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Bar-On O, Goldberg O, Stafler P, Levine H, Jacobi E, Shmueli E, Rothschild B, Prais D, Mei-Zahav M. Wearing face masks while climbing stairs influences respiratory physiology. J Breath Res 2024; 18:036002. [PMID: 38631331 DOI: 10.1088/1752-7163/ad3fde] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 04/17/2024] [Indexed: 04/19/2024]
Abstract
During the COVID-19 pandemic wearing face masks was mandatory. Nowadays, face masks are still encouraged indoors, especially in hospitals. People climbing stairs with masks describe unpredictable dyspnea. In this study, healthy adults climbed 5 floors with and without a mask. Various cardio-respiratory parameters were measured, including O2-saturation (O2-Sat) and end-tidal CO2(EtCO2), at baseline and on the top floor. Subjective indexes, such as Borg's scale, were evaluated. Thirty-two volunteers (16 males), median age 39 years (IQR 32.5-43), median BMI = 23.6 (IQR 21.5-25.1), with good fitness levels, participated. Comparing baseline to end-activity, median (IQR): O2-Sat change was -1.0% (-2-0) without mask, versus -3.0% (-4-0) with mask,p= 0.003; EtCO2+ 7.0 (+3.3-+9) without mask, versus +8.0 (+6-+12) with mask,p= 0.0001. Hypercarbia was seen in 5 (15.6%) participants without mask, median = 48 mmHg (IQR 47.5-51), and in 11 (34%) participants with mask, median = 50 mmHg (IQR 47-54),p< 0.001. Desaturation (O2-Sat < 95%) was seen in 5 (15.6%) participants without mask, median = 94% (IQR 93%-94%), and in 10 (31%) participants with mask, median = 91.5% (IQR 90%-93%),p= 0.06. Regression analysis demonstrated that only male sex was significantly associated with abnormal EtCO2(OR = 26.4, 95% CI = 1.9-366.4,p= 0.005). Ascent duration increased from median (IQR) of 94 s (86-100) without mask to 98 s (89-107) with mask,p< 0.001. Borg's scale of perceived exertion (range 0-10) increased from median (IQR) of 3.0 (2.5-3.87) without mask to 4.0 (3.0-4.37) with mask,p< 0.001. To conclude, during routine daily activities, such as stair-climbing, face masks cause dyspnea, and have measurable influences on ventilation, including true desaturation and hypercapnia, especially in males.
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Affiliation(s)
- Ophir Bar-On
- Pulmonology Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Ori Goldberg
- Pulmonology Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Pediatric Pulmonary Service, Kaplan Medical Center (affiliated with the Faculty of Medicine, Hebrew University, Jerusalem, Israel), Rehovot, Israel
| | - Patrick Stafler
- Pulmonology Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Hagit Levine
- Pulmonology Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Eyal Jacobi
- Pulmonology Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Einat Shmueli
- Pulmonology Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Ben Rothschild
- Pulmonology Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Dario Prais
- Pulmonology Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Meir Mei-Zahav
- Pulmonology Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel
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Ramoti N, Siahaan AMP, Indharty S, Adella CA. Effect of face masks on dyspnea perception, cardiopulmonary parameters, and facial temperature in healthy adults. NARRA J 2024; 4:e574. [PMID: 38798847 PMCID: PMC11125298 DOI: 10.52225/narra.v4i1.574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/26/2024] [Indexed: 05/29/2024]
Abstract
Respiratory droplets, naturally produced during expiration, can transmit pathogens from infected individuals. Wearing a face mask is crucial to prevent such transmission, yet the perception of dyspnea and uncomfortable breathing remains a common concern, particularly during epidemics. The aim of this study was to investigate the impact of face mask use on the perception of dyspnea, cardiopulmonary parameters, and facial temperature during physical activity. A randomized crossover study was conducted on healthy adults at a physiology laboratory located in the Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia, in November 2022. Participants underwent five stages of physical exercise tests based on the Bruce Protocol under three conditions: without any face mask (control), wearing a surgical mask, and an N95 mask, forming the study's main groups. Dyspnea perception (measured by the Modified Borg Dyspnea Scale), cardiopulmonary parameters (heart rate, oxygen saturation, respiratory rate, blood pressure, and mean arterial pressure) and facial temperature were measured before the exercise test (pre-workout), at the end of stage 1, 2, 3, 4, 5, and after the whole exercise test (post-workout). A two-way repeated measures ANOVA was conducted, considering two factors: the type of mask (control, surgical mask, N95 mask) and the various stages of the exercise test. A total of 36 healthy adults were included in the study. We found that dyspnea perception was much worse in the N95 mask group, particularly during vigorous exercise. There was no significant difference between groups in cardiopulmonary parameters. However, participants wearing N95 had a greater supralabial temperature than those wearing surgical masks or no mask at all. It is recommended to undertake a more in-depth evaluation of cardiopulmonary physiological measures.
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Affiliation(s)
- Natanael Ramoti
- Department of Physiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Andre MP. Siahaan
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Suzy Indharty
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Cut A. Adella
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Janse van Rensburg DC, Jansen van Rensburg A, Botha T, Elliott K, Ramagole D, Pillay L, Hendricks S, Eyden D, Arnott C, Stevens DJ. Effects of no mask, a surgical mask and a fabric buff on peripheral oxygenation saturation during moderate intensity exercise: a randomised cross-over study. J Thorac Dis 2024; 16:1854-1865. [PMID: 38617788 PMCID: PMC11009602 DOI: 10.21037/jtd-23-1178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/15/2023] [Indexed: 04/16/2024]
Abstract
Background Mask-wearing caused significant reductions in coronavirus disease 2019 (COVID-19) transmission. We aimed to determine whether face mask-wearing during exercise caused reductions in peripheral oxygen saturation (SpO2) and whether it affected secondary physiological measures [end-tidal carbon dioxide (EtCO2), respiratory rate (RR), heart rate (HR), expired breath temperature (EBT)]. Subjective measurements included ratings of perceived exertion (RPE), ratings of perceived breathlessness (RPB), and symptomology. Methods A randomised cross-over trial examined no mask (NM), surgical mask (SM) and a buff mask (BM). Thirty participants (30-45 years) cycled at 60% power output for 30 min in three exercise sessions, 24 h apart, within 6 days. Each session recorded all measures at resting baseline (T0), 9 min (T1), 18 min (T2), and 27 min (T3). Dependent statistical tests determined significant differences between masks and time-points. Results SpO2 decreased for SM and BM between T0 compared to T1, T2 and T3 (all P<0.005). BM caused significant reductions at T1 and T2 compared to NM (P<0.001 and P=0.018). Significant changes in EtCO2 and EBT occurred throughout exercise and between exercise stages for all mask conditions (P<0.001). As expected for moderate intensity exercise, RR and HR were significantly higher during exercise compared to T0 (P<0.001). RPB significantly increased for each condition at each time point (P<0.001). RPE was not significant between mask conditions at any exercise stage. Conclusions SM and BM caused a mild but sustained reduction in SpO2 at commencement of exercise, which did not worsen throughout short (<30 min) moderate intensity exercise. Level of perception was similar, suggesting healthy people can wear masks during moderate exercise and activities of daily living.
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Affiliation(s)
| | | | - Tanita Botha
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa
| | - Kirsty Elliott
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Dimakatso Ramagole
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Lervasen Pillay
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Shona Hendricks
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Devlin Eyden
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Claire Arnott
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - David James Stevens
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
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Ko SL, Hung CL, Chen CN, Tsao TP, Fong MC, Yin WH, Chang HY. Effects of Mask Wearing on Treadmill Exercise Test. Am J Cardiol 2024; 213:161-163. [PMID: 38160925 DOI: 10.1016/j.amjcard.2023.12.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/19/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Shao-Lun Ko
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chung-Lieh Hung
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei City, Taiwan and Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan
| | - Chiao-Nan Chen
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tien-Ping Tsao
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Man-Cai Fong
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Wei-Hsian Yin
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Hung-Yu Chang
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, and School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Klophaus N, Wehmeier UF, Forstner J, Jansen A, Probst H, Grüter S, Hilberg T. The Impact of Medical Face Masks and Rehabilitation Duration on the Performance Output and Outcomes of Cardiologic Rehabilitants. J Clin Med 2024; 13:1086. [PMID: 38398399 PMCID: PMC10889284 DOI: 10.3390/jcm13041086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/19/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
During the COVID-19 pandemic, wearing a medical face mask became mandatory in daily life and also in cardiological rehabilitation. In order to investigate whether the performance and outcomes of cardiological rehabilitation were affected by face masks, we compared data from patients who underwent rehabilitation with face masks with data from patients without face masks. In total, 114 patients from an ambulant rehabilitation center were included. Of them, 60 patients completed rehabilitation without a face mask (NFM). In contrast, 54 patients (with a face mask, WFM) completed their rehabilitation during the COVID-19 pandemic and had to wear medical face masks for the entire day and also during ergometer training or other interventions. Subgroups were formed with patients who accepted to extend rehabilitation for one week (4 WG); the other patients only completed 3-week rehabilitation (3 WG). We analyzed the performance and outcomes of all groups (NFM; WFM, 3 WG and 4 WG). At baseline, no group differences were detected. All groups significantly improved their power output and heart rate recovery, without any group differences. We conclude that face masks and also an additional rehabilitation week do not affect the exercise performance or outcomes of out-house cardiological rehabilitation.
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Affiliation(s)
- Nils Klophaus
- Department of Sports Medicine, University of Wuppertal, Moritzstr. 14, 42117 Wuppertal, Germany; (N.K.); (T.H.)
- Cardiowell, Arrenberger Str. 20, 42117 Wuppertal, Germany
| | - Udo F. Wehmeier
- Department of Sports Medicine, University of Wuppertal, Moritzstr. 14, 42117 Wuppertal, Germany; (N.K.); (T.H.)
| | - Julia Forstner
- Department of Sports Medicine, University of Wuppertal, Moritzstr. 14, 42117 Wuppertal, Germany; (N.K.); (T.H.)
| | - Armin Jansen
- Cardiowell, Arrenberger Str. 20, 42117 Wuppertal, Germany
| | - Herbert Probst
- Cardiowell, Arrenberger Str. 20, 42117 Wuppertal, Germany
| | - Stephan Grüter
- Cardiowell, Arrenberger Str. 20, 42117 Wuppertal, Germany
| | - Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Moritzstr. 14, 42117 Wuppertal, Germany; (N.K.); (T.H.)
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Weigelt A, Schöffl I, Rottermann K, Wällisch W, Müller SK, Dittrich S, Hübner MJ. Sports despite masks: no negative effects of FFP2 face masks on cardiopulmonary exercise capacity in children. Eur J Pediatr 2024; 183:639-648. [PMID: 37950791 PMCID: PMC10912408 DOI: 10.1007/s00431-023-05316-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/13/2023]
Abstract
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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Affiliation(s)
- Annika Weigelt
- Department of Pediatric Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany.
| | - Isabelle Schöffl
- Department of Pediatric Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany
- School of Clinical and Applied Sciences, Leeds Beckett University, LS13HE Leeds, UK
| | - Kathrin Rottermann
- Department of Pediatric Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany
| | - Wolfgang Wällisch
- Department of Pediatric Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany
| | - Sarina Katrin Müller
- Department of Otholaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstraße 1, 91054, Erlangen, Germany
| | - Sven Dittrich
- Department of Pediatric Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany
| | - Matthias Jens Hübner
- Department of Pediatric Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany
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Alagoz S, Bal KK, Ozdas T, Delibas V, Kuran G, Ekici NY, Gorgulu O, Oztornacı RO. Effect of Using N95 and Surgical Masks on Otoacoustic Emission in Cochlear Outer Hair Cells. EAR, NOSE & THROAT JOURNAL 2024; 103:NP16-NP21. [PMID: 34315247 DOI: 10.1177/01455613211034600] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Distortion product otoacoustic emission (DPOAE) was measured to investigate the effect of mask use and type on oxygen saturation on cochlear function in health care professionals during the COVID-19 pandemic. MATERIAL AND METHODS Group 1 participants wore surgical masks; Group 2 participants wore N95 masks. Distortion product otoacoustic emission and oxygen saturation were measured in both groups before and after mask use. RESULTS Comparison of signal-to-noise ratio (SNR) values before and after surgical mask use in DPOAE measurements of group 1 revealed statistically significant difference in the right and left ears. Comparison of the SNR values in DPOAE measurements of group 2 before and after 8 hours of N95 mask use revealed statistically significant differences in the right ear at 988, 2963, 4444, and 8000 Hz and in the left ear at 8000 Hz. CONCLUSION We found that prolonged mask use may affect the outer hair cells in the cochlea, causing deterioration in DPOAE values.
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Affiliation(s)
- Sedat Alagoz
- Otorhinolaryngology Department, University Of Health Sciences Adana City Training and Research Hospital, Adana/Turkey
| | - Kemal Koray Bal
- Otorhinolaryngology Department, University Of Health Sciences Adana City Training and Research Hospital, Adana/Turkey
| | - Talih Ozdas
- Otorhinolaryngology Department, University Of Health Sciences Adana City Training and Research Hospital, Adana/Turkey
| | - Vedat Delibas
- Otorhinolaryngology Department, University Of Health Sciences Adana City Training and Research Hospital, Adana/Turkey
| | - Gokhan Kuran
- Otorhinolaryngology Department, University Of Health Sciences Adana City Training and Research Hospital, Adana/Turkey
| | - Nur Yucel Ekici
- Otorhinolaryngology Department, University Of Health Sciences Adana City Training and Research Hospital, Adana/Turkey
| | - Orhan Gorgulu
- Otorhinolaryngology Department, University Of Health Sciences Adana City Training and Research Hospital, Adana/Turkey
| | - Ragıp Onur Oztornacı
- Otorhinolaryngology Department, University Of Health Sciences Adana City Training and Research Hospital, Adana/Turkey
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Elbanna RHM, Grase MO, Elabd SOA, Abd El-Monaem HAEM. Effect of wearing surgical mask during controlled aerobic training on functional capacity and perceived stress in inactive men: a randomized trial. Sci Rep 2023; 13:22892. [PMID: 38129643 PMCID: PMC10739829 DOI: 10.1038/s41598-023-50178-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
The study aims to assess the impact of wearing a surgical mask during training on inactive men's functional capacity and perceived stress. Seventy non-smoker males with body mass index of 25-30 kg/m2 and moderate-intensity activity of fewer than 150 min/week were allocated randomly into two equal groups. The surgical mask group performed a controlled endurance exercise while wearing a surgical mask of three protection layers. The mask-less group performed a controlled endurance exercise without wearing any mask. Functional capacity and Perceived Stress were evaluated before and after the intervention. A significant improvement was observed within groups post-intervention in favor of the mask group regarding the Time Up and Go test (P < 0.05), with a 15.1% percentage improvement. Post-intervention, there was a significant change in the perceived stress score for the mask and mask-less groups (P < 0.05). The improvement in PSS was in favor of mask-less group participants as they changed from being categorized as moderate to mild stress on the PSS, with a 27.1% percentage improvement. Exercising while wearing a surgical mask Positive impacts functional capacity and negatively impacts Perceived Stress in inactive adults. An additional study evaluating the physiological effects of masks on continuous exercise is necessary.
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Affiliation(s)
- Rana Hesham Mohamed Elbanna
- Department of Cardiovascular/Respiratory Disorders and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
| | - Mariam Omran Grase
- Department of Basic Science, Faculty of Physical Therapy Cairo University, Giza, Egypt
| | - Sherif Osama Abdelsalam Elabd
- Department of Physical Therapy for Internal Medicine and Geriatrics, Faculty of Physical Therapy, May University, Cairo, Egypt
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Mezghani N, Ammar A, Boukhris O, Masmoudi L, Boujelbane MA, Ben Ayed R, Alzahrani TM, Hadadi A, Abid R, Ouergui I, Glenn JM, Trabelsi K, Chtourou H. The Impact of Wearing Different Face Masks on Vigorous Physical Exercise Performance and Perceived Exertion among COVID-19 Infected vs. Uninfected Female Students. Eur J Investig Health Psychol Educ 2023; 13:2709-2723. [PMID: 37998077 PMCID: PMC10670499 DOI: 10.3390/ejihpe13110187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/28/2023] [Accepted: 11/12/2023] [Indexed: 11/25/2023] Open
Abstract
Under certain circumstances, masks are an effective and immediate solution to reduce the spread of viral infection. However, the impact of masks on the ability to perform vigorous exercise remains an area of concern. Primarily, this impact has been explored in healthy subjects, yielding contradictory findings, and little is known of it among COVID-19-infected individuals. This study examined the effects of surgical masks, N-95 masks, and unmasked conditions on the performance and perceived exertion (RPE) of infected vs. non-infected young women during high-intensity, repeated sprint exercise (5mSRT). Following a familiarization session, eighty-three (42 COVID-19-previously infected (PIG) and 43 non-infected (NIG)), female participants (age 20.02 ± 1.05 years, BMI 21.07 ± 2.1 kg/m2) were randomly assigned to one of three mask conditions: unmasked, surgical mask, or N95 mask. All participants attended three test sessions (i.e., one session for each mask condition) at least one week apart. At the beginning of each test session, data related to participants' physical activity (PA) and sleep behaviours during the previous week were collected. In each test session, participants performed the 5mSRT, during which performance indicators (best distance (BD), total distance (TD), fatigue index (FI) and percentage decrement (PD)) were collected, along with RPE. ANOVA indicated no significant main effects of Groups and Masks, and no significant interaction for Groups × Masks for BD, FI, PD, RPE and most sleep and PA behaviours (p > 0.05). For TD, the Groups × Mask interaction was significant (p = 0.031 and ƞp2 = 0.042). Posthoc analysis revealed, in the unmasked condition, there was no difference in TD between PIG and NIG (p > 0.05). However, when wearing a surgical mask, PIG covered lower TD compared to NIG (p < 0.05). Additionally, different types of masks did not affect TD in NIG, while PIG performed the worst using the surgical mask (p < 0.05). These results suggest post-COVID-19 individuals can maintain physical fitness through regular exercise (i.e., sport science curricula) in unmasked conditions, but not when wearing a surgical mask. Furthermore, the impact of different types of face masks on physical performance seems to be minimal, particularly in uninfected populations; future research is warranted to further explore this impact in post-COVID conditions.
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Affiliation(s)
- Nourhen Mezghani
- Department of Sport Sciences, College of Education, Taif University, Taif 21944, Saudi Arabia; (N.M.); (T.M.A.); (A.H.)
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55099 Mainz, Germany;
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS (Faculty of Sport Sciences), UPL, Paris Nanterre University, 39200 Nanterre, France
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (L.M.); (K.T.); (H.C.)
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax 3029, Tunisia;
| | - Omar Boukhris
- SIESTA Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia;
- Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia
| | - Liwa Masmoudi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (L.M.); (K.T.); (H.C.)
- Research Laboratory, Education, Motricity, Sport and Health (EM2S), LR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
| | - Mohamed Ali Boujelbane
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55099 Mainz, Germany;
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (L.M.); (K.T.); (H.C.)
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia
| | - Rayda Ben Ayed
- National Institute of Agronomy of Tunisia (INAT), University of Carthage-Tunis, 43 Avenue Charles Nicolle, El Mahrajène 1082, Tunisia;
- Laboratory of Extremophile Plants, Centre of Biotechnology of Borj-Cédria, B.P. 901, Hammam Lif 2050, Tunisia
| | - Turki Mohsen Alzahrani
- Department of Sport Sciences, College of Education, Taif University, Taif 21944, Saudi Arabia; (N.M.); (T.M.A.); (A.H.)
| | - Atyh Hadadi
- Department of Sport Sciences, College of Education, Taif University, Taif 21944, Saudi Arabia; (N.M.); (T.M.A.); (A.H.)
| | - Rihab Abid
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax 3029, Tunisia;
| | - Ibrahim Ouergui
- High Institute of Sport and Physical Education of Kef, University of Jendouba, El Kef 7100, Tunisia;
- Research Unit, Sports Science, Health and Movement, University of Jendouba, El Kef 7100, Tunisia
| | - Jordan M. Glenn
- Department of Health, Exercise Science Research Center Human Performance and Recreation, University of Arkansas, Fayetteville, AR 72701, USA;
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (L.M.); (K.T.); (H.C.)
- Research Laboratory, Education, Motricity, Sport and Health (EM2S), LR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
| | - Hamdi Chtourou
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (L.M.); (K.T.); (H.C.)
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia
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Michalik K, Smolarek M, Borkowski J, Tchorowski M, Korczuk N, Gorczyca P, Wojtarowicz N, Zatoń M. Changes in Reaction Time, Balance and Neuroplasticity after Exercise with a Face Mask in Male Adults with Mild COVID-19 Symptoms. Healthcare (Basel) 2023; 11:2800. [PMID: 37893874 PMCID: PMC10606898 DOI: 10.3390/healthcare11202800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/10/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
This study compared physiological, perceptual and neuroprotective hormone and metabolite responses and changes in coordination as an effect of aerobic exercise with and without a face mask in people with mild symptoms of COVID-19. Forty men took part in this study. Half declared mild symptoms of SARS-CoV-2 infection in the 6 months before the study (Declared) and the other half did not (Non-declared). In a random order, with a 7-day interval, they performed a 30-min walk on a treadmill at a speed of 6 km/h wearing a surgical face mask (Masked) and without it (Unmasked). The heart rate, heart rate variability, oxygen saturation, lactate concentration and rate of perceived exertion were recorded. The reaction time and balance were measured before and after the exercise. The concentrations of brain-derived neurotrophic factor, testosterone, cortisol, epinephrine and antibodies in the blood serum were determined. Physiological and perceptual responses, reaction times, and balance did not differ between the tested conditions. Three-way RM-ANOVA with post hoc Bonferroni analysis revealed lower post-exercise cortisol concentrations in the Masked and Unmasked conditions in both groups (p ≤ 0.001). Asymptomatic infection with this virus is prevalent, and mild COVID-19 causes similar responses to aerobic exercise with a surgical face mask and does not lead to impaired coordination.
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Affiliation(s)
- Kamil Michalik
- Department of Human Motor Skills, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland;
| | - Marcin Smolarek
- Department of Human Motor Skills, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland;
| | - Jacek Borkowski
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland; (J.B.); (M.Z.)
| | - Miłosz Tchorowski
- Students Scientific Association Exercise Physiology, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland; (M.T.); (N.K.); (P.G.); (N.W.)
| | - Natalia Korczuk
- Students Scientific Association Exercise Physiology, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland; (M.T.); (N.K.); (P.G.); (N.W.)
| | - Piotr Gorczyca
- Students Scientific Association Exercise Physiology, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland; (M.T.); (N.K.); (P.G.); (N.W.)
| | - Natalia Wojtarowicz
- Students Scientific Association Exercise Physiology, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland; (M.T.); (N.K.); (P.G.); (N.W.)
| | - Marek Zatoń
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland; (J.B.); (M.Z.)
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11
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Chen X, Sani I, Xia X, Li Y, Li C, Yue F, Wang X, Bao S, Fan J. The impact of wearing facemask on COPD patients: A protocol of a systematic review and meta-analysis. PLoS One 2023; 18:e0292388. [PMID: 37768979 PMCID: PMC10538665 DOI: 10.1371/journal.pone.0292388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/19/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is a common, irreversible but preventable disease characterized by persistent respiratory symptoms. The mortality rate of COPD is predicted to reach 5.4 million by the year 2060. Despite its heavy burden on healthcare expenditure worldwide, only 15% of cases are medically identified. The potential benefits of facemask-wearing for COPD patients remain a topic of debate. METHODS We will conduct a systematic review of all randomized trials and non-randomized controlled trials to evaluate the impact of facemasks on COPD patients. Our review will be based on literature obtained through a comprehensive search strategy across multiple electronic databases, including the Cochrane Library, Embase, PubMed, Web of Science, the Chinese Biomedical Database (SinoMed), and China National Knowledge Infrastructure (CNKI), with no restrictions on language or date of publication. Two independent researchers will extract and assess all relevant data using pre-designed data extraction forms. The included studies will be assessed using the Cochrane RoB2 tool and the suggested risk of bias criteria proposed by the Effective Practice and Organization of Care reviews group of the Cochrane collaboration. The quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We will use Review Manager 5.4 software for statistical analysis. DISCUSSION In the context of COVID-19, it is important for COPD patients to wear facemasks. This study aims to conduct a comprehensive and systematic assessment of the impact of facemasks on the physiology and activity of COPD patients. TRIAL REGISTRATION PROSPERO registration number CRD42022326265.
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Affiliation(s)
- Xuwen Chen
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Ibrahim Sani
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Xiaoli Xia
- Department of Geriatrics, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Yi Li
- Department of Respiratory Cadres, Gansu Provincial People’s Hospital, Lanzhou, Gansu, China
| | - Caiyun Li
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Feiyan Yue
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Xinhua Wang
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Shisan Bao
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Jingchun Fan
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
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12
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Yang SC, Lee CW. Physiological effects of N95 respirators on rescuers during cardiopulmonary resuscitation. Heliyon 2023; 9:e18970. [PMID: 37600379 PMCID: PMC10432712 DOI: 10.1016/j.heliyon.2023.e18970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 07/14/2023] [Accepted: 08/03/2023] [Indexed: 08/22/2023] Open
Abstract
Objectives There is a lack of evidence in the medical literature reporting the physiological stress imposed by the wearing of N95 respirators during cardiopulmonary resuscitation (CPR) in healthcare providers. The aim of this study is to monitor the changes in hemodynamics and blood gas profiles in rescuers during the performance of CPR while wearing N95 respirators. Methods Thirty-two healthy healthcare workers performed standard CPR on manikins, each participant conducted 2 min of chest compression followed by 2 min of rest for 3 cycles. A non-invasive blood gas measuring device via a fingertip detector was used to collect arterial blood gas and hemodynamic data. Student t-test was used for comparison of various physiologic parameters before and after each session of chest compression. Results There were no significant differences in arterial blood gas profiles including partial pressure of arterial carbon dioxide and partial pressure of arterial oxygen before and after each session of chest compression (p > 0.05 for all). Heart rate and cardiac output were significantly higher after CPR (p < 0.05 for all), but no significant changes were found on blood pressure. Conclusions Our data suggest that healthcare providers wearing N95 respirators during provision of CPR in a short period of time does not cause any significant abnormalities in blood gas profiles and blood pressure. This may provide evidence to reassure the safe use of N95 respirator during performance of CPR.
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Affiliation(s)
- Shih-Chia Yang
- Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi-Wei Lee
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
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13
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Bell ZW, Wong V, Spitz RW, Yamada Y, Song JS, Kataoka R, Chatakondi RN, Abe T, Loenneke JP. Unilateral high-load resistance training influences strength changes in the contralateral arm undergoing low-load training. J Sci Med Sport 2023; 26:440-445. [PMID: 37423835 DOI: 10.1016/j.jsams.2023.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/17/2023] [Accepted: 06/20/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVES Within-subject training models have become common within the exercise literature. However, it is currently unknown if training one arm with a high load would impact muscle size and strength of the opposing arm training with a low load. DESIGN Parallel group. METHODS 116 participants were randomized to one of three groups that completed 6-weeks (18 sessions) of elbow flexion exercise. Group 1 trained their dominant arm only, beginning with a one-repetition maximum test (≤5 attempts), followed by four sets of exercise using a weight equivalent to 8-12 repetition maximum. Group 2 completed the same training as Group 1 in their dominant arm, while the non-dominant arm completed four sets of low-load exercise (30-40 repetition maximum). Group 3 trained their non-dominant arm only, performing the same low-load exercise as Group 2. Participants were compared for changes in muscle thickness and elbow flexion one-repetition maximum. RESULTS The greatest changes in non-dominant strength were present in Groups 1 (Δ 1.5 kg; untrained arm) and 2 (Δ1.1 kg; low-load arm with high load on opposite arm), compared to Group 3 (Δ 0.3 kg; low-load only). Only the arms being directly trained observed changes in muscle thickness (≈Δ 0.25 cm depending on site). CONCLUSIONS Within-subject training models are potentially problematic when investigating changes in strength (though not muscle growth). This is based on the finding that the untrained limb of Group 1 saw similar changes in strength as the non-dominant limb of Group 2 which were both greater than the low-load training limb of Group 3.
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Affiliation(s)
- Zachary W Bell
- Department of Kinesiology and Physical Education, McGill University, Canada
| | - Vickie Wong
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise, Science, and Recreation Management, The University of Mississippi, USA
| | - Robert W Spitz
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise, Science, and Recreation Management, The University of Mississippi, USA
| | - Yujiro Yamada
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise, Science, and Recreation Management, The University of Mississippi, USA
| | - Jun Seob Song
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise, Science, and Recreation Management, The University of Mississippi, USA
| | - Ryo Kataoka
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise, Science, and Recreation Management, The University of Mississippi, USA
| | - Raksha N Chatakondi
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise, Science, and Recreation Management, The University of Mississippi, USA
| | - Takashi Abe
- Graduate School of Health and Sports Science & Institute of Health and Sports Science and Medicine, Juntendo University, Japan
| | - Jeremy P Loenneke
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise, Science, and Recreation Management, The University of Mississippi, USA.
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14
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Das A, Azarudheen S, Chandrasekaran B, Fernandes S, Davis F. The plausible effects of wearing face masks on sports performance - A scoping review. Sci Sports 2023; 38:S0765-1597(23)00133-8. [PMID: 38620146 PMCID: PMC10300654 DOI: 10.1016/j.scispo.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 12/29/2022] [Indexed: 04/17/2024]
Abstract
Objectives The objectives of this scoping review are to discuss, firstly, the positive aspects of wearing face masks during training (such as a barrier to COVID-19 transmission, air pollutant exposure, and adding load on respiratory resistance flow); secondly, the negative aspects (adverse effects on body temperature and hypoxia risks); and thirdly, the training responses of wearing face masks on aerobic and anaerobic performance. News Besides social distancing and hand hygiene, wearing a face mask is proposed to be the prime advocacy for virus containment. During the period of high risk of contamination, the return to sport guidelines proposed by international and national sport federations included wearing face masks during training sessions. However, it is necessary to discuss the pros and cons of wearing face masks during exercise. Prospects Although it was essential to wear a face mask during exercise or sport-specific training, there is conflicting evidence on the implications of the use of face masks on physical, physiological as well as psychological well-being or performance. Based on the conflicting empirical findings and anecdotal evidence, certain recommendations have been made for adequate use of face masks during exercise; both to break the chain of transmission and prevent the physiological compromise expected from wearing face masks during exercise. The present review can help stakeholders balance sport guidelines in the event of a respiratory virus pandemic with athlete safety. Conclusion Conflicting evidence of mechanistic links between the dose of exercise and the possible adverse effects associated with exercising with face masks is available. Adequately powered studies with strong methodological quality on appropriate selection of masks and usage based on the intensity, duration, and type of sport, age, and gender is needed now for the stakeholders to make informed decisions with respect to exercising with face masks.
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Affiliation(s)
- A Das
- Department of Sports Science and Yoga, Ramakrishna Mission Vivekananda Educational and Research Institute, Belur Math, Howrah, West Bengal, India
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - S Azarudheen
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Center for Sports Science, Medicine and Research, Manipal Academy of Higher Education, Manipal, India
| | - B Chandrasekaran
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Center for Sports Science, Medicine and Research, Manipal Academy of Higher Education, Manipal, India
| | - S Fernandes
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Center for Sports Science, Medicine and Research, Manipal Academy of Higher Education, Manipal, India
| | - F Davis
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Center for Sports Science, Medicine and Research, Manipal Academy of Higher Education, Manipal, India
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15
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Brooks JP, Layman J, Willis J. Physiologic effects of surgical masking in children versus adults. PeerJ 2023; 11:e15474. [PMID: 37342359 PMCID: PMC10278594 DOI: 10.7717/peerj.15474] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/07/2023] [Indexed: 06/22/2023] Open
Abstract
Background Surgical masks remain a focal part of the CDC guidelines to decrease COVID-19 transmission. Evidence refuting significant effects of masking on ventilation is mostly limited to small studies, with a paucity of studies on children, and none comparing children to adults. Methods A total of 119 subjects were enrolled (71 adults, 49 children) in a prospective interventional study with each subject serving as their own mask-free control. End tidal CO2 (ETCO2), inspired CO2 (ICO2), and respiratory rate were measured by nasal cannula attached to an anesthesia machine D-fend module. Pulse oximetry and heart rate were also followed. After the mask-free period, an ASTM Level 3 disposable surgical mask was donned and 15 min of mask-worn data were collected. Results A steady state was confirmed for ETCO2 and ICO2 over the masked period, and mean ICO2 levels rose significantly (p < 0.001) after masking in all age groups. The increase in ICO2 for the 2- to 7-year-old group of 4.11 mmHg (3.23-4.99), was significantly higher (p < 0.001) than the final ΔICO2 levels for both the 7- to 14-year-old group, 2.45 mmHg (1.79-3.12), and adults, 1.47 mmHg (1.18-1.76). For the pediatric group there was a negative, significant correlation between age and ΔICO2, r = -0.49, p < 0.001. Masking resulted in a statistically significant (p < 0.01) rise in ETCO2 levels of 1.30 mmHg in adults and 1.36 mmHg in children. The final respective ETCO2 levels, 34.35 (33.55-35.15) and 35.07 (34.13-36.01), remained within normal limits. Pulse oximetry, heart rate, and respiratory rate were not significantly affected. Discussion The physiology of mechanical dead space is discussed, including the inverse relationship of subject age vs ICO2. The methodology and results are compared to previously published studies which detracted from the physiologic safety of surgical masking. Conclusions The wearing of a surgical mask results in a statistically significant rise in ICO2 and a smaller rise in ETCO2. Because ETCO2 and other variables remain well within normal limits, these changes are clinically insignificant.
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Affiliation(s)
- J Patrick Brooks
- School of Anesthesia, Missouri State University, Springfield, Missouri, United States
- Department of Biomedical Sciences, Missouri State University, Springfield, Missouri, United States
| | - Jill Layman
- School of Anesthesia, Missouri State University, Springfield, Missouri, United States
| | - Jessica Willis
- RStats Institute, Missouri State University, Springfield, Missouri, USA
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Martín-Moya R, Tejada-Medina V. Considerations after lockdown and overcoming Covid-19: A systematic review for returning to safe physical exercise practice. Sci Sports 2023:S0765-1597(23)00107-7. [PMID: 37362085 PMCID: PMC10176101 DOI: 10.1016/j.scispo.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/15/2022] [Indexed: 06/28/2023]
Abstract
Objective This systematic review aims to understand the problems associated with lockdown and the various conditions of Covid-19 infection and to help prepare athletes and exercise enthusiasts for the safe resumption of sport in a manner that promotes wellness, healthy competition, and a sports industry that survives the current situation. This systematic review was carried out, following the recommendations of the currently pre-established reporting elements for systematic reviews and meta-analyses. The following databases were consulted: ISI Web of Science (WOS), Scopus and Google Scholar. This review includes a total of 19 articles. News The results are presented based on three predominant themes: (1) psychological impact produced by SARS-CoV-2; (2) post-Covid-19 cardiac abnormalities and (3) protocols for an adequate return to physical practice. Prospects and projects Most of the protocols shown by the various papers are consistent in terms of duration and number of phases. Based on this, the safe return to practice protocol can be divided into four stages of seven days in each phase in order to progress according to the symptoms perceived. In each phase, the physiological demand and efforts necessary to cover the proposed activities are increased until optimal physical condition is recovered.
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Affiliation(s)
- R Martín-Moya
- Physical Education and Sports Department, Faculty of Education and Sport Sciences of Melilla, University of Granada, Melilla, Spain
| | - V Tejada-Medina
- Physical Education and Sports Department, Faculty of Education and Sport Sciences of Melilla, University of Granada, Melilla, Spain
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Han JH, Jang MH, Kim DH, Kim JH. Added Breathing Resistance during Exercise Impairs Pulmonary Ventilation and Exaggerates Exercise-Induced Hypoxemia Leading to Impaired Aerobic Exercise Performance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105757. [PMID: 37239486 DOI: 10.3390/ijerph20105757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/28/2023] [Accepted: 04/23/2023] [Indexed: 05/28/2023]
Abstract
Protective masks impose variable breathing resistance (BR) on the wearer and may adversely affect exercise performance, yet existing literature shows inconsistent results under different types of masks and metabolic demands. The present study was undertaken to determine whether added BR impairs cardiopulmonary function and aerobic performance during exercise. Sixteen young healthy men completed a graded exercise test on a cycle ergometer under the four conditions of BR using a customized breathing resistor at no breathing resistance (CON), 18.9 (BR1), 22.2 (BR2), and 29.9 Pa (BR3). The results showed that BR significantly elevates respiratory pressure (p < 0.001) and impairs ventilatory response to graded exercise (reduced VE; p < 0.001) at a greater degree with an increased level of BR which caused mild to moderate exercise-induced hypoxemia (final mean SpO2: CON = 95.6%, BR1 = 94.4%, BR2 = 91.6%, and BR3 = 90.6%; p < 0.001). Especially, such a marked reduction in SpO2 was significantly correlated with maximal oxygen consumption at the volitional fatigue (r = 0.98, p < 0.001) together with exaggerated exertion and breathing discomfort (p < 0.001). In conclusion, added BR commonly experienced when wearing tight-fitting facemasks and/or respirators could significantly impair cardiopulmonary function and aerobic performance at a greater degree with an increasing level of BR.
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Affiliation(s)
- Jean-Hee Han
- Department of Physical Education, General Graduate School, Kyung Hee University, Yongin-si 17104, Republic of Korea
| | - Min-Hyeok Jang
- Department of Physical Education, General Graduate School, Kyung Hee University, Yongin-si 17104, Republic of Korea
| | - Dae-Hwan Kim
- Department of Physical Education, General Graduate School, Kyung Hee University, Yongin-si 17104, Republic of Korea
| | - Jung-Hyun Kim
- Department of Sports Medicine, Kyung Hee University, Yongin-si 17104, Republic of Korea
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Kisielinski K, Hirsch O, Wagner S, Wojtasik B, Funken S, Klosterhalfen B, Kanti Manna S, Prescher A, Sukul P, Sönnichsen A. Physio-metabolic and clinical consequences of wearing face masks—Systematic review with meta-analysis and comprehensive evaluation. Front Public Health 2023; 11:1125150. [PMID: 37089476 PMCID: PMC10116418 DOI: 10.3389/fpubh.2023.1125150] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/17/2023] [Indexed: 04/08/2023] Open
Abstract
BackgroundAs face masks became mandatory in most countries during the COVID-19 pandemic, adverse effects require substantiated investigation.MethodsA systematic review of 2,168 studies on adverse medical mask effects yielded 54 publications for synthesis and 37 studies for meta-analysis (on n = 8,641, m = 2,482, f = 6,159, age = 34.8 ± 12.5). The median trial duration was only 18 min (IQR = 50) for our comprehensive evaluation of mask induced physio-metabolic and clinical outcomes.ResultsWe found significant effects in both medical surgical and N95 masks, with a greater impact of the second. These effects included decreased SpO2 (overall Standard Mean Difference, SMD = −0.24, 95% CI = −0.38 to −0.11, p < 0.001) and minute ventilation (SMD = −0.72, 95% CI = −0.99 to −0.46, p < 0.001), simultaneous increased in blood-CO2 (SMD = +0.64, 95% CI = 0.31–0.96, p < 0.001), heart rate (N95: SMD = +0.22, 95% CI = 0.03–0.41, p = 0.02), systolic blood pressure (surgical: SMD = +0.21, 95% CI = 0.03–0.39, p = 0.02), skin temperature (overall SMD = +0.80 95% CI = 0.23–1.38, p = 0.006) and humidity (SMD +2.24, 95% CI = 1.32–3.17, p < 0.001). Effects on exertion (overall SMD = +0.9, surgical = +0.63, N95 = +1.19), discomfort (SMD = +1.16), dyspnoea (SMD = +1.46), heat (SMD = +0.70), and humidity (SMD = +0.9) were significant in n = 373 with a robust relationship to mask wearing (p < 0.006 to p < 0.001). Pooled symptom prevalence (n = 8,128) was significant for: headache (62%, p < 0.001), acne (38%, p < 0.001), skin irritation (36%, p < 0.001), dyspnoea (33%, p < 0.001), heat (26%, p < 0.001), itching (26%, p < 0.001), voice disorder (23%, p < 0.03), and dizziness (5%, p = 0.01).DiscussionMasks interfered with O2-uptake and CO2-release and compromised respiratory compensation. Though evaluated wearing durations are shorter than daily/prolonged use, outcomes independently validate mask-induced exhaustion-syndrome (MIES) and down-stream physio-metabolic disfunctions. MIES can have long-term clinical consequences, especially for vulnerable groups. So far, several mask related symptoms may have been misinterpreted as long COVID-19 symptoms. In any case, the possible MIES contrasts with the WHO definition of health.ConclusionFace mask side-effects must be assessed (risk-benefit) against the available evidence of their effectiveness against viral transmissions. In the absence of strong empirical evidence of effectiveness, mask wearing should not be mandated let alone enforced by law.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021256694, identifier: PROSPERO 2021 CRD42021256694.
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Affiliation(s)
- Kai Kisielinski
- Orthopaedic and Trauma Surgery, Clinical Medicine, Private Practice, Düsseldorf, Germany
- *Correspondence: Kai Kisielinski
| | - Oliver Hirsch
- Department of Psychology, Fachhochschule für Oekonomie und Management (FOM) University of Applied Sciences, Siegen, Germany
| | - Susanne Wagner
- Veterinary Medicine, Wagner Medical Science Liason (MSL) Management, Blankenfelde-Mahlow, Germany
| | - Barbara Wojtasik
- Department of Genetics and Biosystematics, Faculty of Biology, University of Gdańsk, Gdansk, Poland
| | - Stefan Funken
- Internal Medicine, Clinical Medicine, Private Practice, Moers, Germany
| | | | - Soumen Kanti Manna
- Biophysics and Structural Genomics Division, Saha Institute of Nuclear Physics, Kolkata, India
| | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy (MOCA), Rhine-Westphalia Technical University of Aachen, Aachen, Germany
| | - Pritam Sukul
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Department of Anesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
- Pritam Sukul
| | - Andreas Sönnichsen
- Internal Medicine, Clinical Medicine, Private Practice, Gesundheit für Österreich e.V. (Health for Austria), Vienna, Austria
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19
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Anil AK, Mannan R, Shanmugasundaram K, Bade G, Talwar A, Deepak KK. Comparative study of the effect of N95 facemask and Powered Air-purifying Respirator (2 fans, N95 filter) on cardiovascular parameters of healthy individuals during exercise. INDUSTRIAL HEALTH 2023; 61:125-133. [PMID: 35444091 PMCID: PMC10079503 DOI: 10.2486/indhealth.2021-0279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/11/2022] [Indexed: 06/14/2023]
Abstract
N95 masks filter 95% of the small particles and respiratory droplets (>0.3 µm diameter). Therefore, they are widely used both by general public and health workers during pandemic. When physical activity or exercise is performed wearing N95 mask, it induces hypercapnic environment. The heat burden is also increased leading to discomfort and reduced compliance. This study was done to compare physiological effects and subjective perceptions while wearing N95 mask and powered air-purifying respirator (PAPR) (2 fans, N95 filter) during incremental exercise. ECG, respiratory movement, SpO2, temperature inside the mask were recorded and perception of discomfort was also assessed. Heart rate variability (HRV) values during baseline were within normal limits in both the mask conditions signifying that cardiac autonomic tone is comparable. During incremental exercise, fall in SpO2 was significantly lesser in PAPR as compared to N95 mask at 60-70% and 70-80% of maximum achievable heart rate. The temperatures inside both the mask conditions were significantly higher than ambient temperature. The scores of humid, hot, breath resistance and fatigue were significantly lower in PAPR than N95 mask. In conditions where prolonged use of mask is required with strenuous physical exertion or exercise, PAPR could be preferred over N95 mask.
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Affiliation(s)
- Abhijith K Anil
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Raihan Mannan
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - K Shanmugasundaram
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Geetanjali Bade
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Anjana Talwar
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Kishore K Deepak
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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20
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Kisielinski K, Wagner S, Hirsch O, Klosterhalfen B, Prescher A. Possible toxicity of chronic carbon dioxide exposure associated with face mask use, particularly in pregnant women, children and adolescents - A scoping review. Heliyon 2023; 9:e14117. [PMID: 37057051 PMCID: PMC9981272 DOI: 10.1016/j.heliyon.2023.e14117] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction During the SARS-CoV-2-pandemic, face masks have become one of the most important ubiquitous factors affecting human breathing. It increases the resistance and dead space volume leading to a re-breathing of CO2. So far, this phenomenon and possible implications on early life has not been evaluated in depth. Method As part of a scoping review, literature was systematically reviewed regarding CO2 exposure and facemask use. Results Fresh air has around 0.04% CO2, while wearing masks more than 5 min bears a possible chronic exposure to carbon dioxide of 1.41% to 3.2% of the inhaled air. Although the buildup is usually within the short-term exposure limits, long-term exceedances and consequences must be considered due to experimental data. US Navy toxicity experts set the exposure limits for submarines carrying a female crew to 0.8% CO2 based on animal studies which indicated an increased risk for stillbirths. Additionally, mammals who were chronically exposed to 0.3% CO2 the experimental data demonstrate a teratogenicity with irreversible neuron damage in the offspring, reduced spatial learning caused by brainstem neuron apoptosis and reduced circulating levels of the insulin-like growth factor-1. With significant impact on three readout parameters (morphological, functional, marker) this chronic 0.3% CO2 exposure has to be defined as being toxic. Additional data exists on the exposure of chronic 0.3% CO2 in adolescent mammals causing neuron destruction, which includes less activity, increased anxiety and impaired learning and memory. There is also data indicating testicular toxicity in adolescents at CO2 inhalation concentrations above 0.5%. Discussion There is a possible negative impact risk by imposing extended mask mandates especially for vulnerable subgroups. Circumstantial evidence exists that extended mask use may be related to current observations of stillbirths and to reduced verbal motor and overall cognitive performance in children born during the pandemic. A need exists to reconsider mask mandates.
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Affiliation(s)
- Kai Kisielinski
- Independent Researcher, Surgeon, Private Practice, 40212 Düsseldorf, Germany
| | - Susanne Wagner
- Non Clinical Expert, Veterinarian, Wagner MSL Management, 15831 Mahlow, Germany
| | - Oliver Hirsch
- Department of Psychology, FOM University of Applied Sciences, 57078 Siegen, Germany
| | | | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy (MOCA), 52074 Aachen, Germany
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21
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Response and Adaptation of the Cardiac Autonomic System to Functional High-intensity Interval Training with Respiratory Facemasks: Impacts of the Training Period and Facemask Modality During a COVID-19 Pandemic. Asian J Sports Med 2023. [DOI: 10.5812/asjsm-130134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
Background: Following the SARS-CoV-2 pandemic in 2019, medical face masks were widely recommended for large numbers of people and for long periods of time. The effect of wearing surgical and N95 face masks during long-term high-intensity interval training on the cardiac autonomic system has not been reported. Methods: Eighteen healthy men were randomly divided into three groups (surgical mask, N95 mask, and no mask) and performed high-intensity interval training with (80-90%-heart rate max) intensity three times a week, three repetitions in a session for four weeks. Heart rate variability parameters were evaluated with an electrocardiogram device and Kubius software. The R-R interval was recorded for 5 minutes in a sitting position in the pre-and post-modified Bruce test before and after four weeks of interval training to extract parasympathetic (RMSSD, HF, SD1), sympathetic indices (LF, LF/HF) and RR mean. We used the two-way ANOVA test and the Bonferroni post hoc test. Results: In all groups, four-week functional HIIT exercises increased the resting parasympathetic indices (RMSSD, SD1) compared to baseline levels. This increase was more evident in the N95 mask group than in the surgical mask group. In addition, the five-minute recovery of the cardiac autonomic system after a modified Bruce test following functional HIIT exercise increased parasympathetic tone (RMSSD, HFn.u) in all groups compared to baseline levels. Therefore, a four-week adaptation to HIIT exercises leads to faster recovery of sympathetic indices (LFn.u, LF/HF) in the Nomask group, as compared to the surgical and N95 groups. Despite the above, there was no significant difference in the recovery and resting values of cardiac autonomic system indices between the two types of surgical masks and N95 compared to the control group (No mask). Conclusions: Four weeks of high-intensity interval training using surgical and N95 face masks improved the cardiac autonomic nervous system. This data is important for recommending the use of face masks during physical activity.
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22
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Ferguson ON, Mitchell RA, Schaeffer MR, Ramsook AH, Dhillon SS, Dominelli PB, Molgat-Seon Y, Guenette JA. Effects of Face Masks on the Multiple Dimensions and Neurophysiological Mechanisms of Exertional Dyspnea. Med Sci Sports Exerc 2023; 55:450-461. [PMID: 36469484 DOI: 10.1249/mss.0000000000003074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
INTRODUCTION During the coronavirus disease 2019 pandemic, public health officials widely adopted the use of face masks (FM) to minimize infections. Despite consistent evidence that FMs increase dyspnea, no studies have examined the multidimensional components of dyspnea or their underlying physiological mechanisms. METHODS In a randomized crossover design, 16 healthy individuals ( n = 9 women, 25 ± 3 yr) completed incremental cycling tests over three visits, where visits 2 and 3 were randomized to either surgical FM or no mask control. Dyspnea intensity and unpleasantness were assessed throughout exercise (0-10 Borg scale), and the Multidimensional Dyspnea Profile was administered immediately after exercise. Crural diaphragmatic EMG and esophageal pressure were measured using a catheter to estimate neural respiratory drive and respiratory muscle effort, respectively. RESULTS Dyspnea unpleasantness was significantly greater with the FM at the highest equivalent submaximal work rate achieved by a given participant in both conditions (iso-work; 5.9 ± 1.7 vs 3.9 ± 2.9 Borg 0-10 units, P = 0.007) and at peak exercise (7.8 ± 2.1 vs 5.9 ± 3.4 Borg 0-10 units, P = 0.01) with no differences in dyspnea intensity ratings throughout exercise compared with control. There were significant increases in the sensory quality of "smothering/air hunger" ( P = 0.01) and the emotional response of "anxiousness" ( P = 0.04) in the FM condition. There were significant increases in diaphragmatic EMG and esophageal pressure at select submaximal work rates, but no differences in heart rate, pulse oximetry-derived arterial oxygen saturation, or breathing frequency throughout exercise with FMs compared with control. FMs significantly reduced peak work rate and exercise duration (both P = 0.02). CONCLUSIONS FMs negatively impact the affective domain of dyspnea and increase neural respiratory drive and respiratory muscle effort during exercise, although the impact on other cardiorespiratory responses are minimal.
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Affiliation(s)
| | | | | | | | - Satvir S Dhillon
- Centre for Heart Lung Innovation, Providence Research, The University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, CANADA
| | - Paolo B Dominelli
- Department of Kinesiology, Faculty of Health, University of Waterloo, Waterloo, Ontario, CANADA
| | - Yannick Molgat-Seon
- Faculty of Kinesiology and Applied Health, The University of Winnipeg, Winnipeg, Manitoba, CANADA
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23
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Vishwanath V, Favo CL, Tu TH, Anderson B, Erickson C, Scarpulla M, Kern J, DeWinter L, Gawelko A, Bolch C, Al-Nakkash L. Effects of face masks on oxygen saturation at graded exercise intensities. J Osteopath Med 2023; 123:167-176. [PMID: 36259531 DOI: 10.1515/jom-2022-0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/09/2022] [Indexed: 11/06/2022]
Abstract
CONTEXT Mask wearing to mitigate the spread of COVID-19 and other viral infections may raise concerns on the effects of face masks on breathing and cardiopulmonary health. Non-evidence-based apprehensions may limit the use of masks in public. OBJECTIVES We will assess the parameters related to heart and lung physiology between healthy male and female adults exposed to wearing face masks (or not) under conditions of rest and graded exercise. METHODS We performed a cross-sectional study including 20 male and 20 female adults who met our inclusion criteria. Adults with underlying respiratory and cardiac conditions were excluded. Physiologic parameters were measured while the participants underwent three activity levels (10 min each) in a randomly assigned order: rest, walking, and stair climbing. Each activity level was conducted under three mask conditions: no mask, surgical mask, and N95 respirator. Heart rate (HR) and blood oxygen saturation (SpO2) were recorded via pulse oximeter after each activity. Perceived exertion was recorded utilizing a Borg 15-point scale. A mixed-effects analysis of variance (ANOVA) was utilized to interpret the results. RESULTS A significant increase in perceived exertion was reported for N95 users (p<0.0001). There was also a significant increase in mean HR for N95 users in comparison to no-mask users (p=0.0031). The mean SpO2 in females was higher than males under rest and walking conditions (p=0.0055). There was no change in SpO2 between mask type overall, nor between mask type vs. exercise intensity, nor between mask type and sex. CONCLUSIONS Our findings provide evidence that surgical masks and N95 respirators do not influence SpO2 at rest or during exercise.
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Affiliation(s)
- Varnita Vishwanath
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
| | - Clinnt L Favo
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
| | - Trevyn H Tu
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
| | - Blake Anderson
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
| | - Colby Erickson
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
| | - Megan Scarpulla
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
| | - Julia Kern
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
| | - Lisa DeWinter
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
| | - Anette Gawelko
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
| | - Charlotte Bolch
- Office of Research & Sponsored Programs, Midwestern University, Glendale, AZ, USA
| | - Layla Al-Nakkash
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA.,Department of Physiology, College of Graduate Studies, Midwestern University, Glendale, AZ, USA
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24
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Qin LY. A Comparison of the Effect of Facemasks on Perceived Breathability and Air Quality during Daily Activities and Indoor Exercises. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4144. [PMID: 36901156 PMCID: PMC10002446 DOI: 10.3390/ijerph20054144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Transmission of COVID-19 occurs predominantly through respired droplets and aerosols containing the SARS-CoV-2 virus. As a solution, face masks have been used to protect against infection. Wearing face masks during indoor exercises is essential to prevent the spread of virus-containing respiratory droplets and aerosols. However, previous studies have not investigated all elements, including the users' perceived breathability (PB) and perceived air quality (PAQ) when wearing a face mask during indoor exercises. The current study aimed to assess users' perceived comfort (PC) of face masks based on assessment criteria of PB and PAQ during moderate to vigorous exercises, and compare them with those during normal daily activities. Data on PC, PB, and PAQ were collected from an online questionnaire survey from 104 participants doing regular moderate to vigorous exercises. Within-subjects comparison with self-controlled case series design was performed to compare PC, PB, and PAQ between wearing face masks during exercises and daily activities. Results showed that the degree of dissatisfaction with PC, PB, and PAQ while wearing face masks and performing indoor exercises is higher than when performing daily activities (p < 0.05). The significance of the study implies that masks comfortable for daily activities may not remain the same during moderate to vigorous exercises, especially during indoor exercises.
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Affiliation(s)
- Lai-Yin Qin
- Academy of Visual Arts, School of Creative Arts, Hong Kong Baptist University, Hong Kong, China
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25
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Driver S, Brown KD, Gilliland T, Reynolds M, Bennett M, McShan E, Kim CHJ, Freese E, Belling P, Gottlieb RL, Jones A. Effects of cloth face masks on physical and cognitive performance during maximal exercise testing. Proc AMIA Symp 2023; 36:318-324. [PMID: 37091771 PMCID: PMC10120526 DOI: 10.1080/08998280.2023.2177483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Wearing a cloth face mask has been shown to impair exercise performance; it is essential to understand the impact wearing a cloth face mask may have on cognitive performance. Participants completed two maximal cardiopulmonary exercise tests on a cycle ergometer (with and without a cloth face mask) with a concurrent cognitive task. Blood pressure, heart rate, oxygen saturation, perceived exertion, shortness of breath, accuracy, and reaction time were measured at rest, during each exercise stage, and following a 4-minute recovery period. The final sample included 35 adults (age = 26.1 ± 5.8 years; 12 female/23 male). Wearing a cloth face mask was associated with significant decreases in exercise duration (-2:00 ± 3:40 min, P = 0.003), peak measures of maximal oxygen uptake (-818.9 ± 473.3 mL/min, -19.0 ± 48 mL·min-1·kg-1, P < 0.001), respiratory exchange ratio (-0.04 ± 0.08, P = 0.005), minute ventilation (-36.9 ± 18 L/min), oxygen pulse (-3.9 ± 2.3, P < 0.001), heart rate (-7.9 ± 12.6 bpm, P < 0.001), oxygen saturation (-1.5 ± 2.8%, P = 0.004), and blood lactate (-1.7 ± 2.5 mmol/L, P < 0.001). While wearing a cloth face mask significantly impaired exercise performance during maximal exercise testing, cognitive performance was unaffected in this selected group of young, active adults.
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Affiliation(s)
- Simon Driver
- Sports Therapy and Research, Baylor Scott and White Health, Frisco, Texas
| | - Katelyn D. Brown
- Sports Therapy and Research, Baylor Scott and White Health, Frisco, Texas
| | - Taylor Gilliland
- Sports Therapy and Research, Baylor Scott and White Health, Frisco, Texas
| | - Megan Reynolds
- Sports Therapy and Research, Baylor Scott and White Health, Frisco, Texas
| | - Monica Bennett
- Biostatistics Core, Baylor Scott and White Research Institute, Dallas, Texas
| | - Evan McShan
- Sports Therapy and Research, Baylor Scott and White Health, Frisco, Texas
| | - Chol Ho J. Kim
- Clinical Research Management, University of North Texas, Fort Worth, Texas
| | - Eric Freese
- Gatorade Sport Science Institute, Frisco, Texas
| | | | - Robert L. Gottlieb
- Center for Advanced Heart and Lung Disease, Baylor University Medical Center, Dallas, Texas
- Department of Internal Medicine, Texas A&M Health Science Center, Dallas, Texas
- Department of Internal Medicine, TCU School of Medicine, Fort Worth, Texas
| | - Alan Jones
- Department of Orthopedics, Baylor University Medical Center at Dallas, Dallas, Texas
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26
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Wells AD, Mermier CM, Bellovary BN, Deyhle MR, Hsiao YY, Amorim FT. The physiological, perceptual, and thermoregulatory responses to facemask use during exercise. J Sports Med Phys Fitness 2023; 63:264-272. [PMID: 35912891 DOI: 10.23736/s0022-4707.22.14032-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The use of masks in public settings and when around people has been recommended to limit the spread of Coronavirus disease 2019 (COVID-19) by major public health agencies. Several different types of masks classified as either medical- or non-medical grade are commonly used among the public. However, concerns with difficulty breathing, re-breathing exhaled carbon dioxide, a decrease in arterial oxygen saturation, and a decrease in exercise performance have been raised regarding the use of mask during exercise. We review the current knowledge related to the effect of different masks during exercise on cardiorespiratory, metabolic, thermoregulatory, and perceptual responses. As such, the current literature seems to suggest that there are minimal changes to cardiovascular, metabolic, and no changes to thermoregulatory parameters with facemask use. However, differences in ventilatory parameters have been reported with submaximal and maximal intensity exercise to volitional fatigue. Literature on perceptual responses to exercise indicate an impact on ratings of perceived exertion, dyspnea, and overall discomfort dependent on mask use as well as exercise intensity. In conclusion, data from the current literature suggests a minimal impact on physiological, perceptual, and thermoregulatory responses dependent on the type of mask used during exercise.
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Affiliation(s)
- Andrew D Wells
- Department of Health, Exercise and Sports Sciences, University of New Mexico, Albuquerque, NM, USA - .,Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA -
| | - Christine M Mermier
- Department of Health, Exercise and Sports Sciences, University of New Mexico, Albuquerque, NM, USA
| | | | - Michael R Deyhle
- Department of Health, Exercise and Sports Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Yu-Yu Hsiao
- Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, NM, USA
| | - Fabiano T Amorim
- Department of Health, Exercise and Sports Sciences, University of New Mexico, Albuquerque, NM, USA
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27
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Dabidi Roshan V, Ahmadian M, Nasiri K, Akbari A, Ghasemi M, Nasrollahi Borujeni N, Zahedmanesh F, Nabavi Chashmi SM, Imani F. Exercise-induced expression of SARS-CoV-2 entry receptors: impact of mask modality, sex, and exercise intensity. J Sports Med Phys Fitness 2023; 63:319-328. [PMID: 35686871 DOI: 10.23736/s0022-4707.22.14093-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Wearing a facemask affects physiological responses to exercise. We explored how exercising with a facemask affects the expression of SARS-CoV-2 entry receptor (angiotensin-converting enzyme 2 [ACE2]) and some associated genes (angiotensin type-1 receptors [AT<inf>1</inf>R]; Mas receptor [MasR]; hypoxia-inducible factor 1α [HIF-1α]; endothelial nitric oxide synthase [eNOS]) among healthy males and females. METHODS One hundred forty-four apparently healthy individuals (72 females; age: 30±6) were allocated to three mask groups of 48 (N95, Surgical, No Mask) with two exercise subgroups for each mask for both sexes. Participants in each experimental group performed either a submaximal (walking with no grade) or maximal (a modified Bruce Protocol) treadmill exercise test. Blood samples were collected before and after each exercise test and used to analyze the mRNA expression of the genes studied. RESULTS The post-exercise expression of genes examined were comparable between Surgical, N95, and No Mask (P>0.05). ACE2 was significantly greater in Surgical and N95 against No Mask at baseline and following moderate-intensity exercise (P<0.05). Whilst similar expressions were noted for MasR and eNOS (P>0.05), AT<inf>1</inf>R was greater in N95 than Surgical following high-intensity exercise (P<0.05). HIF-1α following either exercise intensity was significantly lower in N95 than Surgical (P<0.05). AT<inf>1</inf>R and HIF-1α were similar between Surgical and N95 against No Mask (P>0.05). ACE2 and AT<inf>1</inf>R were significantly higher in either mask modality than No Mask in males at baseline and postexercise (P<0.05). HIF-1α, MasR, and eNOS expressions were comparable between all mask groups in either sex (P<0.05). CONCLUSIONS Our findings suggest that wearing a facemask does not differentiate the gene expression of SARS-CoV-2 entry receptor following exercise among both sexes.
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Affiliation(s)
- Valiollah Dabidi Roshan
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran - .,Athletic Performance and Health Research Center, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran -
| | - Mehdi Ahmadian
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Khadijeh Nasiri
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | - Abolfazl Akbari
- School of Veterinary Medicine, Department of Physiology, Shiraz University, Shiraz, Iran
| | - Mohammad Ghasemi
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | | | - Foruzan Zahedmanesh
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | - Seyedeh M Nabavi Chashmi
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | - Fattaneh Imani
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
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28
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Reeder EL, O'Connell CJ, Collins SM, Traubert OD, Norman SV, Cáceres RA, Sah R, Smith DW, Robson MJ. Increased Carbon Dioxide Respiration Prevents the Effects of Acceleration/Deceleration Elicited Mild Traumatic Brain Injury. Neuroscience 2023; 509:20-35. [PMID: 36332692 DOI: 10.1016/j.neuroscience.2022.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/30/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022]
Abstract
Acceleration/deceleration forces are a common component of various causes of mild traumatic brain injury (mTBI) and result in strain and shear forces on brain tissue. A small quantifiable volume dubbed the compensatory reserve volume (CRV) permits energy transmission to brain tissue during acceleration/deceleration events. The CRV is principally regulated by cerebral blood flow (CBF) and CBF is primarily determined by the concentration of inspired carbon dioxide (CO2). We hypothesized that experimental hypercapnia (i.e. increased inspired concentration of CO2) may act to prevent and mitigate the actions of acceleration/deceleration-induced TBI. To determine these effects C57Bl/6 mice underwent experimental hypercapnia whereby they were exposed to medical-grade atmospheric air or 5% CO2 immediately prior to an acceleration/deceleration-induced mTBI paradigm. mTBI results in significant increases in righting reflex time (RRT), reductions in core body temperature, and reductions in general locomotor activity-three hours post injury (hpi). Experimental hypercapnia immediately preceding mTBI was found to prevent mTBI-induced increases in RRT and reductions in core body temperature and general locomotor activity. Ribonucleic acid (RNA) sequencing conducted four hpi revealed that CO2 exposure prevented mTBI-induced transcriptional alterations of several targets related to oxidative stress, immune, and inflammatory signaling. Quantitative real-time PCR analysis confirmed the prevention of mTBI-induced increases in mitogen-activated protein kinase kinase kinase 6 and metallothionein-2. These initial proof of concept studies reveal that increases in inspired CO2 mitigate the detrimental contributions of acceleration/deceleration events in mTBI and may feasibly be translated in the future to humans using a medical device seeking to prevent mTBI among high-risk groups.
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Affiliation(s)
- Evan L Reeder
- University of Cincinnati James L. Winkle College of Pharmacy, Division of Pharmaceutical Sciences, Cincinnati, OH 45267, USA
| | - Christopher J O'Connell
- University of Cincinnati James L. Winkle College of Pharmacy, Division of Pharmaceutical Sciences, Cincinnati, OH 45267, USA
| | - Sean M Collins
- University of Cincinnati James L. Winkle College of Pharmacy, Division of Pharmaceutical Sciences, Cincinnati, OH 45267, USA
| | - Owen D Traubert
- University of Cincinnati College of Arts and Sciences, Department of Biological Sciences, Cincinnati, OH 45221, USA
| | - Sophia V Norman
- University of Cincinnati College of Arts and Sciences, Department of Biological Sciences, Cincinnati, OH 45221, USA
| | - Román A Cáceres
- University of Cincinnati College of Medicine, Department of Cancer and Cell Biology Cincinnati, OH 45267, USA
| | - Renu Sah
- University of Cincinnati College of Medicine, Department of Pharmacology and Systems Physiology, Cincinnati, OH 45267, USA
| | | | - Matthew J Robson
- University of Cincinnati James L. Winkle College of Pharmacy, Division of Pharmaceutical Sciences, Cincinnati, OH 45267, USA.
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29
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Effects of High-Intensity Exercise on Physiological Indicators of Recovery Period by Wearing Face Masks of Elite Athletes. Healthcare (Basel) 2023; 11:healthcare11020268. [PMID: 36673636 PMCID: PMC9858813 DOI: 10.3390/healthcare11020268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
Athletes need to maintain the necessary physical conditioning for sports performance while wearing face masks to reduce the risk of virus transmission during training and competition during the COVID-19 situation. The quantitative and physiological effects of face masks on exercise capacity needs to be reported. The purpose of this study was to evaluate elite athletes to quantify, in detail, the effect of a KF94 face mask on changes in lactic acid during recovery after high-intensity aerobic exercise. Thirteen elite soft tennis athletes were recruited. A crossover design was used to examine the effects of using a disposable KF94 face mask compared with not masking during exercise. The participants completed a shuttle run test experiment two times during a 3-day period, including 5−10 min of warmup according to their personal preferences. The lactic acid concentration at 20 min of recovery after maximum exercise was 5.98 ± 1.53 mM/L without a mask and 7.61 ± 1.85 mM/L with a KF94 mask (p < 0.001). The maximum laps of shuttle run tests were 101.5 ± 22.5 laps without a mask and 94.2 ± 20.2 laps with a KF94 mask (p < 0.001). Intense exercise after wearing quarantine masks reduces the maximum aerobic exercise ability and decreases the ability to recover lactic acid.
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Harber P, Beckett WS. Health effects of filtering facepiece respirators: Systematic review of pulmonary and cardiovascular effects. Am J Ind Med 2023; 66:181-198. [PMID: 36464991 PMCID: PMC9878161 DOI: 10.1002/ajim.23450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/11/2022]
Abstract
Filtering facepiece respirators (FFRs) were introduced to protect the wearer by removing small particles from inspired air. FFRs are now also used to reduce the spread of transmissible agents from the wearer and are worn outside traditional healthcare and other workplaces. The COVID-19 pandemic increased concerns about potential adverse effects on wearers. A PUBMED query retrieved articles through June 2022. Abstracts and selected full-text articles were systematically reviewed by the authors. This article focuses upon cardiopulmonary physiologic effects (e.g., ventilation, CO2 elimination, oxygen uptake, and respiratory control) with emphasis upon current and potential research methods as well as summarizing results. 1985 records were identified, of which only 26% were published before 2020. FFR effects on CO2 elimination appear more likely to be significant than effects on oxygenation or cardiovascular function. While FFRs appear well tolerated by healthy persons, more research is needed for those with pulmonary or cardiac disorders, and for children. Many traditional pulmonary exercise study methods require special care when applied to filtering facepiece respirators. Studying additional parameters may explain the paradox of many subjective discomfort reports despite very limited physiologic effects.
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Affiliation(s)
- Philip Harber
- University of Arizona‐Mel and Enid Zuckerman College of Public HealthTucsonArizonaUSA
| | - William S. Beckett
- Harvard Medical School and Mount Auburn HospitalCambridgeMassachusettsUSA
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Adams J, Wymer E, Rao PSS. Impact of COVID-19 pandemic on cross-country runners: changes in training, sleep, diet, and mental health. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-11. [PMID: 36595576 DOI: 10.1080/07448481.2022.2153602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 10/21/2022] [Accepted: 11/13/2022] [Indexed: 06/17/2023]
Abstract
Objective: Determine the impact of the COVID-19 pandemic on the changes in training, sleep, diet, and mental health of cross-country runners. Participants: Cross-country runners from NCAA Division II institutes. Methods: Wilcoxon signed-rank test was performed to analyze survey responses to ordinal questions on the survey while Spearman's rank correlation analysis (ρ) was used to calculate correlation between after the start of pandemic questions. Data was marked significant at p < 0.05. Results: Analysis of the survey responses revealed that cross-country runners were more likely to experience feelings of depression (p < 0.001), lack of motivation (p < 0.001), and higher daily stress (p < 0.001) after the start of the pandemic. After the start of the pandemic, runners running less days per week were more likely to report an increased feeling of depression (ρ=-0.315, p = 0.008) and lack of motivation (ρ=-0.458, p < 0.001). Conclusions: The present study underscores the importance of training, sleep, diet, and mental health amongst cross-country runners.
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Affiliation(s)
- Jack Adams
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Findlay, Findlay, OH, USA
| | - Eric Wymer
- Athletics Department, The University of Findlay, Findlay, OH, USA
| | - P S S Rao
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Findlay, Findlay, OH, USA
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Cowie B, Wadlow I, Yule A, Janssens K, Ward J, Foulkes S, Humphries R, McGain F, Dhillon R, La Gerche A. Aerosol Generation During High Intensity Exercise-Implications for COVID-19 Transmission. Heart Lung Circ 2023; 32:67-78. [PMID: 36463077 PMCID: PMC9710566 DOI: 10.1016/j.hlc.2022.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 10/10/2022] [Accepted: 10/24/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND AND AIM COVID-19 can be transmitted through aerosolised respiratory particles. The degree to which exercise enhances aerosol production has not been previously assessed. We aimed to quantify the size and concentration of aerosol particles and evaluate the impact of physical distance and surgical mask wearing during high intensity exercise (HIE). METHODS Using a prospective observational crossover study, three healthy volunteers performed high intensity cardiopulmonary exercise testing at 80% of peak capacity in repeated 5-minute bouts on a cycle ergometer. Aerosol size and concentration was measured at 35, 150 and 300 cm from the participants in an anterior and lateral direction, with and without a surgical face mask, using an Aerodynamic Particle Sizer (APS) and a Mini Wide Range Aerosol Spectrometer (MiniWRAS), with over 10,000 sample points. RESULTS High intensity exercise generates aerosol in the 0.2-1 micrometre range. Increasing distance from the rider reduces aerosol concentrations measured by both MiniWRAS (p=0.003 for interaction) and APS (p=0.041). However, aerosol concentrations remained significantly increased above baseline measures at 300 cm from the rider. A surgical face mask reduced submicron aerosol concentrations measured anteriorly to the rider (p=0.031 for interaction) but not when measured laterally (p=0.64 for interaction). CONCLUSIONS High intensity exercise is an aerosol generating activity. Significant concentrations of aerosol particles are measurable well beyond the commonly recommended 150 cm of physical distancing. A surgical face mask reduces aerosol concentration anteriorly but not laterally to an exercising individual. Measures for safer exercise should emphasise distance and airflow and not rely solely on mask wearing.
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Affiliation(s)
- Brian Cowie
- Sports Cardiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Vic, Australia,Department of Anaesthesia, St Vincent’s Hospital, Melbourne, Vic, Australia,Corresponding author at: Dr Brian Cowie, Department of Anaesthesia, St. Vincent’s Hospital, Melbourne, Vic, Australia
| | - Imogen Wadlow
- Department of Atmospheric Science, University of Melbourne, Melbourne, Vic, Australia,Climate Science Centre, CSIRO Oceans and Atmosphere, Melbourne, Vic, Australia
| | - Andrew Yule
- Australian Radiation Protection and Nuclear Safety Agency, Melbourne, Vic, Australia
| | - Kristel Janssens
- Sports Cardiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Vic, Australia,Department of Cardiometabolic Health, University of Melbourne, Melbourne, Vic, Australia
| | - Jason Ward
- Climate Science Centre, CSIRO Oceans and Atmosphere, Melbourne, Vic, Australia
| | - Steve Foulkes
- Sports Cardiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Vic, Australia,Department of Cardiometabolic Health, University of Melbourne, Melbourne, Vic, Australia
| | - Ruhi Humphries
- Climate Science Centre, CSIRO Oceans and Atmosphere, Melbourne, Vic, Australia
| | - Forbes McGain
- Department of Anaesthesia and Intensive Care, Western Health, Vic, Australia,Department of Critical Care, University of Melbourne, Melbourne, Vic, Australia
| | - Rana Dhillon
- Department of Neurosurgery, St. Vincent’s Hospital, Melbourne, Vic, Australia
| | - André La Gerche
- Sports Cardiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Vic, Australia,Department of Cardiometabolic Health, University of Melbourne, Melbourne, Vic, Australia,National Centre for Sports Cardiology, St Vincent’s Hospital Melbourne, Melbourne, Vic, Australia
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Zheng C, Poon ETC, Wan K, Dai Z, Wong SHS. Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis. Sports Med 2023; 53:125-150. [PMID: 36001290 PMCID: PMC9400006 DOI: 10.1007/s40279-022-01746-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Wearing face masks in public is an effective strategy for preventing the spread of viruses; however, it may negatively affect exercise responses. Therefore, this review aimed to explore the effects of wearing different types of face masks during exercise on various physiological and psychological outcomes in healthy individuals. METHODS A literature search was conducted using relevant electronic databases, including Medline, PubMed, Embase, SPORTDiscus, Web of Science, and Cochrane Central Register of Controlled Trials on April 05, 2022. Studies examining the effect of mask wearing (surgical mask, cloth mask, and FFP2/N95 respirator) during exercise on various physiological and psychological parameters in apparently healthy individuals were included. For meta-analysis, a random effects model was used. Mean difference (MD) or standardized MD (SMD) with 95% confidence intervals (CI) were calculated to analyze the total effect and the effect in subgroups classified based on face mask and exercise types. The quality of included studies was examined using the revised Cochrane risk-of-bias tool. RESULTS Forty-five studies with 1264 participants (708 men) were included in the systematic review. Face masks had significant effects on gas exchange when worn during exercise; this included differences in oxygen uptake (SMD - 0.66, 95% CI - 0.87 to - 0.45), end-tidal partial pressure of oxygen (MD - 3.79 mmHg, 95% CI - 5.46 to - 2.12), carbon dioxide production (SMD - 0.77, 95% CI - 1.15 to - 0.39), and end-tidal partial pressure of carbon dioxide (MD 2.93 mmHg, 95% CI 2.01-3.86). While oxygen saturation (MD - 0.48%, 95% CI - 0.71 to - 0.26) decreased slightly, heart rate was not affected. Mask wearing led to higher degrees of rating of perceived exertion, dyspnea, fatigue, and thermal sensation. Moreover, a small effect on exercise performance was observed in individuals wearing FFP2/N95 respirators (SMD - 0.42, 95% CI - 0.76 to - 0.08) and total effect (SMD - 0.23, 95% CI - 0.41 to - 0.04). CONCLUSION Wearing face masks during exercise modestly affected both physiological and psychological parameters, including gas exchange, pulmonary function, and subjective discomfort in healthy individuals, although the overall effect on exercise performance appeared to be small. This review provides updated information on optimizing exercise recommendations for the public during the COVID-19 pandemic. SYSTEMATIC REVIEW REGISTRATION NUMBER This study was registered in the International Prospective Register of Systematic Review (PROSPERO) database (registration number: CRD42021287278).
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Affiliation(s)
- Chen Zheng
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eric Tsz-Chun Poon
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Kewen Wan
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zihan Dai
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Stephen Heung-Sang Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Kanda J, Wakasugi M, Kondo Y, Ueno S, Kaneko H, Okada Y, Okano Y, Kishihara Y, Hamaguchi J, Ishihara T, Igarashi Y, Nakae R, Miyamoto S, Yamada E, Ikechi D, Yamazaki M, Tanaka D, Sawada Y, Suda C, Yoshimura S, Onodera R, Kano K, Hongo T, Endo K, Iwasaki Y, Kodaira H, Yasuo S, Seki N, Okuda H, Nakajima S, Nagato T, Terazumi K, Nakamura S, Yokobori S. Heat stroke management during the COVID-19 pandemic: Recommendations from the experts in Japan (2nd edition). Acute Med Surg 2023; 10:e827. [PMID: 37056485 PMCID: PMC10086676 DOI: 10.1002/ams2.827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/08/2023] [Indexed: 04/15/2023] Open
Abstract
Both coronavirus disease 2019 (COVID-19) and heat stroke have symptoms of fever or hyperthermia and the difficulty in distinguishing them could lead to a strain on emergency medical care. To mitigate the potential confusion that could arise from actions for preventing both COVID-19 spread and heat stroke, particularly in the context of record-breaking summer season temperatures, this work offers new knowledge and evidence that address concerns regarding indoor ventilation and indoor temperatures, mask wearing and heat stroke risk, and the isolation of older adults. Specifically, the current work is the second edition to the previously published guidance for handling heat stroke during the COVID-19 pandemic, prepared by the "Working group on heat stroke medical care during the COVID-19 epidemic," composed of members from four organizations in different medical and related fields. The group was established by the Japanese Association for Acute Medicine Heatstroke and Hypothermia Surveillance Committee. This second edition includes new knowledge, and conventional evidence gleaned from a primary selection of 60 articles from MEDLINE, one article from Cochrane, 13 articles from Ichushi, and a secondary/final selection of 56 articles. This work summarizes the contents that have been clarified in the prevention and treatment of infectious diseases and heat stroke to provide guidance for the prevention, diagnosis, and treatment of heat stroke during the COVID-19 pandemic.
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Affiliation(s)
- Jun Kanda
- Department of Emergency MedicineTeikyo University School of MedicineItabashiJapan
| | - Masahiro Wakasugi
- Department of Emergency and Disaster MedicineUniversity of ToyamaToyamaJapan
| | - Yutaka Kondo
- Department of Emergency and Critical Care MedicineJuntendo University Urayasu HospitalUrayasuJapan
| | - Satoru Ueno
- Japan Organisation of Occupational Health and SafetyNational Institute of Occupational Safety and HealthKiyoseJapan
| | - Hitoshi Kaneko
- Department of Trauma and Emergency MedicineTokyo Metropolitan Tama Medical CenterFuchuJapan
| | - Yohei Okada
- Department of Public Health Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Yuichi Okano
- Department of Emergency MedicineKumamoto Sekijuji HospitalKumamotoJapan
| | - Yuki Kishihara
- Department of Urology, Emergency Room, Jichi Medical University Saitama Medical CenterJichi Medical UniversityShimotsukeJapan
| | - Jun Hamaguchi
- Department of Emergency and Critical Care MedicineTokyo Metropolitan Tama Medical CenterFuchuJapan
| | - Tadashi Ishihara
- Department of Emergency and Critical Care MedicineJuntendo University Urayasu HospitalUrayasuJapan
| | - Yutaka Igarashi
- Department of Emergency and Critical Care MedicineNippon Medical SchoolBunkyo CityJapan
| | - Ryuta Nakae
- Department of Emergency and Critical Care MedicineNippon Medical SchoolBunkyo CityJapan
| | - Sohma Miyamoto
- Department of Emergency and Critical Care MedicineSt. Luke's International HospitalChuo CityJapan
| | - Eri Yamada
- Advanced Medical Emergency Department and Critical Care CenterMaebashi Red Cross HospitalMaebashiJapan
| | - Daisuke Ikechi
- Department of Emergency and Critical Care MedicineHitachi General HospitalHitachiJapan
| | - Maiko Yamazaki
- Department of Emergency MedicineTeikyo University School of MedicineItabashiJapan
| | - Daiki Tanaka
- Department of Emergency MedicineTeikyo University School of MedicineItabashiJapan
| | - Yusuke Sawada
- Department of Emergency MedicineGunma University Graduate School of MedicineMaebashiJapan
| | - Chiaki Suda
- Department of Emergency and Critical Care MedicineSaku Central Hospital Advanced Care CenterSakuJapan
| | | | - Ryuta Onodera
- Department of Preventive ServicesKyoto University School of Public HealthKyotoJapan
| | - Kenichi Kano
- Emergency and Critical Care MedicineKokuritsu Byoin Kiko Kyoto Iryo CenterKyotoJapan
| | - Takashi Hongo
- Emergency DepartmentOkayama Saiseikai General HospitalOkayamaJapan
| | - Kaori Endo
- Orthopaedic Surgery, Sapporo Tokushukai HospitalHokkaido UniversitySapporoJapan
| | - Yohei Iwasaki
- Trauma and Acute Critical Care CenterTokyo Medical and Dental University HospitalTokyoJapan
| | | | | | - Nozomu Seki
- Department of Emergency and Critical Care MedicineJapanese Red Cross Saitama HospitalSaitamaJapan
| | - Hiroshi Okuda
- Division of Comprehensive MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Satoshi Nakajima
- Department of Emergency MedicineKyoto Prefectural University of MedicineKyotoJapan
| | - Tadashi Nagato
- Department of Respiratory MedicineJCHO Tokyo Yamate Medical CenterKyotoJapan
| | - Keiko Terazumi
- Trauma and Critical CareJapanese Red Cross Kumamoto HospitalKumamotoJapan
| | - Satoshi Nakamura
- Department of Emergency MedicineAsahi General HospitalAsahiJapan
| | - Shoji Yokobori
- Department of Emergency and Critical Care MedicineNippon Medical SchoolBunkyo CityJapan
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A Cloth Facemask Causes No Major Respiratory or Cardiovascular Perturbations During Moderate to Heavy Exercise. J Phys Act Health 2023; 20:35-44. [PMID: 36476970 DOI: 10.1123/jpah.2022-0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 09/25/2022] [Accepted: 10/18/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Investigate whether a cloth facemask could affect physiological and perceptual responses to exercise at distinct exercise intensities in untrained individuals. METHODS Healthy participants (n = 35; 17 men, age 30 [4] y, and 18 women, age 28 [5] y) underwent a progressive square wave test at 4 intensities: (1) 80% of ventilatory anaerobic threshold; (2) ventilatory anaerobic threshold; (3) respiratory compensation point; and (4) exercise peak (Peak) to exhaustion, 5-minute stages, with or without a triple-layered cloth facemask (Mask or No-Mask). Several physiological and perceptual measures were analyzed. RESULTS Mask reduced inspiratory capacity at all exercise intensities (P < .0001). Mask reduced respiratory frequency (P = .001) at Peak (-8.3 breaths·min-1; 95% confidence interval [CI], -5.8 to -10.8), respiratory compensation point (-6.9 breaths·min-1; 95% CI, -4.6 to -9.2), and ventilatory anaerobic threshold (-6.5 breaths·min-1; 95% CI, -4.1 to -8.8), but not at Baseline or 80% of ventilatory anaerobic threshold. Mask reduced tidal volume (P < .0001) only at respiratory compensation point (-0.5 L; 95% CI, -0.3 to -0.6) and Peak (-0.8 L; 95% CI, -0.6 to -0.9). Shallow breathing index was increased with Mask only at Peak (11.3; 95% CI, 7.5 to 15.1). Mask did not change HR, lactate, ratings of perceived exertion, blood pressure, or oxygen saturation. CONCLUSIONS A cloth facemask reduced time to exhaustion but had no major impact on cardiorespiratory parameters and had a slight but clinically meaningless impact on respiratory variables at higher intensities. Moderate to heavy activity is safe and tolerable for healthy individuals while wearing a cloth facemask. CLINICALTRIALS gov: NCT04887714.
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Lima GLDS, Rocha TC, Silva Júnior GPDLD, Martins MT. The influence of N95 and FFP2 masks on cardiorespiratory variables in healthy individuals during aerobic exercise: a systematic review and meta-analysis. J Bras Pneumol 2023; 49:e20220143. [PMID: 36946844 PMCID: PMC10171276 DOI: 10.36416/1806-3756/e20220143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 01/12/2023] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE In view of the current COVID-19 pandemic, the objective of this study was to determine, through a systematic review and meta-analysis, whether the use of N95/FFP2 masks during aerobic exercise has a significant impact on HR, RR, SpO2, and blood pressure (BP) in healthy individuals. METHODS We searched the MEDLINE database for studies published in English between 2005 and 2021. To reduce bias and increase reliability, only randomized controlled trials and randomized crossover clinical trials were considered for inclusion. The selected outcomes included HR, RR, SpO2, and BP, with perceived exertion being evaluated by means of the Borg scale. RESULTS Eight controlled trials were included in the meta-analysis. Seven evaluated HR (p > 0.05), five evaluated RR (p > 0.05), five evaluated SpO2 and BP (p > 0.05 for both), and six evaluated perceived exertion, presenting controversial results such as risk ratios that were grouped for each variable. CONCLUSIONS This study suggests that N95 and FFP2 masks do not have significant effects on HR, RR, SpO2, and BP during aerobic exercise in healthy individuals.
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Affiliation(s)
- Gustavo Lucas da Silva Lima
- . Faculdade de Ciências Médicas e da Saúde de Juiz de Fora - SUPREMA - Juiz de Fora (MG) Brasil
- . Hospital Maternidade Therezinha de Jesus, Juiz de Fora (MG) Brasil
| | - Thiago Casali Rocha
- . Faculdade de Ciências Médicas e da Saúde de Juiz de Fora - SUPREMA - Juiz de Fora (MG) Brasil
- . Hospital Maternidade Therezinha de Jesus, Juiz de Fora (MG) Brasil
| | | | - Marcelo Tarcísio Martins
- . Faculdade de Ciências Médicas e da Saúde de Juiz de Fora - SUPREMA - Juiz de Fora (MG) Brasil
- . Hospital Maternidade Therezinha de Jesus, Juiz de Fora (MG) Brasil
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Marticorena FM, Barreto GC, Guardieiro NM, Esteves GP, Oliveira TN, de Oliveira LF, Pinto ALDS, Riani L, Prado DM, Saunders B, Gualano B. Performing moderate to severe activity is safe and tolerable for healthy youth while wearing a cloth facemask. PLoS One 2023; 18:e0282475. [PMID: 36877666 PMCID: PMC9987789 DOI: 10.1371/journal.pone.0282475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 02/08/2023] [Indexed: 03/07/2023] Open
Abstract
OBJECTIVE To investigate if a cloth facemask could affect physiological and perceptual responses to exercise at distinct exercise intensities in healthy young individuals. METHODS Nine participants (sex, female/male: 6/3; age: 13±1 years; VO2peak: 44.5±5.5 mL/kg/min) underwent a progressive square-wave test at four intensities: (1) 80% of ventilatory anaerobic threshold (VAT), (2) VAT, and (3) 40% between VAT and [Formula: see text] wearing a triple-layered cloth facemask or not. Participants then completed a final stage to exhaustion at a running speed equivalent to the maximum achieved during the cardio-respiratory exercise test (Peak). Physiological, metabolic, and perceptual measures were measured. RESULTS Mask did not affect spirometry (forced vital capacity, peak expiratory flow, forced expiratory volume; all p≥0.27), respiratory (inspiratory capacity, end-expiratory volume [EELV] to functional vital capacity ratio, EELV, respiratory frequency [Rf], tidal volume [VT], Rf/VT, end-tidal carbo dioxide pressure, ventilatory equivalent to carbon dioxide ratio; all p≥0.196), hemodynamic (heart rate, systolic and diastolic blood pressure; all p>0.41), ratings of perceived exertion (p = 0.04) or metabolic measures (lactate; p = 0.78) at rest or at any exercise intensity. CONCLUSIONS This study shows that performing moderate to severe activity is safe and tolerable for healthy youth while wearing a cloth facemask. TRIAL REGISTRATION ClinicalTrials.gov: NCT04887714.
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Affiliation(s)
- Felipe Miguel Marticorena
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
| | - Gabriel Castanho Barreto
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
| | - Natália Mendes Guardieiro
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
- Clinical Hospital, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, Brazil
| | - Gabriel Perri Esteves
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
| | - Tamires Nunes Oliveira
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
| | - Luana Farias de Oliveira
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
| | - Ana Lucia de Sá Pinto
- Clinical Hospital, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, Brazil
- Laboratory of Assessment and Conditioning in Rheumatology, Rheumatology Division, Universidade de São Paulo, São Paulo, Brazil
| | - Luiz Riani
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
| | - Danilo Mendes Prado
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
| | - Bryan Saunders
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
- Institute of Orthopaedics and Traumatology, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
- Laboratory of Assessment and Conditioning in Rheumatology, Rheumatology Division, Universidade de São Paulo, São Paulo, Brazil
- Food Research Center, University of São Paulo, São Paulo, Brazil
- * E-mail:
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Balestracci B, La Regina M, Di Sessa D, Mucci N, Angelone FD, D'Ecclesia A, Fineschi V, Di Tommaso M, Corbetta L, Lachman P, Orlandini F, Tanzini M, Tartaglia R, Squizzato A. Patient safety implications of wearing a face mask for prevention in the era of COVID-19 pandemic: a systematic review and consensus recommendations. Intern Emerg Med 2023; 18:275-296. [PMID: 36103082 PMCID: PMC9472745 DOI: 10.1007/s11739-022-03083-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/11/2022] [Indexed: 02/01/2023]
Abstract
In the past, the use of face masks in western countries was essentially limited to occupational health. Now, because of the COVID-19 pandemic, mask-wearing has been recommended as a public health intervention. As potential side effects and some contraindications are emerging, we reviewed the literature to assess the impact of them in daily life on patient safety and to provide appropriate guidelines and recommendations. We performed a systematic review of studies investigating physiological impact, safety, and risk of masks in predefined categories of patients, which have been published in peer-reviewed journals with no time and language restrictions. Given the heterogeneity of studies, results were analyzed thematically. We used PRISMA guidelines to report our findings. Wearing a N95 respirator is more associated with worse side effects than wearing a surgical mask with the following complications: breathing difficulties (reduced FiO2, SpO2, PaO2 increased ETCO2, PaCO2), psychiatric symptoms (panic attacks, anxiety) and skin reactions. These complications are related to the duration of use and/or disease severity. Difficulties in communication is another issue to be considered especially with young children, older person and people with hearing impairments. Even if benefits of wearing face masks exceed the discomfort, it is recommended to take an "air break" after 1-2 h consecutively of mask-wearing. However, well-designed prospective studies are needed. The COVID-19 pandemic could represent a unique opportunity for collecting large amount of real-world data.
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Affiliation(s)
- Beatrice Balestracci
- SC Governo e rischio clinico, programmazione sanitaria e controllo di gestione, Azienda Sociosanitaria Ligure 5 (ASL5), La Spezia, Italy
| | - Micaela La Regina
- SC Governo e rischio clinico, programmazione sanitaria e controllo di gestione, Azienda Sociosanitaria Ligure 5 (ASL5), La Spezia, Italy.
| | - Domenico Di Sessa
- SC Governo e rischio clinico, programmazione sanitaria e controllo di gestione, Azienda Sociosanitaria Ligure 5 (ASL5), La Spezia, Italy
| | - Nicola Mucci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | | | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University, Rome, Italy
| | - Mariarosaria Di Tommaso
- Department of Gynaecology, Perinatology and Human Reproduction, University of Florence, Florence, Italy
| | - Lorenzo Corbetta
- Department of Interventional Pneumology, University of Florence, Florence, Italy
| | - Peter Lachman
- Lead Faculty Quality Improvement Programme- Royal College of Physicians of Ireland, Dublin, Ireland
| | | | | | - Riccardo Tartaglia
- Department of Innovation and Information Engineering, G. Marconi University, Rome, Italy
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The effects of cloth face masks on cardiorespiratory responses and VO 2 during maximal incremental running protocol among apparently healthy men. Sci Rep 2022; 12:22292. [PMID: 36566337 PMCID: PMC9789509 DOI: 10.1038/s41598-022-26857-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022] Open
Abstract
We aimed to determine the effects of wearing a cloth face mask on cardiorespiratory response, peak oxygen uptake (Vo2), respiratory muscle effort, and exercise tolerance during incremental exercise. The study had a randomized crossover design: 11 apparently healthy young men performed the Bruce protocol treadmill test in two conditions, wearing a cloth face mask (CFM) and without CFM (CON), in random order. Minute ventilation and oxygen uptake were measured using a mass spectrometry metabolic analyzer; cardiac output (CO) was measured using an impedance CO monitor; and mouth pressure (Pm) was measured and calculated as an integral Pm to assess respiratory muscle effort. Maximal minute ventilation was 13.4 ± 10.7% lower in the CFM condition than in the CON condition (P < 0.001). The peak Vo2 (52.4 ± 5.6 and 55.0 ± 5.1 mL/kg/min in CFM and CON, respectively) and CO were not significantly different between the two conditions. However, the integral value of Pm was significantly higher (P = 0.02), and the running time to exhaustion was 2.6 ± 3.2% lower (P = 0.02) in the CFM condition than in the CON condition. Our results suggest that wearing a cloth face mask increased respiratory muscle effort and decreased ventilatory volume in healthy young men; however, Vo2 remained unchanged. Exercise tolerance also decreased slightly.
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Exercise Capacity and Perceived Exertion on Treadmill Stress Test Performed While Wearing vs Without a Surgical Mask: A Randomized Clinical Trial in Healthy Adults. CJC Open 2022; 4:1036-1042. [PMID: 36124078 PMCID: PMC9473141 DOI: 10.1016/j.cjco.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/07/2022] [Accepted: 07/10/2022] [Indexed: 12/14/2022] Open
Abstract
Background The graded exercise treadmill stress test (GXT) is among the most frequently performed tests in cardiology. The COVID-19 pandemic led many healthcare facilities to require patients to wear a mask during the test. This study evaluated the effect of wearing a surgical face mask on exercise capacity and perceived exertion. Methods In this prospective, randomized crossover trial, 35 healthy adults performed a GXT using the Bruce protocol while wearing a surgical mask, and without a mask. The primary outcome was exercise capacity in metabolic equivalents (MET), and the secondary outcome was exercise perception on the modified Borg scale (from 0 to 10). Effort duration, heart rate, oxygen saturation, and blood pressure were also analyzed. Results Exercise capacity was reduced by 0.4 MET (95% confidence interval [CI] -0.7 to -0.2) during the GXT with a mask (11.8 ± 2.7 vs 12.3 ± 2.5 MET, P = 0.001), and the final perceived effort increased by 0.5 points (95% CI 0.2 to 0.8; 8.4 ± 1.3 vs 7.9 ± 1.6, P = 0.004). Effort duration was cut down by 24 seconds (CI -0:39 to -0:09; 10:03 ± 2:30 vs 10:27 ± 2:16 [minutes:seconds], P = 0.003). Oxygen saturation was slightly lower at the end of the test when participants wore a mask. No significant differences occurred in heart rate or blood pressure during the test. Conclusion Wearing a surgical mask causes a statistically significant decrease in exercise capacity and increase in perceived exertion. This small effect is not clinically significant for the interpretation of test results.
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Ginszt M, Zieliński G, Szkutnik J, Wójcicki M, Baszczowski M, Litko-Rola M, Zielińska D, Różyło-Kalinowska I. The Difference in Electromyographic Activity While Wearing a Medical Mask in Women with and without Temporomandibular Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315559. [PMID: 36497634 PMCID: PMC9737111 DOI: 10.3390/ijerph192315559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 05/27/2023]
Abstract
Wearing a medical mask influences resting activity of the temporalis anterior and masseter muscles in healthy young women. However, no studies link medical mask-wearing with masticatory muscle activity in patients with temporomandibular disorders (TMDs). Therefore, this study aims to compare electromyographic patterns while wearing a medical mask between women with and without temporomandibular disorders. Based on the Research Diagnostic Criteria for Temporomandibular Disorders, 115 adult women qualified for the study. Participants were divided into the following two groups: diagnosed TMDs (n = 55; mean age: 23.5 ± 2.3 years) and healthy women (n = 60; mean age: 23.7 ± 2.6 years). Examinations of the resting and functional electromyographic activity of the temporalis anterior (TA), superficial masseter (MM), anterior bellies of the digastric muscle (DA), and the middle part of the sternocleidomastoid muscle (SCM) were carried out using the BioEMG III™. Both groups showed statistically significant decreases in resting masticatory muscle activity during medical mask examination compared to no mask measurement. The significant differences in no mask measurement between both groups were noted regarding resting masticatory activity, clenching in the intercuspal position, and clenching on dental cotton rollers. During medical mask examination, women with TMDs showed differences in resting masticatory activity and clenching on dental cotton rollers compared to the healthy group. In all analyzed variables, both groups showed similar electromyographic patterns in the maximum mouth opening measurement during medical mask and no mask examination. A medical mask influences the resting bioelectric activity of the masticatory muscles in women with temporomandibular disorders and healthy women. We observed differences and some similarities in resting and functional electromyographic patterns within masticatory and neck muscles in both groups during medical mask and no mask examination.
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Affiliation(s)
- Michał Ginszt
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland
| | - Grzegorz Zieliński
- Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland
| | - Jacek Szkutnik
- Independent Unit of Functional Masticatory Disorders, Medical University of Lublin, 20-093 Lublin, Poland
| | - Marcin Wójcicki
- Independent Unit of Functional Masticatory Disorders, Medical University of Lublin, 20-093 Lublin, Poland
| | - Michał Baszczowski
- Interdisciplinary Scientific Group of Sports Medicine, Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland
| | - Monika Litko-Rola
- Independent Unit of Functional Masticatory Disorders, Medical University of Lublin, 20-093 Lublin, Poland
| | - Diana Zielińska
- Independent Unit of Functional Masticatory Disorders, Medical University of Lublin, 20-093 Lublin, Poland
| | - Ingrid Różyło-Kalinowska
- Department of Dental and Maxillofacial Radiodiagnostics, Medical University of Lublin, 20-093 Lublin, Poland
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Chen X, Zhang C, Ibrahim S, Tao S, Xia X, Li Y, Li C, Yue F, Wang X, Bao S, Fan J. The impact of facemask on patients with COPD: A systematic review and meta-analysis. Front Public Health 2022; 10:1027521. [PMID: 36466486 PMCID: PMC9709116 DOI: 10.3389/fpubh.2022.1027521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Since the emergence of COVID-19, mandatory facemask wearing has been implemented around the world to prevent viral transmission, however, the impact of wearing facemasks on patients with COPD was unclear. Methods The current study undertakes a systematic review and meta-analysis of a comprehensive literature retrieval from six databases, based on the pre-determined eligibility criteria, irrespective of language. The risk of bias was assessed using an established instrument. We primarily focused on analyzing ETCO2, SpO2, and heart and respiratory rates, and also considered the impacts on physiological and exercise performance. A descriptive summary of the data and possible meta-analysis was performed. Forest plots were generated to pool estimates based on each of the study outcomes. Results Of the 3,751 publications considered, six publications were selected for a systematic review and two publications were included for meta-analysis, however, the quality of these six studies was relatively low overall. In the case of inactivity, the facemask wearing COPD cohort had higher respiratory rates than that of the non-facemask wearing cohort (MD = 1.00 and 95% CI 0.47-1.53, P < 0.05). There was no significant difference in ETCO2 (MD = 0.10 and 95% CI -1.57-1.78, P > 0.05) and heart rate (MD = 0.40 and 95% CI -3.59-4.39, P > 0.05) nor SpO2 (MD = -0.40 and 95% CI -0.84-0.04, P > 0.05) between the COPD patients with and without facemasks. Furthermore, it was observed that the only significant differences between the COPD patients with and without facemasks undertaking different activities were FEV1 (%) (MD = 3.84 and 95% CI 0.14-7.54, P < 0.05), FEV1/FVC (%) (MD = 3.25 and 95% CI 0.71-5.79, P < 0.05), and blood lactate (MD = -0.90 and 95% CI -1.73 to -0.07, P < 0.05). Conclusion Wearing facemasks decreased the exercise performance of patients with COPD, however, it had minimal impact on physiological indexes. Further investigations will be performed on the high-quality data from randomized control studies. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=326265, identifier: CRD42022326265.
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Affiliation(s)
- Xuwen Chen
- School of Public Health, Center for Laboratory and Simulation Training, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China
| | - Changqing Zhang
- Department of Radiology, Gansu Provincial People's Hospital, Lanzhou, China
| | - Sani Ibrahim
- School of Public Health, Center for Laboratory and Simulation Training, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China
| | - Shunyu Tao
- School of Public Health, The University of Sydney, Camperdown, NSW, Australia
| | - Xiaoli Xia
- Department of Geriatrics, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China
| | - Yi Li
- Department of Respiratory Cadres, Gansu Provincial People's Hospital, Lanzhou, China
| | - Caiyun Li
- School of Public Health, Center for Laboratory and Simulation Training, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China
| | - Feiyan Yue
- School of Public Health, Center for Laboratory and Simulation Training, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China
| | - Xinhua Wang
- School of Public Health, Center for Laboratory and Simulation Training, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China,Xinhua Wang
| | - Shisan Bao
- School of Public Health, Center for Laboratory and Simulation Training, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China,Shisan Bao
| | - Jingchun Fan
- School of Public Health, Center for Laboratory and Simulation Training, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China,*Correspondence: Jingchun Fan
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Glänzel MH, Barbosa IM, Machado E, Prusch SK, Barbosa AR, Lemos LFC, Schuch FB, Lanferdini FJ. Facial mask acute effects on affective/psychological and exercise performance responses during exercise: A meta-analytical review. Front Physiol 2022; 13:994454. [PMID: 36406998 PMCID: PMC9667098 DOI: 10.3389/fphys.2022.994454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/18/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Face masks are widely used during the COVID-19 pandemic as one of the protective measures against the viral infection risk. Some evidence suggests that face mask prolonged use can be uncomfortable, and discomfort can be exacerbated during exercise. However, the acute responses of mask-wearing during exercise on affective/psychological and exercise performance responses is still a topic of debate. Purpose: To perform a systematic review with meta-analysis of the acute effects of mask-wearing during exercise on affective/psychological and exercise performance responses in healthy adults of different/diverse training status. Methods: This review (CRD42021249569) was performed according to Cochrane's recommendations, with searches performed in electronic (PubMed, Web of Science, Embase, SportDiscus, and PsychInfo) and pre-print databases (MedRxiv, SportRxiv, PsyArXiv, and Preprint.Org). Syntheses of included studies' data were performed, and the RoB-2 tool was used to assess the studies' methodological quality. Assessed outcomes were affective/psychological (discomfort, stress and affective responses, fatigue, anxiety, dyspnea, and perceived exertion) and exercise performance time-to-exhaustion (TTE), maximal power output (POMAX), and muscle force production] parameters. Available data were pooled through meta-analyses. Results: Initially 4,587 studies were identified, 36 clinical trials (all crossover designs) were included. A total of 749 (39% women) healthy adults were evaluated across all studies. The face mask types found were clothing (CM), surgical (SM), FFP2/N95, and exhalation valved FFP2/N95, while the most common exercises were treadmill and cycle ergometer incremental tests, beyond outdoor running, resistance exercises and functional tests. Mask-wearing during exercise lead to increased overall discomfort (SMD: 0.87; 95% CI 0.25-1.5; p = 0.01; I2 = 0%), dyspnea (SMD: 0.40; 95% CI 0.09-0.71; p = 0.01; I2 = 68%), and perceived exertion (SMD: 0.38; 95% CI 0.18-0.58; p < 0.001; I2 = 46%); decreases on the TTE (SMD: -0.29; 95% CI -0.10 to -0.48; p < 0.001; I2 = 0%); without effects on POMAX and walking/running distance traveled (p > 0.05). Conclusion: Face mask wearing during exercise increases discomfort (large effect), dyspnea (moderate effect), and perceived exertion (small effect), and reduces the TTE (small effect), without effects on cycle ergometer POMAX and distance traveled in walking and running functional tests. However, some aspects may be dependent on the face mask type, such as dyspnea and perceived exertion. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021249569], identifier [CRD42021249569].
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Affiliation(s)
- Marcelo Henrique Glänzel
- Biomechanics Laboratory, Federal University of Santa Maria, Santa Maria, RS, Brazil,Biomechanics and Kinesiology Research Group, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,*Correspondence: Marcelo Henrique Glänzel, ; Fábio Juner Lanferdini,
| | - Igor Martins Barbosa
- Biomechanics Laboratory, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Esthevan Machado
- Biomechanics and Kinesiology Research Group, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Samuel Klippel Prusch
- Biomechanics Laboratory, Federal University of Santa Maria, Santa Maria, RS, Brazil,Graduate Program in Gerontology, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Luiz Fernando Cuozzo Lemos
- Biomechanics Laboratory, Federal University of Santa Maria, Santa Maria, RS, Brazil,Graduate Program in Gerontology, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Fábio Juner Lanferdini
- Biomechanics Laboratory, Federal University of Santa Maria, Santa Maria, RS, Brazil,*Correspondence: Marcelo Henrique Glänzel, ; Fábio Juner Lanferdini,
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Vogt G, Radtke K, Jagim A, Peckumn D, Lee T, Mikat R, Foster C. Effect of Face Masks on Physiological and Perceptual Responses during 30 Minutes of Self-Paced Exercise in Older Community Dwelling Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12877. [PMID: 36232176 PMCID: PMC9564912 DOI: 10.3390/ijerph191912877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
This study examined the effects of different types of masks (no mask, surgical mask (SM), and N95-mask) on physiological and perceptual responses during 30-min of self-paced cycle ergometer exercise. This study was a prospective randomly assigned experimental design. Outcomes included workload (Watts), oxygen saturation (SpO2), end-tidal carbon dioxide (PetCO2), heart rate (HR), respiratory rate (RR), rating of perceived exertion (RPE), and rating of perceived dyspnea (RPD). Volunteers (54-83 years (n = 19)) completed two familiarization sessions and three testing sessions on an air braked cycle ergometer. No significant difference was found for condition x time for any of the dependent variables. RPE, RPD, and PetCO2 were significantly higher with an N95-mask vs. no mask (NM) ((p = 0.012), (p = 0.002), (p < 0.001)). HR was significantly higher with the SM compared to the NM condition (p = 0.027) (NM 107.18 ± 9.96) (SM 112.34 ± 10.28), but no significant difference was found when comparing the SM to the N95 condition or when comparing the N95condition to the NM condition. Watts increased across time in each condition (p = 0.003). Initially RR increased during the first 3 min of exercise (p < 0.001) with an overall gradual increase noted across time regardless of mask condition (p < 0.001). SpO2 significantly decreased across time but remained within normal limits (>95%). No significant difference was found in Watts, RR, or SpO2 regardless of mask condition. Overall, the N95mask was associated with increased RPE, RPD, and PetCO2 levels. This suggests trapping of CO2 inside the mask leading to increased RPE and RPD.
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Affiliation(s)
- Grace Vogt
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA
| | - Kimberley Radtke
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA
| | - Andrew Jagim
- Sports Medicine, Mayo Clinic Health System, Onalaska, WI 54650, USA
| | - Dominique Peckumn
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA
| | - Teresa Lee
- Department of Health, Exercise & Rehabilitative Sciences, Winona State University, Winona, MN 55987, USA
| | - Richard Mikat
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA
| | - Carl Foster
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA
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Wang Y, Gao Z, Lv H, Xu Y. Online public attention toward allergic rhinitis in Wuhan, China: Infodemiology study using Baidu index and meteorological data. Front Public Health 2022; 10:971525. [PMID: 36262246 PMCID: PMC9574193 DOI: 10.3389/fpubh.2022.971525] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/13/2022] [Indexed: 01/25/2023] Open
Abstract
Background With the popularization of the Internet and medical knowledge, more and more people are learning about allergic rhinitis (AR) on the Internet. Objective This study aims to analyze the epidemiological characteristics and online public attention to AR in Wuhan, China, utilizing the most popular search engine in mainland China and meteorological data of Wuhan. Methods To study the Internet attention and epidemiological characteristics of AR in Wuhan, the search volume (SV) of "Allergic Rhinitis" in Mandarin and AR-related search terms from 1 January 2014 through 31 December 2021 were recorded. For user interest, the search and demand data were collected and analyzed. Results The yearly average Baidu SV of AR in both Wuhan and China increased year by year but began to decline gradually after the COVID-19 pandemic. Baidu SV of AR in Wuhan exhibited significant seasonal variation, with the first peak was from March to May and the second peak occurring between September and October. Correlation analysis revealed a moderate positive correlation between the monthly average SV of "Allergic Rhinitis" and "Mites" and "Mites + Pollen Allergy" in Wuhan, a weak positive correlation between the monthly average SV of "Allergic Rhinitis" and "Pollen Allergy," and a positive correlation between monthly SV of "Allergic Rhinitis" and the meteorological index of pollen allergy (MIPA). Conclusion The attention given to the topic on the internet, as measured by the search volume, was reflective of the situation in Wuhan, China. It has the potential to predict the epidemiological characteristics of AR and help medical professionals more effectively plan seasonal AR health education.
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Muacevic A, Adler JR. A Systematic Review of Whether the Use of N95 Respirator Masks Decreases the Incidence of Cardiovascular Disease in the General Population. Cureus 2022; 14:e29823. [PMID: 36199761 PMCID: PMC9526995 DOI: 10.7759/cureus.29823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2022] [Indexed: 12/02/2022] Open
Abstract
The usage of masks such as the N95 has increased exponentially worldwide. With the ever-increasing global rates of cardiovascular disease, it is vital that preventative measures are adopted to help tackle this crisis. N95 masks have been promoted as health prevention odysseys in the battle against viruses such as COVID-19. A systematic review was conducted on whether the N95 masks could help improve our cardiovascular health. Our data sources included PubMed, Medline and Scopus. Eleven studies met the eligibility criteria to be included in the review. N95 mask usage led to increased reports of dyspnoea, however, no significant effect was seen on blood pressure. N95 masks also showed improvement in aortic parameters. While encouraging results were yielded, further focussed studies on the use of N95 masks and the effect on various cardiovascular parameters would help strengthen the association.
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Slimani M, Paravlic A, Abazovic E, Znazen H, Bragazzi NL. Effect of facemask use on cognitive function during a maximal running aerobic fitness test. Front Physiol 2022; 13:912740. [PMID: 36246122 PMCID: PMC9557100 DOI: 10.3389/fphys.2022.912740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background: The aim of the present randomized, crossover study was to determine the physiological and cognitive function responses while wearing a facemask during a maximal running aerobic fitness test. Methods: Fourteen healthy, nonsmoking physical education students (age = 17.5 years, height = 1.72 m, body mass = 70.4 kg) volunteered to participate in this study. They carried out a 20 m multistage fitness test (MSFT) while wearing or not a cloth facemask on two separate occasions performed in random order. The “Rating of Perceived Exertion” (RPE) and the d2 test for visual attention were administered and assessed before and immediately after the MSFT for both conditions (with or without a facemask). Results: When wearing the facemask, the participants exhibited lower maximal aerobic speed (p = 0.039), VO2max (p = 0.039), distance covered during the MSFT (p = 0.057), and concentration performance (p < 0.001), when compared with the control situation (without facemask). Moreover, they made more errors compared with the control condition (p = 0.021). The use of a cloth facemask during maximal endurance running tests (such as the MSFT) reduced VO2max, and measures of cognitive performance as assessed by the test of focused visual attention (the d2 test). This data suggests avoiding using a cloth facemask during maximal aerobic fitness tests, and before any tasks that require a high level of visual attention.
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Affiliation(s)
- Maamer Slimani
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), Genoa University, Genoa, Italy
- Higher Institute of Sport and Physical Education of Ksar Said, University of Manouba, Tunisia, North Africa
- *Correspondence: Maamer Slimani,
| | - Armin Paravlic
- Faculty of Sport, Institute of Kinesiology, University of Ljubljana, Ljubljana, Slovenia
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Faculty of Sports Studies, Masaryk University, Brno, Czechia
| | - Ensar Abazovic
- Faculty of Sports and Physical Education, Sarajevo, Bosnia and Herzegovina
| | - Hela Znazen
- Department of Physical Education and Sport, College of Education, Taif University, Taif, Saudi Arabia
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
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Nejad FN, Mohammadi Gharehghani MA, Ahmadi S. Collective and individual rationality dilemma and the failure of anti-Covid-19 policies: Why some people don't wear masks? Int J Surg 2022; 105:106866. [PMID: 36044957 PMCID: PMC9420078 DOI: 10.1016/j.ijsu.2022.106866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Farhad Nosrati Nejad
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | | | - Sina Ahmadi
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Kogel A, Hepp P, Stegmann T, Tünnemann-Tarr A, Falz R, Fischer P, Mahfoud F, Laufs U, Fikenzer S. Effects of surgical and FFP2 masks on cardiopulmonary exercise capacity in patients with heart failure. PLoS One 2022; 17:e0269470. [PMID: 35998172 PMCID: PMC9397906 DOI: 10.1371/journal.pone.0269470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 05/22/2022] [Indexed: 11/25/2022] Open
Abstract
Aims Surgical and FFP2 masks are recommended to reduce transmission of SARS-CoV-2. The cardiopulmonary effects of facemasks in patients with chronic heart failure are unknown. This prospective, cross-over study quantified the effects of wearing no mask (nm), surgical mask (sm), and FFP2 mask (ffpm) in patients with stable heart failure. Methods 12 patients with clinically stable chronic heart failure (HF) (age 63.8±12 years, left ventricular ejection fraction (LVEF) 43.8±11%, NTProBNP 573±567 pg/ml) underwent spiroergometry with and without masks in a randomized sequence. Comfort/discomfort was assessed using a standardized questionnaire. Results Maximum power was reduced with both types of masks (nm: 108.3 W vs. sm: 101.2 W vs. ffpm: 95.6 W, p<0.01). Maximum respiratory oxygen uptake (1499ml/min vs. 1481 ml/min vs. 1300 ml/min, p = 0.95 and <0.01), peak ventilation (62.1 l/min vs. 56.4 l/min vs. 50.3 l/min, p = 0.15 and p<0.05) and O2-pulse (11.6 ml/beat vs. 11.8 ml/beat vs. 10.6 ml/beat, p = 0.87 and p<0.01) were significantly changed with ffpm but not sm. Discomfort was moderately but significantly increased (nm: 1.6 vs. sm: 3.4 vs. ffpm: 4.4, p<0.05). Conclusion Both surgical and FFP masks reduce exercise capacity in heart failure patients, while FFP2 masks reduce oxygen uptake and peak ventilation. This reduction in cardiopulmonary performance should be considered in heart failure patients whose daily life activities are often just as challenging as exercise is for healthy adults.
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Affiliation(s)
- Alexander Kogel
- Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig, Germany
- * E-mail:
| | - Pierre Hepp
- Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Tina Stegmann
- Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | | | - Roberto Falz
- Institute of Sport Medicine and Prevention, University of Leipzig, Leipzig, Germany
| | - Patrick Fischer
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Saarland University, Homburg (Saar), Germany
| | - Felix Mahfoud
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Saarland University, Homburg (Saar), Germany
| | - Ulrich Laufs
- Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Sven Fikenzer
- Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig, Germany
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Conners RT, Whitehead PN, Skarp T, Waller B, Richard M, Bain C, Monks M, Faghy MA. Acute Effects of Facial Coverings on Anaerobic Exercise Performance in College-Aged Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10500. [PMID: 36078215 PMCID: PMC9517774 DOI: 10.3390/ijerph191710500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
The use of facial coverings has been amplified during the COVID-19 pandemic as a means to minimize the spread of disease. However, facial coverings may impede ventilation during high-intensity activity, leading to a reduction in cardiopulmonary exercise capacity. Thus, the purpose of this study was to determine the acute impact of different facial coverings on exercise performance in college-aged individuals during a 300-yard shuttle. It was hypothesized that the lowest heart rate (HR), completion time (CT), and rate of perceived exertion (RPE) would occur with no mask. Furthermore, it was hypothesized the SHEMA97 mask would have lower HR, CT, and RPE compared to surgical and fabric masks. Results showed the use of the fabric mask resulted in significantly higher HR compared to no mask (p = 0.006). The SHEMA97 mask resulted in faster CT and lower RPE compared to both the fabric and surgical masks (p < 0.001). All mask conditions yielded significantly higher levels of perceived discomfort than wearing no mask (p < 0.05). While the use of facial coverings can help prevent the spread of disease, their use during exercise may pose limitations to performance; however, the ability of the SHEMA97 to provide minimal changes to CT and RPE provides a promising option.
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Affiliation(s)
- Ryan T. Conners
- Department of Kinesiology, The University of Alabama in Huntsville, Huntsville, AL 35899, USA
| | - Paul N. Whitehead
- Department of Kinesiology, The University of Alabama in Huntsville, Huntsville, AL 35899, USA
| | - Thomas Skarp
- Department of Kinesiology, The University of Alabama in Huntsville, Huntsville, AL 35899, USA
| | - Briana Waller
- Department of Kinesiology, The University of Alabama in Huntsville, Huntsville, AL 35899, USA
| | - Mark Richard
- Department of Kinesiology, The University of Alabama in Huntsville, Huntsville, AL 35899, USA
| | - Carrington Bain
- Department of Kinesiology, The University of Alabama in Huntsville, Huntsville, AL 35899, USA
| | - Megan Monks
- Department of Kinesiology, The University of Alabama in Huntsville, Huntsville, AL 35899, USA
| | - Mark A. Faghy
- School of Human Sciences, University of Derby, Derby DE22 1GB, UK
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