The talk test—A costless tool for exercise prescription in Indian cardiac rehabilitation

Abstract

Exercise-based cardiac rehabilitation (CR) plays a vital role in improving function and preventing mortality of cardiovascular disease (CVD) patients. Outpatient (Phase II and III) CR is almost nonexistent in India because of several reasons such as time, cost, distance, education level, scarcity of resources and so forth. Cardiologists or cardiac surgeons can directly advise patients and their family members to do an optimal dose of exercise in low-resource settings, that is, rural, low-income, or low-educated patients. Talk test is a no-cost, subjective tool for exercise prescription which is gaining popularity in CR because of its simplicity. This brief descriptive review covers history, administration, physiological mechanisms, reliability and validity, and safety among cardiac patients along with limitations of the ‘talk test’. This review also theoretically discusses how the talk test could be used in primary and secondary prevention of CVD. Finally, it advocates Indian CR team to use this simple validated tool as a self-monitoring tool of exercise intensity.

Professional Exercise Recommendations for Healthy Women Who Are Pregnant: A Systematic Review

“…There was some disagreement on the methods for measuring intensity. ODPHP, CASEM, Consensus Physical Activity Guidelines for Asian Indians, SOGC/CSEP, SMA, PSS, FIMS, ACSM, and ACOG recommended use of the “talk test,” 30 a subjective measure of exercise intensity during which a person is able to comfortably, with difficulty, or uncomfortably hold a conversation during exercise. 3 , 5–7 , 17 , 19 , 21 , 22 , 24 SASMA, SMA, ACOG, CASEM, and Fitness Australia recommended that moderate intensity should be determined by an RPE score of 12–14 on the 6 to 20 Borg scale.…”

Application and Measurement Properties of the Talk Test in Cardiopulmonary Patients: A Systematic Review

“…Despite the diversity in the TT protocols and the resulting difficulty in arriving at conclusions, the reliability of the TT was satisfactory [29], both for the assessment by the individual and the physiotherapist [31]. Good results regarding the TT reliability in the context of cardiovascular rehabilitation (CR) were found [41,42]. However, Petersen et al [33] found poor reliability when the test was administered by more than one evaluator, even with acceptable ICC values.…”

“…Among the parameters used for exercise prescription (frequency, intensity, time, type), the intensity seems to be the one that most requires attention so that the benefits of the exercise component of CR may be acquired. The TT can be an alternative tool that has the potential to facilitate exercise prescription and self-monitoring in the recommended target intensity [6,18,42]. As highlighted by Saini et al [42], the TT can be useful especially in contexts like India, where low-cost and more accessible tools are necessary to overcome some causes of the CR underutilization.…”

“…The TT can be an alternative tool that has the potential to facilitate exercise prescription and self-monitoring in the recommended target intensity [6,18,42]. As highlighted by Saini et al [42], the TT can be useful especially in contexts like India, where low-cost and more accessible tools are necessary to overcome some causes of the CR underutilization.…”

Summary and application of the WHO 2020 physical activity guidelines for patients with essential hypertension in primary care

“…Intensity of aerobic PA can be measured by different methods. Previous work has provided guidance on assessment of PA intensity, such as the talk test [ 48 , 49 , 50 ], heart rate monitoring by using wearable devices [ 51 , 52 , 53 , 54 ], metabolic equivalent (MET) [ 28 ], and rating of perceived exertion (RPE) [ 55 , 56 ]. Each method has different limitations and benefits that should be considered by the patient and/or the exercise professionals with whom they are working.…”