title: Self-rating level of perceived exertion for guiding exercise intensity during a 12-week cardiac rehabilitation programme and the influence of heart rate reducing medication.
abstract: OBJECTIVE
  To investigate whether self-rating level of perceived exertion can adequately guide exercise intensity during a 12-week cardiac rehabilitation programme.
  
  
  METHODS
  Linear regression analysis using rehabilitation data from two randomised controlled trials.
  
  
  METHODS
  Patients undergoing radiofrequency ablation for atrial fibrillation or following heart valve surgery and participating in exercise-based rehabilitation were included. The 12-week rehabilitation outpatient programme comprised three weekly training sessions, each consisting of 20min aerobic exercise divided into three steps. Patients were asked to base their exercise intensity for each step on a predefined rating of perceived exertion specified in a training diary. Exercise intensity was objectively measured by heart rate during the last 2min for each exercise step. Comparative analysis and linear regression of the rating of perceived exertion and heart rate were performed.
  
  
  RESULTS
  A total of 2622 ratings of perceived exertion were collected from 874 training sessions in 97 patients. Heart rate and rating of perceived exertion were associated both across all three exercise steps and individually for each step, with a mean of 6 to7bpm per 1-point difference in the rating of perceived exertion (p<0.001). Adjusting for rate-reducing medication slightly improved the strength of the association.
  
  
  CONCLUSIONS
  The association between change in the rating of perceived exertion and change in heart rate indicates that a diary-led and self-regulated model using rating of perceived exertion can help guide exercise intensity in everyday clinical practice among patients with heart disease, irrespective if they are taking heart rate-reducing medication.
authors.affiliation: Department of Cardiology, The Heart Centre, Rigshospitalet Copenhagen University Hospital, Denmark; CopenRehab, Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark; Bachelor's Degree Programme in Physiotherapy, Department of Rehabilitation and Nutrition, Faculty of Health and Technology, Metropolitan University College, Denmark; The Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Denmark. Electronic address: Lars.hermann.tang@regionh.dk.
authors.forename: Lars H
authors.initials: LH
authors.lastname: Tang
authors.affiliation: Department of Cardiology, The Heart Centre, Rigshospitalet Copenhagen University Hospital, Denmark; National Centre for Rehabilitation and Palliative Care, University of Southern Denmark and Odense University Hospital, Denmark.
authors.forename: Ann-Dorthe
authors.initials: AD
authors.lastname: Zwisler
authors.affiliation: Institute of Health Research, University of Exeter Medical School, United Kingdom; National Institute of Public Health, University of Southern Denmark, Denmark.
authors.forename: Rod S
authors.initials: RS
authors.lastname: Taylor
authors.affiliation: Department of Health Sciences, University of York, United Kingdom.
authors.forename: Patrick
authors.initials: P
authors.lastname: Doherty
authors.affiliation: Department of Cardiology, The Heart Centre, Rigshospitalet Copenhagen University Hospital, Denmark.
authors.forename: Graziella
authors.initials: G
authors.lastname: Zangger
authors.affiliation: Department of Cardiology, The Heart Centre, Rigshospitalet Copenhagen University Hospital, Denmark.
authors.forename: Selina K
authors.initials: SK
authors.lastname: Berg
authors.affiliation: CopenRehab, Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark.
authors.forename: Henning
authors.initials: H
authors.lastname: Langberg
mesh_terms: D000368:Aged; D000072038:Cardiac Rehabilitation / Q000379:methods*; D015444:Exercise / Q000523:psychology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D016032:Randomized Controlled Trials as Topic; D057566:Self Report
keywords: Atrial fibrillation; Exercise prescription; Exercise therapy; Heart rate; Heart valve disease