Quantification of Perceived Exertion During Isometric Force Production With the Borg Scale in Healthy Individuals and Patients With Chronic Stroke

Background: The Borg Rating of Perceived Exertion (RPE) scale is widely used for many patient populations, but the ability of patients to accurately report their RPE without visual feedback has not been studied. Objective: The objective was to determine whether the Borg scale could be used as a measure of perceived isometric exertion in healthy subjects and patients with stroke. Methods: In experiment 1, young healthy subjects (n = 15) were instructed to perform spontaneous pushes (ie, self-selected effort) without visual feedback and to produce and hold self-determined isometric finger flexion at 5 Borg levels without visual feedback. In experiment 2, subjects with chronic stroke (n = 10) were instructed to produce self-determined isometric elbow flexion at 4 perceptual levels on the impaired and nonimpaired sides. Results: In experiment 1, young healthy subjects, asked to self-select without visual feedback (spontaneous push), tended to exert at a "somewhat hard" level, about 12% of maximal voluntary contraction (MVC). Self-selection of forces ranged from 2% of MVC (ie, very light) to 39% of MVC (ie, very hard). In experiment 2, subjects with stroke were able to distinguish different levels of perceived exertion among light (19% MVC), somewhat hard (33% MVC), and hard (63% MVC) levels; this ability was not different for the impaired and nonimpaired limbs. Conclusion: Both healthy subjects and subjects with stroke are able to differentiate distinct levels of perceived exertion during isometric force when prompted with the Borg scale. Efforts at lower percentages of MVC are perceived by subjects with stroke as greater-than-normal Borg RPE levels.