The relationship between perceived exertion and physiologic indicators of stress during graded arm exercise in persons with spinal cord injuries.
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.
Lewis
John E
JE
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, and The National Rehabilitation Hospital, Washington, DC, USA.
Nash
Mark S
MS
Hamm
Larry F
LF
Martins
Shannon C
SC
Groah
Suzanne L
SL
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