Validity, Reliability, and Diagnostic Accuracy of Ratings of Perceived Exertion to Identify Dependence in Performing Self-care Activities in Older Women

ABSTRACT

Background: Dependence in self-care activities among older women has been previously evaluated through performance-based tests. However, these tests have presented inability to accurately distinguish between dependent and independent older adults in performing activities of daily living.

Aim: To examine the validity, reliability, and diagnostic accuracy of rating of perceived exertion (RPE) to identify dependence in performing self-care activities in older women.

Methods: Thirty-five older women performed two different constant-load tasks (walking on treadmill at 4 km/h for five minutes and arm curls with two kg for one minute), reporting RPE at the end, in four sessions. Performance-based tests (30-second chair stand and 6-minute walk) were also evaluated. Katz Index and Lawton and Brody questionnaires were applied to evaluate the dependence level in performing basic and instrumental activities of daily living.

Results: RPE was greater on the first session (RPE 14 ± 2) than second session (RPE 13 ± 2), while it was similar through other sessions, with high values of intraclass coefficient correlation (0.96–0.99). Basic activities of daily living and instrumental activities of daily living presented high correlations with RPE measures (0.75–0.82), whereas performance-based tests presented moderate correlations (0.47–0.59). RPE responses explained the most variance in identifying dependence in self-care activities and presented high diagnostic accuracy to differentiate dependent from independent older women. So the hypotheses had been confirmed that RPE responses in constant-load exercise are better predictors of dependence in self-care activities than performance-based tests.

Conclusions: RPE of constant-load physical tasks was valid, reliable, and accurate in identifying dependence in performing self-care activities in older women; therefore, it is possible to use the perceived exertion to identify dependence in performing activities of daily living in older women.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest. This manuscript has not been published elsewhere and it has not been submitted simultaneously for publication elsewhere.