Using rating of perceived exertion in assessing cardiorespiratory fitness in endometrial cancer survivors

ABSTRACT

For cancer survivors, who also often present with co-existing health conditions, exercise testing is often performed using submaximal protocols incorporating linear heart rate response for estimating the cardiorespiratory capacity and assessing exercise tolerance. However, use of beta-blocker medications, during sub-maximal protocols based on linear HR response can be problematic. Rating of perceived exertion (RPE), which takes into account an individual’s overall perception of effort, can be used as a complementary tool that does not rely solely on the heart rate response to increased workload. We compared heart rate response (VO₂HR) and self-rating of perceived exertion (VO₂RPE) in a graded submaximal exercise test (GXT) in 93 endometrial cancer survivors. The results of the GXT were stratified according to whether participants were taking beta-blocker (BB) medications or not (non-BB). Among non-BB participants, there was no difference between the mean VO₂HR and the mean VO₂RPE estimates of cardiorespiratory capacity (mlO_2//kg/min) (20.4 and 19.3, respectively; p = 0.166). Among BB participants, the mean VO₂HR approached significant difference than the mean VO₂RPE (21.7 mlO_2//kg/min and 17.6 mlO_2//kg/min, respectively; p = 0.087). Bland–Altman plots for both methods showed a proportional bias for the non-BB group; but not the BB group. Our results suggest that sub-maximal protocols based on Borg’s Rating of Perceived exertion (RPE) produce differing results from sub-maximal protocols based on HR response when applied to clinical population taking BB medications. Using RPE instead of HR for participants on BB medications may be a better method for assessing the exercise tolerance for estimating the cardiorespiratory capacity in sub-maximal exercise testing.

KEYWORDS:

• Cardiorespiratory fitness
• exercise testing
• perceived effort

Acknowledgement

This study was supported by R01 CA 109919, R25T CA 057730, R25E CA 056452, K01 CA 134550, U54CA153511, P30 CA 016672 (PROSPR Shared Resource) and the Center for Energy Balance in Cancer Prevention and Survivorship, Duncan Family Institute for Cancer Prevention and Risk Assessment.

Declaration of interest

The authors report no conflicts of interest.