title: Assessment of the talk test and rating of perceived exertion for exercise intensity prescription in persons with paraplegia.
abstract: BACKGROUND
  Physical activity recommendations require accurate estimations of exercise intensity. Rating of Perceived Exertion (RPE) and talk test (TT) are 2 commonly recommended techniques to gauge intensity. It is not known whether these are valid to select an exercise intensity that would elicit a training effect for persons with spinal cord injury (SCI).
  
  
  OBJECTIVE
  To define the exercise intensity of each TT stage and RPE exercise intensity category and assess whether persons with paraplegia are able to use the TT to select a "comfortable" exercise workload they could maintain for 15 minutes.
  
  
  METHODS
  Twelve participants with paraplegia completed 2 arm crank exercise tests on nonconsecutive days within 14 days. Test 1 was an incremental peak effort assessment. Test 2 was a 15-minute simulated exercise session at a participant-selected fixed workload. During each test, participants reported their RPE and performed a TT at 2-minute intervals.
  
  
  RESULTS
  The intensity of the first negative TT stage was vigorous (75 ± 15 %VO2R); at low and moderate intensities, perceived effort was greater than measured intensity; at vigorous and maximal intensities, perceived effort matched measured intensity. Individuals successfully used the TT to select an exercise workload they could maintain for 15 minutes. RPE, but not exercise intensity, increased during the 15-minute session.
  
  
  CONCLUSIONS
  During arm crank exercise when speaking is not comfortable (ie, first negative TT), persons with paraplegia are exercising at vigorous intensity, which is sufficient to elicit training effects. During incremental peak exercise testing, RPE does not appear to accurately index low-moderate exercise intensities. During the simulated exercise session, RPE appeared to index peripheral fatigue.
authors: Department of Neurological Surgery, Miller School of Medicine, University of Miami , Miami, Florida ; Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami , Miami, Florida.
authors: Rachel E
authors: RE
authors: Cowan
authors: Kelly L
authors: KL
authors: Ginnity
authors: Jochen
authors: J
authors: Kressler
authors: Mark S
authors: MS
authors: Nash
authors: Mark S
authors: MS
authors: Nash
keywords: exercise; perceived exertion; spinal cord injury; talk test