The Predictability of Peak Oxygen Consumption Using Submaximal Ratings of Perceived Exertion in Adolescents

Rating of perceived exertion (RPE) extrapolation involves mathematically extending the submaximal relationship between RPE and oxygen consumption (VO₂) to maximal intensity. This technique allows practitioners to forego, potentially dangerous, maximal exertion testing while attaining accurate measures of maximal oxygen consumption used for exercise prescription. This method has been proven accurate in adults, but much less in known when applied to an adolescent population. The purpose of this study was to assess the accuracy of the RPE extrapolation as method for estimating VO_2max in adolescents. Twenty-two healthy, asymptomatic adolescents performed a graded exercise test (GXT) to exhaustion. Heart rate and VO₂ were recorded throughout the bout with RPE being queried every two minutes using the Borg (6-20) RPE scale. Individual regression lines were fitted for each subject using RPE and VO₂ for RPE values up to 13,15, and 17. Theoretical maximal RPE values of 20 and 19 were entered into the equation to calculate an estimated VO_2max. Repeated measures ANOVA with planned contrasts showed that all VO_2max estimation methods significantly overpredicted measured VO_2max (p < .001). Error analysis via Bland-Altman plots revealed large limits of agreement between the all methods, indicating large variability in error between estimated and measured VO_2max. The results suggest that submaximal RPE values using the Borg scale cannot be used to predict VO_2max in children due to the amount of error in the prediction equations. These inaccuracies could lead to potential under or over-prescription of exercise intensity and adverse effects on the person's health.