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Standardized Peak Exercise Perception Score: Validation of a New Index of Effort Perception

Terziyski, Kiril MD; Marinov, Blagoi MD, PhD; Hodgev, Vladimir MD, PhD; Tokmakova, Maria MD, PhD; Kostianev, S. MD, PhD, DMSc

Journal of Cardiopulmonary Rehabilitation & Prevention:
doi: 10.1097/HCR.0b013e3181c85a26
Exercise Physiology/Physical Activity
Abstract

PURPOSE: Standardized peak exercise perception score (SPEPS) is an index representing patient effort perception defined as SPEPS = Borg/METs, where Borg is the Borg CR-10 at maximal exercise intensity and METs is maximal metabolic equivalents. The purpose of the study was to assess the validity of SPEPS in different patient groups and to examine its applicability for evaluation of exercise training outcomes.

METHODS: Patients (n = 17) with chronic heart failure (CHF, New York Heart Association [NYHA] II and III functional class; ejection fraction= 31 ± 14%), 16 patients with chronic obstructive pulmonary disease (COPD, forced expiratory volume in 1 second — FEV1%= 51 ± 14%), and 16 age- and body mass index–matched controls formed the primary study group. An additional 22 ambulatory patients with stable CHF (NYHA II-III) were randomized to training and nontraining groups to test the effect of 8 weeks' exercise training on SPEPS.

RESULTS: Patients showed reduced exercise capacity (V̇O2, mL·kg-1. min-1) = 18.8 ± 3.8 (CHF) vs 21.1 ± 5.1 (COPD) vs 29.9 ± 5.2 (control), corresponding to SPEPS values: 1.15 ± 0.36 (CHF) vs 0.82 ± 0.26 (COPD) vs 0.55 ± 0.22 (control); P < .001. The reduction in SPEPS was the largest compared with the other tested parameters after training and correlated strongly with change in Minnesota Living with Heart Failure Questionnaire (ρ= 0.75, P < .001).

CONCLUSION: SPEPS is a reliable new index for discriminating perceived exertion at the end of exercise test in different groups of patients, presenting both construct and concurrent validity. It is a potent parameter for evaluation of the outcomes in training programs.

In Brief

We assessed the validity of standardized peak exercise perception score (SPEPS) in different patient groups and examined its applicability for evaluation of exercise training outcomes. SPEPS is a reliable new index in discriminating perceived exertion. It is a potent parameter for evaluation of the outcomes in training programs.

Author Information

Department of Pathophysiology, Medical University of Plovdiv (Drs Terziyski and Marinov), and University Hospital St George (Drs Hodgev, Tokmakova, and Kostianev), Plovdiv, Bulgaria.

Corresponding Author: Blagoi Marinov, MD, PhD, Department of Pathophysiology, Medical University of Plovdiv, 15A Vassil Aprilov Blvd, 4002 Plovdiv, Bulgaria (bmarinov@pathophysiology.info).

© 2010 Lippincott Williams & Wilkins, Inc.