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Ratings of perceived exertion at the ventilatory anaerobic threshold in people with coronary heart disease: a CARE CR study.

Nichols, Simon; Engin, Buket; Carroll, Sean; Buckley, John; Ingle, Lee


Buket Engin

Sean Carroll

John Buckley

Lee Ingle


Exercise prescription guidelines for individuals undergoing cardiovascular rehabilitation (CR) are often based on heart rate training zones and rating of perceived exertion (RPE). United Kingdom guidelines indicate that patients should exercise at an intensity of RPE 11 to 14. We aimed to determine the accuracy of this approach by comparing this RPE range with an objectively measured marker of exercise intensity, the ventilatory anaerobic threshold (VAT), and examine whether baseline directly determined cardiorespiratory fitness (CRF) affects the association between VAT and RPE. Participants underwent a maximal cardiopulmonary exercise test before an 8-week community-based CR programme. Peak oxygen uptake (VO2peak) and VAT were recorded, and RPE at the workload at which VAT was identified was recorded. Data were then split into tertiles, based on VO2peak, to determine whether RPE at the VAT differed in participants with low, moderate or higher CRF. We included 70 individuals (mean (SD) age 63.1 (10.0) years; body mass index 29.4 (4.0) kg/m2; 86% male). At baseline, the mean RPE at the VAT (RPE@VAT) was 11.8 (95% confidence interval 11.0–12.6) and significantly differed between low and high CRF groups (P < 0.001). The mean RPE@VAT was 10.1 (8.7–11.5), 11.8 (10.5–13.0), and 13.7 (12.5–14.9) for low, moderate and high CRF groups, respectively. The study therefore found that, when using RPE to guide exercise intensity in CR populations, one must consider the effect of baseline CRF. Mean RPEs of ~10, 12 and 14 correspond to the VAT in low, moderate and higher-fit patients, respectively.


NICHOLS, S., ENGIN, B., CARROLL, S., BUCKLEY, J. and INGLE, L. 2021. Ratings of perceived exertion at the ventilatory anaerobic threshold in people with coronary heart disease: a CARE CR study. Annals of physical and rehabilitation medicine [online], 64(6), article number 101462. Available from:

Journal Article Type Article
Acceptance Date Nov 18, 2020
Online Publication Date Oct 26, 2021
Publication Date Nov 30, 2021
Deposit Date Nov 29, 2023
Publicly Available Date Nov 29, 2023
Journal Annals of Physical and Rehabilitation Medicine
Print ISSN 1877-0657
Electronic ISSN 1877-0665
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 64
Issue 6
Article Number 101462
Keywords Cardiac rehabilitation; Exercise prescription; Cardiorespiratory fitness; Ventilatory anaerobic threshold
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