Borg Rating Of Perceived Exertion: Difference between revisions

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==Objective==
==Introduction==
Borg rating of perceived exertion (RPE) is an outcome measure scale used in knowing [[Physical Activity and Exercise Prescription|exercise intensity prescription]]. It is used in monitoring progress and mode of exercise in cardiac patients as well as in other patient populations undergoing rehabilitation and endurance training.
Rating of perceived exertion (RPE) is an outcome measure scale used to gauge one's exercise intensity without the need to relay on physiological parameters such as peak O2 uptake, heart rate and lactate levels. RPE is used extensively by rehab professionals to aid in exercise prescription.<ref>Hutchinson, M.J., Kouwijzer, I., de Groot, S. ''et al.'' Comparison of two Borg exertion scales for monitoring exercise intensity in able-bodied participants, and those with paraplegia and tetraplegia. ''Spinal Cord'' 59, 1162–1169 (2021)</ref>  Borg RPE scale was developed by Gunnar Borg<ref>Rating of perceived exertion. Available from:


Borg RPE scale was developed by Gunnar Borg<ref>Rating of perceived exertion. Available from:
https://en.wikipedia.org/wiki/Rating_of_perceived_exertion<nowiki/>(accessed 24 May 2019)</ref> for rating exertion, breathlessness and fatigue during [[physical activity]]; that is, how hard the activity is as shown by heart and [[Physical Activity and Respiratory Conditions|respiration rate]], profuse perspiration and muscle exertion.


https://en.wikipedia.org/wiki/Rating_of_perceived_exertion<nowiki/>(accessed 24 May 2019)</ref> for rating exertion and breathlessness during [[physical activity]]; that is, how hard the activity is as shown by high [[Anatomy of the Human Heart|heart]] and [[Physical Activity and Respiratory Conditions|respiration rate]], profuse perspiration and muscle exertion.
The scale is also used in monitoring progress and mode of exercise in patient populations including those with cardiac, respiratory and neurogical diseases undergoing rehabilitation.  


==Versions And Scoring==
==Versions And Scoring==
Borg original version is a scale of 6-20; it has a high correlation to heart rate and multiplying each number by 10 gives the training heart rate as at the time of scoring.  It was later reconstructed to category (C) ratio (R) scale, termed Borg CR10 Scale or modified Borg Dyspnoea Scale which is mostly used in the diagnosis of breathlessness and dyspnea, chest pain and musculoskeletal pain. The CR-10 scale is best used in a specific area of the body sensation such as muscle pain or from pulmonary responses. <ref>Williams N. The Borg Rating of Perceived Exertion (RPE) scale. Occupational Medicine.2017; 67(5):404–405, <nowiki>https://doi.org/10.1093/occmed/kqx063</nowiki>
The original Borg version is a '''scale of 6-20;''' it has a high correlation to one's heart rate and multiplying each number by 10 gives the training heart rate as at the time of scoring.   
 
It was later reconstructed to category (C) ratio (R) scale of 0-10 termed '''Borg CR-10 Scale''' or '''modified Borg Dyspnoea Scale.'''  It is mostly used in the assessment of  the degree of dyspnea, chest pain and musculoskeletal pain. The CR-10 scale is best used in a specific area of the body sensation such as muscle pain, muscle fatigue or from pulmonary responses. <ref>Williams N. The Borg Rating of Perceived Exertion (RPE) scale. Occupational Medicine.2017; 67(5):404–405, <nowiki>https://doi.org/10.1093/occmed/kqx063</nowiki>
</ref>
</ref>
{| class="wikitable sortable"
{| class="wikitable sortable"
! colspan="2" |'''Borg RPE  Scale'''  
! colspan="2" |   '''Borg RPE  Scale'''  


! colspan="2" |'''Borg CR10 Scale'''
! colspan="2" |'''Borg CR10 Scale/Modified Borg Dyspnoea Scale'''
|-
|-
!Scoring
!''Scoring''
!Level of Exertion
!''Level of Exertion''
!Scoring
!''Scoring''
!Level of Exertion
!''Level of Exertion/ Breathlessness/Pain/Leg fatigue''
|-
|-
!6
!6
!No Exertion
!No Exertion
!0
!0
!No Exertion
!No Exertion/Breathlessness/''Pain/Leg fatigue''
|-
|-
!7
!7
Line 84: Line 86:
!Very Hard
!Very Hard
!10
!10
!Maximal
!Maximal Breathlessness/''Pain/Leg fatigue''
|-
|-
!18
!18
Line 106: Line 108:
*17 = ‘very hard’. A healthy person can continue but must push themselves beyond their comfort of being very fatigued.
*17 = ‘very hard’. A healthy person can continue but must push themselves beyond their comfort of being very fatigued.
*19 = extremely strenuous exercise.for most people, the hardest they have ever experienced.
*19 = extremely strenuous exercise.for most people, the hardest they have ever experienced.
==Intended Population==
It is intended for all patients under rehabilitation. and for monitoring exercise prescription in athletes. It may not be suitable for children's use as the scoring is difficult to interpret in this age group.<ref>Pfeiffer K, Pivarnik JM, Womack CJ, Reeves MJ, Robert MM. Reliability and validity of the Borg and OMNI RPE Scales in adolescent girls. Medicine and science in sports and exercise. 2003; 34(12):2057-61. </ref>


==Method of Use==
==Method of Use==
The scale is a very simple numerical list. Participants are asked to rate their exertion on the scale during the activity, taking into consideration feelings of physical stress and fatigue, disregarding any factor such as leg pain or breathlessness but focusing on the whole feeling of exertion. This number chosen connotes the intensity of activity allowing the participant to speed up or slow down movements/activity. The scale takes a few seconds to complete, can be self or researcher administered on a single occasion or multiple times.
The original Borg scale is a simple numerical list. Participants are asked to rate their exertion on the scale during the activity, taking into consideration feelings of physical stress and fatigue, disregarding any factor such as leg pain or breathlessness but focusing on the whole feeling of exertion. This number chosen connotes the intensity of activity allowing the participant to speed up or slow down movements/activity. The scale takes a few seconds to complete, can be self or researcher administered on a single occasion or multiple times. The Borg CR10 questioning should focus on the symptom/sensation related to the body area of interest.


==Evidence==
===Reliability and Validity===
The validity of the Borg scale has been previously been shown to be high though recent research in healthy individuals shows that the criterion related validity may not be as high as was thought and that the validity is only high under certain conditions.<ref>Chen MJ, Fan X, Moe ST. Criterion-related validity of the Borg ratings of perceived exertion scale in healthy individuals: a meta-analysis. ''J Sports Sci''. 2002;20(11):873-899.</ref>However in individuals


===Reliability===
Testing of the subject twice was used in ascertaining reliability in a study and Borg RPE was found to be reliable in rating exertion<ref name=":0">Skinner JS, Hutsler R, Bergsteinová V, Buskirk ER. The validity and reliability of a rating scale of perceived exertion. Medicine and science in sports. 1973;5(2): 94-6. </ref><ref>Lamb KL, Eston RG, Corns D. Reliability of ratings of perceived exertion during progressive treadmill exercise.Br J Sports Med 1999;33:336–339  </ref> The verbal anchor using VAS of the scale when tested in different clinical groups and settings was found to have no significant difference in meaning in the groups except for the group that has a brain injury.<ref>Dawes, Helen N. et al. Borg’s Rating of Perceived Exertion Scales: Do the Verbal Anchors Mean the Same for Different Clinical Groups? Archives of Physical Medicine and Rehabilitation. 2005;86(5): 912 - 916
Testing of the subject twice was used in ascertaining reliability in a study and Borg RPE was found to be reliable in rating exertion<ref name=":0">Skinner JS, Hutsler R, Bergsteinová V, Buskirk ER. The validity and reliability of a rating scale of perceived exertion. Medicine and science in sports. 1973;5(2): 94-6. </ref><ref>Lamb KL, Eston RG, Corns D. Reliability of ratings of perceived exertion during progressive treadmill exercise.Br J Sports Med 1999;33:336–339  </ref> The verbal anchor using VAS of the scale when tested in different clinical groups and settings was found to have no significant difference in meaning in the groups except for the group that has a brain injury.<ref>Dawes, Helen N. et al. Borg’s Rating of Perceived Exertion Scales: Do the Verbal Anchors Mean the Same for Different Clinical Groups? Archives of Physical Medicine and Rehabilitation. 2005;86(5): 912 - 916
</ref>
</ref>


===Validity===
Originally RPE was validated against heart rate.<ref>American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription. Lippincott Williams & Wilkins; 2013 Mar 4.</ref> With time, RPE has since been researched extensively in a variety of different conditions and population groups.  
Originally RPE was validated against heart rate.<ref>American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription. Lippincott Williams & Wilkins; 2013 Mar 4.</ref> With time, RPE has since been researched extensively in a variety of different conditions and population groups.  


Borg RPE scores were positively associated with heart rate in adults during exercise sessions using the Wii Fit Plus.<ref>Pollock BS,  Barkley JE, PotenzinI N, Desalvo RM, Buser SL, Otterstetter et al. Validity of Borg Ratings of Perceived Exertion During Active Video Game Play. Int J Exerc Sci. 2013; 6(2): 164–170.</ref> 
Borg RPE scores were positively associated with heart rate in adults during exercise sessions using the Wii Fit Plus.<ref>Pollock BS,  Barkley JE, PotenzinI N, Desalvo RM, Buser SL, Otterstetter et al. Validity of Borg Ratings of Perceived Exertion During Active Video Game Play. Int J Exerc Sci. 2013; 6(2): 164–170.</ref> 


Skinner et al found no significant differences in any of the physiological and perceptual variables in work intensity when the workload was presented in random order and compared with those obtained during the progressive exercise test.<ref name=":0" />
Skinner et al found no significant differences in any of the physiological and perceptual variables in work intensity when the workload was presented in random order and compared with those obtained during the progressive exercise test.<ref name=":0" />{{#ev:youtube|HgEHl0-IB14|300}}<ref>Vivo Phys-Evan Mathews. RPE - Rating of Perceived Exertion. Available from: http://www.youtube.com/watch?v=HgEHl0-IB14[last accessed 30/4/2019]</ref>
 
=== Evidence ===


A recent study reported that the Borg RPE scale may be used in individuals with Parkinson’s disease in which formal exercise testing may not be available.<ref>PENKO AL, BARKLEY JE, KOOP MM, ALBERTS JL. Borg scale is valid for ratings of perceived exertion for individuals with Parkinson’s disease. International journal of exercise science. 2017;10(1):76.</ref>
# renal patients
{{#ev:youtube|HgEHl0-IB14|300}}<ref>Vivo Phys-Evan Mathews. RPE - Rating of Perceived Exertion. Available from: http://www.youtube.com/watch?v=HgEHl0-IB14[last accessed 30/4/2019]</ref>
# COPD/asthma
# Neuro
# A recent study reported that the Borg RPE scale may be used in individuals with Parkinson’s disease in which formal exercise testing may not be available.<ref>PENKO AL, BARKLEY JE, KOOP MM, ALBERTS JL. Borg scale is valid for ratings of perceived exertion for individuals with Parkinson’s disease. International journal of exercise science. 2017;10(1):76.</ref>


===Responsiveness===
===Responsiveness===

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Introduction[edit | edit source]

Rating of perceived exertion (RPE) is an outcome measure scale used to gauge one's exercise intensity without the need to relay on physiological parameters such as peak O2 uptake, heart rate and lactate levels. RPE is used extensively by rehab professionals to aid in exercise prescription.[1] Borg RPE scale was developed by Gunnar Borg[2] for rating exertion, breathlessness and fatigue during physical activity; that is, how hard the activity is as shown by heart and respiration rate, profuse perspiration and muscle exertion.

The scale is also used in monitoring progress and mode of exercise in patient populations including those with cardiac, respiratory and neurogical diseases undergoing rehabilitation.

Versions And Scoring[edit | edit source]

The original Borg version is a scale of 6-20; it has a high correlation to one's heart rate and multiplying each number by 10 gives the training heart rate as at the time of scoring.

It was later reconstructed to category (C) ratio (R) scale of 0-10 termed Borg CR-10 Scale or modified Borg Dyspnoea Scale. It is mostly used in the assessment of the degree of dyspnea, chest pain and musculoskeletal pain. The CR-10 scale is best used in a specific area of the body sensation such as muscle pain, muscle fatigue or from pulmonary responses. [3]

Borg RPE Scale Borg CR10 Scale/Modified Borg Dyspnoea Scale
Scoring Level of Exertion Scoring Level of Exertion/ Breathlessness/Pain/Leg fatigue
6 No Exertion 0 No Exertion/Breathlessness/Pain/Leg fatigue
7 Extremely Light 0.5 Very very Slight
8 1 Very Slight
9 Very Light 2 Slight
10 3 Moderate
11 Light 4 Somewhat Severe
12 5 Severe
13 Somewhat Hard 6
14 7 Very Severe
15 Hard (Heavy) 8
16 9 Very very Severe
17 Very Hard 10 Maximal Breathlessness/Pain/Leg fatigue
18
19 Extremely Hard
20 Maximal Exertion


In Borg RPE;

  • 9 = ‘very light’ exercise which equals walking slowly for a few minutes at the own pace of a healthy individual.
  • 13 = ‘somewhat hard’ but the individual is still able to continue the activity.
  • 17 = ‘very hard’. A healthy person can continue but must push themselves beyond their comfort of being very fatigued.
  • 19 = extremely strenuous exercise.for most people, the hardest they have ever experienced.

Method of Use[edit | edit source]

The original Borg scale is a simple numerical list. Participants are asked to rate their exertion on the scale during the activity, taking into consideration feelings of physical stress and fatigue, disregarding any factor such as leg pain or breathlessness but focusing on the whole feeling of exertion. This number chosen connotes the intensity of activity allowing the participant to speed up or slow down movements/activity. The scale takes a few seconds to complete, can be self or researcher administered on a single occasion or multiple times. The Borg CR10 questioning should focus on the symptom/sensation related to the body area of interest.

Reliability and Validity[edit | edit source]

The validity of the Borg scale has been previously been shown to be high though recent research in healthy individuals shows that the criterion related validity may not be as high as was thought and that the validity is only high under certain conditions.[4]However in individuals

Testing of the subject twice was used in ascertaining reliability in a study and Borg RPE was found to be reliable in rating exertion[5][6] The verbal anchor using VAS of the scale when tested in different clinical groups and settings was found to have no significant difference in meaning in the groups except for the group that has a brain injury.[7]

Originally RPE was validated against heart rate.[8] With time, RPE has since been researched extensively in a variety of different conditions and population groups.

Borg RPE scores were positively associated with heart rate in adults during exercise sessions using the Wii Fit Plus.[9] 

Skinner et al found no significant differences in any of the physiological and perceptual variables in work intensity when the workload was presented in random order and compared with those obtained during the progressive exercise test.[5]

[10]

Evidence[edit | edit source]

  1. renal patients
  2. COPD/asthma
  3. Neuro
  4. A recent study reported that the Borg RPE scale may be used in individuals with Parkinson’s disease in which formal exercise testing may not be available.[11]

Responsiveness[edit | edit source]

A work[12] done in a laboratory setting comparing physiological measurements and actual lifting tasks in the workplace found a relationship between perceived physical exertion and individual physical capacity; in both cardiovascular[13]and muscular work[14]. However, research by Village et al.[15] shows a weak relationship between perceived physical exertion and workload

References[edit | edit source]

  1. ↑ Hutchinson, M.J., Kouwijzer, I., de Groot, S. et al. Comparison of two Borg exertion scales for monitoring exercise intensity in able-bodied participants, and those with paraplegia and tetraplegia. Spinal Cord 59, 1162–1169 (2021)
  2. ↑ Rating of perceived exertion. Available from: https://en.wikipedia.org/wiki/Rating_of_perceived_exertion(accessed 24 May 2019)
  3. ↑ Williams N. The Borg Rating of Perceived Exertion (RPE) scale. Occupational Medicine.2017; 67(5):404–405, https://doi.org/10.1093/occmed/kqx063
  4. ↑ Chen MJ, Fan X, Moe ST. Criterion-related validity of the Borg ratings of perceived exertion scale in healthy individuals: a meta-analysis. J Sports Sci. 2002;20(11):873-899.
  5. ↑ 5.0 5.1 Skinner JS, Hutsler R, Bergsteinová V, Buskirk ER. The validity and reliability of a rating scale of perceived exertion. Medicine and science in sports. 1973;5(2): 94-6.
  6. ↑ Lamb KL, Eston RG, Corns D. Reliability of ratings of perceived exertion during progressive treadmill exercise.Br J Sports Med 1999;33:336–339
  7. ↑ Dawes, Helen N. et al. Borg’s Rating of Perceived Exertion Scales: Do the Verbal Anchors Mean the Same for Different Clinical Groups? Archives of Physical Medicine and Rehabilitation. 2005;86(5): 912 - 916
  8. ↑ American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription. Lippincott Williams & Wilkins; 2013 Mar 4.
  9. ↑ Pollock BS,  Barkley JE, PotenzinI N, Desalvo RM, Buser SL, Otterstetter et al. Validity of Borg Ratings of Perceived Exertion During Active Video Game Play. Int J Exerc Sci. 2013; 6(2): 164–170.
  10. ↑ Vivo Phys-Evan Mathews. RPE - Rating of Perceived Exertion. Available from: http://www.youtube.com/watch?v=HgEHl0-IB14[last accessed 30/4/2019]
  11. ↑ PENKO AL, BARKLEY JE, KOOP MM, ALBERTS JL. Borg scale is valid for ratings of perceived exertion for individuals with Parkinson’s disease. International journal of exercise science. 2017;10(1):76.
  12. ↑ Jakobsen MD, Sundstrup E, Persson R, Andersen CH, Andersen LL. Is Borg’s perceived exertion scale a useful indicator of muscular and cardiovascular load in blue-collar workers with lifting tasks? A cross-sectional workplace study. Eur J Appl Physiol 2014;114(2):425–434.
  13. ↑ Scherr J, Wolfarth B, Christle JW, Pressler A, Wagenpfeil S, Halle M. Associations between Borg’s Rating of Perceived Exertion and physiological measures of exercise intensity. Eur J Appl Physiol 2013;113(1):147–155
  14. ↑ Fontes EB, Smirmaul BP, Nakamura FY, Pereira G, Okano AH, Altimari LR et al. The relationship between a rating of perceived exertion and muscle activity during exhaustive constant-load cycling. Int J Sports Med 2010;31(10):683–688.
  15. ↑ Village J, Frazer M, Cohen M, Leyland A, Park I, Yassi A. Electromyography as a measure of peak and cumulative workload in intermediate care and its relationship to musculoskeletal injury: an exploratory ergonomic study. Appl Ergon 2005;36(5):609–618
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