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Farah W, Abusalih MF, Hasan B, Lees EH, Fleti F, Elkhatib WY, Johnson BD, Toups G, Wolf M, Murad MH. Safety implications of mask use: a systematic review and evidence map. BMJ Evid Based Med 2024:bmjebm-2024-113028. [PMID: 39326926 DOI: 10.1136/bmjebm-2024-113028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2024] [Indexed: 09/28/2024]
Abstract
BACKGROUND Widespread use of respiratory protection masks has become a critical component of public health response. OBJECTIVES This systematic review synthesises the evidence on the acute physiological, cognitive and psychological impacts associated with different types of masks and provides an evidence map of research gaps. METHODS A comprehensive search from 2000 to 2023 was conducted across multiple databases (MEDLINE, EMBASE, Cochrane databases, Scopus and PubMed). An umbrella systematic overview was conducted for physiological outcomes using existing systematic reviews. We conducted de novo systematic reviews for cognitive and psychological outcomes. Pairs of independent reviewers determined eligibility, extracted data and assessed risk of bias. Certainty at an outcome level was appraised using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS The search resulted in 13 370 potential citations, leading to the inclusion of nine systematic reviews for physiological outcomes (87 primary studies) and 10 primary studies for cognitive and psychological outcomes (3815 participants), with the majority of participants being healthy adults. Studies evaluating physiological outcomes demonstrated that various types of masks have little to no significant difference in heart rate (surgical mask (mean difference (MD): 0.96 (-1.01 to 2.93)), N95 mask (MD: 1.63 (-2.79 to 6.05)) and cloth mask (MD: -0.94 (-6.39 to 4.52))) or respiratory rate during rest or exercise (surgical mask (MD: -1.35 (-3.00 to 0.29)), N95 mask (MD: 0.10 (-3.10 to 3.29)) and cloth mask (MD: -2.57 (-6.44 to 1.29)) (low certainty for most outcomes)). Mask use may be associated with very small changes in minute ventilation (surgical mask (MD: -13.9 (-20.30 to -7.53)) and N95 mask (MD: -16.3 (-28.7 to -3.9))), tidal volume (surgical mask (MD: -0.14 (-0.23 to -0.05)) and N95 mask (MD: -0.10 (-0.33 to 0.13))), oxygen saturation (surgical mask (MD: -0.59% (-0.87 to -0.30)), N95 mask (MD: -0.35% (-0.75 to 0.05)) and cloth mask (MD: -0.50% (-1.23; 0.24))), carbon dioxide partial pressure (surgical mask (standardised MD (SMD): 1.17 (0.70 to 1.64)) and N95 mask (SMD: 0.43 (0.08 to 0.79))) and exercise performance (surgical mask (SMD: -0.12 (-0.39 to 0.15)), N95 mask (SMD: -0.42 (-0.76 to -0.08)) and cloth mask (SMD: -0.26 (-0.54 to 0.02)) (low certainty for most outcomes)). Studies evaluating cognitive outcomes showed mixed results. Some studies reported reduced mental workload, and others showed no significant effect or decreased performance. The impact on attention, errors and reaction time was variable. These studies were small and at moderate to high risk of bias. Evidence was insufficient to estimate the effect of mask use on psychological outcomes (claustrophobia, depression and anxiety) as these studies were small, non-longitudinal and at high risk of bias. CONCLUSION This evidence map provides a comprehensive insight into the multifaceted impact of respiratory protection mask use, and highlights the limited certainty in the available body of evidence. This evidence map supports the development of future research agenda.
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Affiliation(s)
- Wigdan Farah
- Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Mohamed F Abusalih
- Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Bashar Hasan
- Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Elizabeth H Lees
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Farah Fleti
- Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Wiaam Y Elkhatib
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Bruce D Johnson
- Division of Preventive Cardiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Gary Toups
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael Wolf
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - M Hassan Murad
- Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Liang X, Yan Y, Wu X, Li S, Hu A. OCTA quantitative assessment of exercise-induced variations and recovery in retinal microvasculature of healthy subjects with or without masks. Microvasc Res 2024; 155:104719. [PMID: 39038699 DOI: 10.1016/j.mvr.2024.104719] [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: 03/30/2024] [Revised: 07/16/2024] [Accepted: 07/18/2024] [Indexed: 07/24/2024]
Abstract
PURPOSE To investigate the impact of exercise and mask-wearing on retinal microvasculature using optical coherence tomography angiography (OCTA). METHODS A total of 30 healthy volunteers were enrolled and tasked with physical exercise to reach 75-80 % maximum heart rates. Swept-source OCTA was performed on the macular region and optic nerve head (ONH) in participants with no mask, surgical mask, or N95 mask at quiescent conditions (Step 1) and 0 min, 10 min, 20 min, and 30 min post-exercise (Steps 2-5, respectively). The functional vessel density (VD), including the superficial and deep plex (SP and DP) in the macular area and the superficial plex (SP), nerve fiber plex, and small vessels in the optic nerve head, were measured. RESULTS Under quiescent conditions, the functional VD of SP and DP exhibited significant reduction with surgical and N95 masks in the foveal area (P < 0.05). In step 2 (immediately after training) with or without masks, functional VD of SP and nerve fiber both showed significant reduction in the inside disc and peripapillary area, small functional VD of nerve fiber in the ONH showed significant reduction in peripapillary area (P < 0.05). These changes had been recovered in Step 5 (30 min post-exercise) in all groups (no-mask, surgical mask and N95 mask groups) (P > 0.05). CONCLUSIONS Mask-wearing and physical exercise reduce retinal functional VD in macular and ONH areas. The retinal vasoconstriction induced by exercise tends to recover after rest for approximately 30 min. Our research provides insights into mask-wearing and physical exercise's immediate retinal microvasculature effects, hinting at systemic microvascular changes.
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Affiliation(s)
- Xu Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yayi Yan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xinyan Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Songshan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
| | - Andina Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
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Jiang S, Li X, Seo JW, Ahn S, Sung Y, Jamrasi P, Song W. Comparison of face mask effects on cardiorespiratory responses between physically active and sedentary individuals. J Sports Med Phys Fitness 2024; 64:857-862. [PMID: 38842371 DOI: 10.23736/s0022-4707.24.15798-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
BACKGROUND Alterations caused by face masks on physiological responses vary among different population groups. This study aimed to investigate whether physically active and sedentary individuals respond differently to face mask use during exercise. METHODS Sixteen healthy college students were divided into two groups: Physically active group (N.=10; 26.50±2.80 years) and Sedentary group (N.=6; 26.33±2.81 years). They performed three maximal cardiopulmonary exercise test (CPET)s following the Bruce protocol: one without a face mask (NON), one with a surgical mask (SUR) and one with a cloth mask (CLO). Cardiorespiratory parameters and heart rate were monitored continuously during the test. Blood pressure, oxygen saturation and lactate level were measured immediately before and after exertion. RESULTS Significant differences were found between the Physically active and the Sedentary group in peak VO2 (VO2peak) in NON (P=0.030). However, this difference disappeared when the face masks were used. Furthermore, VO2/kg (P=0.002) and METs (P=0.002) decreased significantly at the respiratory compensation point (RCP) only in the Physically active group with face masks. No significant differences were found between the two groups for exercise time, lactate level and dyspnea (P>0.05). CONCLUSIONS The decrease in exercise tolerance and cardiorespiratory responses, particularly VO2peak, due to face mask use was greater in physically active individuals compared to sedentary individuals. Population group characteristics should be considered when adapting face masks to daily life.
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Affiliation(s)
- Shu Jiang
- Department of Physical Education, Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, South Korea
| | - Xinxing Li
- Department of Physical Education, Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, South Korea
| | - Ji-Won Seo
- Department of Physical Education, Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, South Korea
| | - Soyoung Ahn
- Department of Physical Education, Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, South Korea
| | - Yunho Sung
- Department of Physical Education, Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, South Korea
| | - Parivash Jamrasi
- Department of Physical Education, Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, South Korea
| | - Wook Song
- Department of Physical Education, Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, South Korea -
- Institute on Aging, Seoul National University, Seoul, South Korea
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Hamachi N, Kawabata N, Horimoto Y, Matsuda K, Takano Y. Effects of running with surgical masks on cardiopulmonary function in healthy male university students. J Phys Ther Sci 2024; 36:359-363. [PMID: 38832218 PMCID: PMC11144475 DOI: 10.1589/jpts.36.359] [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: 02/09/2024] [Accepted: 03/11/2024] [Indexed: 06/05/2024] Open
Abstract
[Purpose] In Japan, one measure against the novel coronavirus disease-2019 infection involves the public use of surgical masks. Research indicates that exercising while wearing a mask increases the physical burden, particularly affecting young people during high-intensity exercise. This study examined the effects of wearing masks while running in male university students. [Participants and Methods] The participants were 20 healthy male university students (21.6 ± 1.6 years). The participants underwent cardiopulmonary exercise tests with the masks on and off on different days until exhaustion. The following parameters were measured: exercise duration, Borg Scale rating (respiratory or lower extremities), surface temperature around the mouth, time to sweat onset, metabolic reaction, pulmonary ventilation, and cardiovascular reaction parameters. [Results] The results showed that VO2 max remained consistent between the mask-on and mask-off conditions. However, minute ventilation, respiratory rate, and heart rate decreased in the mask-on condition, which correlated with a reduction in exercise duration. Furthermore, running with the mask significantly decreased the VE/VO2, VE/ VO2, Borg Scale rating of the lower extremities, and the time to sweat onset. [Conclusion] Running with a surgical mask affected respiratory function and decreased exercise duration in healthy male university students. However, it did not induce any changes in VO2 max.
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Affiliation(s)
- Nozomi Hamachi
- School of Physical Therapy, Faculty of Rehabilitation,
Reiwa Health Sciences University: 2-1-12 Wajirogaoka, Higashi-ku, Fukuoka 811-0213,
Japan
| | - Naoya Kawabata
- Department of Physical Therapy, Kanagawa Rehabilitation
Hospital, Japan
| | - Yukari Horimoto
- Department of Physical Therapy, School of Health Sciences
at Narita, International University of Health and Welfare, Japan
| | - Kensuke Matsuda
- Department of Physical Therapy, School of Health Sciences
at Fukuoka, International University of Health and Welfare, Japan
| | - Yoshio Takano
- Department of Physical Therapy, School of Health Sciences
at Fukuoka, International University of Health and Welfare, Japan
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Hidaka K, Sonoda S, Yamaguchi T, Kose Y, Hyodo K, Oda K, Eshima H. The effects of wearing face masks on the perception and mood of male healthy male adults during treadmill running: A pilot study. Physiol Rep 2024; 12:e16036. [PMID: 38757255 PMCID: PMC11099753 DOI: 10.14814/phy2.16036] [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: 09/04/2023] [Revised: 04/17/2024] [Accepted: 04/17/2024] [Indexed: 05/18/2024] Open
Abstract
In the past few years, the face mask has been recommended for the prevention of exposing others to COVID-19. Wearing a face mask may have the potential to increase dyspnea and discomfort during exercise; however, controversy exists on whether wearing face masks during exercise affects exercise performance, perception, and mood in runners. We investigated the physiological and perceptual responses of healthy male adults who had experienced long-distance running while exercising at different intensities. Nine healthy young adults who were long-distance runners wearing surgical face mask conducted an incremental treadmill protocol. The protocol was three 6-min stages (20%, 40%, and 60% of maximal heart rate, respectively). The rating of perceived exertion (RPE) and the feeling scale (FS) were measured. RPE was higher in mask condition than in unmask condition (No mask vs. Face mask, light; 8.22 vs. 8.78, p = 0.615, middle; 10.00 vs. 10.78, p = 0.345, high; 12.33 vs. 13.67, p = 0.044.), while FS was not different between conditions. The present study shows that wearing a mask may increase rating of perceived exertion and discomfort when the exercise intensity exceeds a certain threshold in healthy male adults who have experienced long-distance running.
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Affiliation(s)
- Kento Hidaka
- Department of International Tourism, Faculty of Human and Social StudiesNagasaki International UniversitySaseboNagasakiJapan
| | - Shogo Sonoda
- Department of International Tourism, Faculty of Human and Social StudiesNagasaki International UniversitySaseboNagasakiJapan
| | - Taiki Yamaguchi
- Department of International Tourism, Faculty of Human and Social StudiesNagasaki International UniversitySaseboNagasakiJapan
| | - Yuka Kose
- National Institute of TechnologySasebo CollegeSaseboNagasakiJapan
| | - Kazuki Hyodo
- Physical Fitness Research InstituteMeiji Yasuda Life Foundation of Health and WelfareTokyoJapan
| | - Kazuto Oda
- Department of Health and Nutrition, Faculty of Health ManagementNagasaki International UniversitySaseboNagasakiJapan
| | - Hiroaki Eshima
- Department of International Tourism, Faculty of Human and Social StudiesNagasaki International UniversitySaseboNagasakiJapan
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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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Chen X, Jiang X, Zhang X, Ren D, Wei C, Xu A, Yang H, Bai R, Li C, Yue F, Bao S, Shi J, Fan J. Assessing the impact of diverse mask types on COPD patients: a randomised controlled trial study protocol. BMJ Open 2024; 14:e080721. [PMID: 38199633 PMCID: PMC10806656 DOI: 10.1136/bmjopen-2023-080721] [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: 10/09/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Wearing masks has proven beneficial in preventing respiratory pathogen infections in individuals with chronic obstructive pulmonary disease (COPD). However, the impact of different mask types on physiological indicators and daily physical activity in COPD patients remains uncertain. This study aims to assess the immediate effects of various mask types on cardiopulmonary function indicators, subjective perceptions and the 6-minute walking distance (6MWD) in individuals with COPD. METHODS AND ANALYSIS This randomised controlled trial will enrol 129 stable COPD patients. Participants will be randomly divided into three groups: control, N95 mask and surgical mask groups. Each group will undergo both a 6-minute seated test and a 6-minute walk test (6MWT), without or with their respective masks. A 10-minute interval will be provided between the two phases. The primary indicators of the study include the 6MWD and blood oxygen saturation. Secondary outcomes encompass blood pressure, pulse rate, Borg score, Rate of Perceived Exertion (RPE) score and subjective perception score. Oxygen saturation, pulse rate and blood pressure will be recorded four times during the trial, while Borg and RPE scores will be compared before and after the 6MWT. Additionally, subjective perception scores will be collected after each mask-wearing stage. ETHICS AND DISSEMINATION This study has received approval from the Ethics Committee of the Affiliated Hospital of Gansu University of Chinese Medicine (approval number: 202335). We plan to disseminate research results through publication in a peer-reviewed journal or presentation at a conference. TRIAL REGISTRATION NUMBER ChiCTR2300074554.
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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
| | - Xiaomei Jiang
- Department of Psychosomatic and Sleep Medicine, Gansu Gem Flower Hospital, Lanzhou, Gansu, China
| | - Xuhui Zhang
- Department of Pulmonary Diseases, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Dong Ren
- Department of Psychosomatic and Sleep Medicine, Gansu Gem Flower Hospital, Lanzhou, Gansu, China
| | - Caihong Wei
- Pulmonary and Critical Care Medicine, Gansu Gem Flower Hospital, Lanzhou, Gansu, China
| | - Aihong Xu
- Pulmonary and Critical Care Medicine, Gansu Gem Flower Hospital, Lanzhou, Gansu, China
| | - Hong Yang
- Department of Rehabilitation Medicine, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Ruijia Bai
- Department of Pulmonary Diseases, Affiliated Hospital of Gansu University of Chinese Medicine, 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
| | - 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
| | - Jungang Shi
- Pulmonary and Critical Care Medicine, Gansu Gem Flower Hospital, 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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Hodges M, Freigeh GE, Troost J, Baptist AP, Gupta M. Assessment of mask use on oxygen saturation in adults and children with asthma. Allergy Asthma Proc 2024; 45:24-32. [PMID: 38151730 DOI: 10.2500/aap.2024.45.230078] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Background: Mask use is recommended to reduce the transmission of severe acute respiratory syndrome coronavirus 2. The safety of mask use in adults and children with asthma is unknown. Objective: The objective of this study is to evaluate the effect of mask use on peripheral oxygen saturation (SpO₂) in those with and those without asthma. Methods: A two-stage cross-sectional study was performed. In the first stage, the SpO₂ concentration in adults and children with and without asthma was measured with the adults and children at rest during mask use. In the second stage, children years 6-17 performed a 6-minute walk test while wearing masks. The SpO₂ concentration was measured before the exercise and at 3 and 6 minutes into exercise. Subjective dyspnea was evaluated by using the Pediatric Dyspnea Scale (PDS). Results: In the first stage, SpO₂ levels in 393 subjects were analyzed. In the second stage, 50 pediatric subjects were included, 25 with and 25 without asthma. There was no difference in SpO₂ levels between those with and those without asthma in adults and children wearing masks while at rest, with median SpO₂ 98% in both groups. There was no difference in oxygen saturation or reported level of dyspnea between the children with asthma and children without asthma performing the 6-minute walk test while wearing masks. Median SpO₂ levels were at or near 99% in the asthma and non-asthma groups at all time points. Median PDS scores were similar between the asthma and non-asthma groups. Conclusion: Mask use did not affect SpO₂ in adults and children at rest or in children performing low-to-moderate intensity exercise. These findings were consistent in those with and without asthma.
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Affiliation(s)
- Marisa Hodges
- From the SHMG Allergy and Immunology, Corewell Health West, Grand Rapids, Michigan
| | - George E Freigeh
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Jonathan Troost
- Michigan Institute for Clinical Health Research, University of Michigan, Ann Arbor, Michigan, and
| | - Alan P Baptist
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Malika Gupta
- Division of Allergy and Immunology, University of Texas at Southwestern Medical Center, Dallas, Texas
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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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Kuroki T, Momma R, Hoshi D, Hong S, Hizawa N, Mukai N, Watanabe K, Okamoto Y. Consideration on size, velocity and path of droplets emitted during running. J Sports Med Phys Fitness 2023; 63:1100-1117. [PMID: 37428099 DOI: 10.23736/s0022-4707.23.14923-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
BACKGROUND People began to wear face masks during physical activities due to spread of COVID-19. There are no previous studies about the need for wearing masks while running. METHODS Assuming a citizen runner who runs full marathon in 4 hours, we verified the path and the amount of droplet dispersal, setting a humanoid mannequin with a mask in simulated running environment (Experiment 1). We also had six adults exercise in the same environment to examine droplet behaviors when not wearing a face mask (Experiment 2). Average droplet size was determined, and repeated measures ANOVA was carried out to examine statistical significance. To evaluate observed droplet behaviors, theoretical solutions of the downfall motion of large droplets were then derived, taking air resistance into consideration. RESULTS Experiment 1: wearing a face mask caused more droplets to adhere to the face; Experiment 2: droplets were emitted in conversation, coughing or sneezing, and they fell within social distancing. Average droplet size was not sensitive to the wind velocity. It could vary with a significant difference for time and wind velocity. Observed velocity and path of droplet can be expressed by the theoretical solutions. CONCLUSIONS Velocity and path of large droplets can be expressed by the theoretical solution of particles in downfall motion under air resistance. We therefore conclude that wearing a mask while running gives adverse effects in preventing infection. Possibility of droplet transmission while running is considered low even when not wearing a face mask, as long as social distancing is ensured.
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Affiliation(s)
- Takako Kuroki
- Department of Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Reiko Momma
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
- Department of Sport Science and Research, Japan Institute of Sport Science, Tokyo, Japan
| | - Daisuke Hoshi
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Sungchan Hong
- Institute of Health and Sports Sciences, University of Tsukuba, Ibaraki, Japan
| | - Nobuyuki Hizawa
- Division of Clinical Medicine, Department of Pulmonary Medicine, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Naoki Mukai
- Institute of Health and Sports Sciences, University of Tsukuba, Ibaraki, Japan
| | - Koichi Watanabe
- Institute of Health and Sports Sciences, University of Tsukuba, Ibaraki, Japan -
| | - Yoshikazu Okamoto
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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13
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Fukushima A, Manabe Y, Kosaka Y, Akagi S. Sustained exercise load by young adult females while wearing surgical mask raises core body temperature measured with zero-heat-flux thermometer. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023:10.1007/s00484-023-02501-8. [PMID: 37365382 DOI: 10.1007/s00484-023-02501-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023]
Abstract
When a pandemic such as that caused by the novel coronavirus disease termed COVID-19 emerges, it is recommended to wear a mask when in public situations, with information regarding the impact on thermoregulation essential, especially during exercise or hard physical labor. The present study investigated changes in core body temperature (CBT) while wearing a surgical mask (SM) during exercise (TCBT) using a non-invasive zero-heat-flux (ZHF) thermometer. Nine young adult females performed ergometer exercise for 30 min at 60 W with (mask group) and without (control) a SM under a non-hot condition, shown by wet bulb globe temperature (WBGT) findings. TCBT, mean skin temperature (TMST), heart rate (HR), and humidity in the perioral region of the face (%RH) were determined. Each of those markers showed increased values during exercise, with the increases in TCBT, HR, and %RH, but not TMST, during exercise found to be significantly greater in the mask group. HR reserve (%HRR), derived as load intensity during exercise, was also significantly higher in the mask group. Each subject completed all of the experimental protocols without noting pain or discomfort. These results suggest that wearing a SM while performing mild exercise contributes to increased TCBT associated with increased exercise intensity, expressed as %HRR in a non-heated condition. Furthermore, the ZHF thermometer was shown to be safe and is considered useful for conducting such studies. Additional examinations will be necessary to examine gender and age group differences, as well as the use of different exercise methods and intensity and ambient conditions.
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Affiliation(s)
- Ayako Fukushima
- Graduate School of Contemporary Science, Chugoku Gakuen University, 83 Niwase Kita-Ku, Okayama, 701-0197, Japan
| | - Yoshie Manabe
- Graduate School of Contemporary Science, Chugoku Gakuen University, 83 Niwase Kita-Ku, Okayama, 701-0197, Japan
- Department of Human Nutrition, Faculty of Contemporary Science, Chugoku Gakuen University, Okayama, Japan
| | - Yuri Kosaka
- Department of Human Nutrition, Faculty of Contemporary Science, Chugoku Gakuen University, Okayama, Japan
| | - Shuji Akagi
- Graduate School of Contemporary Science, Chugoku Gakuen University, 83 Niwase Kita-Ku, Okayama, 701-0197, Japan.
- Department of Human Nutrition, Faculty of Contemporary Science, Chugoku Gakuen University, Okayama, Japan.
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14
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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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15
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Neranoch B, Apiwan M, Natthapon T. Effect of High Intensity Interval Training Under Mask on Forced Vital Capacity in Football Players. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2023; 16:576-586. [PMID: 37621712 PMCID: PMC10446955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
The purpose of the study was to investigate the effect of high interval training (HIIT) under mask on forced vital capacity in football players. Fourteen male football players (age 20 ± 2 years) were randomized into the without mask group (CON) or with the 2 difference mask groups [Surgical mask (SM), FFP2 mask (FM)]. HIIT program were implemented six movements in each session three times per week. Body composition, forced vital capacity and percutaneous oxygen saturation test were taken before and after 4 weeks intervention. The results show that forced vital capacity was statistically significant increased with both types of masks (SM: 5.68 ± 1.07 L; FM: 5.26 ± 0.86 L; CON: 4.66 ± 0.48 L, p < 0.01). Additionally, not significant difference in percutaneous oxygen saturation (SpO2) was found, and fat free mass (SM: 54.45 ± 4.01 kg; FM: 57.08 ± 4.38kg; CON: 58.34 ± 1.81 kg, p<0.01) were statistically significant changed with SM and CON but not FM. In conclusion, wearing surgical masks and FFP2 face mask during high-intensity interval exercise showed certain positive impacts on cardiopulmonary function. This short-term high-intensity interval training can be used to improve forced vital capacity performance among football players. This finding can be applied to develop the strength of breathing muscles in the future.
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Affiliation(s)
- Bumrung Neranoch
- Exercise and Sport Sciences Program, Khon Kaen University, Khon Kaen, THAILAND
| | | | - Traiperm Natthapon
- Department of Sport and Exercise Sciences, Khon Kaen University, Nong Khai, THAILAND
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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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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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18
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Wangüemert Pérez F, Wangüemert Guerra M, Caballero Dorta E, Acosta Materan CJ, Tormo Juarez JP, Godoy Camacho C, Cardenes Leon A, Segura Villalobos F, Medina Gil JM, Perez ML, García Salvador JJ, Mateos Cañero GO, Jiménez Rivero C, Martínez-Quintana E. Impact of face masks during the treadmill exercise tests. Med Clin (Barc) 2023; 160:101-106. [PMID: 35760609 DOI: 10.1016/j.medcli.2022.05.006] [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: 02/26/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 02/06/2023]
Abstract
INTRODUCTION AND OBJECTIVE There is little literature on the use of face masks in a treadmill test (TMT) during the COVID-19 pandemic. The objective of this study is to analyze the impact of face masks during a TMT performed during the prepandemic (without face mask) and postpandemic (with face mask) era. METHODS Retrospective observational unicentric study of patients undergoing TMT. The inclusion criterion were being over 16years old and having performed at least one TMT in the prepandemic and postpandemic period. RESULTS One thousand six hundred fifty-five patients were included in the study. Nine hundred thirty-five (56.5%) were men and 720 (43.5%) women. The mean age was 57.3±14.9 and the mean follow-up time was 15.4 months. Fifty-three percent patients had arterial hypertension, 20% dyslipidemia, 12% diabetes mellitus, 8% smoking habit, 19% personal history of ischemic heart disease, 5% COPD, 8% bronchial asthma, and 8% atrial fibrillation. In almost all the variables studied in PE, including the appearance of ventricular arrhythmias, no significant differences were found, neither by age nor sex, except for the existence of a very slight decrease in exercise capacity with mask use in older patients (>65years). CONCLUSIONS The use of surgical or FFP2 face masks during the TMT did not affect functional capacity, blood pressure, heart rate, or increased ventricular arrhythmias.
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Affiliation(s)
| | | | - Eduardo Caballero Dorta
- Servicio de Cardiología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España
| | | | | | | | | | | | | | - Marta López Perez
- Cardiavant, Centro Médico Cardiológico, Las Palmas de Gran Canaria, España
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19
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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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20
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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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21
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Seibt R, Bär M, Rieger MA, Steinhilber B. Limitations in evaluating COVID-19 protective face masks using open circuit spirometry systems: respiratory measurement mask introduces bias in breathing pressure and perceived respiratory effort. Physiol Meas 2023; 44. [PMID: 36595319 DOI: 10.1088/1361-6579/aca7ab] [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: 08/19/2022] [Accepted: 11/30/2022] [Indexed: 12/05/2022]
Abstract
Objective.In response to the COVID-19 pandemic and the resulting widespread use of protective face masks, studies have been and are being conducted to investigate potential side effects of wearing masks on the performance and physiological parameters of wearers. The purpose of the present study is to determine whether and to what extent the use of a respiratory measurement (RM) mask-which is normally used during open-circuit spirometry-influences the results of these types of studies.Approach.34 subjects were involved in this intra-subject study with a cross-over design. Four different protective face masks, Community Mask, medical Mouth-Nose-Protection Mask, Filtering Face Piece Mask Class 2 (FFP2), and FFP2 with exhalation valve (FFP2ex), were tested at rest and during deep breathing by using or not using a RM mask (RM versus noRM). Breathing pressure inside the protective face masks was measured during inhalation and exhalation, and subjects rated breathing effort using an 11-stage Borg scale.Main results.The use of an additional RM mask-worn over the protective face masks-significantly increased inspiratory pressures under all mask conditions. The respiratory pressure rises to a level that substantially distorts the results. Expiratory pressure was also significantly increased except for the FFP2ex mask condition. The perceived respiratory effort was significantly increased by 1.0 to 2.8 steps on the Borgs scale for all mask conditions compared with noRM.Significance.We strongly recommend avoiding the use of RM masks for evaluating the effects of protective face masks on human physiology and subjective perception.
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Affiliation(s)
- Robert Seibt
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, D-72074 Tuebingen, Germany
| | - Mona Bär
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, D-72074 Tuebingen, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, D-72074 Tuebingen, Germany
| | - Benjamin Steinhilber
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, D-72074 Tuebingen, Germany
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22
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Wang IL, Su Y, Yao S, Jiang YH, Li HY, Lai CY. Effect of wearing medical protective masks on treadmill running performance in the postpandemic era: a randomised trial. BMC Sports Sci Med Rehabil 2023; 15:6. [PMID: 36631910 PMCID: PMC9832620 DOI: 10.1186/s13102-022-00598-9] [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: 04/21/2022] [Accepted: 11/24/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND In the postpandemic era, wearing protective masks in public places will still be an important means of blocking popular viruses in the future. The purpose of this study was to explore whether sports performance was affected by mask wearing and exercise duration during 15-min treadmill running at a speed of 75% maximal aerobic speed. METHODS Thirty-six males were randomly divided into mask and nonmask groups. The kinematic and kinetic data were obtained at four time points (RN0-1 min, RN5-6 min, RN9-10 min, and RN14-15 min) during running. Two-way mixed ANOVA was applied to examine the effects between groups and times with Bonferroni post hoc comparison and independent samples t-test. RESULTS The results showed that there was no difference between mask and nonmask group during running (p > 0.05). As running time increased, hip joint ROM, hip joint flexion/extension max, and ankle joint plantarflexion max angles increased; knee joint flexion min and ankle joint dorsiflexion max angles decreased; average peak vertical ground reaction forces (PVGRF) increased after 9 min-running (p < 0.05). CONCLUSIONS Wearing a medical protective mask does not affect the joint angle and touchdown PVGRF of lower extremities during treadmill running while affected by running time and changed after 9 min-treadmill running. Future studies will examine the effects of wearing masks during the pandemic on muscle activation and blood biochemical values during exercise. TRIAL REGISTRATION NO ChiCTR2000040535 (date of registration on December 1, 2020). Prospectively registered in the Chinese Clinical Trial Registry.
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Affiliation(s)
- I-Lin Wang
- grid.462271.40000 0001 2185 8047College of Physical Education, Hubei Normal University, Huangshi, 435000 Hubei China
| | - Yu Su
- Graduate Institute, Jilin Sport University, Changchun, 130022 Jilin China
| | - Shun Yao
- Graduate Institute, Jilin Sport University, Changchun, 130022 Jilin China
| | - Yu-Hong Jiang
- Graduate Institute, Jilin Sport University, Changchun, 130022 Jilin China
| | - Hao-Yu Li
- grid.462271.40000 0001 2185 8047Graduate Institute, Hubei Normal University, Huangshi, 435000 Hubei China
| | - Chien-Ying Lai
- grid.411508.90000 0004 0572 9415Orthopedic Department, China Medical University Hospital, Taichung, 40447 Taiwan
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23
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Grafeneder J, Fuhrmann V, Tscherny K, Niederer M, Schreiber W, Herkner H, Roth D, Kienbacher CL. COVID-19: Masks do not influence neurocognitive performance during a shift at the emergency department. World J Emerg Med 2023; 14:317-321. [PMID: 37425077 PMCID: PMC10323511 DOI: 10.5847/wjem.j.1920-8642.2023.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/27/2023] [Indexed: 07/11/2023] Open
Affiliation(s)
- Jürgen Grafeneder
- Department of Emergency Medicine, Medical University of Vienna, Wien 1090, Austria
| | - Verena Fuhrmann
- Department of Emergency Medicine, Medical University of Vienna, Wien 1090, Austria
| | - Katharina Tscherny
- Department of Emergency Medicine, Medical University of Vienna, Wien 1090, Austria
- Department of Anaesthesiology and Intensive Care, Hospital Scheibbs, Scheibbs 3270, Austria
| | - Maximilian Niederer
- Department of Emergency Medicine, Medical University of Vienna, Wien 1090, Austria
- Department of Anaesthesiology and Intensive Care, Hospital Scheibbs, Scheibbs 3270, Austria
| | - Wolfgang Schreiber
- Department of Emergency Medicine, Medical University of Vienna, Wien 1090, Austria
| | - Harald Herkner
- Department of Emergency Medicine, Medical University of Vienna, Wien 1090, Austria
| | - Dominik Roth
- Department of Emergency Medicine, Medical University of Vienna, Wien 1090, Austria
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24
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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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25
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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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26
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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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27
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Liu BB, Niu ZR, Jia XJ, Liu XL, Lu Q. Correlation between Insulin Resistance and Cardiopulmonary Function during Physical Exams for Male Patients. Am J Health Behav 2022; 46:600-605. [PMID: 36721285 DOI: 10.5993/ajhb.46.6.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objective: In this study, we investigated the correlation between insulin resistance (IR) and cardiopulmonary function during physical exams for male patients. Methods: We selected 124 healthy male participants in the physical examination center of our hospital. They were divided into 3 groups according to the homeostasis model assessment of insulin resistance values. The oxygen uptake, peak oxygen uptake (VO₂/kg), heart rate, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by a cardiopulmonary exercise function tester. We analyzed the correlation between the index of IR and cardiopulmonary function. Results: There were statistically significant differences in body mass index, waist circumference, fasting insulin level, anaerobic threshold SBP, maximum VO2/kg and maximum SBP among the 3 groups (p<.05). However, no significant difference was found in SBP, DBP, total cholesterol, low-density lipoprotein cholesterol and fasting blood glucose levels (p>.05). The anaerobic threshold SBP, maximum VO2/kg and maximum SBP were all negatively correlated with the IR index. Conclusion: Our results indicate that IR is associated with cardiopulmonary function and that there are different correlations between the various cardiopulmonary function indexes and IR.
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Affiliation(s)
- Bin-Bin Liu
- Bin-Bin Liu, Department of Functional Inspection, Qinhuangdao First Hospital, Qinhuangdao, China
| | - Zi-Ru Niu
- Zi-Ru Niu, Department of Endocrinology and Metabolic Diseases, Hebei Medical University, Shijiazhuang, China
| | - Xiao-Jiao Jia
- Xiao-Jiao Jia, Department of Endocrinology, Qinhuangdao First Hospital, Qinhuangdao, China
| | - Xiao-Li Liu
- Xiao-Li Liu, Department of Endocrinology, Qinhuangdao First Hospital, Qinhuangdao, China
| | - Qiang Lu
- Qiang Lu, Department of Endocrinology, Qinhuangdao First Hospital, Qinhuangdao, China;,
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28
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Vilarinho R, Toledo A, Silva C, Melo F, Tomaz L, Martins L, Gonçalves T, Melo C, Caneiras C, Montes AM. Reference Equation of a New Incremental Step Test to Assess Exercise Capacity in the Portuguese Adult Population. J Clin Med 2022; 12:jcm12010271. [PMID: 36615071 PMCID: PMC9821567 DOI: 10.3390/jcm12010271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
Step tests are important in community- and home-based rehabilitation programs to assess patients' exercise capacity. A new incremental step test was developed for this purpose, but its clinical interpretability is currently limited. This study aimed to establish a reference equation for this new incremental step test (IST) for the Portuguese adult population. A cross-sectional study was conducted on people without disabilities. Sociodemographic (age and sex), anthropometric (weight, height, and body mass index), smoking status, and physical activity (using the brief physical activity assessment tool) data were collected. Participants performed two repetitions of the IST and the best test was used to establish the reference equation with a forward stepwise multiple regression. An analysis comparing the results from the reference equation with the actual values was conducted with the Wilcoxon test. A total of 155 adult volunteers were recruited (60.6% female, 47.8 ± 19.7 years), and the reference equation was as follows: steps in IST = 475.52 - (4.68 × age years) + (30.5 × sex), where male = 1 and female = 0, and r2 = 60%. No significant differences were observed between the values performed and those obtained by the equation (p = 0.984). The established equation demonstrated that age and sex were the determinant variables for the variability of the results.
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Affiliation(s)
- Rui Vilarinho
- FP-I3ID, Escola Superior de Saúde-Fernando Pessoa, 4200-253 Porto, Portugal
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal
- Healthcare Department, Nippon Gases Portugal, 4470-177 Maia, Portugal
- Correspondence:
| | - Ana Toledo
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal
| | - Carla Silva
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal
| | - Fábio Melo
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal
| | - Leila Tomaz
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal
| | - Luana Martins
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal
| | - Tânia Gonçalves
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal
| | - Cristina Melo
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal
| | - Cátia Caneiras
- Healthcare Department, Nippon Gases Portugal, 4470-177 Maia, Portugal
- Microbiology Research Laboratory on Environmental Health (EnviHealthMicroLab), Institute of Environmental Health (ISAMB), Faculty of Medicine, Universidade de Lisboa (ULisboa), 1649-028 Lisbon, Portugal
- Multidisciplinary Research Center of Egas Moniz (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
- Institute for Preventive Medicine and Public Health, Faculty of Medicine, Universidade de Lisboa (ULisboa), 1649-028 Lisbon, Portugal
| | - António Mesquita Montes
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal
- Department of Physiotherapy, Santa Maria Health School, 4049-024 Porto, Portugal
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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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Shuval K, Leonard D, DeFina LF, Barlow CE, Drope J, Amir O, Gneezy A, Tzafrir S, Chartier KG, Qadan M. Cardiorespiratory Fitness and Depression Symptoms among Adults During the COVID-19 Pandemic: Cooper Center Longitudinal Study. Prev Med Rep 2022; 30:102065. [PMCID: PMC9677558 DOI: 10.1016/j.pmedr.2022.102065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/31/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022] Open
Abstract
This study examined the relation between cardiorespiratory fitness (fitness) and depression symptoms prior to and during COVID-19 among adults seeking preventive medical care. Participants consisted of 967 patients attending the Cooper Clinic (Dallas, TX) pre-pandemic (March 2018-December 2019) and during the pandemic (March-December 2020). The outcome, depression symptoms, was based on the Center for Epidemiological Studies-Depression (CES-D). Maximal metabolic equivalents task (MET) levels for fitness were determined from the final treadmill speed and grade. Multiple linear regression models were computed by sex. Analysis revealed that mean fitness decreased from 11.4 METs (SD=2.1) prior to the pandemic to 10.9 METs (SD=2.3) during the pandemic (p-value<0.001). The mean CES-D score increased from 2.8 (SD= 3.1) before to pandemic to 3.1 (SD=3.2) during the pandemic (p-value=0.003). Results from multiple linear regression indicate that increased fitness was associated with a statistically significant decrease in depression scores in men (-0.17 per MET; 95%CI -0.33, -0.02) but not women. This modest decrease may have been tempered by high fitness levels and low depression scores at baseline in this well-educated sample.
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Affiliation(s)
- Kerem Shuval
- The Cooper Institute, Dallas, Texas 75230, USA,School of Business Administration, University of Haifa, Haifa 3498838, Israel,School of Public Health, University of Haifa, Haifa 3498838, Israel,Corresponding author
| | | | | | | | - Jeffrey Drope
- Health Policy & Administration, School of Public Health, University of Illinois at Chicago, Illinois, USA
| | - On Amir
- Rady School of Management, University of California San Diego, CA, USA
| | - Ayelet Gneezy
- Rady School of Management, University of California San Diego, CA, USA
| | - Shay Tzafrir
- School of Business Administration, University of Haifa, Haifa 3498838, Israel
| | - Karen G. Chartier
- School of Social Work and Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Mahmoud Qadan
- School of Business Administration, University of Haifa, Haifa 3498838, Israel
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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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Shashina EA, Sannikova EA, Shcherbakov DV, Zhernov YV, Makarova VV, Isiutina-Fedotkova TS, Zabroda NN, Belova EV, Ermakova NA, Khodykina TM, Skopin AY, Sukhov VA, Klimova AA, Turnic TN, Yakushina II, Manerova OA, Reshetnikov VA, Mitrokhin OV. Analysis of the Face Mask Use by Public Transport Passengers and Workers during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14285. [PMID: 36361160 PMCID: PMC9657969 DOI: 10.3390/ijerph192114285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/19/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: The use of face masks and gloves in public places directly shows the commitment of the population to the established regulations. Public transport is one of the most-at-risk places of contamination. The aim of the study was to analyze the face mask use by public transport passengers and workers during the COVID-19 pandemic. (2) Methods: Public transport passengers and workers were surveyed. Periodic intermittent selective observation was used to gauge the level of adherence to the established regulations among public transport passengers. Factor analysis was used to identify factors determining the face-mask-wearing comfort. (3) Results: The majority of passengers (87.5%) and all transport workers (100%) used face masks and gloves. Most of the users wore only face masks. Only 41.6% of passengers and 74.7% of transport workers wore face masks correctly. Motivational attitudes at the implementation of preventive measures were determined: established regulations in the public place (55.8%) and the protection of one's own health and the health of family members (44.2%). Only 22.5% of those wearing face masks believed that doing so will have any effect on the spread of an infectious disease, and 10.8% wore masks to maintain the health of people around themselves. A low level of social responsibility was demonstrated. For 53.4% of workers, face mask wearing was uncomfortable. The majority of workers had adverse reactions to mask wearing: feeling short of breath (52.8%), hyperemia of face skin (33.8%), and facial hyperhidrosis (67.4%). (4) Conclusions: The comfort of wearing a mask is determined by adverse reactions occurrence, the properties of the mask, working conditions, and the duration of wearing the face mask. It is necessary to develop recommendations to reduce wearing discomfort. These recommendations, along with methods of raising the social responsibility of the population, can contribute to a greater commitment of the population to non-specific prevention measures.
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Affiliation(s)
- Ekaterina A. Shashina
- Department of General Hygiene, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Ekaterina A. Sannikova
- National Medical Research Center for Urology, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Denis V. Shcherbakov
- Department of General Hygiene, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Yury V. Zhernov
- Department of General Hygiene, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
- Department of Chemistry, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Valentina V. Makarova
- Department of General Hygiene, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Tatiana S. Isiutina-Fedotkova
- Department of General Hygiene, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Nadezhda N. Zabroda
- Department of General Hygiene, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Elena V. Belova
- Department of General Hygiene, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Nina A. Ermakova
- Department of General Hygiene, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Tatiana M. Khodykina
- Department of General Hygiene, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Anton Yu. Skopin
- Department of General Hygiene, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
- F.F. Erisman Federal Scientific Center of Hygiene of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 141014 Moscow, Russia
| | - Vitaly A. Sukhov
- Department of General Hygiene, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Anna A. Klimova
- Department of General Hygiene, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Tamara Nikolic Turnic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- N.A. Semashko Department of Public Health and Healthcare, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Irina I. Yakushina
- N.A. Semashko Department of Public Health and Healthcare, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Olga A. Manerova
- N.A. Semashko Department of Public Health and Healthcare, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Vladimir A. Reshetnikov
- N.A. Semashko Department of Public Health and Healthcare, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Oleg V. Mitrokhin
- Department of General Hygiene, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
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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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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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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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Moris JM, Koh Y. Aerobic Performance Detriments while Wearing a Face Mask Diverge Among Males and Females. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2022; 15:1105-1116. [PMID: 36159158 PMCID: PMC9458284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The current study examined the impact of wearing a face mask (FM) at rest and while exercising on cardiorespiratory variables and aerobic performance between males and females. Nine males (21.4 ± 0.5 yr) and 9 females (21.8 ± 3.6 yr) performed a pulmonary function test and a graded maximal exercise test (GXT) on a treadmill with an FM and without an FM in random order. During the GXT, cardiorespiratory variables were measured at different exercise intensities (rest, 40%, 55%, 70%, 80%, 100% of VO2max) and during recovery. Regardless of sex, both males and females significantly (p = .01) reduced their resting pulmonary functions, including forced vital capacity (18.7% and 19.6%, respectively), forced expiratory volume in one second (43.9% and 45.7%, respectively), and peak expiratory flow (85.2% and 87.5%, respectively) with an FM. During the GXT, both VO2 and ventilation (VE) in males were significantly (p < .01) lower with an FM only at 100% of VO2max, while females showed a significantly (p < .01) lower VO2, VE, and tidal volume (Vt) with an FM throughout the entire GXT. The partial pressure of exhaled CO2 was significantly (p = .02) higher at 100% of VO2max with an FM only in males. Although wearing an FM reduced resting pulmonary functions and the maximal aerobic performance for both males and females, there was a clear sex-specific response during the GXT, indicating that females were less capable to adapt to the pulmonary obstruction induced by wearing an FM.
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Affiliation(s)
- Jose M Moris
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA
| | - Yunsuk Koh
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA
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Wang SY, Chiu CH, Hsu CH, Chou CC, Hsu SM, Shapu LB, Chao TC, Chen CH. Acute Effects of Wearing Different Surgical Face Masks during High-Intensity, Short-Rest Resistance Exercise on Cardiorespiratory and Pulmonary Function and Perceptual Responses in Weightlifters. BIOLOGY 2022; 11:biology11070992. [PMID: 36101371 PMCID: PMC9311899 DOI: 10.3390/biology11070992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022]
Abstract
This study investigated the effect of wearing a typical surgical mask (SM) or a three-dimensional (3D) SM (3DSM) during whole-body, high-intensity, short-rest resistance exercise on cardiorespiratory, respiratory, and perceptual comfort responses in weightlifters. Twenty elite weightlifters (6 women and 14 men; age = 24.1 ± 4.9 years; height: 167.45 ± 7.60 cm; body mass = 76.48 ± 19.86 kg) who participated in this study performed 3 resistance exercise sessions in a randomized order: (1) without a mask (NM), (2) while wearing a typical SM, and (3) while wearing a 3DSM. Resistance exercise consisted of a descending pyramid scheme starting at 10 repetitions, with a decrease of one repetition per set for the back squat, bench press, and deadlift, as fast as possible at 75% of the one-repetition maximum. Cardiorespiratory and pulmonary function and comfort were measured. Across all conditions, effective postexercise hypotension (PEH) was noted in terms of decreased systolic blood pressure (−4.64%), diastolic BP (−5.36%), mean arterial pressure (−5.02%), and ankle–brachial index (−6.84%). However, the heart rate (40.34%) and rate of pressure product (33.60%) increased, and no effects on pulmonary function were observed in the three conditions. The participants reported higher breathing resistance and tightness when wearing a typical SM than when wearing a 3DSM or no mask. Therefore, both wearing and not wearing a face mask during whole-body, high-intensity, short-rest resistance exercise promoted PEH and exerted no detrimental effect on pulmonary function. Coaches, trainers, and athletes should consider wearing a 3DSM during resistance exercise.
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Affiliation(s)
- Shin-Yuan Wang
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung 404401, Taiwan; (S.-Y.W.); (C.-H.C.)
| | - Chih-Hui Chiu
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung 404401, Taiwan; (S.-Y.W.); (C.-H.C.)
| | - Chin-Hsien Hsu
- Department of Leisure Industry Management, National Chi-Yi University of Technology, Taichung 411030, Taiwan
- Correspondence: (C.-H.H.); (C.-H.C.); Tel.: +886-4-2392-4505 (ext. #8306) (C.-H.H.); +886-4-2221-3108 (C.-H.C.)
| | - Chun-Chung Chou
- Physical Education Office, National Taipei University of Technology, Taipei 10608, Taiwan;
| | | | - Lu-Bi Shapu
- School of Physical & Health, Nanning Normal University, Nanning 530011, China;
| | - Tai-Chen Chao
- Sport Science Research Center, National Taiwan University of Sport, Taichung 404401, Taiwan;
| | - Che-Hsiu Chen
- Department of Sport Performance, National Taiwan University of Sport, Taichung 404401, Taiwan
- Correspondence: (C.-H.H.); (C.-H.C.); Tel.: +886-4-2392-4505 (ext. #8306) (C.-H.H.); +886-4-2221-3108 (C.-H.C.)
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Effect of Cloth Masks and N95 Respirators on Maximal Exercise Performance in Collegiate Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137586. [PMID: 35805244 PMCID: PMC9266082 DOI: 10.3390/ijerph19137586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/10/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022]
Abstract
This study compared exercise performance and comfort while wearing an N95 filtering facepiece respirator (N95), cloth mask, or no intervention control for source control during a maximal graded treadmill exercise test (GXT). Twelve Division 1 athletes (50% female, age = 20.1 ± 1.2, BMI = 23.5 ± 1.6) completed GXTs under three randomized conditions (N95, cloth mask, control). GXT duration, heart rate (HR), respiration rate (RR), transcutaneous oxygen saturation (SpO2), transcutaneous carbon dioxide (TcPCO2), rating of perceived exertion (RPE), and perceived comfort were measured. Participants ran significantly longer in control (26.06 min) versus N95 (24.20 min, p = 0.03) or cloth masks (24.06 min, p = 0.04). No differences occurred in the slope of HR or SpO2 across conditions (p > 0.05). TcPCO2 decreased faster in control (B = −0.89) versus N95 (B = 0.14, p = 0.02) or cloth masks (B = −0.26, p = 0.03). RR increased faster in control (B = 8.32) versus cloth masks (B = 6.20, p = 0.04). RPE increased faster in the N95 (B = 1.91) and cloth masks (B = 1.79) versus control (B = 1.59, p < 0.001 and p = 0.05, respectively). Facial irritation/itching/pinching was higher in the N95 versus cloth masks, but sweat/moisture buildup was lower (p < 0.05 for all). Wearing cloth masks or N95s for source control may impact exercise performance, especially at higher intensities. Significant physiological differences were observed between cloth masks and N95s compared to control, while no physiological differences were found between cloth masks and N95s; however, comfort my differ.
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Dalakoti M, Long C, Bains A, Djohan A, Ahmad I, Chan SP, Kua J, Chan PF, Yeo TJ. Effect of Surgical Mask use on Peak Physical Performance During Exercise Treadmill Testing-A Real World, Crossover Study. Front Physiol 2022; 13:913974. [PMID: 35685282 PMCID: PMC9171022 DOI: 10.3389/fphys.2022.913974] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/04/2022] [Indexed: 11/28/2022] Open
Abstract
Background: Mask wearing is an essential strategy to combat the spread of SARS-CoV-2. Some individuals may wear masks during physical activity to reduce disease transmission. This study aimed to investigate the real-world effect of wearing a surgical face mask on physiological parameters at peak exercise in healthy individuals. Methods: In this crossover design study, participants underwent maximal treadmill electrocardiogram exercise tests using the Bruce protocol on two separate occasions, once with a standard 3-ply surgical face mask and once without. Heart rate, oxygen saturation, blood pressure, rate pressure product, metabolic equivalents (METS) and total exercise time were measured. Subjective rate of perceived exertion was also assessed using the modified Borg Scale. Results: 50 adults (mean age = 31.7 ± 6.5 years; 27 males) completed both treadmill tests. Mask wearing resulted in a significant reduction in peak METS by 1.5 units, maximum speed by 0.5 km/h, exercise time by 68.4 s with a significantly lower peak heart rate by 4.4 bpm, and lower percentage of age-predicted maximum heart rate by 2.5% (p < 0.001 for all parameters). During each corresponding stage of the Bruce protocol, the average modified Borg score was found to be significantly higher in subjects exercising with mask after adjusting for age, gender and body mass index (p < 0.03). Conclusion: In a cohort of healthy individuals, wearing of a surgical face mask during maximal treadmill exercise lead to reduced physical performance and increased rate of perceived exertion. Individuals exercising with surgical masks need to be mindful of these limitations while undergoing physical training in order to differentiate these physiological responses from symptoms of early respiratory illness.
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Affiliation(s)
| | - Cheryl Long
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Arshia Bains
- National University Heart Centre, Singapore, Singapore
| | - Andie Djohan
- National University Heart Centre, Singapore, Singapore
| | - Isabel Ahmad
- National University Heart Centre, Singapore, Singapore
| | - Siew Pang Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jieli Kua
- National University Heart Centre, Singapore, Singapore
| | - Po Fun Chan
- National University Heart Centre, Singapore, Singapore
| | - Tee Joo Yeo
- National University Heart Centre, Singapore, Singapore
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Blood gas levels, cardiovascular strain and cognitive performance during surgical mask and filtering face piece application. Sci Rep 2022; 12:9708. [PMID: 35690655 PMCID: PMC9188275 DOI: 10.1038/s41598-022-13711-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/26/2022] [Indexed: 12/12/2022] Open
Abstract
Mask induced airway resistance and carbon dioxide rebreathing is discussed to impact gas exchange and to induce discomfort and impairments in cognitive performance. N = 23 healthy humans (13 females, 10 males; 23.5 ± 2.1 years) participated in this randomized crossover trial (3 arms, 48-h washout periods). During interventions participants wore either a surgical face mask (SM), a filtering face piece (FFP2) or no mask (NM). Interventions included a 20-min siting period and 20 min steady state cycling on an ergometer at 77% of the maximal heart rate (HR). Hemodynamic data (HR, blood pressure), metabolic outcomes (pulse derived oxygen saturation, capillary carbon dioxide (pCO2), and oxygen partial pressure (pO2), lactate, pH, base excess), subjective response (ability to concentrate, arousal, perceived exertion) and cognitive performance (Stroop Test) were assessed. Compared to NM, both masks increased pCO2 (NM 31.9 ± 3.3 mmHg, SM = 35.2 ± 4.0 mmHg, FFP2 = 34.5 ± 3.8 mmHg, F = 12.670, p < 0.001) and decreased pH (NM = 7.42 ± 0.03, SM = 7.39 ± 0.03, FFP2 = 7.39 ± 0.04, F = 11.4, p < 0.001) during exercise. The FFP2 increased blood pressure during exercise (NM = 158 ± 15 mmHg, SM = 159 ± 16 mmHg, FFP2 = 162 ± 17 mmHg, F = 3.21, p = 0.050), the SM increased HR during sitting (NM = 70 ± 8 bpm, SM = 74 ± 8 bpm, FFP2 = 73 ± 8 bpm, F = 4.70, p = 0.014). No mask showed any comparative effect on other hemodynamic, metabolic, subjective, or cognitive outcomes. Mask wearing leads to slightly increased cardiovascular stress and elevated carbon dioxide levels during exercise but did not affect cognitive performance or wellbeing.
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Levine O, Terry M, Tjong V. The Collegiate Athlete Perspective on Return to Sport Amidst the COVID-19 Pandemic: A Qualitative Assessment of Confidence, Stress, and Coping Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116885. [PMID: 35682469 PMCID: PMC9180442 DOI: 10.3390/ijerph19116885] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 12/10/2022]
Abstract
(1) Background: The COVID-19 pandemic has created challenges for college athletes as they return to sport and campus life. Emerging literature highlights some of these challenges, but no studies have used a primarily qualitative approach to assess the impact of the pandemic on college athletes. The purpose of this study was to better understand factors affecting college athletes' return to sport and campus life amidst the COVID-19 pandemic. (2) Methods: Semi-structured interviews were conducted with varsity athletes who participated in the 2020-2021 season at a single university. Qualitative analysis was performed using the Strauss and Corbin method to derive codes, categories, and themes. Additionally, Athletic Coping Skills Inventory-28 (ACSI-28) scores were recorded and analyzed using descriptive statistics. (3) Results: A total of 20 student athletes were interviewed, revealing that confidence and motivation, increased stress and anxiety, and adaptive coping strategies were common themes affecting their experiences returning to sport and campus life. Results from the ACSI-28 showed an average score of 49.5 and a range of 24-66. (4) Conclusions: Semi-structured interviews revealed factors impacting return to sport and student life. These findings can help inform how to better support college athletes throughout the remainder of the current pandemic and moving forward.
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Braun-Trocchio R, Renteria J, Warfield E, Harrison K, Williams A. The Effects of Face Coverings on Perceived Exertion and Attention Allocation during a Stepping Task. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6892. [PMID: 35682473 PMCID: PMC9180205 DOI: 10.3390/ijerph19116892] [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: 04/25/2022] [Revised: 05/28/2022] [Accepted: 06/02/2022] [Indexed: 11/25/2022]
Abstract
The COVID-19 pandemic has impacted the entire world from lockdowns to various recommended restrictions including social distancing and wearing face coverings. In a safe environment, cardiovascular exercise is important for both physical health and mental health. The current study examined the effects of face coverings on rating of perceived exertion and attention allocation during an exertive stepping task. Participants completed a stepping task with a weighted vest at 20% of their bodyweight until volitional fatigue with a face covering (n = 23) or without a face covering (n = 31). Results revealed a non-significant difference (p = 0.25) in the duration of the stepping task (in seconds) between the no face covering (M = 455.81, SD = 289.77) and face covering (M = 547.83, SD = 285.93) conditions. Results indicated increases in perceived exertion (p < 0.001) and heart rate (p < 0.001) as time progressed across the four time points (i.e., 30 s, 1/3 time to exhaustion, 2/3 time to exhaustion, and exhaustion) in both conditions. No significant differences were found between the conditions for RPE (p = 0.09) and heart rate (p = 0.50). Participants wearing a face covering were more internally focused across the duration of the stepping task (p = 0.05). This study has relevance for applied practitioners implementing physical activity interventions that require face coverings.
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Affiliation(s)
- Robyn Braun-Trocchio
- Department of Kinesiology, Texas Christian University, Fort Worth, TX 76129, USA
| | - Jessica Renteria
- Department of Kinesiology, Texas Christian University, Fort Worth, TX 76129, USA
| | - Elizabeth Warfield
- Department of Kinesiology, Texas Christian University, Fort Worth, TX 76129, USA
| | - Kaitlyn Harrison
- Department of Kinesiology, Texas Christian University, Fort Worth, TX 76129, USA
| | - Ashlynn Williams
- Department of Kinesiology, Texas Christian University, Fort Worth, TX 76129, USA
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Ou H, Zheng Y, Li M, Liang J, Chen H, Lang S, Li Q, Chen D, Lin Y, Chen Q, Sun Y, Zheng M, You T, Lin Q. The impacts of surgical mask in young healthy subjects on cardiopulmonary function and muscle performance: a randomized crossover trial. Arch Public Health 2022; 80:138. [PMID: 35581631 PMCID: PMC9112472 DOI: 10.1186/s13690-022-00893-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/02/2022] [Indexed: 02/05/2023] Open
Abstract
Objective To explore the impacts of surgical mask in normal subjects on cardiopulmonary function and muscle performance under different motor load and gender differences. Design Randomized crossover trial. Setting The Fifth Affiliated Hospital of Guangzhou Medical University, June 16th to December 30th, 2020. Participants Thirty-one college students (age: male 21.27 ± 1.22 years; female 21.31 ± 0.79 years) were recruited and randomly allocated in two groups. Interventions Group 1 first received CPET in the mask-on condition followed by 48 h of washout, and then received CPET in the mask-off condition. Group 2 first received CPET in the mask-off condition followed by 48 h of washout, then received CPET in the mask-on condition. The sEMG data were simultaneously collected. Main outcome measures The primary outcome was maximum oxygen uptake (VO2 max) from CPET, which was performed on a cycle ergometer—this is the most important parameter associated with an individual’s physical conditioning. The secondary parameters included parameters reflecting exercise tolerance and heart function (oxygen uptake, anaerobic valve, maximum oxygen pulse, heart rate reserve), parameters reflecting ventilation function (respiration reserve, ventilation volume, tidal volume, breathing frequency), parameters reflecting gas exchange (end-tidal oxygen and carbon dioxide partial pressure, oxygen equivalent, carbon dioxide equivalent, and the relationship between dead space and tidal volume) and parameters reflecting skeletal muscle function [oxygen uptake, anaerobic valve, work efficiency, and EMG parameters including root mean square (RMS)]. Results Comparing the mask-on and mask-off condition, wearing surgical mask had some negative effects on VO2/kg (peak) and ventilation (peak) in both male and female health subjects [VO2/kg (peak): 28.65 ± 3.53 vs 33.22 ± 4.31 (P = 0.001) and 22.54 ± 3.87 vs 26.61 ± 4.03 (P < 0.001) ml/min/kg in male and female respectively; ventilation (peak): 71.59 ± 16.83 vs 82.02 ± 17.01 (P = 0.015) and 42.46 ± 10.09 vs 53.95 ± 10.33 (P < 0.001) liter in male and female respectively], although, based on self-rated scales, there was no difference in subjective feelings when comparing the mask-off and mask-on condition. Wearing surgical masks showed greater lower limb muscle activity just in male subjects [mean RMS of vastus medialis (load): 65.36 ± 15.15 vs 76.46 ± 19.04 μV, P = 0.031]. Moreover, wearing surgical masks produced a greater decrease in △tidal volume (VTpeak) during intensive exercises phase in male subjects than in female [male − 0.80 ± 0.15 vs female − 0.62 ± 0.11 l P = 0.001]. Conclusions Wearing medical/surgical mask showed a negative impact on the ventilation function in young healthy subjects during CPET, especially in high-intensity phase. Moreover, some negative effects were found both in ventilation and lower limb muscle actives in male young subjects during mask-on condition. Future studies should focus on the subjects with cardiopulmonary diseases to explore the effect of wearing mask. Trial registration Chinese Clinical Trial Registry (ChiCTR2000033449).
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Affiliation(s)
- Haining Ou
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China.,The Rehabilitation Medicine Lab, The Fifth Clinical College of Guangzhou Medical University, Guangzhou, 510700, China.,Guangzhou Key Laboratory of Enhanced Recovery after Abdominal Surgery, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, China.,Department of Rehabilitation Therapy, Guangzhou Medical University, Guangzhou, 511436, China
| | - Yuxin Zheng
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China.,The Rehabilitation Medicine Lab, The Fifth Clinical College of Guangzhou Medical University, Guangzhou, 510700, China.,Department of Rehabilitation Therapy, Guangzhou Medical University, Guangzhou, 511436, China
| | - Mei Li
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China.,The Rehabilitation Medicine Lab, The Fifth Clinical College of Guangzhou Medical University, Guangzhou, 510700, China
| | - Junjie Liang
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China.,The Rehabilitation Medicine Lab, The Fifth Clinical College of Guangzhou Medical University, Guangzhou, 510700, China.,Department of Rehabilitation Therapy, Guangzhou Medical University, Guangzhou, 511436, China
| | - Hongxin Chen
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China.,The Rehabilitation Medicine Lab, The Fifth Clinical College of Guangzhou Medical University, Guangzhou, 510700, China.,Department of Rehabilitation Therapy, Guangzhou Medical University, Guangzhou, 511436, China
| | - Shijuan Lang
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China.,The Rehabilitation Medicine Lab, The Fifth Clinical College of Guangzhou Medical University, Guangzhou, 510700, China.,Department of Rehabilitation Therapy, Guangzhou Medical University, Guangzhou, 511436, China
| | - Qinyi Li
- Department of Rehabilitation Therapy, Guangzhou Medical University, Guangzhou, 511436, China
| | - Delong Chen
- Department of Rehabilitation Therapy, Guangzhou Medical University, Guangzhou, 511436, China
| | - Youwei Lin
- Department of Rehabilitation Therapy, Guangzhou Medical University, Guangzhou, 511436, China
| | - Qiuxia Chen
- Department of Geriatrics, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, China
| | - Yue Sun
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China.,The Rehabilitation Medicine Lab, The Fifth Clinical College of Guangzhou Medical University, Guangzhou, 510700, China.,Department of Rehabilitation Therapy, Guangzhou Medical University, Guangzhou, 511436, China
| | - Meifeng Zheng
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China.,The Rehabilitation Medicine Lab, The Fifth Clinical College of Guangzhou Medical University, Guangzhou, 510700, China.,Department of Rehabilitation Therapy, Guangzhou Medical University, Guangzhou, 511436, China
| | - Tingting You
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China.,The Rehabilitation Medicine Lab, The Fifth Clinical College of Guangzhou Medical University, Guangzhou, 510700, China.,Department of Rehabilitation Therapy, Guangzhou Medical University, Guangzhou, 511436, China
| | - Qiang Lin
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China. .,The Rehabilitation Medicine Lab, The Fifth Clinical College of Guangzhou Medical University, Guangzhou, 510700, China. .,Guangzhou Key Laboratory of Enhanced Recovery after Abdominal Surgery, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, China. .,Department of Rehabilitation Therapy, Guangzhou Medical University, Guangzhou, 511436, China.
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Poncin W, Schalkwijk A, Vander Straeten C, Braem F, Latiers F, Reychler G. Impact of surgical mask on performance and cardiorespiratory responses to submaximal exercise in COVID-19 patients near hospital discharge: A randomized crossover trial. Clin Rehabil 2022; 36:1032-1041. [PMID: 35473371 PMCID: PMC9047665 DOI: 10.1177/02692155221097214] [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] [Indexed: 11/25/2022]
Abstract
Background Wearing a surgical mask in hospitalized patients has become recommended during care, including rehabilitation, to mitigate coronavirus disease 2019 (COVID-19) transmission. However, the mask may increase dyspnoea and raise concerns in promoting rehabilitation activities in post-acute COVID-19 patients. Objective To evaluate the impact of the surgical mask on dyspnoea, exercise performance and cardiorespiratory response during a 1-min sit-to-stand test in hospitalized COVID-19 patients close to discharge. Methods COVID-19 patients whose hospital discharge has been planned the following day performed in randomized order two sit-to-stand tests with or without a surgical mask. Outcome measures were recorded before, at the end, and after two minutes of recovery of each test. Dyspnoea (modified Borg scale), cardiorespiratory parameters and sit-to-stand repetitions were measured. Results Twenty-eight patients aged 52 ± 10 years were recruited. Compared to unmasked condition, dyspnoea was significantly higher with the mask before and at the end of the sit-to-stand test (mean difference[95%CI]: 1.0 [0.6, 1.4] and 1.7 [0.8, 2.6], respectively). The difference was not significant after the recovery period. The mask had no impact on cardiorespiratory parameters nor the number of sit-to-stand repetitions. Conclusion In post-acute COVID-19 patients near hospital discharge, the surgical mask increased dyspnoea at rest and during a submaximal exercise test but had no impact on cardiorespiratory response or exercise performance. Patients recovering from COVID-19 should be reassured that wearing a surgical facemask during physical or rehabilitation activities is safe. These data may also mitigate fears to refer these patients in rehabilitation centres where mask-wearing has become mandatory.
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Affiliation(s)
- William Poncin
- Institut de recherche expérimentale et clinique (IREC), pôle de Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Brussels, Belgium.,Service de Pneumologie, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium.,Secteur de Kinésithérapie et Ergothérapie, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium.,Faculté des Sciences de la Motricité, Université Catholique de Louvain, Louvain-La-Neuve, Belgium
| | - Adrien Schalkwijk
- Faculté des Sciences de la Motricité, Université Catholique de Louvain, Louvain-La-Neuve, Belgium
| | - Charlie Vander Straeten
- Faculté des Sciences de la Motricité, Université Catholique de Louvain, Louvain-La-Neuve, Belgium
| | - Frédéric Braem
- Secteur de Kinésithérapie et Ergothérapie, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Fabien Latiers
- Secteur de Kinésithérapie et Ergothérapie, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Gregory Reychler
- Institut de recherche expérimentale et clinique (IREC), pôle de Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Brussels, Belgium.,Service de Pneumologie, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium.,Secteur de Kinésithérapie et Ergothérapie, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium.,Faculté des Sciences de la Motricité, Université Catholique de Louvain, Louvain-La-Neuve, Belgium
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Romero-Ortuno R, Jennings G, Xue F, Duggan E, Gormley J, Monaghan A. Predictors of Submaximal Exercise Test Attainment in Adults Reporting Long COVID Symptoms. J Clin Med 2022; 11:2376. [PMID: 35566502 PMCID: PMC9099491 DOI: 10.3390/jcm11092376] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 02/08/2023] Open
Abstract
Adults with long COVID often report intolerance to exercise. Cardiopulmonary exercise testing (CPET) has been used in many settings to measure exercise ability but has been conducted in a few long COVID cohorts. We conducted CPET in a sample of adults reporting long COVID symptoms using a submaximal cycle ergometer protocol. We studied pre-exercise predictors of achieving 85% of the age-predicted maximum heart rate (85%HRmax) using logistic regression. Eighty participants were included (mean age 46 years, range 25−78, 71% women). Forty participants (50%) did not reach 85%HRmax. On average, non-achievers reached 84% of their predicted 85%HRmax. No adverse events occurred. Participants who did not achieve 85%HRmax were older (p < 0.001), had more recent COVID-19 illness (p = 0.012) with higher frequency of hospitalization (p = 0.025), and had been more affected by dizziness (p = 0.041) and joint pain (p = 0.028). In the logistic regression model including age, body mass index, time since COVID-19, COVID-19-related hospitalization, dizziness, joint pain, pre-existing cardiopulmonary disease, and use of beta blockers, independent predictors of achieving 85%HRmax were younger age (p = 0.001) and longer time since COVID-19 (p = 0.008). Our cross-sectional findings suggest that exercise tolerance in adults with long COVID has potential to improve over time. Longitudinal research should assess the extent to which this may occur and its mechanisms. ClinicalTrials.gov identifier: NCT05027724 (TROPIC Study).
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Affiliation(s)
- Roman Romero-Ortuno
- School of Medicine, Trinity College Dublin, D02 R590 Dublin, Ireland; (G.J.); (F.X.); (E.D.); (J.G.); (A.M.)
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Braga F, Espinosa G, Monteiro A, Marinho B, Drummond E. Physiological Effects of Exercising at Different Intensities Wearing Surgical or Double-layer Cotton Facemasks Compared to Not Wearing a Mask. Eur J Sport Sci 2022; 23:925-935. [PMID: 35418276 DOI: 10.1080/17461391.2022.2065928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Since the beginning of the SARS-CoV-2 pandemic, the community use of facemasks has been widely recommended. However, their use during exercise has raised safety concerns. Thus, we compared the physiological differences between exercising wearing a surgical (SM) or a double-layer-cotton (DLC) facemask and not wearing a mask (NM). Sixteen volunteers underwent 4 bouts of cycling-based exercise, which consisted of two different intensities: light-to-moderate and moderate-to-high. Facemasks were used as follows: bout-1 and 4: NM; bout-2: SM or DLC and bout-3: DLC or SM. Ventilatory, metabolic, pulmonary gas exchange (PGE) and perceptual variables were collected. At both exercise intensities compared to NM, both facemasks induced similar ventilatory adaptations, increasing inspiratory time and tidal volume and decreasing breathing frequency. Effect sizes (ES) were larger for DLC than for SM. At moderate-to-high, both facemasks reduced the minute ventilation, whereas at light-to-moderate, it was only seen with DLC. End tidal and mixed CO2 pressures, as well as the difference between them, increased with both facemasks. Again, ES was larger for DLC than SM. No relevant oxygen saturation drop was observed with both facemaks and exercise intensities. A small ES increament in VO2 and VCO2 were seen with both facemasks. Effort perception increased at moderate-to-high for both exercise intensities, buth larger EF were with DLC than SM . DLC increased facial temperature during both exercise intensities. In conclusion, ventilatory adjustments imposed during facemask exercise influenced PGE and metabolic and perceptual changes. Larger ES were mostly seen for DLC than SM.Novelty Bullets Facemasks affect the breathing pattern by changing the frequency and amplitude of pulmonary ventilation.The augmented ventilatory work increases VO2, VCO2, and RPE and promotes nonconcerning drops in SpO2 and CO2 retention.Increased inspiratory and expiratory pressure can account for the reduction in pulmonary physiological dead space.
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Affiliation(s)
- Fabrício Braga
- Human Performance Laboratory; Rio de Janeiro; Brazil.,Casa de Saúde São José; Rio de Janeiro; Brazil
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48
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Fischer P, Blumenauer D, Egger F, Fikenzer S, Zimmer A, Kulenthiran S, Laufs U, Bewarder Y, Böhm M, Mahfoud F. Effects of Medical Face Masks on Physical Performance in Patients With Coronary Artery Disease or Hypertension. Am J Cardiol 2022; 173:1-7. [PMID: 35418332 DOI: 10.1016/j.amjcard.2022.02.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/19/2022] [Accepted: 02/22/2022] [Indexed: 12/27/2022]
Abstract
In this randomized, prospective monocentric study, 40 subjects with coronary artery disease or hypertension (cardiovascular disease [CVD] group) were assigned to either surgical mask (SM) or class 2 filtering facepiece mask (FFP2). They performed cycle ergometry exercise tests with progressive intensity until exhaustion with the assigned mask and another test with no mask (NM) in random order. A control group of 10 healthy subjects randomly performed 3 exercise tests with NM, SM, and FFP2, respectively. Blood pressure, heart rate, 12-lead electrocardiogram, exertion, shortness of breath, and capillary blood gases from the earlobe were documented. Across all groups, exercise testing with face masks resulted in a significantly reduced peak power output in watts compared with testing with NM (CVD group: SM vs NM: -5.0 ± 7.0%, p = 0.005; FFP2 vs NM: -4.7 ± 14%, p = 0.03; control group: SM vs NM: -6.8 ± 4.4%, p = 0.008; FFP2 vs NM: -8.9 ± 6.3%; p = 0.01) without differences in hemodynamic parameters, such as maximum heart rate and systolic blood pressure. Wearing an FFP2 compared with NM resulted in significant higher carbon dioxide partial pressure (CVD group: FFP2: 36.0 ± 3.2 mm Hg vs NM: 33.3 ± 4.4 mm Hg, p = 0.019; control group: FFP2: 32.6 ± 2.8 mm Hg vs NM: 28.1 ± 1.7 mm Hg, p <0.001) with corresponding differences in hydrogen carbonate and base excess, but not to a clinically critical extent. In conclusion, exercise testing with SM and FFP2 resulted in a significant reduction of peak power output without differences in hemodynamic parameters in subjects with preexisting CVD and in healthy subjects.
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Affiliation(s)
- Patrick Fischer
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg (Saar), Germany.
| | - Dominic Blumenauer
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg (Saar), Germany
| | - Florian Egger
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Sven Fikenzer
- Clinic and Polyclinic for Cardiology, University Hospital Leipzig, Leipzig, Germany
| | - Angela Zimmer
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg (Saar), Germany
| | - Saarraaken Kulenthiran
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg (Saar), Germany
| | - Ulrich Laufs
- Clinic and Polyclinic for Cardiology, University Hospital Leipzig, Leipzig, Germany
| | - Yvonne Bewarder
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg (Saar), Germany
| | - Michael Böhm
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg (Saar), Germany
| | - Felix Mahfoud
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg (Saar), Germany
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49
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do Prado DML, Silvino VO, Motta-Santos D, Dos Santos MAP. The effect of the protective face mask on cardiorespiratory response during aerobic exercise. Clin Exp Pharmacol Physiol 2022; 49:453-461. [PMID: 35090062 DOI: 10.1111/1440-1681.13624] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 11/10/2021] [Accepted: 11/20/2021] [Indexed: 11/29/2022]
Abstract
Protective face mask (PFM) has been widely used for safety purposes and, after the advent of the COVID-19 pandemic, its use is growing steadily, not only among healthcare personnel but also the general population. While PFM is important to preserve the wearer from contaminating agents present in the airflow, they are well known to increase the subjective perception of breathing difficulty. Although some studies demonstrated that PFM use worsens exercise tolerance, there are several studies stating that there is no such limitation with the use of PFM. Moreover, no serious adverse effects during physical exercise have been found in the literature. Physical exercise represents a significant challenge to the human body through a series of integrated changes in function that involve most of its physiologic systems. In this respect, cardiovascular and respiratory systems provide the capacity to sustain physical tasks over extended periods. Within this scenario, both convective oxygen (O2 ) transport (product of arterial O2 content x blood flow) to the working locomotor muscles and O2 diffusive transport from muscle capillaries to mitochondria are of paramount importance to endurance performance. Interestingly, the effects of PFM on cardiorespiratory response during aerobic exercise depends on the type of mask and exercise (i.e., walking, running, or cycling), including decrease in ventilatory demands, arterial oxygen levels, maximal oxygen consumption, and endurance performance. The purpose of this review was to elucidate the effect of protective face mask-wearing on 1) cardiorespiratory responses during aerobic exercise and 2) endurance performance.
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Affiliation(s)
| | - Valmir Oliveira Silvino
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health, Federal University of Piaui, PI, Brazil
| | - Daisy Motta-Santos
- School of Physical Education, Physiotherapy, and Occupational Therapy, Federal University Minas Gerais, MG, Brazil
| | - Marcos Antônio Pereira Dos Santos
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health, Federal University of Piaui, PI, Brazil
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Suminski RR, Dominick GM, Wagner NJ, Obrusnikova I. Direct Observation of COVID-19 Prevention Behaviors and Physical Activity in Public Open Spaces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1335. [PMID: 35162355 PMCID: PMC8834671 DOI: 10.3390/ijerph19031335] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/10/2022] [Accepted: 01/22/2022] [Indexed: 01/08/2023]
Abstract
Mask wearing and physical distancing are effective at preventing COVID-19 transmission. Little is known about the practice of these behaviors during physical activity (PA). In this longitudinal study, direct observation was used to describe COVID-19 prevention behaviors among physically active individuals. The Viral Transmission Scan (VT-Scan) was used to assess COVID-19 prevention behaviors of people standing, sitting, walking, jogging, and cycling in educational, retail, and residential areas. The VT-Scan was performed once per week over 22 weeks between 11:00 a.m. and 2:30 p.m. Information was manually extracted from videos collected during VT-Scans. A total of 4153 people were described, of which 71.2% were physically active, 80.0% were 18-30 years of age, 14.0% were non-white, 61.0% were female, and were 19.6% obese. Individuals not engaged in PA were less compliant with COVID-19 prevention behaviors than physically active people. Compliance differed by PA type, with walkers less compliant with COVID-19 prevention behaviors than joggers and cyclists. Among those physically active, non-compliance with COVID-19 prevention behaviors was higher in 18-30-year-olds, whites, and men. Engagement in COVID-19 prevention behaviors varies as a function of PA. Efforts to promote compliance with recommendations may benefit from tailored messaging, taking into account PA participation, PA type, and characteristics of physically active individuals.
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Affiliation(s)
- Richard R. Suminski
- Center for Innovative Health Research, Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19726, USA
| | - Gregory M. Dominick
- Physical Activity Measurement and Evaluation Laboratory, Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19726, USA;
| | - Norman J. Wagner
- Chemical & Biomolecular Engineering, University of Delaware, Newark, DE 19716, USA;
| | - Iva Obrusnikova
- HBS Health and Disability Concentration and the Health and Disability Laboratory, Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19726, USA;
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