Effects of surgical facemasks on perceived exertion during submaximal exercise test in healthy children

Reychler, Grégory; Standaert, Marie; Audag, Nicolas; Caty, Gilles; Robert, Annie; Poncin, William

doi:10.1007/s00431-022-04430-x

Cited by 6 publications

(7 citation statements)

References 27 publications

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“…Interestingly, the children in this study could not tell, which test had been more strenuous and many even asked which one should have been more strenuous. This is in concordance with previous studies in children, in which cloth face-masks did not affect ratings of perceived exertion during a progressive square-wave test [36] or during a submaximal sit-to-stand test [37]. So far, the only studies investigating the impact of wearing FFP2/N95 face masks on exercise tolerance have been limited to adults with higher degrees of rating of perceived exertion, dyspnea, fatigue, and thermal sensation [17; 27-30; 33; 45].…”

Section: Discussionsupporting

confidence: 93%

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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

Preprint

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Introduction: Face masks were recognized as one of the most effective ways for preventing the spread of the COVID-19-virus in adults, the benefits of wearing those were extended to children and adolescents and led to limited physical education (PE) lessons or cancellation of them. 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 on 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 prepared in a better way for alternative options to lockdown and limitation of PA in such a scenario. Material and Methods 20 healthy children aged 8–10 years performed two identical cardiopulmonary exercise tests as an incremental step test on a treadmill within an interval of two weeks, one time without wearing a protective mask and one time wearing a FFP2 mask. The cardiopulmonary exercise parameter and especially the endexpiratory gas exchange for oxygen and carbon dioxide (petO2 and petCO2) were documented for each step, at rest and 1 minute after reaching physical exhaustion. Results 12 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, mean O2pulse 7.84 ± 1.9 ml/min vs. 6.89 ± 1.8, mean VE/VCO2slope 33.4 ± 5.9 vs. 34.0 ± 5.3). The most significant difference was the respiratory exchange rate (RER, 1.01 ± 0.08 vs 0.95 ± 0.08). The measured respiratory gases (end tidal O2 and CO2) decreased respectively increased significantly into nearly each step wearing an additional FFP2-mask without reaching levels of hypercapnia or hypoxia. Conclusion In this study, no significant differences of the cardiorespiratory function at peak exercise could be discerned when wearing a 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 pathological levels. 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 wearing these masks instead of simply stopping pushing children to perform at their best seems premature and should be reconsidered in the future.

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Section: Discussionsupporting

confidence: 93%

“…So far, no effects on SpO 2 or retention of carbon dioxide (CO 2 ) could be observed during treadmill running [35]. Nor were there any differences in lung function tests or perceived exertion during square-wave-tests [36] or sit-to-stand tests [37].…”

Section: Introductionmentioning

confidence: 99%

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

Weigelt

Schöffl

Rottermann

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Interestingly, the children in this study could not tell, which test had been more strenuous and many even asked which one should have been more strenuous. This is in concordance with previous studies in children, in which cloth face masks did not affect ratings of perceived exertion during a progressive square-wave test [ 36 ] or during a submaximal sit-to-stand test [ 37 ]. So far, the only studies investigating the impact of wearing FFP2/N95 face masks on exercise tolerance have been limited to adults with higher degrees of rating of perceived exertion, dyspnea, fatigue, and thermal sensation [ 17 , 27 – 30 , 33 , 46 ].…”

Section: Discussionsupporting

confidence: 93%

“…So far, no effects on SpO 2 or retention of carbon dioxide (CO 2 ) could be observed during treadmill running [ 35 ]. Nor were there any differences in lung function tests or perceived exertion during square-wave tests [ 36 ] or sit-to-stand tests [ 37 ].…”

Section: Introductionmentioning

confidence: 99%

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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“…As described in the previous section, we should consider the accumulation of contaminated droplets for long periods and their release as aerosols. Children's modified Borgi score, an indicator of breath shortness, was significantly increased by the simple exercise with surgical mask compared to not wearing a mask ( 93 ).…”

Section: Mask Rules (Mandate): Review Of Side Effectsmentioning

confidence: 99%

Lessons from the health policies for children during the pandemic in Japan

Shobako

2022

Front. Public Health

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It is everyone's desire to seek the sound growth of children through food education and there is a critical need for fostering an environment for this purpose. Health policies are important for this support. To the present, the Japanese society has been greatly disrupted by COVID-19 pandemic. “Stay at home”, “mokusyoku (silent eating)”, and mask wearing were encouraged in nationwide campaigns as public health measures to combat COVID-19. There are some papers reporting negative effects of “stay at home” and lockdowns such as weight gain, decrease in physical activities and change in eating habits. In Japan, while benefits and advantages of food education during mealtime were previously well studied, the “mokusyoku” rule may directly run counter to this food education. Moreover, there are several reports showing that nutrients might contribute to prevention of infectious diseases. Japanese children were also encouraged to wear masks all day long. The results of the clinical research, especially randomized control trials, show limited protective effect of masks. On the other hand, negative outcomes of the masks were reported in various scenes. This review focuses on these topics and arousing reconsideration for a better environment for children.

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Effects of surgical facemasks on perceived exertion during submaximal exercise test in healthy children

Cited by 6 publications

References 27 publications

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

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

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

Lessons from the health policies for children during the pandemic in Japan

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