Modified Talk Test: a Randomized Cross-over Trial Investigating the Comparative Utility of Two “Talk Tests” for Determining Aerobic Training Zones in Overweight and Obese Patients

Abstract

Background To validate the traditional talk test (TTT) and an alternative talk test (ATT; using a visual analog scale) in overweight/obese (OW-OB) patients and to establish its accuracy in determining the aerobic training zones. Methods We recruited 19 subjects aged 34.9 ± 6.7 years, diagnosed with overweight/obesity (BMI 31.8 ± 5.7). Every subject underwent incremental cycloergometric tests for maximal oxygen consumption, and TTT in a randomized order. At the end of each stage during the TTT, each subject read out loud a 40 words text and then had to identify the comfort to talk in two modalities: TTT which consisted in answering “Yes,” “I don’t know,” or “No” to the question Was talking comfortable?, or ATT through a 1 to 10 numeric perception scale (visual analog scale (VAS)). The magnitude of differences was interpreted in comparison to the smallest worthwhile change and was used to determine agreement. Results There was an agreement between the power output at the VAS 2–3 of ATT and the power output at the ventilatory threshold 1 (VT1) (very likely equivalent; mean difference − 1.3 W, 90% confidence limit (CL) (− 8.2; 5.6), percent chances for higher/similar/lower values of 0.7/99.1/0.2%). Also, there was an agreement between the power output at the VAS 6–7 of ATT and the power output at the ventilatory threshold 2 (VT2) (very likely equivalent; mean difference 11.1 W, 90% CL (2.8; 19.2), percent chances for higher/similar/lower values of 0.0/97.6/2.4%). Conclusions ATT is a tool to determine exercise intensity and to establish aerobic training zones for exercise prescription in OW-OB patients.

Clinical practice guidelines on physical activity and exercise for pregnant women with gestational diabetes mellitus: A systematic review

“…target heart rate) could become an obstacle to compliance by individuals (Persinger et al, 2004). Recently, some research demonstrated the consistency of the counting talk test (CTT) (Loose et al, 2012) and the alternative talk test (ATT; using a visual analogue scale) (Orizola‐Cáceres et al, 2021), showing results were accurate and consistent. Hence, subjective methods of exercise training intensity such as the TT and Borg's scale may be more appropriate for exercise during pregnancy.…”

Next steps to advance general physical activity recommendations towards physical exercise prescription: a narrative review

“…23 The TT asks the participants how comfortable they feel speaking during exercise, and its use has been associated with low (≤2 mmol/L; speaking comfortably ), moderate (~3–4 mmol/L; not speaking comfortably ) and high (>5 mmol/L; unable to speak comfortably ) levels of BLa during continuous aerobic type exercise, and has a close relationship with RPE 24 and VT1 or gas exchange threshold. 25 Moreover, the use of the TT can be extended to different populations, including cardiac patients, 26 overweight and obese people 27 and elite athletes, 28 where the use of an analogue scale can strengthen this approach. 27 However, it is important to highlight that the RPE and TT must be approached individually according to the type of exercise prescribed.…”

“…25 Moreover, the use of the TT can be extended to different populations, including cardiac patients, 26 overweight and obese people 27 and elite athletes, 28 where the use of an analogue scale can strengthen this approach. 27 However, it is important to highlight that the RPE and TT must be approached individually according to the type of exercise prescribed. In support of the use of the RPE and TT, recently Bok et al reported that both instruments are reliable and valid measures for the demarcation of ventilatory and lactate thresholds and can be used to elicit homeostatic disturbances associated with moderate, heavy and severe-intensity domains during continuous exercise.…”

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

“…The application of the TT has been explored since 2002 in different populations, such as athletes [ 13 , 14 , 15 ], men with prostate cancer [ 16 ], overweight and obese patients [ 17 ], and patients with CVD [ 18 ]. It is presently a recommended test in the current guidelines for CVD patients even without a clear definition of the most appropriate protocol [ 19 , 20 ].…”