Rajiv Gandhi University of Health Sciences s80

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

ANNEXURE II PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION 1. Name of the Candidate SHAH LOPA DILIP and Address SRINIVAS COLLEGE OF PHYSIOTHERAPY AND RESEARCH CENTER, PANDESHWARA, MANGALORE – 575 001. 2. Name of the Institute SRINIVAS COLLEGE OF PHYSIOTHERAPY AND RESEARCH CENTER, MANGALORE. 3. Course of Study and Master of Physiotherapy (MPT) Subject 2 years Degree Course. “Physiotherapy in Cardio-Respiratory Disorders and Intensive Care” 4. Date of Admission 10-06-2009 To Course

5. Title of the Topic “A study to find out the correlation of heart rate and rate of perceived exertion in Indian population.”

1 6. Brief resume of the intended work: 6.1 Need for the study:

Physical fitness attribute relate to how well one performs physical activity. It is preserved by doing planned, structured, repetitive and purposeful physical activity which in turn is physiologic stressors1.

As it carries many risk factors, designing of exercise is necessary and thus exercise prescription is done. It is the process whereby a person’s recommended regimen of physical activity is designed in a systematic and individualized manner with consideration of several components such as mode, intensities, duration, frequency and progression of activity2,3. Various techniques are used to prescribe and monitor exercise intensity, such as Heart Rate (HR), Metabolic equivalents, Rate of Perceived Exertion (RPE) 4.

American College of Sports Medicine (ACSM) has recommended Borg’s Rate Perceived Exertion (RPE) for exercise intensity since 19864. Borg’s RPE Scale is a numerical Scale from 6-20. Borg’s RPE is based on subjective feeling of exertion and fatigue during exercise where perceived exertion is how hard that you interpret that your body is working5.

Perceived exertion is a feeling which is purely subjective and is based on physical sensation experienced during physical activity. This includes increased Heart Rate, Respiration or Breathing rate, increased sweating and muscle fatigue6.

Heart Rate (HR) is used as the silver standard to set exercise intensity because of the relative linear relationship between HR and

%VO2max, the maximal capacity for oxygen consumption by the body during

2 maximal exertion7.

In the exercise testing, Vo2 max is one of the measures to find out “Cardio-Vascular” endurance of an individual8.

Queens College Step Test is one of the simplest and inexpensive tests used to estimate the physical performance of an individual. During this test subjects will be asked to assess his/her Rate of exertion with RPE Scale9.

Though there has been many studies proving the co-relations between RPE and HR, there are many other literatures suggesting inconsistencies in the strength of correlation of RPE and HR10,11.

Hence, there is a need to find whether RPE alone can be safely employed to assess exercise intensity for which correlation of RPE-HR deserves further research7,10.

As there are anthropometric variations due to geographical and topological difference and ethnicity there is a need of replicating research in Indian Population12. So the purpose of this study is to investigate the relationship between Perceived Exertion and Heart Rate using Queens College Step Test in Indian Population.

6.2 Review of Literature: 1. Ozkan et al. (2007) did a study to determine the reliability and validity of regulating exercise intensity by RPE in step dance sessions and concluded that RPE was reliable but not valid method for regulating exercise intensity in step dance sessions13.

3 2. Satipati Chatterjee et al. (2005) found validity of Queen’s College Step Test for estimation of maximum oxygen uptake in female students and concluded Queens college step test is a valid method to evaluate cardio- respiratory fitness in large number of sedentary females14.

3. Chatterjee S. et al. (2004) assessed suitability of the Queen’s College step test (QCT) to predict maximum oxygen uptake in Indian men and concluded that QCT can be applied in the studied population to produce a good estimation of maximum oxygen uptake, especially in the field where Large numbers of participants are to be evaluated without a well equipped laboratory15.

4. Pfeiffer et al. (2002) did a study on Reliability and Validity of Borg and OMNI rating of perceived exertion scale adolescent girls and concluded OMNI pictorial scale was found to be reliable and valid for use with adolescent girls for use in the population treadmill exercise16.

5. Perez et al. (2002) did a study on physiological differences and rating of perceived exertion (RPE) in professional, amateur and young cyclist. Concluded that professional road cyclists reached a VO2max, VO2max.Kg-1 and a maximum power higher than the other categories; so, therefore, these parameters are good as performance indicators, and RPE is of practical value to prescribe exercise training intensities in each category17.

6. Chen et al. (2002) conducted meta-analysis on Criterion-related validity of the Borg rating of perceived exertion scale in healthy individuals. The result revealed that overall RPE-HR validity coefficient was 0.62, and the highest RPE-HR correlations were found during unusual/unfamiliar exercise tasks. The author concluded that although RPE scale had been shown to be a valid measure of exercise intensity, its validity might not be as high as previously

4 thought (r-0.80-0.90), except under certain conditions10.

7. Whaley et al. (1997) did a study to evaluate validity of rating of perceived exertion during graded exercise testing in apparently healthy adults and cardiac patients and concluded that peak RPE was higher for apparently healthy subjects compared with cardiac patients18.

8. Eston and Williams et al. (1988) did a study to assess the reliability of rating’s of perceived effort regulation of exercise intensity concluded RPE can be used as reliable (r-0.92 at RPE 17)frame of reference for the production of appropriate levels of effort by healthy adults during cycle ergometry19. 9. Eston R G. and J G Williams et at. (1986) did a study on Exercise intensity and perceived exertion in adolescent boys and concluded there is a close relationship between perceived exertion, heart rate and exercise intensity in adolescent school boys5.

6.3 Objective of the study

 To Correlate Borg’s RPE and HR in males and females of Indian origin.

6.3 Hypotheses:

Experimental Hypothesis: There will be significant correlation between heart rate and rate of perceived exertion (R.P.E.). Null Hypothesis: There will not be any correlation between heart rate and rate of perceived exertion (R.P.E.).

5 Material and Methods:

7.1 Source of data:

Young College Adults both males and females from Mangalore.

7.2 Method of data collection :

Sample Size: 150 samples.

Sampling: Random sampling.

Procedures:  From each participant written informed consent will be taken.  Participant should take light breakfast 2-3 hours before the test and refrained from any energetic drink. 7.  Prior to testing, the subjects will be instructed on how to use the Borg’s scale.  Subjects’ height and weight will be measured and noted.  Then the subjects will be asked to step up and step down in cadence with the metronome for three minutes .For  Males: 24 steps/min  Females: 22 steps/min  At each minute subject will be asked to rate their feeling on Borg’s Scale of Perceived Exertion.  Simultaneously heart rate will also be noted from the display of Cardiovigil (multi-parameter patient monitor) or Telemetry. After 5 seconds of conclusion of test the subject will be asked to sit and immediately RPE and Heart Rate will be monitored for 30 seconds and multiplied by 2(if its is regular), which will be noted on a paper.

6 Materials to be used:

1. Stop watch 2. Metronome 3. 16.25” step 4. Measuring Tape 5. Cardiovigil / Telemetry 6. Weighing machine Inclusion Criteria: 1. Age Group: 20 to 30 years. 2. Gender: Males and females.

Exclusion Criteria: 1. Musculoskeletal Abnormalities. 2. Neurological Problems. 3. Cardiovascular Insufficiency. 4. Physiologically Unstable Condition. 5. Pulmonary Pathologies. 6. Athletic population.

Statistical analysis:

Study design: Co-relational study design.

TEST: Pearson’s Product Moment correlation.

7.3 Does the study require any investigations or interventions to be conducted on patients or other humans or animals? If so please describe briefly.

This study intends to measure heart rate and Borg’s RPE.

7 7.4 Has ethical clearance been obtained from your institution in case of 7.3? YES. Consent has been taken from institute ethical clearance committee.

List of reference:

1. Elizabeth Arendt, Teff Blatnick, Ralph Boston. Definition: Health, Fitness and Physical Activity. The president council of physical fitness and Sports. Research Digests 2009.

2. William D. Mcardle, Frank I. Katch, Victor L. Katch. Exercise Physiology, Energy, Nutrition and Human Performance. 5th edition: Lippincott Williams and Wilkins. Section 7, chapter 31 Physical Activity, Health, and Aging. Page 868-911.

3. Rozen N. Lemaitre, David S. Siscovick, Trivellore E. Raghunathan, Shula Weinmann, Patrick Arbogast, Dan YuLin. Liseure-Time Physical Activity and the Risk of Primary Cardiac Arrest. Archives of Internal Medicine, 1999, Vol. 159(7):159-686.

4. American College of Sports Medicine. ACSM ’s Guidelines for Exercise Testing and Prescription. 4th edition. Philadelphia: Lea & Fabiger; 8. 1991.chapter 4, Guidelines for Exersise Test Administration. Page 55-91.

5. R. G. Eston and J. G. Williams. Exercise intensity and perceived exertion in adolescent boys. British Journal of Sports Medicine. 1986, Vol. 20(1);27-30.

6. Centers for Disease Control and Prevention website. http://www.cdc.gov/nccdphp/dnpa/physical/mesuring/perceivedexertion.htm.

8 17,2006.

7. Spiridon G. Karavatas, Kamran Tavakol. Concurrent Validity of Borgs’s Rating of Perceived Exertion in African-American Young Adults, Employing Heart Rate as the Standard. The Internet Journal of Allied Health Sciences and Practice. 2005, Vol. 3(1); 1-4.

8. Ashley Clifton, Tonya Skalon. The correlation of Heart Rate and Rate of Perceived Exertion. Ball State University. 2006.

9. American College of Sports Medicine. ACSM’s Health-Related Physical Fittness Assessment Manual.2nd edition.Philadelphia: Lippincott Williams and Wilkins.2000:90.

10. Chen M. J.; Fan X.; Moe S. T. Criterion-related validity of the Borg ratings of Perceived exertion scale in healthy individuals: a meta-analysis. Journal of Sports Science. 2002; 20(11):873-899.

11. Itamar Levinger, Roger Bronks, David V. Cody, Ian Linton and Allan Davie. Perceived exertion as an exercise intensity indicator in chronic heart failure patients on beta blocker : Journal of Sport Science and Medicine: 2004(3), 23-27.

12. P. A. Seniors and R. Bhopal. Ethinicity as a variable in epidemiologic research. British Medical Journal.1994, 309 (6950):327-330.

13. Ozkan A. and A. Kin-Isler. The reliability and validity of regulating exercise intensity by rating of perceived exertion in step dance sessions. Journal of Strength Conditioning and Respiration. 2007: 21(1) 296-300.

9 14. Satipati Chatterjee, Pratima Chatterjee and Amit Bandyopadhyay. Validity of Queen’s College Step Test for estimation of maximum oxygen uptake in female students. Indian Journal of Medical Research. 2005, 121, 32-35.

15. S. Chatterjee, P. Chatterjee, P S Mukherjee and A. Bandyopadhyay. Validity of Queen’s College step test for use with young Indian men. British Journal of Sports Medicine. 2004,Vol.38;289-291.

16. Pfeiffer K.A., Pivarnik J. M., Womack C. J., Revees M. J., Malina R.Reliability and validity of the Borg and OMNI rating of perceived exertion scales in adolescent girls. Medicine and Science in Sports and Exercise. 2002; 34(12):2057-2061.

17. Perez L. J., Fernandez G. B., Rodriguez M., Gracia H. F., Gracio Z. P., Patterson A. M., Terrados N. Physiological differences and rating of perceived exertion (RPE) in professional, amateur and young cyclists. Journal of Sports Medicine and Physical Fitness. 2002;42(4):389-395.

18. Whaley M. H., Brubaker P. H., Kaminsky L. A., Miller C. R. Validity of rating of perceived exertion during graded exercise testing in apparently healthy adults and Cardiac Patients. Journal of Cardiopulmonary Rehabilitation.1997;17(4):261-267

19. Eston R. G. and J. G. Williams. Reliability of rating’s of perceived effort regulation of exercise intensity. British Journal of Sports Medicine. 1988:22(4):153-155.