IMR Press / RCM / Volume 23 / Issue 7 / DOI: 10.31083/j.rcm2307225
Open Access Systematic Review
Application and Measurement Properties of the Talk Test in Cardiopulmonary Patients: A Systematic Review
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1 Physical Therapy Graduate Program (PPGFT), Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
2 Research Group on Cardiovascular Health and Exercise (GEPCardio), Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
3 Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC H4J 1C5, Canada
4 Physical Therapy Undergraduate Program, Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
5 Physical Therapy Undergraduate Program, University of Vale do Itajaí (UNIVALI), 88302-901 Itajaí, SC, Brazil
6 Graduate Program in Rehabilitation Sciences (PPG-CR), Federal University of Health Sciences of Porto Alegre (UFCSPA), 90050-170 Porto Alegre, RS, Brazil
*Correspondence: (Marlus Karsten)
Academic Editor: Lee Stoner
Rev. Cardiovasc. Med. 2022, 23(7), 225;
Submitted: 19 February 2022 | Revised: 15 April 2022 | Accepted: 22 April 2022 | Published: 24 June 2022
(This article belongs to the Special Issue Cardiac rehabilitation)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: The talk test (TT) evaluates the exercise intensity by measuring speech comfort level during aerobic exercise. There are several application protocols available to assess individuals with cardiopulmonary diseases. However, the measurement properties of the TT were not systematically reviewed yet. Methods: A systematic review was developed, registered (CRD420181068930), and reported according to PRISMA Statement. Randomized clinical trials, cross-sectional studies, or series cases were identified through multiple databases and were selected if they presented concomitant speech provocation and an exercise test. Included studies were evaluated based on methodological quality (adapted New Castle-Ottawa Scale), descriptive quality (STROBE Statement), and risk of bias (COSMIN bias risk scale). Results: Ten studies were included. Seven studies presented moderate to high quality and the majority presented good scores according to the STROBE statement. Four hundred and fourteen subjects performed the TT, the majority being patients with coronary artery disease. The test validity was supported by the included studies. Talk Test reliability was considered satisfactory, although only one study presented an adequate reliability analysis. The studies found a correlation between the last positive stage of the TT with the first ventilatory threshold. Workload, oxygen uptake, and heart rate in the last positive stage of the TT were not different from the same parameters related to the first ventilatory threshold. Conclusions: The evidence indicates that the TT is suitable as an alternative tool for the assessment and prescription of exercise in individuals with cardiovascular diseases. The stage when the individual is still able to speak comfortably is suggested as the intensity for aerobic exercise prescription. As there is still no well-defined and fully explored TT protocol, caution is required when interpreting the TT results.

exercise test
heart diseases
cardiorespiratory evaluation
Fig. 1.
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