The Talk Test The Poor Man’s Way to Gauge Exercise Training Intensity Carl Foster, Ph.D., FACSM Department of Exercise and Sport Science University of Wisconsin-La Crosse

Every Story Starts Someplace Some Stories Start Twice 1970 1998

Exercise is Medicine Overwhelming Epidemiologic and Clinical Evidence Event Free Survival R Hambrecht et al. Circulation 109: 1371-1378, 2004 Months

Exercise is Medicine Order of Magnitude Effect Effect of Walking on 5 Year Mortality Vs -1% with Rx for HTN & Cholesterol -8% =stopping smoking vs continuing to smoke after first MI

Components of an Exercise Program Frequency 5-7 x weekly Intensity Hardest to define Time 20-60 min Type

Prescription of Exercise Training Intensity Objective Markers VO2 & METs 60-80% max 45/50-85% reserve Heart Rate 50/65-90% max 40/50-85% reserve Limits of the “relative percent concept” Individual response thresholds Wide prescriptive window Metabolic markers Ventilatory Threshold Lactate Threshold Subjective Markers RPE Talk Test

Talk Test

What Does the Talk Test Look Like?

Speech Provoking Stimulus N Shafer et al. JCRP 20: 289, 2000 JP Porcari et al. JCRP 22: 369, 2002 (Amy Kelso-Amann)

Evidence that the Talk Test is a Marker of Appropriate Exercise Intensity

C Foster et al. J Str Cond Res 23: 2425-2429, 2009 (Neepa Talati) E Jeanes et al. J Str Cond Res 25: 590-596, 2011

+Talk Test vs VT M Dehart-Beverley et al. Clin Exerc Physiol 2: 34-38, 2000 N Shafer et al. JCRP 20: 289, 2000 S Voelker et al. Clin Exerc Physiol 4: 120-123, 2002 P Recalde et al. S Afri J Sports Med 9: 5-8, 2002 R Persinger et al. MSSE 36: 1716-1722, 2004

+/-Talk Test vs VT M Dehart-Beverley et al. Clin Exerc Physiol 2: 34-38, 2000 N Shafer et al. JCRP 20: 289, 2000 S Voelker et al. Clin Exerc Physiol 4: 120-123, 2002 P Recalde et al. S Afri J Sports Med 9: 5-8, 2002 R Persinger et al. MSSE 36: 1716-1722, 2004

-Talk Test vs VT M Dehart-Beverley et al. Clin Exerc Physiol 2: 34-38, 2000 N Shafer et al. JCRP 20: 289, 2000 S Voelker et al. Clin Exerc Physiol 4: 120-123, 2002 P Recalde et al. S Afri J Sports Med 9: 5-8, 2002 R Persinger et al. MSSE 36: 1716-1722, 2004

VO2 @ VT vs Talk Test * *

-Talk Test vs RCT P Recalde et al. S Afri J Sports Med 9: 5-8, 2002

Ok, the Talk Test Matches VO2, HR and VT Markers of Exercise Capacity……Does it Work in Real Life?

Does the Talk Test Reflect Changes in Exercise Intensity? “If we’re going to keep talking, you have to slow down”

Can the Talk Test Prevent Exertional Myocardial Ischemia? Exertional ischemia is the one substantial danger in ExRx K Meyer (Eur Heart J 16: 623, 1995) has shown that the VT often precedes ST segment changes in patients with CAD CA Cannon et al. Am J Med Sport 6: 52-57, 2004

Can the Talk Test Track Permutations in Exercise Capacity?

Can You “Translate” From Exercise Testing to Exercise Training with the Talk Test? C Foster et al. J Str Cond Res 23: 2425-2429, 2009 Neepa Talati Sedentary individuals Incremental exercise test to identify + +/- - stages of Talk Test 20 min exercise bouts at LP-1, LP, EQ

Translating GXT to Training

Does “Translating” Exercise Intensity Work for Fitter Individuals? EA Jeanes et al. J Str Cond Res 25: 590-596, 2011 Well-trained non athletes including several “t-shirt runners” Incremental exercise to identify stages of TT 40 min stead state exercise sessions at LP-1, LP, EQ

Newest Data on Translating Exercise Training Intensity C Foster et al. J Str Cond Res 23: 2425-2429, 2009 (N Talati) EA Jeanes et al. J Str Cond Res 25: 590-596, 2011 + L Walraven + J Lueck

So, Where Does this Leave Us?

Summary Talk Test---a good ‘old idea’ Easy to perform eliminates need for maximal exercise forgiving of variations in speech producing stimulus Accurately places exercisers in exercise intensity defined by conventional criteria %HRmax %VO2max VT RPE Apparently useful as tool for avoiding exertonal ischemia Responsive to permutations in exercise capacity Easy to translate into exercise training intensity