Exercise Prescription Using a Group‐Normalized Rating of Perceived Exertion in Adolescents and Adults With Spina Bifida

Background People with spina bifida (SB) face personal and environmental barriers to exercise that contribute to physical inactivity, obesity, risk of cardiovascular disease, and poor aerobic fitness. The WHEEL rating of perceived exertion (RPE) Scale was validated in people with SB to monitor exercise intensity. However, the psycho‐physiological link between RPE and ventilatory breakpoint (Vpt), the group‐normalized perceptual response, has not been determined and would provide a starting point for aerobic exercise in this cohort. Objectives The primary objectives were to determine the group‐normalized RPE equivalent to Vpt based on WHEEL and Borg Scale ratings and to develop a regression model to predict Borg Scale (conditional metric) from WHEEL Scale (criterion metric). The secondary objective was to create a table of interchangeable values between WHEEL and Borg Scale RPE for people with SB performing a load incremental stress test. Design Cross‐sectional observational. Setting University laboratory. Participants Twenty‐nine participants with SB. Methods Participants completed a load incremented arm ergometer exercise stress test. WHEEL and Borg Scale ratings were recorded the last 15 seconds of each 1‐minute test phase. Outcome Measures WHEEL and Borg Scale ratings, metabolic measures (eg, oxygen consumption, carbon dioxide production). Determined Vpt via plots of oxygen consumption and carbon dioxide production against time. Results Nineteen of 29 participants achieved Vpt (Group A). The mean ± standard deviation peak oxygen consumption at Vpt for Group A was 61.76 ± 16.26. The WHEEL and Borg Scale RPE at Vpt were 5.74 ± 2.58 (range 0‐10) and 13.95 ± 3.50 (range 6‐19), respectively. A significant linear regression model was developed (Borg Scale rating = 1.22 × WHEEL Scale rating + 7.14) and used to create a WHEEL‐to‐Borg Scale RPE conversion table. Conclusion A significant linear regression model and table of interchangeable values was developed for participants with SB. The group‐normalized RPE (WHEEL, 5.74; Borg, 13.95) can be used to prescribe and self‐regulate arm ergometer exercise intensity approximating the Vpt. Level of Evidence III