Hand loading, rates of perceived exertion, and usability during assisted walking in patients with type 2 diabetes mellitus

BACKGROUND

Patients suffering from a diabetic foot ulcer often receive a non-weight bearing prescription of the affected limb to promote healing. Total unilalteral offloading of the affected foot necessitates walking aids that require loading at the hands during ambulation. Excessive loading at the hands can increase of the risk of crutch palsy. In addition, certain walking aids can also be more strenuous and less comfortable to use than others, resulting in lower prescription compliance. This study aimed to investigate hand loading, rates of perceived exertion, and usability of typically prescribed walking aids in patients with Type 2 Diabetes.

METHODS

Twenty patients (12 F | 8 M, 61.0 ± 10.36 yrs., 90.54 ± 13.34 kg, 1.71 ± 0.08 m) walked as much as 200 m without assistance and with crutches, walkers, and a wheeled knee walker instrumented with flexible force-sensing pads on walking aid handles. Patients rated exertion using a Modified Borg Scale and completed a System Usability Scale questionnaire after each walking condition with or without walking aids.

FINDINGS

Results show that using a wheeled knee walker required 94% less hand loading than crutches and walkers. Patients reported 45% lower exertion with the WKW compared to crutches and walkers, and scored the usability of the wheeled knee walker 106% higher than crutches and walkers.

INTERPRETATION

The wheeled knee walker could be the preferred walking aid for total unilateral offloading because of the reduced loading demand at the hands, lower exertion during use, and greater usability compared to crutches and walkers.

Effects of Exercise Testing and Cardiac Rehabilitation in Patients with Coronary Heart Disease on Fear and Self-Efficacy of Exercise: A Pilot Study

BACKGROUND

Exercise fear and low exercise self-efficacy are common in patients attending cardiac rehabilitation (CR). This study tested whether exercise prescription methods influence exercise fear and exercise self-efficacy. We hypothesized that the use of graded exercise testing (GXT) with a target heart rate range exercise prescription, relative to standard exercise prescription using rating of perceived exertion (RPE), would produce greater reductions in exercise fear and increase self-efficacy during CR.

METHOD

Patients in CR (N = 32) were randomized to an exercise prescription using either RPE or a target heart rate range. Exercise fear and self-efficacy were assessed with questionnaires at three time points: baseline; after the GXT in target heart rate range group; and at session 6 for the RPE group and CR completion. Items were scored on a five-point Likert-type scale with higher mean scores reflecting higher fear of exercise and higher self-efficacy. To analyze mean differences, a mixed effects analysis was run.

RESULTS

There were no significant changes in exercise self-efficacy between baseline and discharge from CR; these were not statistically significant (mean differences baseline - 0.63; end - 0.27 (p = 0.13)). Similarly, there was no change in fear between groups (baseline 0.30; end 0.51 (p = 0.37)).

CONCLUSION

Patients in the RPE and target heart rate groups had non-significant changes in exercise self-efficacy over the course of CR. Contrary to our hypothesis, the use of GXT and target heart rate range did not reduce fear, and we noted sustained or increases in fear of exercise among patients with elevated baseline fear. A more targeted psychological intervention seems warranted to reduce exercise fear and self-efficacy in CR.

Intensity of occupational physical activity in blue-collar workers: do self-reported rating and device-worn measurements agree?

PURPOSE

High intensity occupational physical activity (OPA) seem to aggravate health and increase risk of sick leave and early retirement. Most intensity of OPA monitoring has been self-reported, e.g. by rating of perceived exertion (RPE). However, no studies have investigated the precision and risk of bias in RPE reporting during free-living OPA. This study investigated the agreement between OPA intensity in percentage of the heart rate reserve (%HRR) estimated from RPE and device-measured heart rate (HR), and potential bias factors on this agreement.

METHODS

The CR10 scale measured RPE at work. The Actiheart monitor measured HR during 24-h a day for 2-4 days. Both RPE and device-worn HR were converted to %HRR. The difference between both %HRR and their limits of agreement was determined in a Bland Altman plot. To detect bias factors, the difference between both %HRR was regressed on age, sex, cardiorespiratory fitness, occupational lifting, medication, consequences of musculoskeletal disorders and the interactions between these factors with device-work %HRR.

RESULTS

Six hundred and twenty-three participants were included in the analysis. Mean difference between RPE-based and device-worn %HRR was 54.6% (SD 19.5). The limits of agreement were wide (11.6-90.1%HRR). Age (0.48%HRR, 95% CI 0.18-0.79) occupational lifting (9.84%HRR, 95% CI 3.85-15.83) and cardiorespiratory fitness (0.41%HRR, 95% CI 0.03-0.79) significantly biased the agreement between the estimations of OPA intensity.

CONCLUSION

RPE overestimated OPA intensity, and was biased by several factors. Device-worn %HRR should be preferred when evaluating OPA intensity among workers with physically demanding jobs.

Eccentric-only versus concentric-only resistance training effects on biochemical and physiological parameters in patients with type 2 diabetes

Background

The benefits of resistance training for patients with type 2 diabetes (T2D) are well documented; however, the effects of exercise with different muscle contraction types such as eccentric versus concentric contractions on physiological outcomes for this population are not clear. This study compared eccentric-only (ECC) and concentric-only resistance training (CON) to test the hypothesis that ECC would be superior to CON to improve insulin sensitivity, lipid profile, body composition, muscle strength and physical function of patients with T2D.

Methods

Adults with T2D (50–79 years) were allocated to the ECC (n = 9) or CON group (n = 9). Resistance exercises (chest press, lateral pulldown, bicep curl, triceps extension, leg extension, leg curl, calf raise, abdominal crunch) consisting of 2–3 sets of 10 eccentric-only (5 s) or concentric-only contractions (1–2 s) was performed twice a week for 12 weeks. Changes in blood biomarkers, body composition, muscle strength and physical function from pre- to post-intervention were compared between groups.

Results

Overall rating of perceived exertion (RPE, 1–10 Borg scale) was lower (p < 0.05) for ECC (2.9 ± 1.2) than CON (5.4 ± 1.1). No significant changes in blood biomarkers were found for both groups. Lean mass increased [effect size (ES) = 0.148, ECC 3.2 ± 6.9%; CON 3.6 ± 2.3%], and fat mass decreased (ES = 0.545, ECC − 6.1 ± 12.4%; CON − 7.1 ± 16.4%) (p < 0.05) similarly. One-repetition maximal strength of each exercise increased (p < 0.05) for both ECC (12–37%) and CON (27–68%). Both groups improved (p < 0.05) 6-min walk distance (ES = 0.083, ECC 12.2 ± 2.3%; CON 12.5 ± 15.3%) and chair rise time (ES = 0.463, ECC − 13.4 ± 25.4%; CON − 20.0 ± 53.3%) but only ECC improved (p < 0.05) the timed up-and-go test (− 11.3 ± 13.6%, ES 0.014). No significant changes in balance tests were found for both groups.

Conclusion

These results did not fully support the hypothesis but showed that ECC was as effective as CON to improve body composition, muscle strength, and physical function with lesser RPE. Future studies should investigate whether larger differences between ECC and CON are evident when increasing the exercise frequency and matching the intensities of the two-exercise protocols.

Trial registration ACTRN12621001026819 (retrospectively registered on 5th Aug 2021).

Heat acclimation training with intermittent and self-regulated intensity may be used as an alternative to traditional steady state and power-regulated intensity in endurance cyclists

The study aimed to determine the effects of self-regulated and variable intensities sustained during short-term heat acclimation training on cycling performance. Seventeen competitive-level male athletes performed a 20-km cycling time trial before (TT-PRE), immediately after (TT-POST1) and one week after (TT-POST2) a 5-day acclimation training program, including either RPE-regulated intermittent (HA-HIT, N = 9) or fixed and low-intensity (HA-LOW, N = 8) training sessions in the heat (39 °C; 40% relative humidity). Total training volume was 23% lower in HA-HIT compared to HA-LOW. Physiological responses were evaluated during a 40-min fixed-RPE cycling exercise performed before (HST-PRE) and immediately after (HST-POST) heat acclimation. All participants in HA-LOW group tended to improve mean power output from TT-PRE to TT-POST1 (+8.1 ± 5.2%; ES = 0.55 ± 0.23), as well as eight of the nine athletes in HA-HIT group (+4.3 ± 2.0%; ES = 0.29 ± 0.31) without difference between groups, but TT-POST2 results showed that improvements were dissipated one week after. Similar improvements in thermal sensation and lower elevations of core temperature in HST-POST following HA-LOW and HA-HIT training protocols suggest that high intensity and RPE regulated bouts could be an efficient strategy for short term heat acclimation protocols, for example prior to the competition. Furthermore, the modest impact of lowered thermal sensation on cycling performance confirms that perceptual responses of acclimated athletes are dissociated from physiological stress when exercising in the heat.

Effects of training frequency on muscular strength for trained men under volume matched conditions

Background

In resistance training, the role of training frequency to increase maximal strength is often debated. However, the limited data available does not allow for clear training frequency “optimization” recommendations. The purpose of this study was to investigate the effects of training frequency on maximal muscular strength and rate of perceived exertion (RPE). The total weekly training volume was equally distributed between two and four sessions per muscle group.

Methods

Twenty-one experienced resistance-trained male subjects (height: 1.85 ± 0.06 m, body mass: 85.3 ± 12.3 kg, age: 27.6 ± 7.6 years) were tested prior to and after an 8-week training period in one-repetition maximum (1RM) barbell back squat and bench press. Subjects were randomly assigned to a SPLIT group (n = 10), in which there were two training sessions of squats and lower-body exercises and two training sessions of bench press and upper-body exercises, or a FULLBODY group (n = 11), in which four sessions with squats, bench press and supplementary exercises were conducted every session. In each session, the subjects rated their RPE after barbell back squat, bench press, and the full session.

Results

Both groups significantly increased 1RM strength in barbell back squat (SPLIT group: +13.25 kg; FULLBODY group: +14.31 kg) and bench press (SPLIT group: +7.75 kg; FULLBODY group: +8.86 kg) but training frequency did not affect this increase for squat (p = 0.640) or bench press (p = 0.431). Both groups showed a significant effect for time on RPE on all three measurements. The analyses showed only an interaction effect between groups on time for the RPE after the squat exercise (p = 0.002).

Conclusion

We conclude that there are no additional benefits of increasing the training frequency from two to four sessions under volume-equated conditions, but it could be favorable to spread the total training volume into several training bouts through the week to avoid potential increases in RPE, especially after the squat exercise.

Effects of compression garments on surface EMG and physiological responses during and after distance running

BACKGROUND

The few previous studies that focused on the effects of compression garments (CG) on distance running performance have simultaneously measured electromyogram, physiological, and perceptual parameters. Therefore, this study investigated the effects of CG on muscle activation and median frequency during and after distance running, as well as blood-lactate concentration and rating of perceived exertion (RPE) during distance running.

METHODS

Eight healthy male recreational runners were recruited to randomly perform two 40 min treadmill running trials, one with CG, and the other with control garment made of normal cloth. The RPE and the surface electromyography (EMG) of 5 lower extremity muscles including gluteus maximus (GM), rectus femoris (RF), semitendinosus (ST), tibialis anterior (TA), and gastrocnemius (GAS) were measured during the running trial. The blood-lactate levels before and after the running trial were measured.

RESULTS

Wearing CG led to significant lower muscle activation (p  <  0.05) in the GM (decreased 7.40%-14.31%), RF (decreased 4.39%-4.76%), and ST (decreased 3.42%-7.20%) muscles; moreover, significant higher median frequency (p< 0.05) in the GM (increased 5.57%) and ST (increased 10.58%) muscles. Wearing CG did not alter the RPE values or the blood-lactate levels (p > 0.05).

CONCLUSION

Wearing CG was associated with significantly lower muscle activation and higher median frequency in the running-related key muscles during distance running. This finding suggested that wearing CG may improve muscle function, which might enhance running performance and prevent muscle fatigue.

The influence of core affect on cyclo-ergometer endurance performance: Effects on performance outcomes and perceived exertion

BACKGROUND

Core affect is defined as the most general affective construct consciously accessible that is experienced constantly. It can be experienced as free-floating (mood) or related to prototypical emotional episodes. The aim of this study was to examine the influence of pleasant and unpleasant core affect on cyclo-ergometer endurance performance. Specifically, we considered the influence of pleasant and unpleasant core affect on performance outcomes (i.e., time to task completion) and rate of perceived exertion (RPE; Borg Scale, category ratio-10) collected during the task.

METHODS

Thirty-one participants aged 20-28 years were recruited. Core affect was randomly elicited by 2 sets of pleasant and unpleasant pictures chosen from the international affective picture system. Pictures were displayed to participants during a cyclo-ergometer performance in 2 days in a counterbalanced order. RPE was collected every minute to detect volunteers' exhaustion.

RESULTS

The study sample was split into 2 groups. Group 1 comprised participants who performed better with pleasant core affect, whereas Group 2 included participants who performed better with unpleasant core affect. Mixed between-within subjects analysis of variance revealed a significant 2 (group) × 2 (condition) × 5 (isotime) interaction (p = 0.002, η_p² = 0.158). Post hoc comparisons showed that participants who obtained better performance with pleasant core affect (pleasant pictures; Group 1) reported lower RPE values at 75% of time to exhaustion in a pleasant core affect condition compared to an unpleasant core affect condition. On the other hand, participants who obtained better performance with unpleasant core affect (unpleasant pictures; Group 2) reported lower RPE values at 75% and 100% of time to exhaustion in an unpleasant core affect condition.

CONCLUSION

Findings suggest differential effects of pleasant and unpleasant core affect on performance. Moreover, core affect was found to influence perceived exertion and performance according to participants' preferences for pleasant or unpleasant core affect.

"Does isometric exercise improve leg stiffness and hop pain in subjects with Achilles tendinopathy? A feasibility study"

BACKGROUND

In Achilles tendinopathy (AT) the ability to store and recycle elastic energy during ground contact phase is often altered. A measure of this function is represented by leg stiffness (LS). Immediate responses in LS following therapeutic intervention have not been examined.

OBJECTIVE

The aim of this paper was to examine the feasibility of the protocol in participants with AT.

DESIGN

Single cohort feasibility study.

PARTICIPANTS

Adults with persistent AT pain, symptoms on palpation and less than 80 points on the Visa-A questionnaire.

INTERVENTION

heavy isometric exercise sequence in plantarflexion.

OUTCOME MEASURES

Feasibility was assessed by evaluating: the willingness of participants to enroll into the study, the number of eligible participants, the recruitment rate, adherence to the intervention, the drop-out rate, the tolerability of the protocol. LS, reactive strength index, pain and rate of perceived effort were secondary outcomes.

RESULTS

22 AT were eligible for data collection and 19 entered the statistical analysis. The intervention was well tolerated, no withdrawals. Pain scores were low during both the intervention and the assessment. Immediate improvements in LS and pain were recorded.

CONCLUSIONS

The isometric exercise protocol was feasible. Future research should investigate its effectiveness.

A strength-oriented exercise session required more recovery time than a power-oriented exercise session with equal work

The present randomized cross-over controlled study aimed to compare the rate of recovery from a strength-oriented exercise session vs. a power-oriented session with equal work. Sixteen strength-trained individuals conducted one strength-oriented session (five repetitions maximum (RM)) and one power-oriented session (50% of 5RM) in randomized order. Squat jump (SJ), countermovement jump (CMJ), 20-m sprint, and squat and bench press peak power and estimated 1RMs were combined with measures of rate of perceived exertion (RPE) and perceived recovery status (PRS), before, immediately after and 24 and 48 h after exercise. Both sessions induced trivial to moderate performance decrements in all variables. Small reductions in CMJ height were observed immediately after both the strength-oriented session (7 ± 6%) and power-oriented session (5 ± 5%). Between 24 and 48 h after both sessions CMJ and SJ heights and 20 m sprint were back to baseline. However, in contrast to the power-oriented session, recovery was not complete 48 h after the strength-oriented session, as indicated by greater impairments in CMJ eccentric and concentric peak forces, SJ rate of force development (RFD) and squat peak power. In agreement with the objective performance measurements, RPE and PRS ratings demonstrated that the strength-oriented session was experienced more strenuous than the power-oriented session. However, these subjective measurements agreed poorly with performance measurements at the individual level. In conclusion, we observed a larger degree of neuromuscular impairment and longer recovery times after a strength-oriented session than after a power-oriented session with equal total work, measured by both objective and subjective assessments. Nonetheless, most differences were small or trivial after either session. It appears necessary to combine several tests and within-test analyses (e.g., CMJ height, power and force) to reveal such differences. Objective and subjective assessments of fatigue and recovery cannot be used interchangeably; rather they should be combined to give a meaningful status for an individual in the days after a resistance exercise session.

Caffeine and sodium bicarbonate supplementation alone or together improve karate performance

Background

The ergogenic properties of acute caffeine (CAF) and sodium bicarbonate (NaHCO₃) ingestion on athletic performance have been previously investigated. However, each sport has unique physiological and technical characteristics which warrants optimizing supplementations strategies for maximizing performance. This study examined the effects of CAF and NaHCO₃ ingestion on physiological responses and rate of perceived exertion during a Karate-specific aerobic test (KSAT) in competitive karatekas.

Methods

In a double-blind, crossover, randomized placebo-controlled trial, eight Karatekas underwent five experimental conditions including control (CON), placebo (PLA), CAF, NaHCO₃, and CAF + NaHCO₃ before completing KSAT. Capsules containing 6 mg/kg BW CAF were consumed 50 min prior to a KSAT whilst 0.3 g/kg BW NaHCO₃ was consumed for 3 days leading to and 120, 90, and 60 min prior to a KSAT. Time to exhaustion (TTE), rate of perceived exertion (RPE), and blood lactate (BL) were measured before, immediately after and 3 min following KSAT.

Results

TTE was significantly greater following CAF, NaHCO₃, and CAF + NaHCO₃ consumption compared to PLA and CON. However, the differences between CAF, NaHCO₃, and CAF + NaHCO₃ were not statistically significant (p > 0.05). BL increased significantly from baseline to immediately after and 3 min following KSAT in all conditions (p < 0.01), while RPE at the end of KSAT was not significantly different between conditions (p = 0.11).

Conclusions

Karate practitioners may benefit from the ergogenic effects of CAF and NaHCO₃ when consumed separately or together.

Psychophysiological Stress Response of a Paralympic Athlete During an Ultra-Endurance Event. A Case Study

Psychophysiological response of athletes with spinal cord injurie has not been reported yet in scientific literature. The aim of this study is to examine the psychophysiological stress response of Paralympic athlete during competitive activities. We collected the following psychophysiological measurements: anxiety-trait, anxiety-state, locus of control, perceived psychological stress, stress-copying style, rate of perceived exertion, perceived muscle pain, body temperature, forced vital capacity, blood oxygen saturation, blood glucose and lactate concentrations, isometric hand strength, cortical arousal, heart rate variability, heart rate and velocities of a female Paralympic spinal cord injured athlete in a 11 h and 44 min ultraendurance mountain event. An ultraendurance mountain even produced an increase in the sympathetic autonomous modulation, heart rate, lactate, muscular pain and rated of perceived exertion and a decrease in cortical arousal, hand strength and respiratory muscle in a spinal cord injurie female athlete during. The Paralympic athletes presented a low psychological inflexibility, high life engagement, strong internal locus of control, a low trait and state anxiety and medium perceived psychological stress. These results are consistent with the expected response during a highly stressful situation and consistent with previous findings in athletes without spinal cord injurie.

Comparison of two warm-up models for obese and normal-weight adults performing supramaximal cycling exercise

This study examines the impact of two forms of active warm-up on supramaximal cycling performance among sedentary adults. Thirty-seven adults [23.05 (6.4) years; BMI=26.05 (1.3) kg/m², FM=30.1 (4.2)%, VO_2max=23.8 (5.8) ml/min/kg] participated in a cross-over randomized study, and all underwent a supramaximal cycling test (SCT) following 5 minutes of two models of warm-up pedalled at a constant velocity of 60 rpm. In the first experimental condition, the warm-up was set at 50% of maximal aerobic power (WU50%MAP). In the second experimental condition, the intensity was set at 50% of maximal heart rate (WU50%MHR). During both experimental conditions the rating of perceived exertion (RPE) at the end of the warm-up and the performance reduction in percentage (ΔPr%) during the SCT were recorded. During the WU50%MAP experimental condition, obese (OB) adults showed higher values of post-warm-up heart rate (~30%) than in the normal weight (NW) group (p<0.01). In addition, the RPE scores determined after the warm-up were significantly higher in OB compared to NW (~30%; p<0.01). However, after the WU50%MHR experimental condition, no significant differences remained between OB and NW. Moreover, the analyses showed a significant positive association between the elevated heart rate values observed after WU50%MAP and both RPE and ΔPr% (r= 0.71 and r =0.81, p <0.05 respectively). In contrast to NW individuals, the WU50%MHR seems to be more suitable for the OB group undergoing the SCT given that WU50%MAP affected supramaximal cycling performances.

Effect of official judo matches on handgrip strength and perceptual responses

This study aimed to verify the effect of judo matches on handgrip strength and perceptual responses during an official tournament in medalists and nonmedalists. Thirty-four male judo athletes participated in an official judo tournament. Before the first match and immediately after each match, maximum isometric handgrip strength and rate of perceived exertion overall and in specific areas were assessed. Analysis of variance for repeated measures was used to compare variables before the first match and after each match, and t-test was used to compare medalists and nonmedalists with the level of significance set at 5%. Also, effect size (ES) analysis was used. The results showed decrease in handgrip strength in both hands from the third match (P<0.05). The rate of perceived exertion (RPE) increased from the first match and remained high over the subsequent matches (P<0.001). A very large effect for nonmedalist group (ES=3.44) and large effect for medalist group (ES=1.94) was found in the third match compared to prematch. Forearm and fingers were the body regions most cited by athletes in both groups. We concluded that an official judo competition induced significant drop in handgrip strength from the third match and increased the RPE from first match. Medalists seem to have better recovery after the third match compared to nonmedalists.

Psychophysiological, Body Composition, Biomechanical and Autonomic Modulation Analysis Procedures in an Ultraendurance Mountain Race

The current research aimed to analyze psychophysiological, body composition, biomechanical and autonomic modifications in an ultraendurance mountain race. We analyzed 11 finisher voluntary athletes that participated in a 51.2 km ultraendurance mountain race. We measured before and after the mountain ultraendurance event the following parameters: Rate of perceived exertion, body composition, cortical arousal, blood pressure, body temperature, forced vital capacity, blood oxygen saturation, isometric hand strength and heart rate variability parameters. The results of temperature, rate of perceived exertion, heart rate and the percentage of body water at the end of the race increased significantly. However, the variables of body weight, body fat, muscle, body mass index, abdominal fat, blood oxygen saturation, systolic and diastolic blood pressure, cortical arousal and hands and legs strength significantly decreased after the race. The square root of the average of the sum of the differences squared between normal adjacent R-R intervals, percentage of differences between normal adjacent R-R intervals, high-frequency, sensitivity of the short-term variability, and long-term variability decreased significantly after the race. By contrary low-frequency increased significantly at the end of the race. An ultraendurance mountain event produced a large anticipatory anxiety response, an increase in sympathetic modulation, body fat consumption, percentage of body water, and RPE, not affecting the cortical arousal.

Physiological responses and exercise preference between the Trikke and the bicycle ergometer

Background/Objective

The positive relationship between health benefits or the wellbeing of individuals and their engagement in physical activity is well-documented. Nevertheless, many Americans show no interest or perceive that “exercise is boring” as one of the reasons for not exercising. For these reasons, it is important to promote fun and enjoyment aspects of the activity to motivate people to participate in physical activity. The purpose of this study was to examine the physiological responses and the perception of enjoyment between the Trikke and the bicycle ergometer.

Methods

Thirty college students (15 males and 15 females) aged 18–45 years old voluntarily participated in the study and showed up on three occasions. The first session involved a 5-minute instructional video and practice on the Trikke. Participants were then randomized into sessions which involved either riding the Trikke or the bicycle ergometer. Participants of each group performed a 20-minute ride at 75–80% of maximal predicted heart rate.

Results

Results of mixed design analysis of variance (ANOVAs) indicated that VO₂, energy expenditure, and rate of perceived exertion (RPE) of the participants were significantly (p < 0.001) higher when using the bicycle ergometer than the Trikke, and female participants were able to manipulate the Trikke more efficiently than their male counterparts.

Conclusion

Participants were more efficient in using the Trikke than the bicycle ergometer. The Trikke may be an enjoyable alternative for those individuals, particularly women, who have lost interest in traditional forms of exercise.

Evolution of perceived footwear comfort over a prolonged running session

BACKGROUND

The purpose of this study was to investigate the subjective perception of overall footwear comfort over a prolonged running session.

METHODS

Ten runners performed two similar sessions consisting of a 13-km trail run (5 laps of 2.6 km) as fast as possible. The overall footwear comfort was evaluated before running and at the end of each lap with a 150-mm visual analogic scale, as well as speed, heart rate and rate of perceived exertion.

RESULTS

The results showed that both overall footwear comfort and speed decreased consistently during the run session, and significantly after 44 min of running (i.e. the 3rd lap). It could be hypothesized that the deterioration of overall footwear comfort was explained by mechanical and energetical parameter changes with time and/or fatigue occurring at the whole body, foot and footwear levels.

CONCLUSION

These results justify the use of a prolonged running test for running footwear comfort evaluation.

Validation of rate of perceived exertion-based exercise training in patients with heart failure: insights from autonomic nervous system adaptations

BACKGROUND

Exercise prescription in cardiac patients is based on heart rate (HR) response to exercise. How to prescribe long-term exercise training outside medically-supervised settings also considering changes in individual physical capacity over time is unknown. In this study we hypothesized that in patients with chronic heart failure (CHF) the session-rate of perceived exertion (RPE), a subjective-based training methodology, provides autonomic and functional capacity changes superimposable to those observed with HR-based Training Impulses (TRIMPi) method.

METHODS

Twenty patients with stable CHF were randomized to either aerobic continuous training (ACT) or aerobic interval training (AIT) for 12 weeks. For each TRIMPi-guided exercise session, the session-RPE was recorded. By this method, internal training load (TL) is quantified by multiplying the RPE of the whole training session, using the Borg CR10-scale, by its duration. Heart rate variability (HRV), and baroreflex sensitivity (BRS) were assessed at baseline and at 3 weeks intervals.

RESULTS

Significant correlations were found between TRIMPi and individual session-RPE, for both ACT and AIT (r=0.63 to 0.81), (P<0.05). The same occurred when ACT and AIT groups were pooled together (r=0.72; P<0.01). R-R interval, HRV and BRS were significantly and very highly correlated with weekly RPE-session (r(2) ranged from 0.77 to 0.97; P<0.001). A significant relationship between session-RPE and performance at the 6MWT was also found.

CONCLUSIONS

Session-RPE is an easy-to-use, inexpensive and valid method for exercise prescription and health maintenance, consistent with objective physiological indices of training, that could be used for long-term physical activity in patients with CHF.