Exercise Prescription & Programming

How do you know if your patients are using the RPE scale appropriately?

We instruct our patients, but we don't show our patients the different levels of RPE. I thought if we created a protocol that required them to exercise in a graded fashion, we could stand by to say, "this is what it feels like to work at RPE of 11 or 13."

I welcome your input.

Just curious as to why you don't show your patients the RPE levels/scale. We discuss it during our patient's classroom orientation, again during their 1 on 1 first billable exercise session and continuously during their program. We have laminated posters on the walls as well as laminated 81/2x11 sheets with RPE on most exercise equipment. That way we can grab it and reexplain when needed. It's virtually impossible to show someone how a specific number will feel to them because its their perception. A 13 for one person will feel different to another. Sometimes you have to explain if they give you a crazy number. For example, if a patient is working at a MET of about say 5 or 6 and they say "This feels like a 6" I usually respond back, "So this feels like your sitting on the couch doing nothing?" By then they usually catch on.

Amy, thanks for your input. Just like you, we discuss RPE on their first exercise session, and just about every session until they can give an RPE number that seems to resemble their level of exertion. There are RPE posters and other RPE signage around the gym, so it's visible from every piece of exercise equipment and in the cooldown area.

In spite of all the signage and the intruction on using the RPE scale, I feel many patients don't use it properly. If there were a protocol that would monitor HR and ask RPE and correlate with MET levels--that's what I'm wondering about.

Or is there even a need for this?