The Physiological Effects of Face Masks During Exercise Worn Due to COVID-19: A Systematic Review

Abstract

Context: Use of facemasks in sport has been a particularly complex issue during the COVID-19 pandemic. Objectives: A systematic review to examine the physiological effects the different types of masks have on healthy adults when doing physical exercise. Data sources: PubMed, SPORTDiscus, Scopus, and Litcovid were searched up to March 20, 2021, following the PRISMA model. Articles published in the last 5 years with healthy adults. Study Selection: A total of 633 studies related to the use of masks during physical exercise were found, of which 8 articles met the criteria to be included. Study Design: Systematic review. Level of Evidence: Level 2. Data Extraction: The search process and the review of the articles were carried out by independent expert researchers. The risk of bias and the methodological quality of the different studies included in the systematic review were calculated following the Cochrane criteria using an adaptation for random cross-studies. Once the information was properly structured, the results were extracted, and the findings of the study analyzed. Results: There were significant changes in the following physiological variables when engaging in physical exercise using masks: 25% in the heart rate and dyspnea, 37.5% in the rating of perceived exertion, 50% in the pulmonary variables, and 37.5% in discomfort. The oxygen saturation, blood pressure, systolic blood pressure, diastolic blood pressure, and the concentration of blood lactate did not present any significant effect in this study. Conclusions: The usage of masks by a healthy adult population during the performance of physical exercise has shown minimal effects with regard to physiological, cardiorespiratory, and perceived responses. Some symptoms can be dyspnea, effort perceived, or discomfort, among others. These findings indicate that the use of masks is not harmful to individuals’ health. It does not present any significant detrimental effect on physical performance or risk to their well-being. However, further experiments are required to corroborate the findings of this review.

RETRACTED: Physio-metabolic and clinical consequences of wearing face masks—Systematic review with meta-analysis and comprehensive evaluation

“…Due to the exclusion of children, pregnant women and diseased patients from these evaluations and conclusions ( 28 , 31 ), the reviews do not provide sufficient evidence that masks can be safely used the general population. Moreover, the application of fixed statistical models ( 27 ), use of narratives rather than quantitative analysis and statistics (despite claiming to be systematic) ( 32 ), focus on health care workers ( 31 ), as well as comparing the different mask types without any baseline/control group ( 31 ) were ubiquitous limitations of those studies. Physiological systematic reviews based purely on physiological effects of masks limit data interpretations to normal physio-metabolic fluctuations i.e., beyond the domain of pathophysiological compensatory mechanisms (especially in the older individuals and those with diminished compensatory reserves) and/or acute/chronic subliminal changes in the human microbiome ( 28 , 30 ).…”

WITHDRAWN: Physio-metabolic and clinical consequences of wearing face masks -Systematic review with meta-analysis and comprehensive evaluation

“…Due to the exclusion of children, pregnant women and diseased patients from these evaluations and conclusions 22,25 , the reviews do not provide sufficient evidence that masks can be employed in the general population as safe protective measures. Moreover, the application of fixed statistical models 21 , use of narratives rather than quantitative analysis and statistics (despite claiming to be systematic) 26 , focus only on health care workers and their complaints 25 , as well as comparing the different mask types without any baseline/control group 25 were ubiquitous limitations of those studies. Physiological systematic reviews based purely on physiological effects of masks limit data interpretations to normal physiometabolic fluctuations i.e.…”

The Effects of Wearing Facemasks during Vigorous Exercise in the Aspect of Cardiopulmonary Response, In-Mask Environment, and Subject Discomfort

“…On the other hand, there were other attempts to analyze the other variables including degree of subjective discomfort as well as the cardiopulmonary response. There are few review articles that have evaluated the comprehensive effect of wearing masks, including subjective discomfort and the work of breathing [ 15 , 16 , 17 ]. One of the studies referenced in this article proposed that there was a significant relationship between subjective discomfort and in-mask environment, such as humidity and temperature, but the respirator used in this experiment was a respiratory protective mask, not one that would be used in daily life [ 18 ].…”