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Evaluation of the Numeric Rating Scale for perception of effort during isometric elbow flexion exercise

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Abstract

The aim of the study was to examine the reliability and validity of the numerical rating scale (0-10 NRS) for rating perception of effort during isometric elbow flexion in healthy people. 33 individuals (32 ± 8 years) participated in the study. Three re-test measurements within one session and three weekly sessions were undertaken to determine the reliability of the scale. The sensitivity of the scale following 10 min isometric fatiguing exercise of the elbow flexors as well as the correlation of the effort with the electromyographic (EMG) activity of the flexor muscles were tested. Perception of effort was tested during isometric elbow flexion at 10, 30, 50, 70, 90, and 100% MVC. The 0-10 NRS demonstrated an excellent test–retest reliability [intra class correlation (ICC) = 0.99 between measurements taken within a session and 0.96 between 3 consecutive weekly sessions]. Exploratory curve fitting for the relationship between effort ratings and voluntary force, and underlying EMG showed that both are best described by power functions (y = ax b). There were also strong correlations (range 0.89–0.95) between effort ratings and EMG recordings of all flexor muscles supporting the concurrent criterion validity of the measure. The 0-10 NRS was sensitive enough to detect changes in the perceived effort following fatigue and significantly increased at the level of voluntary contraction used in its assessment (p < 0.001). These findings suggest the 0-10 NRS is a valid and reliable scale for rating perception of effort in healthy individuals. Future research should seek to establish the validity of the 0-10 NRS in clinical settings.

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Acknowledgments

The authors would like to acknowledge the financial support of the School of Health Science and Social Care of Brunel University, and to thank staff and student participants of the university who volunteered in this study.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Physiotherapy Department, Technological Educational Institute of Patras at Aigio, Patra, 25100, Greece

    Sofia Lampropoulou

  2. Centre for Rehabilitation Research, School of Health Sciences and Social Care, Brunel University, Uxbridge, UB8 3PH, UK

    Alexander V. Nowicky

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  1. Sofia Lampropoulou
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  2. Alexander V. Nowicky
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Correspondence to Sofia Lampropoulou.

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Communicated by Fausto Baldissera.

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Lampropoulou, S., Nowicky, A.V. Evaluation of the Numeric Rating Scale for perception of effort during isometric elbow flexion exercise. Eur J Appl Physiol 112, 1167–1175 (2012). https://doi.org/10.1007/s00421-011-2074-1

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  • DOI: https://doi.org/10.1007/s00421-011-2074-1

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