Modeling Perceived Exertion during Graded Arm Cycling Exercise in Spinal Cord Injury.

Purpose: Ratings of perceived exertion (RPE) may be useful for exercise testing and prescription in individuals with spinal cord injury (SCI), though 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 describe their relationship to cardiorespiratory outcomes. Methods: Thirty-six individuals with SCI (13 paraplegia; 23 tetraplegia) completed a maximal graded-arm cycling exercise test to volitional exhaustion (5W/min paraplegia; 10W/min tetraplegia). Participants were asked to report central (CRPE) and peripheral (PRPE) ratings of perceived exertion 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. Results: Cardiorespiratory indices increased linearly during graded arm exercise. In contrast, both CRPE and PRPE responses were best fit to a quadratic model with positively accelerating growth in individuals with paraplegia (p

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