{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T11:13:29Z","timestamp":1780571609316,"version":"3.54.1"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute on Aging Cooperative Agreement","award":["UO1 AG22376"],"award-info":[{"award-number":["UO1 AG22376"]}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung and Blood Institute","doi-asserted-by":"crossref","award":["3U01AG022376-05A2S"],"award-info":[{"award-number":["3U01AG022376-05A2S"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]},{"name":"University of Florida Claude D.\u00a0Pepper Older Americans Independence Center","award":["1 P30 AG028740"],"award-info":[{"award-number":["1 P30 AG028740"]}]},{"name":"Claude D.\u00a0Pepper Older Americans Independence Center","award":["P30AG021342"],"award-info":[{"award-number":["P30AG021342"]}]},{"name":"Pittsburgh Claude D.\u00a0Pepper Older Americans Independence Center","award":["P30 AG024827"],"award-info":[{"award-number":["P30 AG024827"]}]},{"name":"Claude D.\u00a0Pepper Older Americans Independence Center","award":["1 P30 AG21332"],"award-info":[{"award-number":["1 P30 AG21332"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study evaluated the association between ratings of perceived exertion (RPE) of walking and major mobility disability (MMD), as well as their transitions in response to a physical activity (PA) compared to a health education (HE) program.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Older adults (n = 1633) who were at risk for mobility impairment were randomized to structured PA or HE programs. During a 400 m walk, participants rated exertion as \u201clight\u201d or \u201chard.\u201d An MMD event was defined as the inability to walk 400 m. MMD events and RPE values were assessed every 6 months for an average of 2.6 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Participants rating their exertion as \u201chard\u201d had a nearly threefold higher risk of MMD compared with those rating their exertion as \u201clight\u201d (HR: 2.61, 95% CI: 2.19\u20133.11). The association was held after adjusting for disease conditions, depression, cognitive function, and walking speed (HR: 2.24, 95% CI: 1.87\u20132.69). The PA group was 25% more likely to transition from \u201clight\u201d to \u201chard\u201d RPE than the HE group (HR: 1.25, 95% CI: 1.05\u20131.49). Additionally, the PA group was 27% (HR: 0.73, 95% CI: 0.55 \u2013 0.97) less likely to transition from a \u201chard\u201d RPE to inability to walk 400 m and was more likely to recover their ability to walk 400 m by transitioning to a \u201chard\u201d RPE (HR: 2.10, 95% CI: 1.39\u20133.17) than the HE group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Older adults rating \u201chard\u201d effort during a standardized walk test were at increased risk of subsequent MMD. A structured PA program enabled walking recovery, but was more likely to increase transition from \u201clight\u201d to \u201chard\u201d effort, which may reflect the greater capacity to perform the test.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/gerona\/glab036","type":"journal-article","created":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T07:13:26Z","timestamp":1613373206000},"page":"e264-e271","source":"Crossref","is-referenced-by-count":3,"title":["Ratings of Perceived Exertion During Walking: Predicting Major Mobility Disability and Effect of Structured Physical Activity in Mobility-Limited Older Adults"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7402-6495","authenticated-orcid":false,"given":"Erta","family":"Cenko","sequence":"first","affiliation":[{"name":"Department of Epidemiology, University of Florida, Gainesville, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6450-0368","authenticated-orcid":false,"given":"Thomas M","family":"Gill","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Geriatric Medicine, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy W","family":"Glynn","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1176-8544","authenticated-orcid":false,"given":"Rebecca M","family":"Henderson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby C","family":"King","sequence":"additional","affiliation":[{"name":"Department of Health Research and Policy, Stanford University, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Pahor","sequence":"additional","affiliation":[{"name":"Department of Aging and Geriatric Research, University of Florida, Gainesville, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peihua","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Florida, Gainesville, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvito","family":"Rego","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran F","family":"Reid","sequence":"additional","affiliation":[{"name":"Nutrition, Exercise Physiology and Sarcopenia Lab, Tufts University, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catrine","family":"Tudor-Locke","sequence":"additional","affiliation":[{"name":"College of Human and Health Services, UNC Charlotte, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Valiani","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine, Universit\u00e0 degli Studi di Bari Aldo Moro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"You","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Florida, Gainesville, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd M","family":"Manini","sequence":"additional","affiliation":[{"name":"Department of Aging and Geriatric Research, University of Florida, Gainesville, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,15]]},"reference":[{"key":"2021091314244046600_CIT0001","volume-title":"Perceived Exertion","author":"Noble","year":"1996"},{"key":"2021091314244046600_CIT0002","volume-title":"An Introduction to Borg\u2019s RPE-Scale","author":"Borg","year":"1985"},{"key":"2021091314244046600_CIT0003","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1249\/00003677-199700250-00017","article-title":"Perception of physical exertion: methods, mediators, and applications","volume":"25","author":"Robertson","year":"1997","journal-title":"Exerc Sport Sci Rev"},{"key":"2021091314244046600_CIT0004","volume-title":"A Social-Cognitive Perspective of Perceived and Sustained Effort. Handbook of Sport Psychology.","author":"Tenenbaum","year":"2007"},{"key":"2021091314244046600_CIT0005","first-page":"97","article-title":"Psychological factors influencing perceived exertion","volume":"5","author":"Morgan","year":"1973","journal-title":"Med Sci Sports"},{"key":"2021091314244046600_CIT0006","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","article-title":"Psychophysical bases of perceived exertion","volume":"14","author":"Borg","year":"1982","journal-title":"Med Sci Sports Exerc"},{"key":"2021091314244046600_CIT0007","first-page":"1","article-title":"Perceived exertion research in the 21st century: developments, reflections and questions for the future","volume":"6","author":"Faulkner","year":"2008","journal-title":"J Exerc Sci Fit"},{"key":"2021091314244046600_CIT0008","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1111\/jgs.12638","article-title":"Assessing fatigability in mobility-intact older adults","volume":"62","author":"Simonsick","year":"2014","journal-title":"J Am Geriatr Soc"},{"key":"2021091314244046600_CIT0009","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.pmrj.2010.03.022","article-title":"Fatigue and fatigability in older adults","volume":"2","author":"Eldadah","year":"2010","journal-title":"PM R"},{"key":"2021091314244046600_CIT0010","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1093\/gerona\/glu146","article-title":"Walking energetics, fatigability, and fatigue in older adults: the study of energy and aging pilot","volume":"70","author":"Richardson","year":"2015","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2021091314244046600_CIT0011","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1093\/ajcn\/86.5.1738","article-title":"L-Carnitine treatment reduces severity of physical and mental fatigue and increases cognitive functions in centenarians: a randomized and controlled clinical trial","volume":"86","author":"Malaguarnera","year":"2007","journal-title":"Am J Clin Nutr"},{"key":"2021091314244046600_CIT0012","first-page":"40","article-title":"Randomized, controlled, six-month trial of yoga in healthy seniors: effects on cognition and quality of life","volume":"12","author":"Oken","year":"2006","journal-title":"Altern Ther Health Med"},{"key":"2021091314244046600_CIT0013","first-page":"319","article-title":"The effects of a pulmonary rehabilitation program on pulmonary function tests and exercise tolerance in patients with Parkinson\u2019s disease","volume":"12","author":"K\u00f6seo\u011flu","year":"1997","journal-title":"Funct Neurol"},{"key":"2021091314244046600_CIT0014","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/01823246-199708040-00002","article-title":"Changes in exercise response and tolerance following an eight-week rehabilitation program","volume":"8","author":"Nielsen","year":"1997","journal-title":"Cardiopulm Phys Ther J"},{"key":"2021091314244046600_CIT0015","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1093\/gerona\/glr123","article-title":"The Lifestyle Interventions and Independence for Elders Study: design and methods","volume":"66","author":"Fielding","year":"2011","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2021091314244046600_CIT0016","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1097\/00005768-200107000-00010","article-title":"CHAMPS physical activity questionnaire for older adults: outcomes for interventions","volume":"33","author":"Stewart","year":"2001","journal-title":"Med Sci Sports Exerc"},{"key":"2021091314244046600_CIT0017","doi-asserted-by":"crossref","first-page":"M85","DOI":"10.1093\/geronj\/49.2.M85","article-title":"A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission","volume":"49","author":"Guralnik","year":"1994","journal-title":"J Gerontol"},{"key":"2021091314244046600_CIT0018","first-page":"314","article-title":"The modified Mini-Mental State (3MS) Examination","volume":"48","author":"Teng","year":"1987","journal-title":"J Clin Psychiatry"},{"key":"2021091314244046600_CIT0019","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.2147\/CIA.S49737","article-title":"Promoting physical activity for elders with compromised function: the Lifestyle Interventions and Independence for Elders (LIFE) study physical activity intervention","volume":"8","author":"Rejeski","year":"2013","journal-title":"Clin Interv Aging"},{"key":"2021091314244046600_CIT0020","volume-title":"Perceived Exertion and Pain Scales.","author":"Borg","year":"1988"},{"key":"2021091314244046600_CIT0021","first-page":"90","article-title":"Perceived exertion: a note of \u201chistory\u201d and methods","volume":"5","author":"Borg","year":"2010","journal-title":"Med Sci Sports Exerc"},{"key":"2021091314244046600_CIT0022","doi-asserted-by":"crossref","first-page":"212","DOI":"10.3138\/ptc.58.3.212","article-title":"Reliability of four functional tests and rating of perceived exertion in persons with multiple sclerosis","volume":"58","author":"Fry","year":"2006","journal-title":"Physiother Can"},{"key":"2021091314244046600_CIT0023","doi-asserted-by":"crossref","first-page":"2387","DOI":"10.1001\/jama.2014.5616","article-title":"Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial","volume":"311","author":"Pahor","year":"2014","journal-title":"JAMA"},{"key":"2021091314244046600_CIT0024","doi-asserted-by":"crossref","first-page":"833","DOI":"10.7326\/M16-0529","article-title":"Effect of structured physical activity on overall burden and transitions between states of major mobility disability in older persons: secondary analysis of a randomized trial","volume":"165","author":"Gill","year":"2016","journal-title":"Ann Intern Med"},{"key":"2021091314244046600_CIT0025","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.2522\/ptj.20110326","article-title":"Perceived effort of walking: relationship with gait, physical function and activity, fear of falling, and confidence in walking in older adults with mobility limitations","volume":"92","author":"Julius","year":"2012","journal-title":"Phys Ther"},{"key":"2021091314244046600_CIT0026","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1111\/jgs.14138","article-title":"Fatigued, but not frail: perceived fatigability as a marker of impending decline in mobility-intact older adults","volume":"64","author":"Simonsick","year":"2016","journal-title":"J Am Geriatr Soc"},{"key":"2021091314244046600_CIT0027","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/BF02895777","article-title":"Physical activity, self-esteem, and self-efficacy relationships in older adults: a randomized controlled trial","volume":"22","author":"McAuley","year":"2000","journal-title":"Ann Behav Med"},{"key":"2021091314244046600_CIT0028","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1080\/10413200802351151","article-title":"The effect of manipulated self-efficacy on perceived and sustained effort","volume":"20","author":"Hutchinson","year":"2008","journal-title":"J Appl Sport Psychol"},{"key":"2021091314244046600_CIT0029","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/01.HCR.0000291298.70517.7e","article-title":"Influence of self-efficacy on the functional relationship between ratings of perceived exertion and exercise intensity","volume":"27","author":"Hu","year":"2007","journal-title":"J Cardiopulm Rehabil Prev"},{"key":"2021091314244046600_CIT0030","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1111\/jgs.14742","article-title":"LIFE Study Investigators. Effect of physical activity on self-reported disability in older adults: results from the LIFE study","volume":"65(5)","author":"Manini","year":"2017","journal-title":"J Am Geriatr Soc"},{"key":"2021091314244046600_CIT0031","doi-asserted-by":"crossref","first-page":"340","DOI":"10.2466\/06.15.29.PMS.116.1.340-351","article-title":"Rating of perceived exertion after 12 weeks of high-intensity, intermittent sprinting","volume":"116","author":"Heydari","year":"2013","journal-title":"Percept Mot Skills"},{"key":"2021091314244046600_CIT0032","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1038\/sj.sc.3101389","article-title":"Long-term exercise training in persons with spinal cord injury: effects on strength, arm ergometry performance and psychological well-being","volume":"41","author":"Hicks","year":"2003","journal-title":"Spinal Cord"},{"key":"2021091314244046600_CIT0033","doi-asserted-by":"crossref","first-page":"385","DOI":"10.5993\/AJHB.36.3.9","article-title":"Longitudinal change in physical activity and disability in adults","volume":"36","author":"Gretebeck","year":"2012","journal-title":"Am J Health Behav"},{"key":"2021091314244046600_CIT0034","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1093\/aje\/kwg237","article-title":"Prognostic effect of prior disability episodes among nondisabled community-living older persons","volume":"158","author":"Gill","year":"2003","journal-title":"Am J Epidemiol"},{"key":"2021091314244046600_CIT0035","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1001\/archinte.165.1.106","article-title":"Factors associated with recovery of independence among newly disabled older persons","volume":"165","author":"Hardy","year":"2005","journal-title":"Arch Intern Med"},{"key":"2021091314244046600_CIT0036","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1081\/COPD-200050655","article-title":"Minimally clinically important difference for the UCSD shortness of breath questionnaire, Borg scale, and visual analog scale","volume":"2","author":"Ries","year":"2005","journal-title":"COPD"}],"container-title":["The Journals of Gerontology: Series A"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/biomedgerontology\/advance-article-pdf\/doi\/10.1093\/gerona\/glab036\/36583284\/glab036.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/biomedgerontology\/article-pdf\/76\/10\/e264\/40355117\/glab036.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/biomedgerontology\/article-pdf\/76\/10\/e264\/40355117\/glab036.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T14:26:21Z","timestamp":1631543181000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/biomedgerontology\/article\/76\/10\/e264\/6135114"}},"subtitle":[],"editor":[{"given":"Anne B","family":"Newman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,2,15]]},"references-count":36,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,2,15]]},"published-print":{"date-parts":[[2021,9,13]]}},"URL":"https:\/\/doi.org\/10.1093\/gerona\/glab036","relation":{},"ISSN":["1079-5006","1758-535X"],"issn-type":[{"value":"1079-5006","type":"print"},{"value":"1758-535X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,10,1]]},"published":{"date-parts":[[2021,2,15]]}}}