Au Jason S, Totosy DE Zepetnek Julia O, Macdonald Maureen J
1Department of Kinesiology, McMaster University, Hamilton, ON, CANADA.
Med Sci Sports Exerc. 2017 Jun;49(6):1190-1196. doi: 10.1249/MSS.0000000000001203.
RPE may be useful for exercise testing and prescription in individuals with spinal cord injury (SCI), although the roles of differentiated central and peripheral fatigue during exercise are not clear. We aimed to model differentiated RPE responses during graded arm cycling in individuals with SCI and to describe their relationship to cardiorespiratory outcomes.
Thirty-six individuals with SCI (13 paraplegia and 23 tetraplegia) completed a maximal graded arm cycling exercise test to volitional exhaustion (5 W·min paraplegia; 10 W·min tetraplegia). Participants were asked to report central RPE (CRPE) and peripheral RPE (PRPE) every minute using the Borg category ratio (CR10) scale until termination of exercise. Heart rate and breath-by-breath respiratory outcomes were collected throughout the exercise test. Ventilatory threshold (VT) was assessed using the ventilatory equivalents method.
Cardiorespiratory indices increased linearly during graded arm exercise. By contrast, both CRPE and PRPE responses were best fit to a quadratic model with positively accelerating growth in individuals with paraplegia (P < 0.01) and tetraplegia (P < 0.05). PRPE developed faster than CRPE in individuals with tetraplegia (P < 0.01). Individuals with paraplegia had accelerated CRPE (P < 0.05) and PRPE (P < 0.05) responses compared with tetraplegia, but not when considering only individuals who reached VT. PRPE was higher than CPRE only in the late stages (80%-100% test duration; P < 0.05) in both groups when only considering individuals who reached VT.
PRPE develops faster than CRPE in individuals with tetraplegia in a nonlinear fashion, despite linear increases in cardiorespiratory responses during graded arm cycling. Although there is promise to use differentiated RPE for exercise testing and prescription within the SCI population, our results indicate that there are differences in how individuals with tetraplegia perceive peripheral versus central exertion.
尽管运动过程中中枢性疲劳和外周性疲劳的作用尚不清楚，但主观用力程度（RPE）可能对脊髓损伤（SCI）患者的运动测试和运动处方有用。我们旨在建立SCI患者在分级手臂骑行运动中不同RPE反应的模型，并描述其与心肺功能指标的关系。
36例SCI患者（13例截瘫和23例四肢瘫）完成了最大分级手臂骑行运动测试，直至自愿疲劳（截瘫患者为5W·min；四肢瘫患者为10W·min）。要求参与者在运动结束前每分钟使用Borg类别比率（CR10）量表报告中枢RPE（CRPE）和外周RPE（PRPE）。在整个运动测试过程中收集心率和逐次呼吸的呼吸指标。使用通气当量法评估通气阈值（VT）。
在分级手臂运动过程中，心肺指标呈线性增加。相比之下，截瘫患者（P<0.01）和四肢瘫患者（P<0.05）的CRPE和PRPE反应最适合二次模型，且呈正加速增长。四肢瘫患者的PRPE比CRPE发展得更快（P<0.01）。与四肢瘫患者相比，截瘫患者的CRPE（P<0.05）和PRPE（P<0.05）反应加速，但仅考虑达到VT的个体时则不然。仅考虑达到VT的个体时，两组在运动后期（测试持续时间的80%-100%）PRPE均高于CPRE（P<0.05）。
尽管在分级手臂骑行运动中心肺反应呈线性增加，但四肢瘫患者的PRPE比CRPE以非线性方式发展得更快。尽管有望在SCI人群中使用不同的RPE进行运动测试和运动处方，但我们的结果表明，四肢瘫患者对外周与中枢用力的感知存在差异。
