European Journal of Applied Physiology

, Volume 118, Issue 9, pp 2007–2019 | Cite as

Overall and differentiated sensory responses to cardiopulmonary exercise test in patients with cystic fibrosis: kinetics and ability to predict peak oxygen uptake

  • Mathieu GruetEmail author
  • Laurent Mely
  • Jean-Marc Vallier
Original Article



We evaluated the validity of predicting peak oxygen uptake (\(\dot {V}\)O2peak) from submaximal ratings of perceived exertion (RPE) during incremental cardiopulmonary exercise test (CPET) in patients with cystic fibrosis (CF) and compared the predictive accuracy between overall and differentiated RPE scores.


Thirty-five adults with CF (FEV1 = 58 ± 23%) performed a CPET on cycle ergometer with gas exchange measurements. Leg, chest and overall RPE were collected every minute throughout the test. Linear regressions between \(\dot {V}\)O2 and RPE ≤ 15 were extrapolated to maximal theoretical RPE (i.e. RPE18 and RPE19) to predict \(\dot {V}\)O2peak. Agreements between measured and all predicted \(\dot {V}\)O2peak were tested using Bland–Altman Plots, for the whole group and for subjects presenting significant exercise intolerance (n = 24).


Leg, chest and overall RPE increased similarly with exercise intensity. No differences were found between predicted \(\dot {V}\)O2peak and measured \(\dot {V}\)O2peak with RPE18 as maximal RPE, for both overall and differentiated RPE (P range 0.94–0.98). Ranges for Pearson correlations and limits of agreements were 0.88–0.91 and 380–461 mL min−1 for the whole group and 0.92–0.94 and 269–365 mL min−1 for subjects with significant exercise intolerance. The greatest association and narrowest limits of agreements were obtained from chest RPE scores.


Submaximal RPE scores obtained during CPET can provide acceptable estimate of \(\dot {V}\)O2peak in adults with CF, particularly in those having significant exercise intolerance. Future studies should assess whether the prediction can be improved, particularly by encouraging the regular use of RPE scales during physical activities/exercise rehabilitations sessions.


Cystic fibrosis Physical functioning Rating of perceived exertion Peak aerobic capacity 



Breathing reserve index at maximum exercise


Cystic fibrosis


Chronic obstructive pulmonary disease


Cardiopulmonary exercise test


Category-ratio 10


Heart rate


Forced expiratory volume in 1 s


Limits of agreement


Physical activity


Ratings of perceived exertion


Chest RPE




Overall RPE

\(\dot {V}\)O2peak

Peak oxygen uptake



We are grateful to Nadège Goriot-Raynaud and Alicia Bordel for their support during this study.

Author contributions

MG contributed to study design, literature search, data collection, data analysis, manuscript writing and review. LM contributed to study design, data collection, data analysis and manuscript review. JMV contributed to study design, literature search, data collection, data analysis, and manuscript review. All authors read and approved the manuscript.



Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Mathieu Gruet
    • 1
    Email author
  • Laurent Mely
    • 1
    • 2
  • Jean-Marc Vallier
    • 1
  1. 1.Université de Toulon, LAMHESSToulonFrance
  2. 2.Hôpital Renée Sabran, CRCMGiensFrance

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