Convergent validity of ratings of perceived exertion during resistance exercise in healthy participants: A systematic review and meta-analysis

Background: The validity of ratings of perceived exertion (RPE) during aerobic training is well established; however, it’s validity during resistance exercise is less clear. This meta-analysis used the known relationships between RPE and exercise intensity (EI), heart rate (HR), blood lactate (BLa), blood pressure (BP) and electromyography (EMG) to determine the convergent validity of RPE as a measure of resistance exercise intensity and physiological exertion, during different forms of resistance exercise. Additionally, this study aims to assess the effect of several moderator variables on the strength of the validity coefficients, so that clearer guidance can be given on the use of RPE during resistance exercise.
Methods: An online search of 4 databases and websites (PubMed, Web of science, SPORT Discus and Research Gate) was conducted up to 28 February 2020. Additionally, the reference lists of the included articles were inspected manually for further unidentified studies. The inclusion criteria were; healthy participants of any age, a rating scale used to measure RPE, resistance exercise of any type, one cohort receiving no other intervention, and must present data from one of the following outcome measures: EI, HR, BP, EMG or BLa. Weighted mean effect sizes (r) were calculated using a random-effects model. Heterogeneity was assessed using the Tau2 and I2 statistics. Moderator analysis was conducted using random-effects meta-regression.

Results: One-hundred and eighteen studies were included in the qualitative synthesis, with 75 studies (99 unique cohorts) included in the meta-analysis. The overall weighted mean validity coefficient was large (0.88; 95% CI 0.84 to 0.91) and between studies heterogeneity was very large (Tau2 = 0.526, I2 = 96.1%). Studies using greater workload ranges, isometric muscle actions, and those that manipulated workload or repetition time, showed the highest validity coefficients. Conversely, sex, age, training status, RPE scale used, and outcome measure did not have an effect.

Conclusions: RPE provides a valid measure of exercise intensity and physiological exertion during resistance exercise, with effect sizes comparable or greater than those shown during aerobic exercise. Therefore, RPE may provide an easily accessible means of prescribing and monitoring resistance exercise training.

Registration: The systematic review protocol was registered on the PROSPERO database (CRD42018102640).