Validity of a Pictorial Perceived Exertion Scale for Effort Estimation and Effort Production During Stepping Exercise in Adolescent Children

Abstract

Recent developments in the study of paediatric effort perception have continued to emphasize the importance of child-specific rating scales. The purpose of this study was to examine the validity of an illustrated 1–10 perceived exertion scale: the Pictorial Children’s Effort Rating Table (PCERT). Four class groups comprising 104 children, 27 boys and 29 girls, aged 12.1±0.3 years and 26 boys, 22 girls, aged 15.3±0.2 years were selected from two schools and participated in the initial development of the PCERT. Subsequently, 48 of these children, 12 boys and 12 girls from each age group, were randomly selected to participate in the PCERT validation study. Exercise trials were divided into two phases and took place 7 to 10 days apart. During Phase 1, children completed 5 three minute incremental stepping exercise bouts interspersed with two minute recovery periods. Heart rate (HR) and ratings of exertion were recorded during the final 15 seconds of each exercise bout. In Phase 2 the children were asked to regulate their exercising effort during 4 four minute bouts of stepping so that it matched randomly prescribed PCERT levels (3, 5, 7 and 9). Analysis of data from phase 1 yielded significant ( p<0.01) relationships between perceived and objective (HR) effort measures for girls. In addition, the main effects of exercise intensity on perceived exertion and HR were significant ( p<0.01); perceived exertion increased as exercise intensity increased and this was reflected in simultaneous significant rises in HR. During phase 2, HR and estimated power output (POapprox) produced at each of the four prescribed effort levels were significantly different ( p<0.01). The children in this study were able to discriminate between four different exercise intensities and regulate their exercise intensity according to four prescribed levels of perceived exertion. In seeking to contribute towards children’s recommended physical activity levels and helping them understand how to self-regulate their activity, the application of the PCERT within the context of physical education is a desirable direction for future research.