Letter to the editors referring to Fikenzer, S., Uhe, T., Lavall, D., Rudolph, U., Falz, R., Busse, M., Hepp, P., &amp; Laufs, U. (2020). Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clinical Research in Cardiology

Petru, Raluca; Ochmann, Uta; Nowak, Dennis

doi:10.1007/s00392-020-01735-5

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…Continuous physical activity is only possible if the exercise intensity does not exceed the anaerobic threshold. According to previous studies, the endurance threshold for an 8-h shift of heavy manual occupational labor is 33%–40% of an individual’s maximum oxygen uptake [ 5 ]. Even in physically highly demanding occupational tasks, the ventilatory threshold of an individual was only exceeded for short periods at 35–69% of maximal oxygen uptake [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Wearing Face Masks on Exercise Capacity and Ventilatory Anaerobic Threshold in Healthy Subjects During the COVID-19 Epidemic

Lin

Cai

et al. 2022

Med Sci Monit

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Background Face masks have become an important part of the COVID-19 prevention approach. This study aimed to explore the effect of wearing masks on exercise ability and ventilatory anaerobic threshold (VAT). Material/Methods Thirty-four young, healthy volunteers were included in this study, consisting of 18 men and 16 women. The subjects were randomized to perform 2 cardiopulmonary exercise tests (CPET) on a cycle ergometer with gas exchange analysis, one with and another without wearing a face mask (cross-over design). The general data for all subjects and indicators from the 2 exercise tests performed with and without wearing a face mask were collected. Results In cardiopulmonary exercise tests, wearing a mask significantly ( P <0.05) decreased peak indexes (eg, work rate (WR), oxygen consumption per kg body weight (VO 2 /kg), heart rate (HR), ventilation per minute (VE) and carbon dioxide ventilation equivalent (VE/VCO 2 )) and anaerobic threshold indexes (eg, WR, HR, VE, breath frequency (BF), dead space ratio (VD/VT), and VE/VCO 2 ). However, the PETCO 2 at peak was significantly higher. There was a positive linear correlation between WR difference and VO 2 difference at VAT (abbreviated as δWR@VAT and δVO 2 @VAT, respectively) (r=0.495, P =0.003). Subgroup analysis of the VAT indexes showed that WR, VO 2 /kg, and VE were significantly decreased in the advanced VAT group with mask compared with the stable VAT group with mask ( P <0.05). Logistic regression showed that δVE, δBF, and δVE/VCO 2 had independent influences on VAT. Conclusions Wearing masks advances VAT in healthy young subjects during CPET. The advanced VAT was associated with changes in VE, BF, and VE/VCO 2 while wearing masks.

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Section: Introductionmentioning

confidence: 99%

Effects of Wearing Face Masks on Exercise Capacity and Ventilatory Anaerobic Threshold in Healthy Subjects During the COVID-19 Epidemic

Lin

Cai

et al. 2022

Med Sci Monit

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Limitations in evaluating COVID-19 protective face masks using open circuit spirometry systems: respiratory measurement mask introduces bias in breathing pressure and perceived respiratory effort

et al. 2023

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Objective: In response to the COVID-19 pandemic and the resulting widespread use of protective face masks, studies have been and are being conducted to investigate potential side effects of wearing masks on the performance and physiological parameters of wearers. The purpose of the present study is to determine whether and to what extent the use of a respiratory measurement mask - which is normally used during open-circuit spirometry - influences the results of these types of studies. Approach: 34 subjects were involved in this intra-subject study with a cross-over design. Four different protective face masks, Community Mask, medical Mouth-Nose-Protection Mask, Filtering Face Piece Mask Class 2 (FFP2), and FFP2 with exhalation valve (FFP2ex), were tested at rest and during deep breathing by using or not using a respiratory measurement mask (RM vs. noRM). Breathing pressure inside the protective face masks was measured during inhalation and exhalation, and subjects rated breathing effort using an 11-stage Borg scale. Main results: The use of an additional respiratory measurement (RM) mask - worn over the protective face masks - significantly increased inspiratory pressures under all mask conditions. The respiratory pressure rises to a level that substantially distorts the results. Expiratory pressure was also significantly increased except for the FFP2ex mask condition. The perceived respiratory effort was significantly increased by 1.0 to 2.8 steps on the Borgs scale for all mask conditions compared with noRM. Significance: We strongly recommend avoiding the use of respiratory measurement masks for evaluating the effects of protective face masks on human physiology and subjective perception.

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Effects of Face Masks on Physical Performance and Physiological Response during a Submaximal Bicycle Ergometer Test

Steinhilber

Seibt

Gabriel

et al. 2022

IJERPH

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The ongoing COVID-19 pandemic requires wearing face masks in many areas of our daily life; hence, the potential side effects of mask use are discussed. Therefore, the present study explores whether wearing a medical face mask (MedMask) affects physical working capacity (PWC). Secondary, the influence of a filtering facepiece mask with exhalation valve class 2 (FFP2exhal) and a cotton fabric mask (community mask) on PWC was also investigated. Furthermore, corresponding physiological and subjective responses when wearing face masks as well as a potential moderating role of subjects’ individual cardiorespiratory fitness and sex on face mask effects were analyzed. Thirty-nine subjects (20 males, 19 females) with different cardiorespiratory fitness levels participated in a standardized submaximal bicycle ergometer protocol using either a MedMask, FFP2exhal, community mask, or no mask (control) on four days, in randomized order. PWC130 and PWC150 as the mechanical load at the heart rates of 130 and 150 beats per minute were measured as well as transcutaneous carbon dioxide partial pressure, saturation of peripheral capillary oxygen, breathing frequency, blood pressure, perceived respiratory effort, and physical exhaustion. Using the MedMask did not lead to changes in PWC or physiological response compared to control. Neither appeared changes exceeding normal ranges when the FFP2exhal or community mask was worn. Perceived respiratory effort was up to one point higher (zero-to-ten Likert scale) when using face masks (p < 0.05) compared to control. Sex and cardiorespiratory fitness were not factors influencing the effects of the masks. The results of the present study provide reason to believe that wearing face masks for infection prevention during the COVID-19 pandemic does not pose relevant additional physical demands on the user although some more respiratory effort is required.

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Letter to the editors referring to Fikenzer, S., Uhe, T., Lavall, D., Rudolph, U., Falz, R., Busse, M., Hepp, P., & Laufs, U. (2020). Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clinical Research in Cardiology

Cited by 3 publications

References 6 publications

Effects of Wearing Face Masks on Exercise Capacity and Ventilatory Anaerobic Threshold in Healthy Subjects During the COVID-19 Epidemic

Effects of Wearing Face Masks on Exercise Capacity and Ventilatory Anaerobic Threshold in Healthy Subjects During the COVID-19 Epidemic

Limitations in evaluating COVID-19 protective face masks using open circuit spirometry systems: respiratory measurement mask introduces bias in breathing pressure and perceived respiratory effort

Effects of Face Masks on Physical Performance and Physiological Response during a Submaximal Bicycle Ergometer Test

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