Effects of a taped filter mask on peak power, perceived breathlessness, heart rate, blood lactate and oxygen saturation during a graded exercise test in young healthy adults: a randomized controlled trial

Abstract

Background Face masks are an effective, non-pharmacological strategy to reduce the transmission of Severe Acute Respiratory Syndrome Coronavirus-2 and other pathogens. However, it is a challenge to keep masks sealed during exercise, as ventilation can increase from 5 to 10 L/min at rest to up to 200 L/min so that masks may be blown away from the face. To reduce leakage e.g. during exercise, a face mask was developed that is taped onto the face. The aim of this study was to investigate during a graded exercise test the effect of a taped filter mask on the perception of breathlessness, heart rate, blood lactate concentration, and oxygen saturation when compared to a surgical mask and no mask. Methods Eight healthy trained participants (4 females), aged 24.5 ± 3.3 years performed graded exercise test until volitional exhaustion under three conditions: (1) No mask/control, (2) surgical mask or (3) taped filter mask. During these tests, we measured perception of breathlessness, heart rate, blood lactate concentration and peripheral oxygen saturation and analysed the resultant data with one or two-way repeated measures ANOVAs. We also used a questionnaire to evaluate mask comfort and analysed the data with paired t-tests. Results When compared to wearing no mask, maximal workload was significantly reduced with a taped filter face mask by 12 ± 6% (p < 0.001) and with a surgical mask by 3 ± 6% (p > 0.05). Moreover, subjects perceive the sensation of "severe breathlessness" at a 12 ± 9% lower workload (p = 0.012) with a taped face mask, and 7 ± 13% lower workload with a surgical mask (p > 0.05) when compared to wearing no mask. Oxygen saturation at 65% of the maximal workload is 1.5% lower (p = 0.018) with a taped mask than no mask. Heart rate and blood lactate concentration are not significantly different in-between no mask, surgical mask and taped mask at any workload. When compared to wearing a surgical mask, wearing a taped filter face mask has a significantly better wearing comfort (p = 0.038), feels better on the skin (p = 0.004), there is a lower sensation of moisture (p = 0.026) and wearers perceive that less heat is generated (p = 0.021). We found no sex/gender differences for any of the measured parameters. Conclusions A taped mask is well tolerated during light and moderate exercise intensity but reduces maximal exercise capacity.

Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis

“…Overall, 22 studies used a progressive exercise test [ 3 , 12 , 14 , 18 , 24 , 26 , 30 , 35 , 36 , 39 , 41 , 43 – 45 , 48 , 50 , 51 , 53 – 55 , 59 , 60 ], while 19 employed the steady-state constant exercise test [ 13 , 15 , 25 , 29 , 31 , 34 , 37 , 38 , 40 , 42 , 46 , 47 , 49 , 52 , 56 – 58 , 61 , 62 ], and two used interval exercise tests [ 28 , 32 ]. Moreover, one study used a resistance exercise test [ 33 ], and one used a sit-to-stand test [ 27 ].…”

“…The most common parameter analyzed was heart rate, which was reported in 40 articles [ 3 , 12 – 15 , 18 , 24 – 31 , 33 – 35 , 37 – 50 , 53 , 55 – 62 ]. A total of 37 studies were included in the meta-analysis, including data extracted using WebPlotDigitizer from three studies [ 37 , 61 , 62 ].…”

“…Lactate levels were reported in seven studies [ 3 , 30 , 34 , 38 , 42 , 44 , 53 ], but no significant changes were observed in the total effect (MD − 0.15 mmol/L, 95% CI − 1.19 to 0.89; p = 0.78, I 2 = 82%). Similarly, no significant differences were observed for those wearing surgical masks ( p = 0.87) and FFP2/N95 ( p = 0.06), as shown in Fig.…”

“…A total of 25 studies evaluated exercise performance, and 23 studies were included in the meta-analysis, as data were unavailable for two studies [ 27 , 39 ]. Most studies used power output ( n = 13) [ 3 , 28 , 30 , 41 – 43 , 45 , 48 , 51 , 53 – 55 , 59 ], while others used test duration ( n = 6) [ 12 , 14 , 18 , 32 , 50 , 60 ], exercise speed ( n = 2) [ 34 , 35 ], and exercise distance ( n = 2) [ 13 , 25 ]. WebPlotDigitizer was used for data extraction from one study [ 55 ].…”

Aerosol particle emission increases exponentially above moderate exercise intensity resulting in superemission during maximal exercise

“…( 30 ) proposed that the majority of outbreaks were caused by the combination of one superspreader in a small room with poor ventilation, we recommend additional measures to reduce the risk of infection during indoor group exercise above 2 W/kg when superemission occurs. This could include 15-min airing breaks in between classes, pre-exercise infection testing of participants, safety shields in between exercisers, mobile air filters ( 19 , 31 ), and the wearing of masks even during exercise ( 26 , 32 – 34 ).…”