Effects of face masks on performance and cardiorespiratory response in well-trained athletes

Egger, F.; Blumenauer, Dominic; Fischer, Patrick; Venhorst, Andreas; Kulenthiran, Saarraaken; Bewarder, Yvonne; Zimmer, A.; Böhm, Michael; Meyer, Tim; Mahfoud, Felix

doi:10.1007/s00392-021-01877-0

Cited by 30 publications

(97 citation statements)

References 30 publications

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“…This is the first study to analyze physical response to the use of a specially developed face mask, Emotion reusable respirator, compared to no mask and with the use of FFP2. Interestingly, cardiopulmonary performance was globally very similar with no mask and the use of Emotion, this way improving previously reported results from cloth and surgical masks [4,[13][14][15][16]. On the other side, it was significantly lower with FFP2, confirming previously reported findings [14,15].…”

Section: Discussionsupporting

confidence: 89%

“…These objective findings were completed with the Visual Analogic Scale for ventilatory effort perception (VAS VE), as subjects reported significantly higher perceived ventilatory effort with FFP2 in all stages of the test, as previously reported by other past studies [14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 71%

“…This study ratifies that face masks, both FFP2 and Emotion, are safe for healthy, athletic people to practice sport with, even at high intensities. Regarding performance, several previous studies [14][15][16] have reported a significant reduction in cardiopulmonary and global performance with the use of face masks, both surgical and FFP2. This is the first study to analyze physical response to the use of a specially developed face mask, Emotion reusable respirator, compared to no mask and with the use of FFP2.…”

Section: Discussionmentioning

confidence: 95%

“…Anyway, there is still an important concern about the safety of face masks in high-intensity training, and how they can affect performance. We chose to study an athletic population, as previously done by Egger et al [16], to have a specific approach to maximal-intensity exercise, and we chose to do it on a treadmill rather than a bicycle ergometer, in contrast to all recent studies [14][15][16], to better mimic their everyday athletic gesture. This study ratifies that face masks, both FFP2 and Emotion, are safe for healthy, athletic people to practice sport with, even at high intensities.…”

Section: Discussionmentioning

confidence: 99%

“…A previous study discovered that, at constant load (steady state exercise), using SM was associated with a significant increase in airway resistance, reduced oxygen uptake, and increased heart rate [13]. Furthermore, some studies compared pulmonary and cardiovascular capacity, at maximal load, using SM and FFP2/N95 in healthy adults [14][15][16], showing that there is a significant reduction in performance (Pmax and VO 2 max) with FFP2/N95, whereas that reduction, although present, is not that consistent with SM. Therefore, according to these studies, medical masks have a marked negative impact on cardiopulmonary capacity that significantly impairs strenuous physical and work activities.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Different Types of Face Masks on the Ventilatory and Cardiovascular Response to Maximal-Intensity Exercise

Rojo-Tirado

Benítez-Muñoz

Alcocer-Ayuga

et al. 2021

Biology

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The development of new models of face masks makes it necessary to compare their impact on exercise. Therefore, the aim of this work was to compare the cardiopulmonary response to a maximal incremental test, perceived ventilation, exertion, and comfort using FFP2 or Emotion masks in young female athletes. Thirteen healthy sportswomen (22.08 ± 1.75 years) performed a spirometry, and a graded exercise test on a treadmill, with a JAEGER® Vyntus CPX gas analyzer using an ergospirometry mask (ErgoMask) or wearing the FFP2 or the Emotion mask below the ErgoMask, randomized on 3 consecutive days. Also, menstrual cycle status was monitored to avoid possible intrasubject alterations. The results showed lower values for the ErgoMask+FFP2, compared to ErgoMask or ErgoMask+Emotion, in forced vital capacity (3.8 ± 0.2, 4.5 ± 0.2 and 4.1 ± 0.1 l, respectively); forced expiratory volume in 1 s (3.3 ± 0.2, 3.7 ± 0.2 and 3.5 ± 0.1 l); ventilation (40.9 ± 1.5, 50.6 ± 1.5 and 46.9 ± 1.2 l/min); breathing frequency (32.7 ± 1.1, 37.4 ± 1.1 and 35.3 ± 1.4 bpm); VE/VO2 (30.5 ± 0.7, 34.6 ± 0.9 and 33.6 ± 0.7); VE/VCO2 (32.2 ± 0.6, 36.2 ± 0.9 and 34.4 ± 0.7) and time to exhaustion (492.4 ± 9.7, 521.7 ± 8.6 and 520.1 ± 9.5 s) and higher values in inspiratory time (0.99 ± 0.04, 0.82 ± 0.03 and 0.88 ± 0.03 s). In conclusion, in young healthy female athletes, the Emotion showed better preservation of cardiopulmonary responses than the FFP2.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effect of Different Types of Face Masks on the Ventilatory and Cardiovascular Response to Maximal-Intensity Exercise

Rojo-Tirado

Benítez-Muñoz

Alcocer-Ayuga

et al. 2021

Biology

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Physical interventions to interrupt or reduce the spread of respiratory viruses

Jefferson

Dooley

Ferroni

et al. 2023

Cochrane Database of Systematic Reviews

156

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Background Viral epidemics or pandemics of acute respiratory infections (ARIs) pose a global threat. Examples are influenza (H1N1) caused by the H1N1pdm09 virus in 2009, severe acute respiratory syndrome (SARS) in 2003, and coronavirus disease 2019 (COVID‐19) caused by SARS‐CoV‐2 in 2019. Antiviral drugs and vaccines may be insufficient to prevent their spread. This is an update of a Cochrane Review last published in 2020. We include results from studies from the current COVID‐19 pandemic. Objectives To assess the effectiveness of physical interventions to interrupt or reduce the spread of acute respiratory viruses. Search methods We searched CENTRAL, PubMed, Embase, CINAHL, and two trials registers in October 2022, with backwards and forwards citation analysis on the new studies. Selection criteria We included randomised controlled trials (RCTs) and cluster‐RCTs investigating physical interventions (screening at entry ports, isolation, quarantine, physical distancing, personal protection, hand hygiene, face masks, glasses, and gargling) to prevent respiratory virus transmission. Data collection and analysis We used standard Cochrane methodological procedures. Main results We included 11 new RCTs and cluster‐RCTs (610,872 participants) in this update, bringing the total number of RCTs to 78. Six of the new trials were conducted during the COVID‐19 pandemic; two from Mexico, and one each from Denmark, Bangladesh, England, and Norway. We identified four ongoing studies, of which one is completed, but unreported, evaluating masks concurrent with the COVID‐19 pandemic. Many studies were conducted during non‐epidemic influenza periods. Several were conducted during the 2009 H1N1 influenza pandemic, and others in epidemic influenza seasons up to 2016. Therefore, many studies were conducted in the context of lower respiratory viral circulation and transmission compared to COVID‐19. The included studies were conducted in heterogeneous settings, ranging from suburban schools to hospital wards in high‐income countries; crowded inner city settings in low‐income countries; and an immigrant neighbourhood in a high‐income country. Adherence with interventions was low in many studies. The risk of bias for the RCTs and cluster‐RCTs was mostly high or unclear. Medical/surgical masks compared to no masks We included 12 trials (10 cluster‐RCTs) comparing medical/surgical masks versus no masks to prevent the spread of viral respiratory illness (two trials with healthcare workers and 10 in the community). Wearing masks in the community probably makes little or no difference to the outcome of influenza‐like illness (ILI)/COVID‐19 like illness compared to not wearing masks (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84 to 1.09; 9 trials, 276,917 participants; moderate‐certainty evidence. Weari...

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Sports despite masks: no negative effects of FFP2 face masks on cardiopulmonary exercise capacity in children

Weigelt,

Schöffl,

Rottermann

et al. 2023

Eur J Pediatr

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Face masks were recognized as one of the most effective ways to prevent the spread of the COVID-19 virus in adults. These benefits were extended to children and adolescents. However, the fear of negative consequences from wearing a face mask during physical exercise led to cancellations of physical education lessons. This further decreased the amount of physical activity available to children and adolescents during the pandemic. However, there is little published data on the potential adverse effects of wearing the most effective and partially mandatory FFP2/N95 face masks during PE or physical activity (PA) in this age. Even though the pandemic has been declared as passed by the WHO, the rise of a new pandemic and thus the use of face masks for limiting its spread is inevitable, so we need to be better prepared for alternative options to lockdown and limitation of PA in such a scenario. Twenty healthy children aged 8–10 years performed two identical cardiopulmonary exercise tests as an incremental step test on a treadmill within an interval of 2 weeks, one time without wearing a protective mask and one time wearing an FFP2 mask. The cardiopulmonary exercise parameter and especially the end-expiratory gas exchange for oxygen and carbon dioxide (petO2 and petCO2) were documented for each step, at rest and 1 min after reaching physical exhaustion. Twelve boys (mean age 8.5 ± 1.4 years) and 8 girls (mean age 8.8 ± 1.4 years) showed no adverse events until maximal exertion. The mean parameters measured at peak exercise did not differ significantly between both examinations (mean peak VO2 = 42.7 ± 9.5 vs 47.8 ± 12.9 ml/min/kg, p = 0.097, mean O2pulse 7.84 ± 1.9 ml/min vs. 6.89 ± 1.8, p = 0.064, mean VE/VCO2slope 33.4 ± 5.9 vs. 34.0 ± 5.3, p = 0.689). The only significant difference was the respiratory exchange rate (RER, 1.01 ± 0.08 vs 0.95 ± 0.08, p = 0.004). The measured respiratory gases (end-tidal O2 and CO2) decreased and respectively increased significantly in almost every step when wearing an FFP2 mask. However, these levels were well below hypercapnia and above hypoxia.Conclusion: In this study, no significant differences in the cardiorespiratory function at peak exercise could be discerned when wearing an FFP2/N95 face mask. While the end-tidal values for CO2 increased significantly and the end-tidal values for O2 decreased significantly, these values did never reach levels of hypercapnia or hypoxia. Furthermore, the children terminated the exercise at a lower RER and heart rate (HR) suggesting a subconscious awareness of the higher strain. Since the detrimental effects of limiting sports during the pandemic are well documented, stopping PE lessons altogether because of the minor physiological effects of wearing these masks instead of simply stopping pushing children to perform at their best seems premature and should be reconsidered in the future. What is Known:• Wearing a face mask has an influence on psychological, social, and physiological functions in adults.• Because of the observed effects of wearing face masks in adults, physical activity in children was limited during the pandemic. What is New:• Wearing an FFP2/N95 mask during physical activity did not lead to hypercapnia or hypoxia in children in this study.• Even though end-tidal CO2 values were significantly higher and end-tidal O2 values significantly lower when wearing an FFP2/N95 face mask, no pathological values were reached.

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Effects of face masks on performance and cardiorespiratory response in well-trained athletes

Cited by 30 publications

References 30 publications

Effect of Different Types of Face Masks on the Ventilatory and Cardiovascular Response to Maximal-Intensity Exercise

Effect of Different Types of Face Masks on the Ventilatory and Cardiovascular Response to Maximal-Intensity Exercise

Physical interventions to interrupt or reduce the spread of respiratory viruses

Sports despite masks: no negative effects of FFP2 face masks on cardiopulmonary exercise capacity in children

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