Impact of Face Masks on Exercise Capacity and Lactate Thresholds in Healthy Young Adults

Abstract

Background: Although many countries have introduced strict guidelines regarding mouth and nose coverage in public to contain infection rates during the SARS-CoV-2 pandemic, more information is needed regarding the impact of wearing face masks on lactate thresholds (LT) and performance parameters during exercise. Methods: Ten healthy male and 10 healthy female subjects (age = 33.4 [10.26] y, body mass index = 23.52 [2.36] kg/m2) performed 3 incremental performance tests, wearing no mask (NM), surgical mask (SM), and filtering face piece mask class 2 (FFP2), with a cycle ergometer. The authors analyzed changes in the LT, in blood gas parameters, and in the rating of perceived exertion (RPE). Results: Performance at LT remained unchanged in subjects wearing SM or FFP2 in comparison with NM (162.5 [50.6] vs 167.2 [58.9] vs 162.2 [58.4] W with NM, SM, and FFP2, respectively, P = .24). However, the peak performance was significantly reduced wearing FFP2 compared with NM (213.8 [71.3] vs 230.5 [77.27] W, FFP2 vs NM, respectively, P < .001). Capillary pCO2 was increased while wearing SM as well as FFP2 compared with NM (29 [3.1] vs 33.3 [4] vs 35.8 [4.9] mmHg with NM, SM, and FFP2, respectively; P < .001), and pO2 decreased under maximum performance (84 [6.7] vs 79.1 [7.5] vs 77.3 [8.2] mmHg with NM, SM, and FFP2, P < .01). Importantly, rating of perceived exertion was significantly increased by wearing FFP2 compared with NM at LT according to Mader (16.7 [2.7] vs 15.3 [1.8] FFP2 vs NM, respectively, P < .01). Conclusion: Wearing face masks during exercise showed no effect on LT, limited maximum performance, and induced discrete changes in capillary pCO2 and pO2 within the physiologic range while increasing RPE at LT.

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 ].…”

“…When considering the exercise type, a significant reduction was noted in the V O 2 in both progressive (SMD − 0.68, 95% CI − 0.93 to − 0.43; p < 0.01, I 2 = 48%) and steady-state (SMD − 0.57, 95% CI − 0.94 to − 0.21; p < 0.01, I 2 = 21%) exercise (Table 2 ). Six studies reported on variations in PetO 2 [ 3 , 37 , 39 , 43 , 48 , 59 ]. In the meta-analysis, a significant reduction in PetO 2 was observed in those wearing surgical masks (MD − 3.17 mmHg, 95% CI − 4.87 to − 1.47; p < 0.01, I 2 = 0%), FFP2/N95 respirators (MD − 5.10 mmHg, 95% CI − 9.27 to − 0.94; p = 0.02, I 2 = 44%), and total effect (MD − 3.79 mmHg, 95% CI − 5.46 to − 2.12; p < 0.01, I 2 = 21%), as shown in Fig.…”

“…4 a) (SMD − 0.74 and SMD − 0.77, respectively). Additionally, 13 studies reported PetCO 2 [ 13 – 15 , 29 , 37 , 39 , 43 , 48 , 52 , 55 , 56 , 58 , 59 ]. From the meta-analysis, a significant increase in PetCO 2 was observed in the total effect (MD 2.93 mmHg, 95% CI 2.01 to 3.86; p < 0.01, I 2 = 65%) and in those wearing surgical masks (MD 2.32 mmHg) and FFP2/N95 respirators (MD 3.44 mmHg) (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 ].…”

Face Masks at the Gymnasium: Physiological Responses and Mechanical Performance Are Not Compromised by Wearing Surgical or Filtering Facepiece 2 Masks in Healthy Subjects

“…Despite the proven effectiveness of face masks against infection transmission, there is also a perception that masks are uncomfortable to wear while exercising and come with a reduction in ventilation and cardiopulmonary exercise capacity (7,15). A recent study suggested that both the use of surgical and FFP2 masks produced discrete reductions in capillary CO 2 and O 2 partial pressure and a greater rate of perceived exertion (RPE) on lactate thresholds during incremental cycling tests (23). Furthermore, FFP2 masks have been shown to compromise maximum oxygen uptake and maximum power output to a greater extent than the surgical mask (7).…”