13.4: Managing Sensations of Effort and Exertion

Perceived effort and exertion are commonly cited barriers to exercise participation. “Physical exertion” or “feelings of physical discomfort” have been reported as the primary barrier to exercise (exceeding other barriers such as lack of time) in a variety of populations including female university students (Lovell et al., 2010) and culturally diverse adolescents and adults (Bragg et al., 2009). Moreover, sensations of effort and exertion can lead to aversive affective responses to exercise, which can create a negative association with exercise (Ekkekakis et al., 2018) and negatively impact exercise participation (Williams et al., 2008). For more discussion on the relationship between affective responses to exercise and exercise behavior, see Chapters 4 (Brand & Ekkekakis, 2021), 11 (Jones & Zenko, 2021), and 12 (Zenko & Ladwig, 2021). Consequently, interventions aimed at coping with and/or reducing perceptions of effort and exertion are likely to have a positive impact on exercise behavior.

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13.4.1. Attentional Focus Interventions

Exercise interventions aimed at diverting attentional focus away from sensations of effort and exertion have been effective in reducing RPE at fixed workloads (Hutchinson & Tenenbaum, 2019). On the contrary, the removal of distracting external information (via sensory deprivation) can increase perception of effort (Razon et al., 2009). The underlying premise for attentional focus interventions is that attentional capacity is fixed and limited; therefore, distracting stimuli can occupy attentional bandwidth that is critical for bringing perceptions of effort and exertion into focal awareness. It is important to note that this strategy is most effective during low-to-moderate intensity exercise. At very high exercise intensities, attentional processes are dominated by strong afferent feedback that demands attention; thus, perceptions of exertion override the distraction capabilities of external stimuli (Hutchinson et al., 2011).

A variety of attentional focus interventions have been used to draw attention away from internal task-related sensations during exercise. For example, dissociative imagery (images unrelated to the exercise task and/or related sensory inputs), has been found to significantly lower RPE when compared to associative (task-related) imagery and control (no imagery) conditions during a cycling task (Razon et al., 2014). Researchers have also explored the effect of sensory interventions, including taste and smell, on RPE but reported no significant effects (Basevitch et al., 2011; 2013; Raudenbush et al. 2001; Ritchie et al., 2016).

A recent meta-analytic review reported a significant beneficial effect of music listening onRPE (Terry et al., 2020). Appropriately selected music appears to lower RPE by approximately 10% during submaximal aerobic exercise (Karageorghis & Priest, 2012) and explosive power movements (Biagini et al., 2012), and by approximately 6% during strength testing (Silva et al., 2020). When workload is not fixed, music can have an ergogenic, or work-enhancing, effect with no associated increase in RPE (e.g., Waterhouse et al., 2010). The combination of audio and visual stimuli (e.g., music and video) can lower RPE when compared to control and sensory deprivation conditions (Bigliassi et al., 2019; Hutchinson et al., 2015) although this combination does not appear to be significantly superior to music alone (Hutchinson et al., 2015). The content of the audiovisual stimuli is an important consideration; pleasant audiovisual stimuli appears to reduce RPE whereas RPE is actually increased in the presence of unpleasant audiovisual stimuli (Barreto-Silva et al., 2018). See Chapter 23 for more discussion on the effects of music in sport (Karageorghis et al., 2021).

Advances in technology have facilitated recent interventions in the realm of virtual reality and exergaming, which refers to the combination of exercise with a computer-simulated interactive game. Initial investigations show promising effects, for example a sample of college students reported significantly higher RPE during a traditional exercise biking session compared with a VR-based exercise biking session (Zeng et al., 2017). Similarly, among active adults, exergaming using XBOX Kinect™ was associated with significantly lower RPE than traditional gym-based exercise despite no difference in mean HR (Barryet al. 2016).

Mindfulness represents an alternative attentional approach to coping with and/or reducing perceptions of effort and exertion (see Chapter 14 for more discussion on mindfulness and exercise [Cox & Ullrich-French, 2021]). Drawing upon an intentional and nonjudgmental awareness of the present moment (Kabat-Zinn, 1990), a mindful intervention targets the development of mindful acceptance of internal sensations, as opposed to diverting attention away from such sensations. Salmon et al. (2010) proposed several advantages to mindfulness-based attention allocation during sustained physical activity, including enhanced awareness, decreased emotional reactivity and improved attentional control. To date, there has been little empirical research on the impact of mindfulness on RPE, although one study indicated a small-to-moderate positive effect, where participants felt like they were not working as hard when they were in the mindfulness condition relative to control (Cox et al., 2018). In a second study, participants reported more accurate RPE (i.e., self-ratings better matched physiological indices of exertion) following a brief mindfulness training intervention (Meggs & Chen, 2021), supporting the notion of improved awareness as an outcome of mindful attention (Salmon et al., 2010).

13.4.2. Mental Skills

The use of mental skills training (MST), also called Psychological Skills Training (PST), is extensive in sport psychology, but less so in exercise psychology. Mental skills in sport have been broken down into basic skills (self-talk, relaxation, goal-setting, and imagery) and advanced skills, which primarily comprise self-regulatory strategies (Hardy et al., 2010). See Chapter 20 for more discussion on psychological skills training (Rymal et al., 2021).

13.4.2.1. Basic Mental Skills

Self-talk, and in particular motivational self-talk, has been shown to influence perceptions of effort and exertion. Blanchfield et al. (2014a) assessed the effects of motivational self-talk (vs. no-intervention control) on RPE and endurance performance in a constant-load cycling time-to-exhaustion test. The self-talk intervention significantly reduced RPE during the test despite an 18% increase in time-to-exhaustion. Additional studies have reported greater power output with the use of motivational self-talk with no corresponding change in RPE, which infers a perceptual benefit of motivational self-talk (Barwood et al., 2015; Hatzigeorgiadis et al., 2018).

Relaxation training is often incorporated as part of MST interventions in sport, although in exercise settings it is more commonly studied relative to exercise recovery. For example, the use of sedative music during recovery from an exhaustive cycling task was associated with greater decreases in RPE when compared to a no-music control group (Jing & Xudong, 2008). Interesting research exploring the effects of deliberately adopted facial expressions during exercise has consistently shown increased effort perception when frowning in comparison with consciously relaxing and/or smiling (Brick et al.,2018; Philippen et al., 2012).

The role of goal setting in managing sensations of effort and exertion has received limited empirical investigation. However, qualitative research has revealed that goal setting is used by endurance athletes as a way to remain focused on the task in order to cope with painful sensations of exertion (Kress & Statler, 2007). Mental imagery has also been used to cope with exertive sensations. Both dissociative imagery (Razon et al., 2014) and motivational imagery (Giacobbi et al., 2018) have been reported to lower RPE during brief exercise tasks. Mental skills are often combined as part of a comprehensive MST program. In one such example, a program comprising goal setting, arousal regulation, mental imagery, and positive self-talk produced improvements in running performance without a corresponding increase in RPE (Barwood et al., 2008).

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13.4.2.2. Self-Regulatory Strategies

Broadly, self–regulatory strategies describe particular processes that are engaged in order to achieve a goal. Cognitive reappraisal is a self-regulatory strategy which involves reevaluating emotional stimuli to augment or reduce their emotional impact (Gross, 2007). When instructed to utilize cognitive reappraisal, endurance runners reported lower perceived exertion than when provided no instruction (Giles et al., 2018). Evaluating an exhaustive exercise task as a challenge rather than a threat was associated with marginally lower perceived exertion in the presence of significantly increased power output on the task (Wood et al., 2018). If-then planning, sometimes known as implementation intentions, refers to a self-regulatory strategy for goal-directed behavior that follows an if-then format (e.g., “If Situation X occurs, then I will perform Behavior A, but if Situation Y occurs, then I will perform Behavior B”). The feasibility of if-then plans to manage perceptions of effort and pain have been explored with mixed results (see Bieleke et al., 2020). Interestingly, ironic effects were reported by Bieleke and Wolff (2018) who observed a steeper increase in RPE among “if-then” participants during a static muscular endurance task and significantly higher RPE in the final 10% of the task relative to control group participants. In this study, the implementation intention instruction prompted participants to ignore sensations of exertion and keep going; it is possible that a more proactive plan might yield different results.

13.4.3. Nonconscious Interventions

A great deal of human functioning is rooted in nonconscious or implicit processes (Bargh, 2006). Dual-process models of behavior have highlighted the importance of impulsive, sometimes nonconscious, influences on exercise behavior (see Rebar et al., 2016 for review). An emerging body of evidence indicates that nonconscious processes are amenable to manipulation in an exercise setting(Hutchinson & Tenenbaum, 2019). In particular, priming, which refers to the activation of mental processes through environmental stimuli, can influence a variety of processes and behaviors, including RPE. In a series of experiments, Blanchfield et al., (2014b) assessed the effect of subliminal priming on RPE and effort toleranceduring a cycling task. Subliminal primes refer to stimuli that are presented but not perceived consciously. In the first study, participants persisted longer on the time-to-exhaustion task and had significantly lower RPE when they were primed with happy faces compared to sad faces. In the second study, subliminal priming with action words (e.g., “energy” and “go”) facilitated a significantly lower RPE during the same cycling test despite no significant difference in objective performance between conditions. A later study by Pottratz et al. (2020) embedded positively-valenced subliminal affective primes into music video. This condition yielded significantly lower RPE and more positive affective responses when compared to music-video (no prime), music, and control conditions.

Optical flow patterns play an important role in locomotion and the perception of movement speed. Parry et al. (2012) manipulated optic flow in cyclists using projected video footage of a cycling course that either represented their actual cycling speed or was varied by ±15% to appear slower or faster (unknown to the participants). Both absolute RPE, and RPE normalized for power output, were significantly lower in the slow optic flow condition, which was also associated with a shallower increase in RPE gradient over the 20km trial.