Performing moderate to severe activity is safe and tolerable for healthy youth while wearing a cloth facemask

Marticorena, Felipe Miguel; Barreto, Gabriel Castanho; Guardieiro, Natália Mendes; Esteves, Gabriel Perri; Oliveira, Tamires Nunes; Oliveira, Luana Farias de; Pinto, Ana Lúcia de Sá; Riani, Luiz; Prado, Danilo Mendes; Saunders, Bryan; Gualano, Bruno

doi:10.1371/journal.pone.0282475

Cited by 4 publications

(10 citation statements)

References 31 publications

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“…Additionally, the fact that wearing a face mask during exercise did not cause major physiological or perceptual impacts in healthy children reinforces our findings. 6 Also, face masks were fitted as tightly as possible, but inaccuracies in measurements owing to air escaping cannot be ruled out.…”

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confidence: 99%

“…Despite important physiological differences between healthy children and adults during exercise, 5 we recently demonstrated that performing moderate to severe exercise while wearing a face mask is safe and tolerable for healthy youth, with no major impacts on cardiovascular, respiratory, and perceptual parameters during exercise. 6 This is further reinforced by a study that investigated face mask use in youth ice-hockey players, showing no impairment in performance, heart rate and oxygen saturation. 7 To our knowledge, however, there are no studies involving youth with obesity.…”

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confidence: 99%

“…Participants performed an initial visit in which they underwent an incremental, maximal cardiopulmonary exercise (CPX) test aimed at determining V ̇O2peak and ventilatory thresholds, as previously described. 6 The remaining two main visits consisted of a progressive square-wave test (PSWT) performed with or without the use of a triple-layered antiviral cloth face mask (Fashion Masks, São Paulo, Brazil), in a randomized fashion. This face mask was chosen because it is widely accessible, recommended to the general public by the CDC and appropriate for exercise (https://www.cdc.gov/coronavirus/2019-ncov/preventgetting-sick/cloth-face-cover-guidance.html).…”

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confidence: 99%

“…Details on outcome measures are thoroughly described elsewhere. 6 Statistical analysis was performed using repeated measures mixed models, in which mask (Mask, No-mask) and exercise intensity (Rest, 80%VAT, VAT, 40%Δ, Peak) were considered as fixed factors, with a mask*exercise intensity interaction added to the model, and participants considered as random factors. Spirometry variables and time to exhaustion were analyzed with a fixed factor for mask and a random factor for participants, and had mean differences (Mask vs.…”

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confidence: 99%

“…3 During unmitigated stages of the pandemic, this tool was shown to be useful to circumvent the spread of the disease and to prevent individuals with debilitating conditions to be infected. The adverse effects anecdotally attributed to wearing a face mask during exercise, such as extreme shortness of breath, insufficient supply of oxygen, and other hemodynamic alterations, have been consistently refuted in several populations, 4,6,9 which reinforces the safety of mask usage during exercise. Nonetheless, the concern remains that wearing a mask during exercise, particularly at higher intensities, could further deteriorate cardiorespiratory responses in groups with pre-existing health conditions.…”

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confidence: 99%

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Cloth masks during exercise are safe and tolerable for children with overweight and obesity

Esteves

Novelli

Meletti

et al. 2023

Pediatric Pulmonology

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mentioning

confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Cloth masks during exercise are safe and tolerable for children with overweight and obesity

Esteves

Novelli

Meletti

et al. 2023

Pediatric Pulmonology

Self Cite

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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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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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Performing moderate to severe activity is safe and tolerable for healthy youth while wearing a cloth facemask

Cited by 4 publications

References 31 publications

Cloth masks during exercise are safe and tolerable for children with overweight and obesity

Cloth masks during exercise are safe and tolerable for children with overweight and obesity

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

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