title: The relationship between perceived exertion and physiologic indicators of stress during graded arm exercise in persons with spinal cord injuries.
abstract: OBJECTIVE
  To examine the relationship between psychologic cues of somatic stress and physiologic responses to exercise in persons with paraplegia and tetraplegia.
  
  
  METHODS
  Repeated measures with 2 comparison groups.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Forty-two subjects between 18 and 69 years of age with motor-complete spinal cord injury (SCI) resulting in paraplegia or tetraplegia (American Spinal Injury Association grades A and B).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Subjects underwent peak graded arm ergometry during which heart rate, oxygen consumption (VO2), minute ventilation (VE), and ratings of perceived exertion (RPE) (Borg Categorical 6-20 Scale) were measured at successive work rate increments from baseline to fatigue.
  
  
  RESULTS
  There were inconsistent associations among the outcomes. For subjects with tetraplegia, RPE related positively to heart rate at the initial work rate, but there were no other significant correlations. For subjects with paraplegia, RPE did not correlate significantly with heart rate, VO2, or VE. VO2 and Ve related positively at the first and last work rates. In general, heart rate, VO2, and Ve increased as the exercise intensity increased, and were more pronounced in subjects with paraplegia. While RPE values increased with increasing work rates for each group, we found no differences between groups.
  
  
  CONCLUSIONS
  Our findings contradict the well-accepted relationships between RPE and both heart rate and VO2 during exercise by people without disabilities, and challenge the use of RPE as a valid psychophysiologic index of perceived exertion in persons with SCI.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, and The National Rehabilitation Hospital, Washington, DC, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Lewis
authors.forename: Mark S
authors.initials: MS
authors.lastname: Nash
authors.forename: Larry F
authors.initials: LF
authors.lastname: Hamm
authors.forename: Shannon C
authors.initials: SC
authors.lastname: Martins
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Groah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001132:Arm / Q000502:physiology*; D002574:Cervical Vertebrae; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009039:Motion Perception / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D010264:Paraplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D005082:Physical Exertion / Q000502:physiology*; D011379:Prognosis; D011782:Quadriplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D013312:Stress, Physiological / Q000209:etiology / Q000503:physiopathology*; D013904:Thoracic Vertebrae; D015599:Trauma Severity Indices