Is rating of perceived exertion a valid method for monitoring exergaming intensity in type-1 diabetics? A cross-sectional randomized trial

Abstract

Aims: The rating of perceived exertion (RPE) provides correlations with physiological measurements of exercise intensity, including metabolic equivalent (MET), oxygen consumption (V˙O₂), and heart rate (HR), in real (RS) and virtual (VS) sessions. To use RPE in patients with pathology, we aimed to examine the concurrent validity of RPE in type-1 diabetes mellitus (T1DM) patients while exergaming.

Methods: Ten T1DM patients performed two 30-min crossover sessions of moderate-intensity exercise (washout 72-196 h). The RS group performed running, and the VS group played the Kinect Adventures! video game. METs were measured by a direct gas analyzer during the sessions, and RPE was measured on the 6 - 20 point Borg scale after the sessions.

Results: RS and VS showed similar RPE (13.2 ± 2.7 vs. 14.2 ± 2.4) and MET (4.6 ± 1.1 vs. 4.0 ± 0.8) values (p > 0.05). RPE vs. MET correlation-coefficients were large in RS (r = 0.64; R² = 41; p = 0.04) and were moderate in VS (r = 0.42; R² = 18; p = 0.22). Additionally, RS secondary values (V˙O₂ and HR vs. RPE) showed high coefficients (V˙O_2-r = 0.62; average HR_r = 0.62; maximal HR_r = 0.50, p < 0.05). VS secondary values, on the other hand, showed low-moderate coefficients (V˙O_2-r = 0.42; average HR_r = 0.23; maximal HR_r = 0.21, p > 0.05).

Conclusion: The current validation showed that RPE may not be a valid and strong method for T1DM patients while exergaming. Healthcare professionals should cautiously use the 6 - 20 point RPE scale in pathological patients, specifically in T1DM while exergaming.

Keywords: Blood glucose; Diabetes mellitus; Exercise; Metabolic equivalent; Perception; Video games.