Individual Physical Activity Recommendations

Abstract Background Physical inactivity is a growing risk factor worldwide, therefore getting people into sports is necessary. When prescribing physical activity, it is essential to recommend the correct training intensities. Cardiopulmonary exercise testing (CPX) enables precise determination of individuals’ training intensities but is unavailable for a broad population. Therefore, the Borg scale allows individuals to assess perceived exertion and set their intensity easily and cost-efficiently. In order to transfer CPX to rating of perceived exertion (RPE), previous studies investigated RPE on specific physiological anchors, e.g. blood lactate (bLa) concentrations, but representativeness for a broad population is questionable. Some contradictory findings regarding individual factors influencing RPE occur, whereas univariable analysis has been performed so far. Moreover, a multivariable understanding of individual factors influencing RPE is missing. This study aims to determine RPE values at the individual anaerobic threshold (LT2) and defined bLa concentrations in a large cohort and to evaluate individual factors influencing RPE with multivariable analysis. Methods CPX with bicycle or treadmill ergometer of 6311 participants were analyzed in this cross-sectional study. RPE values at bLa concentrations 2 mmol/l, 3 mmol/l, 4 mmol/l, and LT2 (first rise in bLa over baseline + 1.5 mmol/l) were estimated by spline interpolation. Multivariable cumulative ordinal regression models were performed to assess the influence of sex, age, type of ergometry, VO2max, and duration of exercise testing on RPE. Results Median values [interquartile range (IQR)] of the total population were RPE 13 [11; 14] at 2 mmol/l, RPE 15 [13; 16] at 3 mmol/l, RPE 16 [15; 17] at 4 mmol/l, and RPE 15 [14; 16] at LT2. Main influence of individual factors on RPE were seen especially at 2 mmol/l: male sex (odds ratio (OR) [95%-CI]: 0.65 [0.587; 0.719]), treadmill ergometry (OR 0.754 [0.641; 0.886]), number of stages (OR 1.345 [1.300; 1.394]), age (OR 1.015 [1.012; 1.018]), and VO2max (OR 1.023 [1.015; 1.030]). Number of stages was the only identified influencing factor on RPE at all lactate concentrations/LT2 (3 mmol/l: OR 1.290 [1.244; 1.336]; 4 mmol/l: OR 1.229 [1.187; 1.274]; LT2: OR 1.155 [1.115; 1.197]). Conclusion Our results suggest RPE ≤ 11 for light intensity, RPE 12–14 for moderate intensity, and RPE 15–17 for vigorous intensity, which slightly differs from the current American College of Sports Medicine (ACSM) recommendations. Additionally, we propose an RPE of 15 delineating heavy and severe intensity domain. Age, sex, type of ergometry, duration of exercise, and cardiopulmonary fitness should be considered when recommending individualized intensities with RPE, primarily at lower intensities. Therefore, this study can be used as a new guideline for prescribing individual RPE values in the clinical practice, predominantly for endurance type exercise

COVID-19 in German Competitive Sports: Protocol for a Prospective Multicenter Cohort Study (CoSmo-S)

Objective: It is unclear whether and to what extent COVID-19 infection poses health risks and a chronic impairment of performance in athletes. Identification of individual health risk is an important decision-making basis for managing the pandemic risk of infection with SARS-CoV-2 in sports and return to play (RTP). Methods: This study aims 1) to analyze the longitudinal rate of seroprevalence of SARS-CoV-2 in German athletes, 2) to assess health-related consequences in athletes infected with SARS-CoV-2, and 3) to reveal effects of the COVID-19 pandemic in general and of a cleared SARS-CoV-2 infection on exercise performance. CoSmo-S is a prospective observational multicenter study establishing two cohorts: 1) athletes diagnosed positive for COVID-19 (cohort 1) and 2) federal squad athletes who perform their annual sports medical preparticipation screening (cohort 2). Comprehensive diagnostics including physical examination, laboratory blood analyses and blood biobanking, resting and exercise electrocardiogram (ECG), echocardiography, spirometry and exercise testing added by questionnaires are conducted at baseline and follow-up. Results and Conclusion: We expect that the results obtained, will allow us to formulate recommendations regarding RTP on a more evidence-based level

COVID-19 in German Competitive Sports: Protocol for a Prospective Multicenter Cohort Study (CoSmo-S)

Objective: It is unclear whether and to what extent COVID-19 infection poses health risks and a chronic impairment of performance in athletes. Identification of individual health risk is an important decision-making basis for managing the pandemic risk of infection with SARS-CoV-2 in sports and return to play (RTP). Methods: This study aims 1) to analyze the longitudinal rate of seroprevalence of SARSCoV- 2 in German athletes, 2) to assess health-related consequences in athletes infected with SARS-CoV-2, and 3) to reveal effects of the COVID-19 pandemic in general and of a cleared SARS-CoV-2 infection on exercise performance. CoSmo-S is a prospective observational multicenter study establishing two cohorts: 1) athletes diagnosed positive for COVID-19 (cohort 1) and 2) federal squad athletes who perform their annual sports medical preparticipation screening (cohort 2). Comprehensive diagnostics including physical examination, laboratory blood analyses and blood biobanking, resting and exercise electrocardiogram (ECG), echocardiography, spirometry and exercise testing added by questionnaires are conducted at baseline and follow-up. Results and Conclusion: We expect that the results obtained, will allow us to formulate recommendations regarding RTP on a more evidence-based level

COVID-19 in German Competitive Sports: Protocol for a Prospective Multicenter Cohort Study (CoSmo-S)

Objective: It is unclear whether and to what extent COVID-19 infection poses health risks and a chronic impairment of performance in athletes. Identification of individual health risk is an important decision-making basis for managing the pandemic risk of infection with SARS-CoV-2 in sports and return to play (RTP). Methods: This study aims 1) to analyze the longitudinal rate of seroprevalence of SARSCoV- 2 in German athletes, 2) to assess health-related consequences in athletes infected with SARS-CoV-2, and 3) to reveal effects of the COVID-19 pandemic in general and of a cleared SARS-CoV-2 infection on exercise performance. CoSmo-S is a prospective observational multicenter study establishing two cohorts: 1) athletes diagnosed positive for COVID-19 (cohort 1) and 2) federal squad athletes who perform their annual sports medical preparticipation screening (cohort 2). Comprehensive diagnostics including physical examination, laboratory blood analyses and blood biobanking, resting and exercise electrocardiogram (ECG), echocardiography, spirometry and exercise testing added by questionnaires are conducted at baseline and follow-up. Results and Conclusion: We expect that the results obtained, will allow us to formulate recommendations regarding RTP on a more evidence-based level