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

Aims
The rating of perceived exertion (RPE) provides correlations with physiological measurements of exercise intensity, including metabolic equivalent (MET), oxygen consumption (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 whilst 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 Kinect Adventures! videogame. METs were measured by a direct gas analyzer during the sessions, and RPE was measured on 6–20 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 [02 and HR vs. RPE] showed high coefficients (02-r = 0.62; average HR-r = 0.62; maximal HR-r = 0.50, p < 0.05). However, VS secondary values showed low-moderate coefficients (02-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. Health professionals should cautiously use the 6–20 points RPE scale in pathological patients, specifically in T1DM after Exergaming.