The intraocular pressure response to lower‐body and upper‐body isometric exercises is affected by the breathing pattern

Vera, Jesús; Redondo, Beatríz; Pérez-Castilla, Alejandro; Koulieris, George Alex; Jiménez, Raimundo; García-Ramos, Amador

doi:10.1080/17461391.2020.1790670

Cited by 12 publications

(22 citation statements)

References 46 publications

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“…Regarding IOP, Najmanová et al (2019) [17] found a negative relationship between oxygen saturation and IOP levels during extreme normobaric hypoxia exposure. Also, the manipulation of the breathing pattern adopted during resistance training has demonstrated to alter the IOP behavior, observing a heightened IOP rise when the interchange of gases is compromised [11,12]. Based on this, it is plausible that the alteration of gas concentration and the increased breathing resistance with face masks are responsible for the higher IOP values obtained in the FFP2/N95 mask condition, although further studies are needed to determine the physiological mechanisms responsible for these effects.…”

Section: Discussionmentioning

confidence: 99%

“…The execution of low-intensity endurance exercise (e.g., walking, jogging, or cycling) has an IOP-lowering effect, which is highly recommended in glaucoma patients [9,10]. However, recent investigations suggest that restricting the exchange of gases during resistance training exercises promotes an acute IOP rise [11,12]. In addition, there are claims that face masks reduce cardiopulmonary exercise capacity and increase subjective breathing resistance, with these effects being more pronounced with FFP2/N95 in comparison to surgical masks [13,14].…”

Section: Introductionmentioning

confidence: 99%

“…Based on the widespread use of face masks due to the COVID-19 pandemic and the lack of research in this regard, we designed a randomized clinical trial to determine the IOP responses to low-intensity endurance exercise (400-m walking) while wearing surgical and FFP2/N95 masks in primary open-angle glaucoma (POAG) patients. Considering the increments in IOP values reported in previous studies when the breathing pattern was restricted during the execution of resistance training exercises [11,12] or under hypoxic and hypercapnic conditions [17,18], we hypothesized that wearing face masks during walking would counteract the IOP-lowering effect frequently observed while performing low-intensity endurance exercises [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Intraocular pressure responses to walking with surgical and FFP2/N95 face masks in primary open-angle glaucoma patients

Janićijević

Redondo

Jiménez

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose The use of face mask is globally recommended as a preventive measure against COVID-19. However, the intraocular pressure (IOP) changes caused by face masks remain unknown. The objective of this study was to assess the impact of wearing surgical and FFP2/N95 face masks during a 400-m walking protocol on IOP in primary open-angle glaucoma (POAG) patients. Methods Thirteen subjects diagnosed of POAG (21 eyes) were enrolled in this study. IOP was measured at baseline, during the 400-m walking protocol and after 5 min of passive recovery while POAG patients wore a surgical mask, FFP2/N95 mask and no mask in randomized order. From the 21 POAG eyes, we analyzed the IOP changes caused by physical exercise with two face masks and without wearing any face mask. Results At rest (baseline and recovery measurements), the use of the different face masks did not affect IOP levels (mean differences ranging from 0.1 to 0.6 mmHg). During physical activity, wearing an FFP2/N95 mask caused a small (mean differences ranging from 1 to 2 mmHg), but statistically significant, IOP rise in comparison to both the surgical mask and control conditions (Cohen’s d = 0.63 and 0.83, respectively). Conclusion Face masks must be used to minimize the risk of SARS-CoV-2 transmission, and POAG patients can safely use FFP2/N95 and surgical masks at rest. However, due to the IOP rise observed while walking with the FFP2/N95 mask, when possible, POAG patients should prioritized the use of surgical masks during physical activity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intraocular pressure responses to walking with surgical and FFP2/N95 face masks in primary open-angle glaucoma patients

Janićijević

Redondo

Jiménez

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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“…Vera et al advised the participants to keep a constant pattern of breathing during the hold while our participants were allowed to perform the test with the regular breathing technique. 49 50 Here, the participants were performing lifts that were very close to their maximal effort, and the chances of failure (of the rep) were high. So long that the participants performed the repetition with good form, they were not told how to breathe during the exercise.…”

Section: Discussionmentioning

confidence: 99%

Intraocular pressure fluctuation during resistance exercise

et al. 2021

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ObjectiveTo evaluate the effect of weightlifting (leg press) on intraocular pressure (IOP).DesignProspective cohort study.SubjectsA total of 24 participants met the inclusion criteria and completed the study procedures. Participants had an average age of 22.7±2.7 years and included nine women. The mean baseline IOP was 13.9 mm Hg (SD=2.4) with an average body mass index of 24.5 (SD= 3.1).MethodsThe maximum load for a single lift was found for each participant. Participants then performed three leg press regimens: one repetition using 95% of maximal load (1RM), six repetitions using 75% of maximal load (6RM) and isometric push against a weight much heavier than maximal load (ISO).Main outcome measureIOP was measured pre-exercise, during and immediately following the exercise using an iCare TA01i rebound tonometer. Blood pressure and HR were being monitored continuously during the lift. Optical coherence tomography images were obtained pre and postexercise session.ResultsThe average maximum weight lifted by our participants was 331.9 Kg (SD=97.3). Transient increased IOP was observed across the 1RM, 6RM and ISO exercises with an average increase in 26.4 mm Hg (23.7 mm Hg to 28.7 mm Hg) to reach an average max IOP of 40.7 mm Hg (27.8 mm Hg to 54.2 mm Hg), with an absolute maximum of 70 mm Hg in one participant.ConclusionsThere is a transient and dramatic fluctuation in IOP with resistance training. This coupled with regular exposure to resistance training is potentially a significant risk factor for glaucoma. It should be noted that this study has been carried out in a healthy young population, and, thus, the external validity of these results in glaucoma participants requires further investigation.

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“…18 On the contrary, the execution of resistance training against heavy loads provokes an acute IOP rise, [19][20][21][22][23] and this effect is exacerbated when the interchange of gases is compromised. 24,25 In the same line, the exposure to hypoxia and hypercapnia conditions has been shown to induce a significant IOP rise. 26,27 Remarkably, a recent study showed that using a FFP2 mask counteracts the IOP lowering-effect of low-intensity aerobic exercise on glaucoma patients.…”

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confidence: 91%

Effect of wearing different types of face masks during dynamic and isometric resistance training on intraocular pressure

Vera

Redondo

Koulieris

et al. 2022

Clinical and Experimental Optometry

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Clinical relevance: The use of face masks has demonstrated to be an effective strategy to prevent transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Wearing face masks, mainly FFP2 (Filtering Face Piece 2) masks, during exercise practice has demonstrated to affect several physiological measures, but its impact on intraocular pressure (IOP) remains unknown.Background: This study was aimed at assessing the IOP behavior during the execution of the dynamic and isometric biceps-curl exercise with a surgical and FFP2 face mask.Methods: 22 physically active young adults performed sets of 10 repetitions against the 10-RM (repetition maximum) load and 1-minute isometric effort against a load 15% lower than the 10-RM load with the FFP2 and surgical mask and without any mask. A total of six exercise sets (3 experimental conditions [FFP2, surgical and control] × 2 exercise modalities) were performed. A rebound tonometer was used to measure IOP before, during (10 measurements), and after (30seconds of passive recovery) each training set.Results: At rest, there were not statistically significant IOP differences (p=0.222). During dynamic exercise, IOP showed a progressive IOP rise (p<0.001), observing a higher IOP response with the FFP2 than without mask (corrected p-value=0.003). For the isometric exercise, there was a greater IOP response as a function of accumulated effort (p<0.001), which was dependent of the face mask used (FFP2>surgical>control; corrected p-values<0.01).Conclusions: FFP2 masks cause a heightened IOP response during the execution of dynamic and isometric biceps-curl exercise, suggesting that, when possible, glaucoma patients may limit the use of FFP2 masks during resistance training.

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The intraocular pressure response to lower‐body and upper‐body isometric exercises is affected by the breathing pattern

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Cited by 12 publications

References 46 publications

Intraocular pressure responses to walking with surgical and FFP2/N95 face masks in primary open-angle glaucoma patients

Intraocular pressure responses to walking with surgical and FFP2/N95 face masks in primary open-angle glaucoma patients

Intraocular pressure fluctuation during resistance exercise

Effect of wearing different types of face masks during dynamic and isometric resistance training on intraocular pressure

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