Usefulness of perceived level of exertion in patients with chronic low back pain attending a physical training programme

Abstract

Purpose. Firstly, to examine whether heart rate (HR) can be predicted based on the Borg-scale for perceived exertion in patients with chronic low back pain (CLBP) and secondly, to assess changes in HR, Borg-scores and workload to study the relevance of a stepwise increase of workload based on the Borg-score and HR.

Methods. Ninety-nine patients with CLBP and a mean disability-score (Roland Morris Disability Questionnaire) of 13.8 (SD = 3.7) participated in a 10-week aerobic training programme (20 min, 3 times/week). HR, ratings of perceived exertion (RPE), and workload were monitored. Prior to treatment, patients completed questionnaires on pain, disability, and several psychological factors (catastrophizing, kinesiophobia, and depression).

Results. The original Borg-equation (i.e. ‘HR = Borg × 10’) appears accurate in predicting HR on a group-level. Pain-related and psychological factors were not significantly related to the accuracy of the Borg equation. Whereas mean workload increased significantly (from 93.8 (SD = 29.9) to 129.5 W (SD = 39.7), p < 0.001) throughout the training programme, HR increased only slightly (from 130.2 (SD = 13.5) to 139.2 (SD = 13.9) bpm; p < 0.001) and Borg-scores remained stable (from 13.2 (SD = 1.9) to 13.3 (SD = 1.8); p = 0.48).

Conclusions. The capability of the Borg-scale to accurately predict HR appears moderate. However combined with measuring HR, it results in a relevant and efficient method for training CLBP patients in clinical practice.

Keywords:

• Heart rate
• low back pain
• exercise and Borg scale

Acknowledgements

The authors thank the Rehabilitation Centre Blixembosch, Leijpark, and Breda as well as the many people who contributed to the successful completion of this study, particularly the participating patients, the rehabilitation centre contact persons, therapists and research-assistants. This study was supported by Zorgonderzoek Nederland/Medische Wetenschappen (ZonMw, grant number 014-32-007).