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PubMed1982

Familial myoadenylate deaminase deficiency and exertional myalgia.

In 14 members of four families with a hereditary syndrome of exertional myalgia, five of eight muscle biopsies from symptomatic individuals showed histochemical and biochemical absence of myoadenylate deaminase (MADA). In the others, MADA biochemical activity was normal in two and reduced but not absent (intermediate level) in one. Asymptomatic relatives had normal histochemical MADA activity, but three had intermediate biochemical levels. In a survey of 302 routine muscle biopsies, 3 of 36 patient with myalgia had absence of MADA. Three of 266 biopsied for other conditions were MADA-deficient. Despite some inconsistencies, MADA deficiency seems to be relevant to this clinical syndrome.

AMP Deaminase↗
PubMed1986

Exertional rhabdomyolysis associated with decerebrate posturing.

A case is presented in which decerebrate posturing after a head injury led to rhabdomyolysis and renal failure. Exertional rhabdomyolysis is caused by an energy deficient state in overworked musculature that leads to a loss of integrity of the muscle cell. The resultant myoglobin in serum leads to acute renal failure. This condition should be suspected in a comatose patient with fever, brown discoloration of the urine, and edema of the extremities. Laboratory results will show orthotoluidine positive urine with a clear serum, elevated serum creatine phosphokinase, and serum creatinine elevation out of proportion to blood urea nitrogen. Management consists of fluids and diuretics with dialysis if necessary. Rhabdomyolysis with head injury and decerebracy may occur more frequently than has been previously reported.

Acute Kidney Injury↗
PubMed1981

The heart rate, perceived exertion, and pace of the 1.5 mile run.

The logical validity of a 1.5-mile run as a measure of aerobic capacity, and the validity of Borg's laboratory model of perceived exertion (RPE) were examined in a field setting on a 440-yd cinder track. Performance time, heart rate (HR), and RPE were described for college-age males (N=67) instructed to achieve the lowest time possible during an "all-out" effort. Alpha and canonical factor analyses revealed three robust factors for performance times: 1) lap 1, 2) laps 2.5, 3) lap 6; two robust factors for HR: 1) laps 3-6, 2) laps 1 and 2; and four factors for RPE: 1) lap 6, 2) laps 1-3, 3) laps 4 and 5, 4) first 220 yd of lap 1. Results indicated distinct pacing characteristics of an initial sprint, a stable speed reduction, and a finishing sprint. This pace was generally independent of Ss HR (r's, mean lap 1 = 0.09; mean laps 2-5 = 0.19, mean lap 6 = 0.21) and RPE (r's, mean lap 1 = -0.15; mean laps 2-5 = 0.12; mean lap 6 = 0.07), and in part these findings at least implicate confounding influences by anaerobic metabolism and Ss motivation on performance. This possibility was supported by the fact that 95% of performance variance could be accounted for by pace factors of the initial and finishing sprints. Both HR and RPE response followed a linear-like increase as a function of cumulative time and distance. However, only a small relationship between HR and RPE (r, mean = 0.16) was observed during the run, and the obtained correlations did not support a central RPE-control model based on cardiovascular stress.

Adult↗
PubMed1994

Rating of perceived exertion and heart rate as indicators of exercise intensity in different environmental temperatures.

This study examined the validity of rating of perceived exertion (RPE) and heart rate (HR) obtained during incremental exercise (INC) as indicators of intensity during constant load exercise (CL). Nine cyclists (VO2max = 53.3 +/- 8.9 ml.kg-1.min-1) performed INC to determine intensity at the onset of blood lactate accumulation (OBLA). Three CL work bouts at OBLA were performed in an environmental chamber with temperatures (30 degrees C, 22 degrees C, 14 degrees C) randomly assigned. RPE and HR were determined every 5 min. Data during CL from initial 5 min (5 MIN), second 5 min (10 MIN), midpoint (MID), and exhaustion (END) were used in treatment by time ANOVA to examine differences between temperature conditions, with repeated measures ANOVA testing for differences between INC and CL. Tukey HSD post-hoc tests identified mean differences, with significance set at P < or = 0.01. No significant differences across temperature conditions for RPE or HR were found. RPE obtained at OBLA during INC (13.7 +/- 0.9) was significantly different from 5 MIN, 10 MIN, MID, and END during CL in all temperatures. HR obtained at OBLA during INC (165.4 +/- 12.3 bpm) was significantly higher than 5 MIN for all temperatures (30 degrees C = 153.0 +/- 9.9; 22 degrees C = 151.0 +/- 11.8; 14 degrees C = 150.2 +/- 13.8), but was not significantly different from INC for 10 MIN, MID, or END measures. The data indicate HR is a more valid marker of exercise intensity than RPE.

Adult↗
PubMed1994

Rating of perceived exertion and blood lactate concentration during submaximal running.

We examined whether the relation between of ratings of perceived exertion (RPE) and exercise intensities associated with the lactate threshold (LT) and blood lactate concentrations (BLC) of 2.5 and 4.0 mM, established with an incremental protocol, held during 30-min treadmill run at constant velocity (V). RPE (11.6, 14.9, 16.8, 18.9), oxygen uptake (VO2) (3.2, 3.7, 3.9, 4.2 l.min-1), and V (168, 196, 215, 227 m.min-1) at LT, BLC of 2.5, and 4.0 mM and peak were determined for nine males during incremental exercise. Subjects then completed three 30-min runs at the V associated with LT and BLC of 2.5 and 4.0 mM, with RPE, VO2, and blood [HLa] determined every 5 min. After min 10 during the 30-min runs, RPE, VO2, and BLC were not significantly different from corresponding values observed during the incremental protocol. Regression equations predicting BLC from RPE were generated from results obtained during the incremental protocol. RPE values from the 30-min runs were used to predict BLC, and the measured BLC was used to validate the use of RPE as a predictor of BLC. Correlations ranged from r = 0.79 to r = 0.98 [total error (TE) ranged from 0.6-1.3 mM]. We conclude that RPE is a physiologically valid tool for prescribing exercise intensity when the intent is to use LT and/or BLC as the intensity criterion.

Adult↗
PubMed2003

Diagnosis, treatment options, and rehabilitation of chronic lower leg exertional compartment syndrome.

Chronic exertional compartment syndrome of the lower leg is a well-described and documented cause of exercise-related pain in recreational, elite, and military athletes. Although this condition is common, the exact underlying mechanisms, those most at risk, long-term effects on muscular strength if unrecognized, and prevention strategies are relatively uncertain. Runners are most commonly affected and can be markedly impaired by the recurrent, often predictable pain that develops with exercise. An accurate history, high index of suspicion, and compartment pressure testing before and after symptomatic exercise confirms the diagnosis. Conservative therapy is minimally effective. Fasciotomy is the treatment of choice for athletes who are unwilling to modify their exercise or sport.

Chronic Disease↗
PubMed2003

Concurrent validation of the OMNI perceived exertion scale for resistance exercise.

UNLABELLED: The criterion variables were total weight lifted (Wttot ) determined separately for women and men during BC and KE, and blood lactic acid concentration ([Hla]) determined for a combined female ( N = 10) and male ( N = 10) subset during BC. Subjects performed three separate sets of 4, 8, and 12 repetitions for BC and KE at 65% one-repetition maximum. Rating of perceived exertion for the active muscles (RPE-AM) was measured during the mid and final repetition and RPE for the overall body (RPE-O) during the final repetition. : For both female and male groups across the three sets: (a) RPE-AM ranged from 3.6 to 8.2 for BC and 5.1 to 9.6 for KE and (b) RPE-O ranged from 2.4 to 6.7 for BC and 4.2 to 7.6 for KE. Positive linear regressions ranged from r = 0.79 to 0.91 ( P < 0.01) between Wttot and RPE-AM (mid), RPE-AM (final), and RPE-O for both BC and KE in both sex groupings. A positive ( P < 0.01) linear regression was found between [Hla] and RPE-AM (final) (r = 0.87) during BC. RPE did not differ between women and men at any measurement point within each set for BC and KE. RPE-AM (final) was greater ( P < 0.01) than RPE-O in the three sets of BC and KE. CONCLUSION: Findings provided concurrent validation of the OMNI-RES to measure RPE for the active muscle and overall body in young recreationally trained female and male weight lifters performing upper- and lower-body resistance exercise.

Adolescent↗
PubMed2003

Regulating oxygen uptake during high-intensity exercise using heart rate and rating of perceived exertion.

PURPOSE: The purpose of this study was to comparatively evaluate the use of heart rate (HR) or rating of perceived exertion (RPE) in eliminating the slow component of oxygen uptake (.VO2) during high-intensity aerobic exercise. METHODS: Nine sedentary males (age = 23.9 +/- 4.6 yr, height = 177.4 +/- 10.1 cm, weight = 75.28 +/- 12.95 kg) completed three 15-min submaximal exercise cycle ergometer tests based on: 1) constant power output (PO) corresponding to 75% .VO2max (PO75), 2) HR corresponding with 75% .VO2max (HR75), and 3) RPE response corresponding with 75% .VO2max (RPE75). .VO2, HR, RPE, and blood lactate concentration [La-] were measured during all tests. Data were analyzed using repeated measures analysis of variance, and post hoc means comparisons were performed using a Fisher's LSD test. RESULTS: End-exercise .VO2 was significantly higher than the respective 3-min .VO2 for the PO75 and RPE75 tests, but not the HR75 test. End-exercise .VO2 was significantly greater for the PO75 test than both the RPE75 and HR75 tests, but there was no significant difference between end-exercise .VO2 for the RPE75 and HR75 tests. End-exercise HR and RPE were significantly higher for the PO75 test than both the RPE75 and HR75 tests. There were no significant differences between the RPE75 and HR75 tests for end-exercise HR or end-exercise RPE. CONCLUSION: Results suggest using both HR and RPE are effective at reducing the slow component of .VO2 that occurs during high-intensity exercise.

Adult↗
PubMed2005

The effects of continuous hot weather training on risk of exertional heat illness.

PURPOSE: To determine whether cumulative daily average wet-bulb globe temperature (WBGT) index, over one or two preceding days, is a better measure for predicting cases of exertional heat illness (EHI) than current daily average WBGT, which is the standard heat index used by the Marine Corps; and to identify the most accurate index of heat stress to prevent and predict future cases of EHI. METHODS: A case-crossover study was conducted in male and female Marine Corps recruits in basic training at Marine Corps Recruit Depot, Parris Island, SC. Weather measurements were obtained for 2069 cases of EHI during 1979-1997 and for randomly selected control periods before and after each EHI episode. RESULTS: The risk of EHI increased with WBGT (OR = 1.11 degrees F(-1); 95% CI, 1.10-1.13). EHI risk was associated not only with the WBGT at the time of the event (OR = 1.10 degrees F(-1); 95% CI, 1.08-1.11) but with the previous day's average WBGT as well (OR = 1.03 degrees F(-1); 95% CI, 1.02-1.05). Alternative combinations of WBGT components were identified that better predicted EHI risk. CONCLUSION: Our results provide evidence for a cumulative effect of previous day's heat exposure on EHI risk in these Marine Corps recruits. A simple index for use in predicting EHI risk is proposed that includes the dry-bulb temperature and the relative humidity.

Adult↗
PubMed2005

Effect of distance feedback on pacing strategy and perceived exertion during cycling.

PURPOSE: The aim of this study was to investigate whether providing incorrect distance feedback would alter pacing strategies, perceived exertion, and heart rate during 20-km cycling time trials (TT). METHODS: Well-trained cyclists (N=15) performed a peak power output (PPO) test, familiarization trial, and four 20-km cycling TT during which they were provided with only distance feedback using 1-km distance splits. For the control trial, subjects received accurate feedback at each kilometer split. In the increase trial, they received inaccurate feedback at 0.775 km for the first kilometer split with the distance increasing by 25 m each subsequent split up to 1.25 km in the final kilometer split. For the decrease trial, inaccurate feedback was provided at 1.25 km for the first kilometer split with the distance decreasing by 25 m each subsequent split up to 0.775 km in the final split. For the random trial, distance splits were randomized. RESULTS: No significant differences were found in the finishing times between trials. Pacing strategies were unaltered as suggested by similar power output profiles during all trials. RPE scores were also similar for all trials. However, average heart rate varied significantly between trials (P<0.05). CONCLUSIONS: These results suggest that exercise performance, pacing strategy, and RPE during a 20-km cycling TT are not altered by incorrect distance feedback. The data supported the existence of a pacing strategy that is set before exercise and that is unaffected by external distance feedback.

Adaptation, Physiological↗
PubMed2006

Validation of Omni scale of perceived exertion during prolonged cycling.

PURPOSE: The present investigation was conducted to validate the OMNI ratings of perceived exertion (RPE) scale during prolonged cycle exercise when subjects were supplemented with either carbohydrate or placebo. METHODS: Fifteen trained cyclists cycled for 2.5 h at approximately 60% maximal watts on two occasions while receiving 4 mL x kg(-1) x 15 min(-1) carbohydrate (6%) (C) or placebo (P) beverages in a randomized, counterbalanced design. Concurrent and construct validity was established by evaluating perceptual responses with both the OMNI and Borg RPE scales every 20 min throughout the trials. RESULTS: The pattern of change in RPE over time was significantly different between C and P ingestion (P < 0.05), with an attenuated RPE response in C found at the hundredth minute for both the OMNI and Borg scales. The pattern of change in the respiratory exchange ratio and carbohydrate oxidation rates were significantly greater (P < 0.001) in the C than P condition. RPE-OMNI was positively and linearly related to the RPE-BORG; r = 0.60-0.98 (P < 0.01) throughout exercise for both the C and P conditions. CONCLUSIONS: Concurrent and construct evidence supports the use of the OMNI-cycle scale by adult men to estimate RPE during prolonged cycle exercise under differing conditions of carbohydrate supplementation.

Adult↗
PubMed2006

Exertional heat stroke during a cool weather marathon: a case study.

A well-trained male runner in his late 30s collapsed 10 m before the finish line, nearly completing the 42.1-km marathon course in 3 h, 15 min. He was responsive to pain, agitated, diaphoretic, and unable to walk. The race start temperature was 6 degrees C (43 degrees F) with relative humidity of 99% and the 3-h temperature was 9.5 degrees C (49 degrees F) with a 62% relative humidity. Approximately 27 min after his collapse, his rectal temperature in the emergency department was 40.7 degrees C (105.3 degrees F), and his failing respiratory status required intubation. His initial Glasgow coma score was 6-7 of 15. His renal output was minimal until he was cooled and given a large fluid flush. His initial echocardiogram showed a "stunned" myocardium with an ejection fraction of 35%. He had a viral syndrome the week prior to the race and was paced by a "fresh" runner the last 16 km of the race. He left the hospital in 5 d and has now returned to running without problems, although several months passed before he felt well while exercising. Exertional heat stroke can occur in cool conditions, and rectal temperature should be checked in all collapsed runners who do not progress with rapid recovery of vital signs and cognitive function. Runners should be instructed not to compete when ill and should not use nonparticipant pacers during the runs.

Adult↗
PubMed1984

Estimation of the exertion requirements of coal mining work.

The work requirements of coal mining work were estimated by studying a group of 12 underground coal miners. A two level (rest, 300 kg X m/min) test was performed to estimate the linear relationship between each subject's heart rate and oxygen consumption. Then, heart rates were recorded during coal mining work with a Holter type recorder. From these data, the distributions of oxygen consumptions during work were estimated, allowing characterization of the range of exertion throughout the work day. The average median estimated oxygen consumption was 3.3 METS, the average 70th percentile was 4.3 METS, and the average 90th percentile was 6.3 METS. These results should be considered when assessing an individual's occupational fitness.

Adult↗
PubMed2000

Exertional heat stroke--the prevention of a medical emergency.

In most cases, exertional heat stroke (EHS) can be prevented in the military setting. The actions taken by the Israel Defense Forces (IDF) and their outcome prove this well. Unfortunately, despite the available information, there are still incidents of failure of command in conducting physical exercise, leading to EHS. In our experience, most incidences are a consequence of disregarding safety regulations. The application of simple and reasonable measures will not only prevent accidents from happening, but will also result in better trained soldiers.

Adult↗
PubMed2004

Quantitation of resistance training using the session rating of perceived exertion method.

The purpose of this study was to apply the session rating of perceived exertion (RPE) method, which is known to work with aerobic training, to resistance training. Ten men (26.1 +/- 10.2 years) and 10 women (22.2 +/- 1.8 years), habituated to both aerobic and resistance training, performed 3 x 30 minutes aerobic training bouts on the cycle ergometer at intensities of 56%, 71%, and 83% Vo(2) peak and then rated the global intensity using the session RPE technique (e.g., 0-10) 30 minutes after the end of the session. They also performed 3 x 30 minutes resistance exercise bouts with 2 sets of 6 exercises at 50% (15 repetitions), 70% (10 repetitions), and 90% (4 repetitions) of 1 repetition maximum (1RM). After each set the exercisers rated the intensity of that exercise using the RPE scale. Thirty minutes after the end of the bout they rated the intensity of the whole session and of only the lifting components of the session, using the session RPE method. The rated intensity of exercise increased with the %Vo(2) peak and the %1RM. There was a general correspondence between the relative intensity (%Vo(2) peak and % 1RM) and the session RPE. Between different types of resistance exercise at the same relative intensity, the average RPE after each lift varied widely. The resistance training session RPE increased as the intensity increased despite a decrease in the total work performed (p < 0.05). Mean RPE and session RPE-lifting only also grew with increased intensity (p < 0.05). In many cases, the mean RPE, session RPE, and session RPE- lifting only measurements were different at given exercise intensities (p < 0.05). The session RPE appears to be a viable method for quantitating the intensity of resistance training, generally comparable to aerobic training. However, the session RPE may meaningfully underestimate the average intensity rated immediately after each set.

Adult↗
PubMed2004

Ratings of perceived exertion and muscle activity during the bench press exercise in recreational and novice lifters.

This study examined ratings of perceived exertion (RPE) and electromyography (EMG) during resistance exercise in recreational and novice lifters. Fourteen novice (age = 21.5 +/- 1.5 years) and 14 recreationally trained (age = 21.9 +/- 2.2 years) women volunteered to perform the bench press exercise at 60 and 80% of their 1 repetition maximum (1RM). RPE and EMG were measured during both intensities. Statistical analyses revealed that active muscle RPE increased as resistance exercise intensity increased from 60% 1RM to 80% 1RM (12.32 +/- 1.81 vs. 15.14 +/- 1.74). Integrated EMG also increased as resistance exercise intensity increased from 60% 1RM to 80% 1RM (in the pectoralis major; 98.62 +/- 17.54 vs. 127.98 +/- 29.02). No significant differences in RPE or EMG were found between novice and recreational lifters. These results indicate that RPE is related to the relative exercise intensity lifted as well as muscle activity during resistance exercise for both recreational and novice lifters. These results support the use of RPE as a method of resistance exercise intensity estimation for both types of lifters.

Adolescent↗
PubMed2006

Program design based on a mathematical model using rating of perceived exertion for an elite Japanese sprinter: a case study.

We investigated the effects of program design on 400-m sprint time by applying a Rating of Perceived Exertion (RPE) mathematical model to training performance. The subject was 24 years old and had been training for 9 years. His best performance in 400-m sprint competitions was 45.50 seconds. Body weight, resting heart rate, training time and RPE were monitored daily after training sessions. Similarly, performance in 400-m races was recorded 9 times during 2003. At the World Championships in Athletics in France, the subject's team placed eighth in the 1,600-m relay. The RPE mathematical model was able to predict changes in performance. Rate of matching was statistically significant (r(2) = 0.83, F ratio = 34.27, p < 0.001). Application of the RPE mathematical model to the design of a training program specific to the needs of a 400-m sprinter indicates a potentially powerful tool that can be applied to accurately assess the effects of training on athletic performance.

Adult↗
PubMed1998

Immune deficits induced by strenuous exertion under adverse environmental conditions: manifestations and countermeasures.

A brief description is given of the various laboratory and clinical manifestations of immune suppression that arise when strenuous exertion must be carried out in the face of a negative energy balance, shifts of circadian rhythm, sleep deprivation, psychological stressors, and exposure to hostile environments (extremes of heat or cold, high or low ambient pressures, and hyper- or hypo-gravity conditions). From the operational viewpoint, immune suppression could impair both physical and mental performance by increasing susceptibility to opportunistic microorganisms. It is also likely to increase susceptibility to sepsis following trauma or extensive burns, and has occasionally predisposed to fatal myocarditis. The effects of such challenges are complex, in part because of interactions between the various stressors. It is thus important to investigate the impact and to devise appropriate countermeasures with the full physical and intellectual resources of a defense environmental research laboratory. Existing knowledge of the topic is reviewed, and suggestions are made for research that may lead to new and more effective countermeasures.

Energy Metabolism↗