Effects of Surgical Masks on Cardiopulmonary Function in Healthy Subjects

Li, Mei; Ou, Haining; Li, Qinyi; Liang, Jianying; Liao, Wei-Hao; Lang, Shijuan; Chen, Hongxin; Wang, Yafei; Tang, Kun; Lin, Qiang; Zheng, Yuxin

doi:10.3791/62121

Cited by 16 publications

(19 citation statements)

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“…In accordance, while masking exerts a negative impact on several ventilatory parameters during moderate exercise, this effect increases when cycling within the severe intensity domain—ultimately limiting VO 2peak and time to exhaustion. These findings extend those of previous studies showing that, in healthy young people, the use of surgical masks affects the physiological responses to GXT and constant exercise at a work rate compatible with maximal lactate steady state (Egger et al, 2021 ; Fikenzer et al, 2020 ; Lassing et al, 2020 ; Li et al, 2021 ; Mapelli et al, 2021 ).…”

Section: Discussionsupporting

confidence: 87%

Effects of surgical masks on the responses to constant work‐rate cycling performed at different intensity domains

Jesus

Gomes

Gonçalves

et al. 2021

Clin Physio Funct Imaging

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We aimed at examining the impact of wearing surgical face masks on exercise performance. Thirty‐two healthy adults (16 males and 16 females) completed a graded exercise test to measure peak oxygen uptake (VO 2peak ) and the ventilatory threshold (VT). Then, on separate days, all participants performed resting and standardized protocols (moderate intensity: 25% infra‐VT; severe intensity: 25% supra‐VT) on two different conditions (with and without a surgical mask). The use of masks reduced both VO 2 and minute ventilation during moderate and severe exercise ( p < 0.0001), and this effect was particularly pronounced during severe exercise. Time to exhaustion was also shortened by ~10% on the face mask condition ( p = 0.014). In contrast, neither heart rate nor the respiratory exchange ratio was affected by masking. The submaximal VO 2 was similar between the two epochs of analysis obtained during moderate cycling (i.e. 3–6 min vs. 7–10 min) and this occurred similarly between conditions. In conclusion, the impact of the surgical masks on exercise capacity is particularly pronounced during severe exercise performed at constant work rate. Ultimately, this may implicate a considerable impairment of structured or even unstructured strenuous physical activity. Clinical Trials registration number: NCT04963049.

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Section: Discussionsupporting

confidence: 87%

Effects of surgical masks on the responses to constant work‐rate cycling performed at different intensity domains

Jesus

Gomes

Gonçalves

et al. 2021

Clin Physio Funct Imaging

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“…When placing a rubber mask for assessing ventilation over a surgical mask, this seal is lost and air most likely escapes, resulting in lower ventilation measures. A number of studies found marked reductions in ventilation while wearing a surgical mask during maximal cycle ergometry testing but with no significant differences in maximal work rate, supporting this theory (Fikenzer et al, 2020;Li et al, 2021;Mapelli et al, 2021).…”

Section: Discussionmentioning

confidence: 90%

“…For example, measuring arterial oxygen saturation with pulse oximetry is quite variable, end-tidal CO2 is a crude estimate of alveolar CO2, and most studies estimated arterial CO2 levels with transcutaneous measurements, and would not be as accurate as direct measures of blood gases. Ventilation, tidal volume, and respiratory rate may be difficult to measure while wearing a face mask because it necessitates either wearing a mask for breath collection over the face mask (Fikenzer et al, 2020;Lässing et al, 2020;Li et al, 2021;Mapelli et al, 2021) or insertion of a cannula into the nose underneath the face mask (Epstein et al, 2020). This may affect the normal functioning of a face mask during exercise (e.g., wearing a breath-collection mask over a face mask might effectively seal the face mask to the face and not allow air to escape the sides of the mask).…”

Section: Discussionmentioning

confidence: 99%

The Impact of Face Masks on Performance and Physiological Outcomes during Exercise: A Systematic Review and Meta-analysis

Shaw

Zello

Butcher

et al. 2021

Preprint

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Face masks are promoted for preventing spread of viruses; however, wearing a mask during exercise might increase CO2 rebreathing, decrease arterial oxygenation, and decrease exercise performance. A systematic review and meta-analysis was conducted on the impact of wearing a mask during exercise. Data sources included SPORTDiscus, PubMed, and Medline. Eligibility criteria included all study designs comparing surgical, N95, or cloth masks to a no mask condition during any type of exercise where exercise performance and/or physiological parameters were evaluated. Healthy and clinical participants were included. Mean differences (MD) or standardized mean differences (SMD) with 95% confidence intervals were calculated and pooled effects assessed. Twenty-two studies involving 1,573 participants (620 females, 953 males) were included. Surgical, or N95 masks did not impact exercise performance (SMD −0.05 [-0.16,0.07] and −0.16 [-0.54,0.22], respectively) but increased ratings of perceived exertion (RPE) (SMD 0.33 [0.09,0.58] and 0.61 [0.23,0.99]) and dyspnea (SMD 0.6 [0.3,0.9] for all masks). End-tidal CO2 (MD 3.3 [1.0, 5.6] and 3.7 [3.0,4.4] mmHg), and heart rate (MD 2 [0,4] beats/min with N95 masks) slightly increased. Face masks can be worn during exercise with no influences on performance and minimal impacts on physiological variables.PROSPERO RegistrationCRD42020224988Novelty PointsFace masks can be worn during exercise with no impacts on performance and minimal impacts on physiological variables.

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“…For example, measuring arterial oxygen saturation with pulse oximetry is quite variable, end-tidal CO 2 is a crude estimate of alveolar CO 2 , and most studies estimated arterial CO 2 levels with transcutaneous measurements, and would not be as accurate as direct measures of blood gases. Ventilation, tidal volume, and respiratory rate may be difficult to measure while wearing a face mask because it necessitates either wearing a mask for breath collection over the face mask (Fikenzer et al, 2020;Lässing et al, 2020;Li et al, 2021;Mapelli et al, 2021) or insertion of a cannula into the nose underneath the face mask (Epstein et al, 2020). This may affect the normal functioning of a face mask during exercise (e.g., wearing a breath-collection mask over a face mask might effectively seal the face mask to the face and not allow air to escape the sides of the mask).…”

Section: Discussionmentioning

confidence: 99%

The impact of face masks on performance and physiological outcomes during exercise: a systematic review and meta-analysis

Shaw

Zello

Butcher

et al. 2021

Appl. Physiol. Nutr. Metab.

104

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Face masks are promoted for preventing spread of viruses; however, wearing a mask during exercise might increase CO2 rebreathing, decrease arterial oxygenation, and decrease exercise performance. A systematic review and meta-analysis was conducted on the impact of wearing a mask during exercise. Data sources included SPORTDiscus, PubMed, and Medline. Eligibility criteria included all study designs comparing surgical, N95, or cloth masks to a no mask condition during any type of exercise where exercise performance and/or physiological parameters were evaluated. Healthy and clinical participants were included. Mean differences (MD) or standardized mean differences (SMD) with 95% confidence intervals were calculated and pooled effects assessed. Twenty-two studies involving 1573 participants (620 females, 953 males) were included. Surgical, or N95 masks did not impact exercise performance (SMD −0.05 [−0.16, 0.07] and −0.16 [−0.54, 0.22], respectively) but increased ratings of perceived exertion (SMD 0.33 [0.09, 0.58] and 0.61 [0.23, 0.99]) and dyspnea (SMD 0.6 [0.3, 0.9] for all masks). End-tidal CO2 (MD 3.3 [1.0, 5.6] and 3.7 [3.0, 4.4] mm Hg), and heart rate (MD 2 [0,4] beats/min with N95 masks) slightly increased. Face masks can be worn during exercise with no influences on performance and minimal impacts on physiological variables. PROSPERO registration: CRD42020224988. Novelty: Face masks can be worn during exercise with no impacts on performance and minimal impacts on physiological variables.

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Effects of Surgical Masks on Cardiopulmonary Function in Healthy Subjects

Cited by 16 publications

References 0 publications

Effects of surgical masks on the responses to constant work‐rate cycling performed at different intensity domains

Effects of surgical masks on the responses to constant work‐rate cycling performed at different intensity domains

The Impact of Face Masks on Performance and Physiological Outcomes during Exercise: A Systematic Review and Meta-analysis

The impact of face masks on performance and physiological outcomes during exercise: a systematic review and meta-analysis

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