Validity of the Talk Test as a Method to Estimate Ventilatory Threshold and Guide Exercise Intensity in Cardiac Patients

Abstract

Purpose: To determine the relationship between the Talk Test (TT) and ventilatory threshold (VT) in patients with cardiac disease and to compare the TT with exercise intensity guidelines. Methods: Twenty cardiac patients, aged 65 ± 8.5 yr, performed 2 exercise tests with identical ramp protocols on a cycle ergometer on the same day. One test was a submaximal effort to assess exercise intensity using the TT. The other was a cardiopulmonary exercise test using breath-by-breath gas analysis to identify VT and cardiorespiratory fitness. Results: Oxygen uptake ( ) and workload at the last positive stage (TTpos) was significantly lower than at VT. and workload at the equivocal stage (TTeq) and the first negative stage (TTneg) were not significantly different from VT, but limits of agreement (LoA) were wide. There was no significant difference in heart rate (HR) at TTpos and TTeq compared with VT, but HR at Tneg was significantly higher. The correlations between the TT and VT ranged from 0.37 to 0.60. Intensity at the different TT stages ranged from 58-77% of . All TT stages were within intensity guidelines of 40-80% of . Conclusion: Although no significant differences were found in and workload for TTeq and TTneg when compared with VT, LoA demonstrated wide ranges, suggesting poor individual correspondence. The different stages of the TT can be used as a practical method to guide exercise intensity in patients with cardiac disease.

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.…”

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.…”

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

“…From these findings, the studies proposed the TT+ stage as a prescription parameter and identified its usefulness in most of the individuals evaluated [18,27,35]. Sorensen et al [34] found correlations between the TT stages and VT 1 from 0.37 to 0.60. Also, it was observed that individuals are unlikely to show electrocardiographic signals of myocardial ischemia at the load corresponding to the time they can still speak comfortably (TT+) [28].…”