RPE psychological status and social milieu

Psychosocial factors can influence up to 30% of the variability in an RPE score (Dishman and Landy, 1988; Williams and Eston, 1989). Such influences may help to explain the wider variability of RPE, for a given %HRRmax, reported by Whaley, et al. (1997) in cardiac compared to non-cardiac individuals. The patients' psychological status has two aspects, which can influence RPE: their state of mental well being and the state of motivation to exercise. The social milieu in which the exercise takes place plays a key role in influencing patients' well-being and motivation to exercise (Dishman, 1994). It is known that following a cardiac event, there can be a concomitant psychological morbidity (Todd, et al., 1992). Individuals with heightened anxiety and depression tend to inflate estimation mode RPE scores compared to those without psychological morbidity (Rejeski, 1981). Furthermore, Kohl and Shea (1988) suggested, though the evidence is equivocal, that individuals with an external locus of control compared to those with an internal locus of control give higher RPEs for a given work rate.

It has been reported that RPE inflation also occurs in individuals with limited experience of exercise fatigue and/or in those inhibited by a social situation (Morgan, 1973; Rejeski, 1981; Morgan, 1994). The inhibiting social situation can include an exercise test, individuals feeling inferior to other patients' abilities in ability, consciousness of body image or physical inferiority, and competitiveness during the exercise session. The effect of psychological status and the presence of disease in modulating RPE scores are not new areas of investigation (Borg and Linderholm, 1970; Morgan, 1973; Morgan, 1994). Borg and Linderholm (1970) found that cardiac patients gave higher RPE values for a given HR compared to age-matched control participants. This greater RPE in the patient group was correlated with the severity of disease. Therefore, not only is RPE used as an aid to monitor exercise intensity, but the RPE values that individuals give may provide cues to the practitioner to consider the patient's psychological state.

Considering all of these issues, changes in RPE over a course of rehabilitation may partially be a function of changes in psychological well being. Nevertheless, for patients to perceive their exercise as getting easier over time, independent of the amount of physiological change, provides positive feedback and motivation towards continued participation through a sense of achievement (Dishman, 1994). Continued participation will secure the longer-term physiological benefits that patients can derive from regular exercise.

Getting to Know Anxiety

Getting to Know Anxiety

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