chronic heart failure, chronic obstructive pulmonary disease, effort perception, exercise



  1. Terziyski, Kiril MD
  2. Marinov, Blagoi MD, PhD
  3. Hodgev, Vladimir MD, PhD
  4. Tokmakova, Maria MD, PhD
  5. Kostianev, S. MD, PhD, DMSc


PURPOSE: Standardized peak exercise perception score (SPEPS) is an index representing patient effort perception defined as SPEPS = Borg/METs, where Borg is the Borg CR-10 at maximal exercise intensity and METs is maximal metabolic equivalents. The purpose of the study was to assess the validity of SPEPS in different patient groups and to examine its applicability for evaluation of exercise training outcomes.


METHODS: Patients (n = 17) with chronic heart failure (CHF, New York Heart Association [NYHA] II and III functional class; ejection fraction= 31 +/- 14%), 16 patients with chronic obstructive pulmonary disease (COPD, forced expiratory volume in 1 second - FEV1%= 51 +/- 14%), and 16 age- and body mass index-matched controls formed the primary study group. An additional 22 ambulatory patients with stable CHF (NYHA II-III) were randomized to training and nontraining groups to test the effect of 8 weeks' exercise training on SPEPS.


RESULTS: Patients showed reduced exercise capacity ([latin capital V with dot above]O2, mL[middle dot]kg-1. min-1) = 18.8 +/- 3.8 (CHF) vs 21.1 +/- 5.1 (COPD) vs 29.9 +/- 5.2 (control), corresponding to SPEPS values: 1.15 +/- 0.36 (CHF) vs 0.82 +/- 0.26 (COPD) vs 0.55 +/- 0.22 (control); P < .001. The reduction in SPEPS was the largest compared with the other tested parameters after training and correlated strongly with change in Minnesota Living with Heart Failure Questionnaire ([rho]= 0.75, P < .001).


CONCLUSION: SPEPS is a reliable new index for discriminating perceived exertion at the end of exercise test in different groups of patients, presenting both construct and concurrent validity. It is a potent parameter for evaluation of the outcomes in training programs.