During your cardiovascular stress test, you’ll find that your exercise physiologist will ask you for a number or a phrase on the chart posted on the wall. You may ask yourself things like “Why is he/she asking me this?” or “Why do the numbers go from 6-20 and not 1-10?” In this week’s blog, we hope to answer some of those questions before your next visit.
Borg Scale History
The Borg Scale was developed by Professor Gunnar Borg of Stockholm University all the way back in 1998. He recognized that humans were “built for physical work, but either too much or too little exercise could be detrimental”. Too little exercise and we can find ourselves with severe chronic health complications later in life. Exercise too much and we could experience severe acute pain right in that moment. Therefore, it was imperative for clinicians and fitness professionals alike to have a standardized way to prescribe exercise with this in mind while respecting the needs,concerns, and conditions of the individual.
There has been extensive research into objective measures of exercise intensity we use today such as heart rate and VO2 Max ( the maximum amount of oxygen you’re consuming during intense exercise). However, measuring one’s subjective perception of exertion or pain could account for the differences in fitness level, pre-existing conditions, gender, and other factors. In other words, Borg set out to quantify a qualitative measure. The fields of exercise physiology, athletic training, physical therapy, and general fitness have been using his scale ever since.
You may be wondering why the scale is numbered from 6-20 as opposed to 1-10 like most other scales are. Remember earlier when we discussed that Heart Rate was an objective measure of exercise intensity? Well, professor Borg designed the scale to align with heart rate from rest to max exercise. In the normal healthy population, the typical resting heart rate is around 60 bpm. During intense exercise, it can go up to 170,180, and even higher than 200! Therefore, numbering the scale from 6-20 gives us a way to align both subjective and objective measures of intensity.
Below is an example of the Borg Scale you will see in cardiac rehab centers, fitness facilities, and comprehensive executive physical exam clinics such as Princeton Longevity Center.
During your next visit
Your exercise physiologist will periodically ask you for your perceived level of exertion according to the Borg scale. At higher intensities, you may point your finger to the corresponding rating. It is important you are honest with your exercise physiologist with your rating so that they may terminate the test in safe and effective manner when necessary.
Heath, Edward M. “Borg’s Perceived Exertion and Pain Scales.” Medicine& Science in Sports & Exercise, vol. 30, no. 9, 1998, pp. 14–61., doi:10.1249/00005768-199809000-00018.