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Factors affecting ratings of perceived exertion across a spectrum of health and disease / Factors affecting perceived exertion

Perceived exertion is how hard or heavy an individual feels they are working. Perceived exertion is often quantified using the ratings of perceived exertion (RPE) scale and can be used to measure exercise intensity based on the experience of an individual. While objective methods of assessing exercise intensity, such as measurement of heart rate and percent of peak oxygen uptake, are useful, RPE is commonly implemented for the ease of use and feasibility. For example, RPE is commonly implemented in rehabilitation settings for people with a spinal cord injury and individuals with coronary artery disease because of their non-linear heart rate response to increases in exercise workload. The overarching purpose of this dissertation was to investigate a range of research questions designed to advance the knowledge and use of RPE guided exercise. Through a systematic review and meta-analysis, we examined evidence for the impact on cardiorespiratory fitness and peak power output using RPE-guided interventions in individuals with a spinal cord injury (SCI) and found that RPE-guided interventions improved both after a variety of exercise intervention types and lengths. In a separate retrospective cross-sectional analysis, we then demonstrated that perceived exertion, measured by leg cycling effort during a cardiopulmonary exercise test on a leg cycle ergometer in non-disabled individuals, was predicted by power and maximum power output. After further investigation we found that quadriceps strength predicted maximum power output and therefore is related to leg cycling effort. In the third study of the thesis, we conducted semi-structured interviews in individuals with an SCI and their healthcare practitioners and found that individuals commonly described their sensations associated with the 0-10 RPE scale using muscle sensations when both recalling exercise and after the completion of an acute exercise trial on an arm cycle ergometer. Lastly, we investigated the relationship between psychological and physiological measures and RPE during an arm cycling exercise during a maximal graded exercise test, high intensity interval training, and moderate intensity continuous training using a crossover experimental design in both non-disabled individuals and individuals who were mobility impaired due to SCI. While there were no relationships between any variable and RPE in non-disabled individuals, age and triceps strength predicted central RPE and peak feeling scale predicted peripheral RPE in individuals with an SCI. These mixed methods results collectively suggest that muscle strength, not heart rate, is the strongest predictor of perceived exertion especially in clinical populations completing high intensity exercise. Our novel findings suggest that RPE is regulated through a system of psychological and physiological phenomena, strongly related to muscle sensations arising from the working muscle groups and may have utility and relevance in complementing measures of exercise intensity for a broad range of individuals across the spectrum of health and disease. Future studies should examine the use of muscle sensation descriptions as descriptors of exercise intensity prior to the development of high intensity exercise guidelines in clinical populations, such as individuals with SCI. / Thesis / Candidate in Philosophy / It has been well established that heart rate and ratings of perceived exertion are related in young, healthy individuals, however the nuances of the relationships between other contributors and how clinical populations feel during exercise remain unclear. Using mixed methods, this research sought to determine what sensations help people determine how they feel during exercise, with a focus on high intensity interval training exercise. Our results show that muscle strength may be a key determinant in the perception of effort in individuals with a spinal cord injury and in clinical populations during arm and leg maximal graded exercise tests, but the relationships between physiological variables and perceptions of arm effort in non-impaired individuals remains to be determined. Sensations of effort are regulated through a variety of different mechanisms that vary with population, and the relationships depend on the parameters (e.g., exercise modality and intensity) of the exercise. Future studies should be conducted to determine the individual contributions of different body systems to perceived exertion during exercise in a wide range of populations.

Identiferoai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/29395
Date January 2023
CreatorsValentino, Sydney E.
ContributorsMacDonald, Maureen J., Kinesiology
Source SetsMcMaster University
LanguageEnglish
Detected LanguageEnglish
TypeThesis

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