A critical review of the literature on ratings scales for perceived exertion.

The study of human performance and perceived exertion during physical activity has been an area of considerable interest and research for over 50 years. This review considers the evidence of many investigators who have been researching the physiological basis as well as non-physiological basis for the ratings of perceived exertion. During low levels of activity, physical perception in the working muscles appears to be the primary stimulus for effort perception. When work intensity exceeds the lactate threshold, incremental elevations in blood lactate complement peripheral input from the neuromuscular mechanisms. Once a critical absolute ventilatory threshold is reached, central input also contributes to effort perception. In most instances, peripheral input predominates over central cues, although it has been shown that pronounced central cues may dominate the perception of effort. Central (heart rate, VE, VO2) or local (muscle and blood lactate, adenosine triphosphate, creatine phosphokinase, glycogen) cues highlighted in these studies demonstrate both the complexity of effort perception, and the need for better understanding of the physiological components upon which it is based. Athletes have been shown to have a greater tendency to reduce perceptual ratings than their non-active counterparts. In view of these observations, it is apparent that a theoretical framework based upon physiological and psychological considerations may exist to support the concept of training-induced alterations in perceived exertion. This appears to be particularly true in higher ranges of exercise intensity. Part of the problem in reaching a conclusion on the issue of perceptual ratings trainability centres upon the agreement on what should be recognised as a significant decrement in perceived exertion. It is concluded that there is considerable variation in the findings of the literature and that any reported variations in performance may well be greatly influenced by intersubject variability, the type of exercise, and nutritional status of subject. Further research is required to understand this issue better.