A Cloth Facemask Causes No Major Respiratory or Cardiovascular Perturbations During Moderate to Heavy Exercise

Abstract

Purpose: Investigate whether a cloth facemask could affect physiological and perceptual responses to exercise at distinct exercise intensities in untrained individuals. Methods: Healthy participants (n = 35; 17 men, age 30 [4] y, and 18 women, age 28 [5] y) underwent a progressive square wave test at 4 intensities: (1) 80% of ventilatory anaerobic threshold; (2) ventilatory anaerobic threshold; (3) respiratory compensation point; and (4) exercise peak (Peak) to exhaustion, 5-minute stages, with or without a triple-layered cloth facemask (Mask or No-Mask). Several physiological and perceptual measures were analyzed. Results: Mask reduced inspiratory capacity at all exercise intensities (P < .0001). Mask reduced respiratory frequency (P = .001) at Peak (−8.3 breaths·min−1; 95% confidence interval [CI], −5.8 to −10.8), respiratory compensation point (−6.9 breaths·min−1; 95% CI, −4.6 to −9.2), and ventilatory anaerobic threshold (−6.5 breaths·min−1; 95% CI, −4.1 to −8.8), but not at Baseline or 80% of ventilatory anaerobic threshold. Mask reduced tidal volume (P < .0001) only at respiratory compensation point (−0.5 L; 95% CI, −0.3 to −0.6) and Peak (−0.8 L; 95% CI, −0.6 to −0.9). Shallow breathing index was increased with Mask only at Peak (11.3; 95% CI, 7.5 to 15.1). Mask did not change HR, lactate, ratings of perceived exertion, blood pressure, or oxygen saturation. Conclusions: A cloth facemask reduced time to exhaustion but had no major impact on cardiorespiratory parameters and had a slight but clinically meaningless impact on respiratory variables at higher intensities. Moderate to heavy activity is safe and tolerable for healthy individuals while wearing a cloth facemask. ClinicalTrials.gov: NCT04887714.

Cloth masks during exercise are safe and tolerable for children with overweight and obesity

“…A study from our laboratory showed no major perturbations in respiratory and cardiovascular responses during moderate to heavy exercise in untrained adults, although face mask reduced time to exhaustion. 4 However, data are scant regarding children.…”

“…3 During unmitigated stages of the pandemic, this tool was shown to be useful to circumvent the spread of the disease and to prevent individuals with debilitating conditions to be infected. The adverse effects anecdotally attributed to wearing a face mask during exercise, such as extreme shortness of breath, insufficient supply of oxygen, and other hemodynamic alterations, have been consistently refuted in several populations, 4,6,9 which reinforces the safety of mask usage during exercise. Nonetheless, the concern remains that wearing a mask during exercise, particularly at higher intensities, could further deteriorate cardiorespiratory responses in groups with pre-existing health conditions.…”

“…These findings align well with an increasing body of literature showing that face masks and respirators are tolerable during exercise and cause no major disturbances in physiological responses in athletes and less fit individuals. 4,6,9 The main strength of this study is the fact that a vulnerable population was studied (i.e., children with overweight and obesity, some of whom with dyslipidaemia and type 2 diabetes). Our main limitation involves the low sample size, which was determined by the available human and financial resources along with the safety issues associated with having pediatric participants tested in a laboratory located within a tertiary hospital during the COVID-19 pandemic.…”