Borg Rating Of Perceived Exertion: Difference between revisions

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==Introduction==
==Introduction==
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:
Rating of perceived exertion (RPE) is an outcome measure scale used to gauge one's exercise intensity without the need to rely 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:


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, 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.


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


==Versions And Scoring==
==Versions And Scoring==
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.
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 a category (C) ratio (R) scale of 0-10 termed '''Borg CR-10 Scale''' of which a version is the''' modified Borg Dyspnoea Scale, MBS. '''It is mostly used to assess 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 pulmonary responses such as breathlessness or chest tightness'''.''' <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>
 
==Method of Use==
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>
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 and can be self or researcher-administered before and after the individual has exerted themselves. The '''Borg CR10'' questioning should focus on the symptom/sensation related to the body area of interest, e.g. how on this scale of 0-10, how breathless are you feeling at the moment?
</ref>
{| class="wikitable sortable"
! colspan="2" |    '''Borg RPE  Scale'''  


! colspan="2" |'''Borg CR10 Scale/Modified Borg Dyspnoea Scale'''
[[File:Modified Borg Scale.jpg|left|thumb|Modified Borg 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
!
!
|}
<br>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==
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===
===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
The validity of the Borg scale for aerobic and resistance exercise intensity has been previously shown to be high. However, a meta-analysis on criterion validity of RPE done by Chen<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>,  shows the criterion-related validity may not be as high as was thought and that the validity is only high under certain conditions. In individuals with COPD, the MBS is a reliable measure for quantifying the level of dyspnea following a six-minute walk test. <ref>Clinical Review Report: Riociguat (Adempas) [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2015 Dec. APPENDIX 5, Validity of Outcome Measures. Available from: <nowiki>https://www.ncbi.nlm.nih.gov/books/NBK538663/</nowiki></ref>


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. 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>


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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" />{{#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>
Skinner et al found no significant differences in any 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>
{{#ev:youtube|3de1ADSyxV4}}
 
<ref>Respiratory Therapy Zone from https://www.youtube.com/watch?v=3de1ADSyxV4</ref>
===Evidence===
In the renal population, the Borg RPE was found to be effective at both the provider prescribing exercise as well as having individuals self-monitor their symptoms allowing for a safe increase or decrease of the aerobic exercise intensity.<ref>Philippa Svensson, Matthias Hellberg, Yunan Zhou, Anita Wisén & Naomi Clyne (2023) The Borg scale is a sustainable method for prescribing and monitoring self-administered aerobic endurance exercise in patients with chronic kidney disease, European Journal of Physiotherapy, 25:5, 265-273,</ref>


=== Evidence ===
The MBS is a useful and quick tool in assessing the degree of dyspnea in individuals presenting to the ER. The MBS scores decreased in individuals with asthma, acute bronchospasm and COPD with treatment showing high correlations with clinical parameters such as SpO2 and peak expiratory flow rate as well as study participants rating it as an easy-to-use tool.<ref>Karla R. Kendrick, Sunita C. Baxi, Robert M. Smith,


# renal patients
The usefulness of the modified 0-10 Borg scale in assessing the degree of dyspnea in patients with COPD and asthma, Journal of Emergency Nursing, Volume 26, Issue 3, 2000, Pages 216-222,</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===
A recent study reported that the Borg RPE scale may be used in individuals with Parkinson’s disease where 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>
A work<ref>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.</ref> 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 fitness in individuals with SCI|cardiovascular]]<ref>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</ref>and muscular work<ref>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.</ref>. However, research by Village et al.<ref>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</ref> shows a weak relationship between perceived physical exertion and workload


==References==
==References==

Latest revision as of 12:12, 19 March 2024

Original Editor Uchechukwu Chukwuemeka

Top Contributors - Uchechukwu Chukwuemeka, Prashna Singh, Kim Jackson, Adam Vallely Farrell, Karen Wilson, Lauren Lopez and Ewa Jaraczewska

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 rely 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 neurological 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 a category (C) ratio (R) scale of 0-10 termed Borg CR-10 Scale of which a version is the modified Borg Dyspnoea Scale, MBS. It is mostly used to assess 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 pulmonary responses such as breathlessness or chest tightness. [3]

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 and can be self or researcher-administered before and after the individual has exerted themselves. The 'Borg CR10 questioning should focus on the symptom/sensation related to the body area of interest, e.g. how on this scale of 0-10, how breathless are you feeling at the moment?

Modified Borg Scale

Reliability and Validity[edit | edit source]

The validity of the Borg scale for aerobic and resistance exercise intensity has been previously shown to be high. However, a meta-analysis on criterion validity of RPE done by Chen[4], shows the criterion-related validity may not be as high as was thought and that the validity is only high under certain conditions. In individuals with COPD, the MBS is a reliable measure for quantifying the level of dyspnea following a six-minute walk test. [5]

Testing of the subject twice was used in ascertaining reliability in a study. Borg RPE was found to be reliable in rating exertion.[6][7] 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.[8]

Originally RPE was validated against heart rate.[9] 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.[10] 

Skinner et al found no significant differences in any 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.[6]

[11]

[12]

Evidence[edit | edit source]

In the renal population, the Borg RPE was found to be effective at both the provider prescribing exercise as well as having individuals self-monitor their symptoms allowing for a safe increase or decrease of the aerobic exercise intensity.[13]

The MBS is a useful and quick tool in assessing the degree of dyspnea in individuals presenting to the ER. The MBS scores decreased in individuals with asthma, acute bronchospasm and COPD with treatment showing high correlations with clinical parameters such as SpO2 and peak expiratory flow rate as well as study participants rating it as an easy-to-use tool.[14]

A recent study reported that the Borg RPE scale may be used in individuals with Parkinson’s disease where formal exercise testing may not be available.[15]

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. ↑ Clinical Review Report: Riociguat (Adempas) [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2015 Dec. APPENDIX 5, Validity of Outcome Measures. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538663/
  6. ↑ 6.0 6.1 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.
  7. ↑ Lamb KL, Eston RG, Corns D. Reliability of ratings of perceived exertion during progressive treadmill exercise. Br J Sports Med 1999;33:336–339
  8. ↑ 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
  9. ↑ American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription. Lippincott Williams & Wilkins; 2013 Mar 4.
  10. ↑ 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.
  11. ↑ Vivo Phys-Evan Mathews. RPE - Rating of Perceived Exertion. Available from: http://www.youtube.com/watch?v=HgEHl0-IB14[last accessed 30/4/2019]
  12. ↑ Respiratory Therapy Zone from https://www.youtube.com/watch?v=3de1ADSyxV4
  13. ↑ Philippa Svensson, Matthias Hellberg, Yunan Zhou, Anita Wisén & Naomi Clyne (2023) The Borg scale is a sustainable method for prescribing and monitoring self-administered aerobic endurance exercise in patients with chronic kidney disease, European Journal of Physiotherapy, 25:5, 265-273,
  14. ↑ Karla R. Kendrick, Sunita C. Baxi, Robert M. Smith, The usefulness of the modified 0-10 Borg scale in assessing the degree of dyspnea in patients with COPD and asthma, Journal of Emergency Nursing, Volume 26, Issue 3, 2000, Pages 216-222,
  15. ↑ 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.
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