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Translation of Incremental Talk Test Responses to Steady-State Exercise Training Intensity

Lyon, Ellen MS; Menke, Miranda MS; Foster, Carl PhD; Porcari, John P. PhD; Gibson, Mark MS, PT; Bubbers, Terresa MS

Journal of Cardiopulmonary Rehabilitation and Prevention: July/August 2014 - Volume 34 - Issue 4 - p 271–275
doi: 10.1097/HCR.0000000000000069
Exercise Testing: Brief Reports

PURPOSE: The Talk Test (TT) is a submaximal, incremental exercise test that has been shown to be useful in prescribing exercise training intensity. It is based on a subject's ability to speak comfortably during exercise. This study defined the amount of reduction in absolute workload intensity from an incremental exercise test using the TT to give appropriate absolute training intensity for cardiac rehabilitation patients.

METHODS: Patients in an outpatient rehabilitation program (N = 30) performed an incremental exercise test with the TT given every 2-minute stage. Patients rated their speech comfort after reciting a standardized paragraph. Anything other than a “yes” response was considered the “equivocal” stage, while all preceding stages were “positive” stages. The last stage with the unequivocally positive ability to speak was the Last Positive (LP), and the preceding stages were (LP-1 and LP-2). Subsequently, three 20-minute steady-state training bouts were performed in random order at the absolute workload at the LP, LP-1, and LP-2 stages of the incremental test. Speech comfort, heart rate (HR), and rating of perceived exertion (RPE) were recorded every 5 minutes.

RESULTS: The 20-minute exercise training bout was completed fully by LP (n = 19), LP-1 (n = 28), and LP-2 (n = 30). Heart rate, RPE, and speech comfort were similar through the LP-1 and LP-2 tests, but the LP stage was markedly more difficult.

CONCLUSION: Steady-state exercise training intensity was easily and appropriately prescribed at intensity associated with the LP-1 and LP-2 stages of the TT. The LP stage may be too difficult for patients in a cardiac rehabilitation program.

Cardiac rehabilitation patients performed training bouts at workloads associated with the Last Positive (LP), LP-1, and LP-2 stages of the Talk Test. Based on speech comfort, heart rate, and rating of perceived exertion, reduction in workload associated with LP-1 or LP-2 appears most suitable for prescribing exercise for clinical populations.

Department of Exercise and Sport Science, University of Wisconsin–La Crosse (Mss Lyon and Menke; Drs Foster and Porcari; and Mr Gibson); and Gundersen Lutheran Medical Center, La Crosse, Wisconsin (Ms Bubbers).

Correspondence: Carl Foster, PhD, Department of Exercise and Sport Science, University of Wisconsin–La Crosse, La Crosse, WI 54601 (

The authors declare no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins