The DOI matches its Crossref record; 23 of the 24 references it cites were found in a registry or an index.
Use of Heart Rate Reserve and Rating of Perceived Exertion to Prescribe Exercise Intensity in Diabetic Autonomic Neuropathy
Open accessAbstract
OBJECTIVE—Individuals with diabetic autonomic neuropathy (DAN) exhibit an increased resting heart rate but depressed maximal heart rate. Thus, the purpose of this study was to examine the validity of using either percent of heart rate reserve (HRR) or a rating of perceived exertion (RPE) scale to prescribe exercise intensity in diabetic individuals both with and without DAN. RESEARCH DESIGN AND METHODS—The subjects consisted of 23 individuals with type 2 diabetes, ages 45–75 years, with (DAN; n = 13) or without (No DAN; n = 10) clinical signs of DAN, as assessed by heart rate variability using the expiration-to-inspiration ratio of the R-R interval. Peak aerobic capacity was determined using a graded protocol on a cycle ergometer, with RPE, heart rate, and Vo2 values recorded at each stage. RESULTS—The subjects were similar with the exception of depressed autonomic function in DAN subjects. Peak respiratory exchange ratio values were significantly higher (P < 0.05) in the DAN group (1.08 ± 0.02 vs. 1.02 ± 0.01 in No DAN subjects), although DAN subjects exhibited a significantly lower (P < 0.05) peak exercise heart rate. A similarly highly linear relationship between %HRR and percent Vo2 reserve (Vo2R) existed for both groups (r = 0.98). A similar slightly weaker relationship (r = 0.94) was found between RPE and %Vo2R. CONCLUSIONS—In conclusion, in diabetic individuals, %HRR provides an accurate prediction of %Vo2R and can be used to prescribe and monitor exercise intensity, regardless of the presence of DAN. The RPE scale is also a valid, albeit slightly less accurate, method to monitor exercise intensity in diabetic individuals.
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“The presence of CAN doubles the risk of mortality ( 48 , 265 ) and indicates more frequency of silent myocardial ischemia ( 265 ), orthostatic hypotension, or resting tachycardia ( 76 , 177 ).”
From Exercise and Type 2 Diabetes (2010) · cites this paper as [48]
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Cites
Psychophysical bases of perceived exertion
BORG, G. A. V. (1982) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-198205000-00012 · Cited by 16,580
Pollock, M. L., Gaesser, G. A., Butcher, J. D., Despr??s, J.-P., Dishman, R. K., Franklin, B. A., & Garber, C. E. (1998) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199806000-00032 · Cited by 3,051
(2000) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200007000-00024 · Cited by 604
O'Brien, I. A. D., O'Hare, P. J., & Corrall, R. J. M. (1986) · Heart · doi:10.1136/hrt.55.4.348 · Cited by 483
Heart rate reserve is equivalent to %VO2Reserve, not to %VO2max
SWAIN, D. P., & LEUTHOLTZ, B. C. (1997) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199703000-00018 · Cited by 287 · cited 4×
“This finding is consistent with findings for healthy adults (1,2) and cardiac patients (18).”
BackgroundMethodResultInfluentialSelf-citationThe validity of regulating exercise intensity by ratings of perceived exertion
Dunbar, C. C., Robertson, R. J., Baun, R., BLANDIN, M. F., Metz, K. F., Burdett, R. G., & Goss, F. L. (1992) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199201000-00016 · Cited by 280
Valensi, P. E., Sachs, R.-N., Harfouche, B., Lormeau, B., Pariès, J., Cosson, E., Paycha, F., Leuténegger, M., & Attali, J. R. (2001) · Diabetes Care · doi:10.2337/diacare.24.2.339 · Cited by 236
Exercise capacity in lean versus obese women
Hulens, M., Vansant, G. A. A. M., Lysens, R., Claessens, A., & Muls, E. (2001) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1034/j.1600-0838.2001.110509.x · Cited by 223
Relationship between % heart rate reserve and % VO2reserve in treadmill exercise
SWAIN, D. P., LEUTHOLTZ, B. C., KING, M. E., HAAS, L. A., & BRANCH, J. D. (1998) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199802000-00022 · Cited by 190
Self-citationGeneral Principles of Exercise Prescription
Mahler, D. M. (1995) · Medical Entomology and Zoology · Cited by 167
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Physical activity/exercise and diabetes: A position statement of the American Diabetes Association
Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., Horton, E. S., Castorino, K., & Tate, D. F. (2016) · Diabetes Care · doi:10.2337/dc16-1728 · Cited by 2,991
Self-citationVinik, A. I., Maser, R. E., Mitchell, B. D., & Freeman, R. (2003) · Diabetes Care · doi:10.2337/diacare.26.5.1553 · Cited by 2,044
Self-citationColberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B. J., Rubin, R. R., Chasan-Taber, L., Albright, A. L., & Braun, B. (2010) · Diabetes Care · doi:10.2337/dc10-9990 · Cited by 1,955
“The presence of CAN doubles the risk of mortality (48,265) and indicates more frequency of silent myocardial ischemia (265), orthostatic hypotension, or resting tachycardia (76,177).”
Self-citationDiabetic cardiovascular autonomic neuropathy
Vinik, A. I., & Ziegler, D. (2007) · Circulation · doi:10.1161/circulationaha.106.634949 · Cited by 1,255
Self-citationDiabetes-Related Microvascular and Macrovascular Diseases in the Physical Therapy Setting
Cade, W. T. (2008) · Physical Therapy · doi:10.2522/ptj.20080008 · Cited by 1,141
Metadata
- Authors
- Colberg, S. R., Swain, D. P., & Vinik, A. I.
- Affiliations
- Old Dominion University (US)
- Eastern Virginia Medical School (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2003-04-01
- Volume
- 26
- Issue
- 4
- Pages
- 986-990
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2137336521
- Cited by
- 109
- References
- 24
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 2 · 2023: 3 · 2022: 9 · 2021: 3 · 2020: 10 · 2019: 5 · 2018: 2 · 2017: 1 · 2016: 4 · 2015: 5 · 2014: 5 · 2013: 3 · 2012: 6
- FWCI
- 8.41
- Type
- journal article
- Language
- en
- Open access
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- ODU Digital Commons (Old Dominion University) (submittedVersion)
- Funders
- American Diabetes Association
- Topics
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- diabetic autonomic neuropathy, heart rate reserve, rating of perceived exertion, exercise intensity prescription, type 2 diabetes, peak aerobic capacity, heart rate variability, respiratory exchange ratio, exercise monitoring
- MeSH terms
- Aged, Blood Glucose, Body Constitution, Diabetes Mellitus, Type 2, Diabetic Neuropathies, Physical Exertion, Female, Heart Rate, Humans, Male, Middle Aged, Oxygen Consumption, Regression Analysis, Exercise
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