EFFECTS OF TALK TEST METHODS ON UTTERANCE DURING INCREMENTAL CARDIORESPIRATORY EXERCISE

N.H.O. Abdullah¹, M.S.A. Nurul Nadiah², M. Siti Ruzita², M.S. Maheza Irna², A. Aizreena²

¹Sultanah Aminah Hospital, Physiotherapy Department, Johor Bahru, Malaysia, ²University of Technology Malaysia, School of Biomedical Engineering and Health Sciences, Johor Bahru, Malaysia

Background: The talk test (TT) is a reliable and validated tool for exercise prescription in Cardiac Rehabilitation. There is evidence to support on the use of TT as a self-regulatory intensity monitoring tool during incremental cardiorespiratory exercise by using the physiological process of breathing and speech utterance.

Purpose: The aim of this study was to compare the effects of three variation TT on the speech utterance and physiological responses during four stages of incremental cardiorespiratory exercises.

Methods: A prospective observational study was undertaken at a tertiary care hospital. The sample size was calculated based on previous study on TT, using statistical power of 0.95 at an effect size of 0.6 with an alpha level of 0.05 based on the 95% confident intervals (Nielsen & Vinther, 2016). For this study, 26 healthy participants were recruited. Participants completed 3 submaximal exercise tests on a treadmill on the same day with 1 hour rest period between tests using standardized Modified Bruce Protocol (stage 1 to 4). The primary outcomes were 1) the percentage of exercise Time-regulated Talk Test (TrTT) measured by display tablet, respiratory rate and rate of perceived exertion were measured using Exercise Physiology Monitoring Unit; 2) Speech parameter (speech rate, speech quality and speech duration) using special Praat Software. Three different TT methods were Counting Talk Test (CTT), regulated Monosyllable Talk Test (rMTT) and non-regulated Monosyllable Talk Test (nMTT) were used. This were incorporated into the first, second and third exercise test respectively. In CTT, the estimated exercise intensity was based on percentage of CTT (%CTT), which refers to the ratio between the numbers of counts per breath achieved while exercising and the numbers of counts per breath at rest. Meanwhile, the ratio between the number of successful alphabets uttered per breath while exercising and the numbers of successful alphabets uttered per breath at rest is represented by %rMTT and %nMTT respectively. All parameters were analysed with non parametric test. The changes from the primary outcome for the 3 submaximal tests were analysed using Friedman Test. p < 0.05 is considered significant

Results: 26 Participantshealthy individuals were recruited. There are 8 male and 18 female with mean age of 26.38 ± 6.74 years. There were significant difference of speech rate across exercise stages in all the TT methods (p<0.05). However, the speech quality for CTT and nMTT were consistent (p>0.05) across exercise stages but significant difference in the rMTT (p=0.004). There are also significant differences of estimated exercise intensity (p<0.05), heart rate response (p<0.05) and RPE (p<0.05) across exercise stages for all TT methods.

Conclusions: The results of this study inform an understanding of the TT to guide health professionals as a self-regulatory intensity monitoring tool during incremental cardiorespiratory exercise. All the TT methods (i.e.,CTT, rMTT and nMTT) were able to distinguish all exercise stages in the Modified Bruce Protocol.

Implications: This study provides important information regarding use of TT as a self-regulatory intensity monitoring tool during incremental cardiorespiratory exercise. The utilisation of varying forms of TT warrants further investigation.

Funding acknowledgements: UTM R&D Fund

Keywords:
Cardiorespiratory Exercise
Talk test
Physiological responses

Topics:
Cardiorespiratory
Cardiorespiratory
Professional practice: other

Did this work require ethics approval? Yes

Institution: Malaysia Ministry of Health

Committee: NREC (National Review Ethic Committee)

Ethics number: NMRR ID-21-01978-3NI