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Physiological and Perceived Exertion Responses during Exercise

Effect of β-blockade


Medicine & Science in Sports & Exercise: April 2019 - Volume 51 - Issue 4 - p 782–791
doi: 10.1249/MSS.0000000000001845

Purpose This study investigated the effect of β-blockade on physiological and perceived exertion (RPE) responses during incremental treadmill exercise.

Methods Sixteen healthy participants (n = 8 men; age, 25.3 ± 4.6 yr) performed a maximal treadmill exercise test after ingestion of 100 mg metoprolol or placebo, with a double-blind, randomized, and counterbalanced design. Heart rate (HR), ventilatory, and gas exchange variables were measured continuously, and participants reported RPE at the end of each minute. Physiological and RPE responses during each condition were compared at the ventilatory threshold (VT), respiratory compensation point, and at maximal exercise using repeated-measures ANOVA. Linear regression modeled relationships between perceived exertion and physiological variables.

Results The HR and V˙O2 at the VT, respiratory compensation point, and maximal exercise were all significantly lower after β-blockade (P < 0.05). However, when standardized to within condition peak values, differences were no longer significant. The RPE associated with VT was higher after β-blockade (12.9 ± 1.0 vs 12.3 ± 1.2, P < 0.05) but lower at maximal exercise (19.1 ± 0.6 vs 19.4 ± 0.5, P < 0.05). Increases in RPE relative to HR were greater after β-blockade and remained significant when expressed relative to peak HR. There was no difference in the growth of the relationship between RPE and V˙O2 across conditions, although the origin of the relationship was higher with β-blockade.

Conclusions Although β-blockade resulted in a significant reduction in exercising HR and V˙O2, the RPE for a given relative intensity remained unchanged. The relationship between RPE and V˙O2 was not affected by β-blockade. The results provide evidence that RPE is a useful and reliable measure for exercise testing and prescription in patients prescribed β-blockade therapy.

Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, South Australia, AUSTRALIA

Address for correspondence: Braden L. Mitchell, B.App.Sc.(H.Mov.) B.Hlth.Sc.(Hons), School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia; E-mail:

Submitted for publication June 2018.

Accepted for publication November 2018.

© 2019 American College of Sports Medicine