The Physiological Impact of Masking Is Insignificant and Should Not Preclude Routine Use During Daily Activities, Exercise, and Rehabilitation

Haraf, Rebecca H; Faghy, Mark A; Carlin, Brian; Josephson, Richard

doi:10.1097/hcr.0000000000000577

Cited by 34 publications

(43 citation statements)

References 36 publications

(33 reference statements)

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“…Our findings are supported by multiple previous studies; however, no adverse physiological effects or risk of face mask use during exercise were reported. 14,17,18,32,33 Therefore, overall breathing comfort should be used to guide type of face masks when exercising in the heat.…”

Section: Discussionmentioning

confidence: 99%

Effects of Face Mask Use on Objective and Subjective Measures of Thermoregulation During Exercise in the Heat

Yoshihara

Dierickx

Brewer

et al. 2021

Sports Health: A Multidisciplinary Approach

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Background: While increased face mask use has helped reduce COVID-19 transmission, there have been concerns about its influence on thermoregulation during exercise in the heat, but consistent, evidence-based recommendations are lacking. Hypothesis: No physiological differences would exist during low-to-moderate exercise intensity in the heat between trials with and without face masks, but perceptual sensations could vary. Study Design: Crossover study. Level of Evidence: Level 2. Methods: Twelve physically active participants (8 male, 4 female; age = 24 ± 3 years) completed 4 face mask trials and 1 control trial (no mask) in the heat (32.3°C ± 0.04°C; 54.4% ± 0.7% relative humidity [RH]). The protocol was 60 minutes of walking and jogging between 35% and 60% of relative VO2max. Rectal temperature (Trec), heart rate (HR), temperature and humidity inside and outside of the face mask (Tmicro_in, Tmicro_out, RHmicro_in, RHmicro_out) and perceptual variables (rating of perceived exertion (RPE), thermal sensation, thirst sensation, fatigue level, and overall breathing discomfort) were monitored throughout all trials. Results: Mean Trec and HR increased at 30- and 60-minute time points compared with 0-minute time points, but no difference existed between face mask trials and control trials ( P > 0.05). Mean Tmicro_in, RHmicro_in, and humidity difference inside and outside of the face mask (ΔRHmicro) were significantly different between face mask trials ( P < 0.05). There was no significant difference in perceptual variables between face mask trials and control trials ( P > 0.05), except overall breathing discomfort ( P < 0.01). Higher RHmicro_in, RPE, and thermal sensation significantly predicted higher overall breathing discomfort ( r2 = 0.418; P < 0.01). Conclusion: Face mask use during 60 minutes of low-to-moderate exercise intensity in the heat did not significantly affect Trec or HR. Although face mask use may affect overall breathing discomfort due to the changes in the face mask microenvironment, face mask use itself did not cause an increase in whole body thermal stress. Clinical Relevance: Face mask use is feasible and safe during exercise in the heat, at low-to-moderate exercise intensities, for physically active, healthy individuals.

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Section: Discussionmentioning

confidence: 99%

Effects of Face Mask Use on Objective and Subjective Measures of Thermoregulation During Exercise in the Heat

Yoshihara

Dierickx

Brewer

et al. 2021

Sports Health: A Multidisciplinary Approach

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“…Here, the surgical mask was placed loosely on top of the oxygenation device to limit the effect on the work of breathing. 39 Thus, the primary objective is to deflect the exhalation puffs, rather than to filter them as in the N95 mask. From these side-by-side images, and the associated movies in Figs.…”

Section: Exhaled Puff Redirection With Surgical Mask Covermentioning

confidence: 99%

Mitigating exhalation puffs during oxygen therapy for respiratory disease

Kudrolli

Chang

et al. 2021

Physics of Fluids

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We investigate the dispersal of exhalations corresponding to a patient experiencing shortness of breath while being treated for a respiratory disease with oxygen therapy. Respiration through a nasal cannula and a simple O 2 mask is studied using a supine manikin equipped with a controllable mechanical lung by measuring aerosol density and flow with direct imaging. Exhalation puffs are observed to travel 0.35 ± 0.02 m upward while wearing a nasal cannula, and 0.29 ± 0.02 m laterally through a simple O 2 mask, posing a higher direct exposure risk to caregivers. The aerosol-laden air flows were found to concentrate in narrow conical regions through both devices at several times their concentration level compared with a uniform spreading at the same distance. We test a mitigation strategy by placing a surgical mask loosely over the tested devices. The mask is demonstrated to alleviate exposure by deflecting the exhalations from being launched directly above a supine patient. The surgical mask is found to essentially eliminate the concentrated aerosol regions above the patient over the entire oxygenation rates used in treatment in both devices.

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“…The question arises, however, whether different types of face masks have negative effects on ventilation, cardiovascular function and metabolism. This issue has been addressed in publications that have measured the effects of different types of face mask on hemodynamic, cardiopulmonary, and metabolic parameters during exercise (17,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). Some studies found that wearing a face mask during exercise reduced cardiopulmonary function or exercise performance (7,23,26,27).…”

Section: Introductionmentioning

confidence: 99%

Effect of a Taped Filter Mask on Perceived Breathlessness, Heart Rate, Lactate and Oxygen Saturation During a Graded Exercise Test

Trefz

Schönfelder

et al. 2021

Preprint

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Background: Face masks are an effective, non-pharmacological strategy to reduce the transmission of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and other pathogens. However, it is a challenge to keep masks sealed during exercise, as ventilation can increase from 5-10 L/min at rest to up to 200 L/min so that masks may be blown away from the face. To reduce leakage e.g. during exercise, a face mask was developed that is taped onto the face. The aim of this study was to investigate during a graded cycle ergometry test the effect of a taped mask on the perception of breathlessness, heart rate, lactate, and oxygen saturation when compared to a surgical mask and no mask.Methods: Four trained and healthy males and females each (n=8 in total) performed incremental cycle ergometer tests until voluntary exhaustion under three conditions: (1) No mask/control, (2) surgical mask or (3) taped mask. During these tests, we measured perception of breathlessness, heart rate, the concentration of blood lactate and peripheral oxygen saturation and analysed the resultant data with one or two-way repeated measures ANOVAs. We also used a questionnaire to evaluate mask comfort and analysed the data with paired t-tests. Results: When compared to wearing no mask, a taped face mask significantly reduces the maximal workload in a graded exercise test by 12±6% (p=0.001). Moreover, with a taped face mask, subjects perceive severe breathlessness at 12±9% lower workload (p=0.012) and oxygen saturation at 65% of the maximal workload is 1.5% lower (p=0.018) when compared to wearing no mask. Heart rate and the concentration of lactate were not significantly different at any workload. When compared to wearing a surgical mask, wearing a taped face mask has a significantly better wearing comfort (p=0.038), feels better on the skin (p=0.004), there is a lower sensation of moisture (p=0.026) and wearers perceive that less heat is generated (p=0.021). We found no sex/gender differences for any parameters. Conclusions: A taped mask is well tolerated during light and moderate exercise intensity but reduces maximal exercise capacity.

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The Physiological Impact of Masking Is Insignificant and Should Not Preclude Routine Use During Daily Activities, Exercise, and Rehabilitation

Cited by 34 publications

References 36 publications

Effects of Face Mask Use on Objective and Subjective Measures of Thermoregulation During Exercise in the Heat

Effects of Face Mask Use on Objective and Subjective Measures of Thermoregulation During Exercise in the Heat

Mitigating exhalation puffs during oxygen therapy for respiratory disease

Effect of a Taped Filter Mask on Perceived Breathlessness, Heart Rate, Lactate and Oxygen Saturation During a Graded Exercise Test

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