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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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Zhang J, Liu X, Zha S, Chen H, Zhang Q, Hu K. Physiological Effects and Tolerance of Wearing Surgical and N95 Masks during Sleep in Normal Individuals and Patients with Mild-Moderate Obstructive Sleep Apnea: A Randomized Crossover Trial. Am J Med 2024:S0002-9343(24)00395-4. [PMID: 38925495 DOI: 10.1016/j.amjmed.2024.06.013] [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] [Received: 10/06/2023] [Revised: 04/22/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND In certain situations, masks are worn during sleep to prevent respiratory infections. However, the effects of mask wearing on cardiopulmonary function during sleep are unknown. This study aimed to determine whether wearing masks during sleep has an impact on cardiopulmonary function, including in patients with obstructive sleep apnea. METHODS This was a prospective, randomized crossover-controlled trial. The effects of wearing surgical masks or N95 respirators on cardiopulmonary function were measured in healthy subjects and patients with mild-moderate obstructive sleep apnea. Sleep breathing parameters were monitored during nocturnal sleep using a sleep monitor, and subjective feelings about mask wearing were assessed using a questionnaire. RESULTS Wearing masks during sleep at night did not significantly impact sleep breathing parameters. Furthermore, there were no significant differences in heart rate, blood oxygenation, and blood pressure before and after wearing masks. However, wearing masks wearing, especially the N95 mask, had an adverse impact on sleep quality, and masks were found to be subjectively uncomfortable. CONCLUSION Wearing masks during sleep at night does not adversely affect cardiopulmonary function but they can be uncomfortable, especially the N95 mask. Thus, in circumstances where wearing N95 masks during nocturnal sleep proves intolerable, we recommend the use of surgical masks as a more comfortable alternative.
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Affiliation(s)
- Jingyi Zhang
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xu Liu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shiqian Zha
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hao Chen
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qingfeng Zhang
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ke Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China.
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3
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Greenhalgh T, MacIntyre CR, Baker MG, Bhattacharjee S, Chughtai AA, Fisman D, Kunasekaran M, Kvalsvig A, Lupton D, Oliver M, Tawfiq E, Ungrin M, Vipond J. Masks and respirators for prevention of respiratory infections: a state of the science review. Clin Microbiol Rev 2024; 37:e0012423. [PMID: 38775460 PMCID: PMC11326136 DOI: 10.1128/cmr.00124-23] [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] [Indexed: 06/14/2024] Open
Abstract
SUMMARYThis narrative review and meta-analysis summarizes a broad evidence base on the benefits-and also the practicalities, disbenefits, harms and personal, sociocultural and environmental impacts-of masks and masking. Our synthesis of evidence from over 100 published reviews and selected primary studies, including re-analyzing contested meta-analyses of key clinical trials, produced seven key findings. First, there is strong and consistent evidence for airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory pathogens. Second, masks are, if correctly and consistently worn, effective in reducing transmission of respiratory diseases and show a dose-response effect. Third, respirators are significantly more effective than medical or cloth masks. Fourth, mask mandates are, overall, effective in reducing community transmission of respiratory pathogens. Fifth, masks are important sociocultural symbols; non-adherence to masking is sometimes linked to political and ideological beliefs and to widely circulated mis- or disinformation. Sixth, while there is much evidence that masks are not generally harmful to the general population, masking may be relatively contraindicated in individuals with certain medical conditions, who may require exemption. Furthermore, certain groups (notably D/deaf people) are disadvantaged when others are masked. Finally, there are risks to the environment from single-use masks and respirators. We propose an agenda for future research, including improved characterization of the situations in which masking should be recommended or mandated; attention to comfort and acceptability; generalized and disability-focused communication support in settings where masks are worn; and development and testing of novel materials and designs for improved filtration, breathability, and environmental impact.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - C Raina MacIntyre
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Shovon Bhattacharjee
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, Australia
| | - Abrar A Chughtai
- School of Population Health, University of New South Wales, Sydney, Australia
| | - David Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mohana Kunasekaran
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Amanda Kvalsvig
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Deborah Lupton
- Centre for Social Research in Health and Social Policy Research Centre, Faculty of Arts, Design and Architecture, University of New South Wales, Sydney, Australia
| | - Matt Oliver
- Professional Standards Advocate, Edmonton, Canada
| | - Essa Tawfiq
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Mark Ungrin
- Faculty of Veterinary Medicine; Department of Biomedical Engineering, Schulich School of Engineering; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Joe Vipond
- Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Mohyeldin M, Shrivastava S, Allu SVV. Ibrutinib and atrial fibrillation: An in-depth review of clinical implications and management strategies. World J Cardiol 2024; 16:269-273. [PMID: 38817647 PMCID: PMC11135330 DOI: 10.4330/wjc.v16.i5.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/23/2024] [Accepted: 05/14/2024] [Indexed: 05/23/2024] Open
Abstract
Ibrutinib, a targeted therapy for B-cell malignancies, has shown remarkable efficacy in treating various hematologic cancers. However, its clinical use has raised concerns regarding cardiovascular complications, notably atrial fibrillation (AF). This comprehensive review critically evaluates the association between ibrutinib and AF by examining incidence, risk factors, mechanistic links, and management strategies. Through an extensive analysis of original research articles, this review elucidates the complex interplay between ibrutinib's therapeutic benefits and cardiovascular risks. Moreover, it highlights the need for personalized treatment approaches, vigilant monitoring, and interdisciplinary collaboration to optimize patient outcomes and safety in the context of ibrutinib therapy. The review provides a valuable resource for healthcare professionals aiming to navigate the intricacies of ibrutinib's therapeutic landscape while prioritizing patient well-being.
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Affiliation(s)
- Moiud Mohyeldin
- Internal Medicine, University of Medical Sciences and Technology, Khartoum 11111, Sudan.
| | - Shitij Shrivastava
- Internal Medicine, Bronxcare Health System, Bronx, NY 10457, United States
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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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Ramoti N, Siahaan AMP, Indharty S, Adella CA. Effect of face masks on dyspnea perception, cardiopulmonary parameters, and facial temperature in healthy adults. NARRA J 2024; 4:e574. [PMID: 38798847 PMCID: PMC11125298 DOI: 10.52225/narra.v4i1.574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/26/2024] [Indexed: 05/29/2024]
Abstract
Respiratory droplets, naturally produced during expiration, can transmit pathogens from infected individuals. Wearing a face mask is crucial to prevent such transmission, yet the perception of dyspnea and uncomfortable breathing remains a common concern, particularly during epidemics. The aim of this study was to investigate the impact of face mask use on the perception of dyspnea, cardiopulmonary parameters, and facial temperature during physical activity. A randomized crossover study was conducted on healthy adults at a physiology laboratory located in the Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia, in November 2022. Participants underwent five stages of physical exercise tests based on the Bruce Protocol under three conditions: without any face mask (control), wearing a surgical mask, and an N95 mask, forming the study's main groups. Dyspnea perception (measured by the Modified Borg Dyspnea Scale), cardiopulmonary parameters (heart rate, oxygen saturation, respiratory rate, blood pressure, and mean arterial pressure) and facial temperature were measured before the exercise test (pre-workout), at the end of stage 1, 2, 3, 4, 5, and after the whole exercise test (post-workout). A two-way repeated measures ANOVA was conducted, considering two factors: the type of mask (control, surgical mask, N95 mask) and the various stages of the exercise test. A total of 36 healthy adults were included in the study. We found that dyspnea perception was much worse in the N95 mask group, particularly during vigorous exercise. There was no significant difference between groups in cardiopulmonary parameters. However, participants wearing N95 had a greater supralabial temperature than those wearing surgical masks or no mask at all. It is recommended to undertake a more in-depth evaluation of cardiopulmonary physiological measures.
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Affiliation(s)
- Natanael Ramoti
- Department of Physiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Andre MP. Siahaan
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Suzy Indharty
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Cut A. Adella
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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7
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Janse van Rensburg DC, Jansen van Rensburg A, Botha T, Elliott K, Ramagole D, Pillay L, Hendricks S, Eyden D, Arnott C, Stevens DJ. Effects of no mask, a surgical mask and a fabric buff on peripheral oxygenation saturation during moderate intensity exercise: a randomised cross-over study. J Thorac Dis 2024; 16:1854-1865. [PMID: 38617788 PMCID: PMC11009602 DOI: 10.21037/jtd-23-1178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/15/2023] [Indexed: 04/16/2024]
Abstract
Background Mask-wearing caused significant reductions in coronavirus disease 2019 (COVID-19) transmission. We aimed to determine whether face mask-wearing during exercise caused reductions in peripheral oxygen saturation (SpO2) and whether it affected secondary physiological measures [end-tidal carbon dioxide (EtCO2), respiratory rate (RR), heart rate (HR), expired breath temperature (EBT)]. Subjective measurements included ratings of perceived exertion (RPE), ratings of perceived breathlessness (RPB), and symptomology. Methods A randomised cross-over trial examined no mask (NM), surgical mask (SM) and a buff mask (BM). Thirty participants (30-45 years) cycled at 60% power output for 30 min in three exercise sessions, 24 h apart, within 6 days. Each session recorded all measures at resting baseline (T0), 9 min (T1), 18 min (T2), and 27 min (T3). Dependent statistical tests determined significant differences between masks and time-points. Results SpO2 decreased for SM and BM between T0 compared to T1, T2 and T3 (all P<0.005). BM caused significant reductions at T1 and T2 compared to NM (P<0.001 and P=0.018). Significant changes in EtCO2 and EBT occurred throughout exercise and between exercise stages for all mask conditions (P<0.001). As expected for moderate intensity exercise, RR and HR were significantly higher during exercise compared to T0 (P<0.001). RPB significantly increased for each condition at each time point (P<0.001). RPE was not significant between mask conditions at any exercise stage. Conclusions SM and BM caused a mild but sustained reduction in SpO2 at commencement of exercise, which did not worsen throughout short (<30 min) moderate intensity exercise. Level of perception was similar, suggesting healthy people can wear masks during moderate exercise and activities of daily living.
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Affiliation(s)
| | | | - Tanita Botha
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa
| | - Kirsty Elliott
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Dimakatso Ramagole
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Lervasen Pillay
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Shona Hendricks
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Devlin Eyden
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Claire Arnott
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - David James Stevens
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
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8
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Loprinzi PD, Caplan JB. Lack of effects of acute exercise intensity on mnemonic discrimination. Q J Exp Psychol (Hove) 2024:17470218241238881. [PMID: 38424033 DOI: 10.1177/17470218241238881] [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: 03/02/2024]
Abstract
The hippocampus is thought to support episodic memory by pattern separation, thereby supporting the ability to discriminate high similarity items. Past research evaluating whether acute exercise can improve mnemonic discrimination of high similarity items is mixed. The present experiment attempts to extend these prior mixed findings by evaluating the effects of multiple exercise intensities on hippocampal-dependent, mnemonic discrimination and memory performance. Fifty-seven young adults completed a three-condition (control, moderate-intensity, and vigorous-intensity), within-subjects crossover pretest-posttest comparison. We observed no effects of acute exercise on recognition memory or mnemonic discrimination. We discuss the implications of these null findings with the broader literature by discussing the complexity of this potential exercise-mnemonic discrimination relationship, including the unique role of exercise intensity, differences in the level of processing (e.g., conceptual vs. perceptual), and unique brain regions involved in mnemonic discrimination.
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Affiliation(s)
- Paul D Loprinzi
- Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, Oxford, MS, USA
| | - Jeremy B Caplan
- Department of Psychology, Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
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9
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Ko SL, Hung CL, Chen CN, Tsao TP, Fong MC, Yin WH, Chang HY. Effects of Mask Wearing on Treadmill Exercise Test. Am J Cardiol 2024; 213:161-163. [PMID: 38160925 DOI: 10.1016/j.amjcard.2023.12.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/19/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Shao-Lun Ko
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chung-Lieh Hung
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei City, Taiwan and Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan
| | - Chiao-Nan Chen
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tien-Ping Tsao
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Man-Cai Fong
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Wei-Hsian Yin
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Hung-Yu Chang
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, and School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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10
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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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11
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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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12
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Neal WN, Schleicher EA, Baron K, Oster RA, Brown NI, Demark-Wahnefried W, Pisu M, Baskin ML, Parrish KB, Cole WW, Thirumalai M, Pekmezi DW. Impact of the COVID-19 Pandemic on Physical Activity among Mostly Older, Overweight Black Women Living in the Rural Alabama Black Belt. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7180. [PMID: 38131731 PMCID: PMC10743260 DOI: 10.3390/ijerph20247180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/08/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
Despite well-documented global declines in physical activity (PA) during the COVID-19 pandemic, little is known regarding the specific impact among underserved, rural Alabama counties. This is concerning as this region was already disproportionately burdened by inactivity and related chronic diseases and was among the hardest hit by COVID-19. Thus, the current study examined the effect of COVID-19 on PA in four rural Alabama counties. An ancillary survey was administered between March 2020 and August 2021 to the first cohort (N = 171) of participants enrolled in a larger PA trial. Main outcomes of this survey included the perceived impact of COVID-19 on PA, leisure-time PA, and social cognitive theory (SCT) constructs at 3 months. Almost half of the participants reported being less active during the pandemic (49.7%) and endorsed that COVID-19 made PA more difficult (47.4%), citing concerns such as getting sick from exercising outside of the home (70.4%) and discomfort wearing a face mask while exercising (58%). Perceived COVID-19 impact on PA was significantly associated with education, household dependents, and gender (p's < 0.05). More women, parents, and college graduates reported that the COVID-19 pandemic made PA more difficult. Overall, there were no significant associations between PA, SCT constructs, or perceived COVID-19 impact on PA scores at 3 months. While the pandemic made PA difficult for many participants, these barriers were not associated with leisure-time PA levels or related theoretical mechanisms of action, which bodes well for the success of our ongoing intervention efforts and the resiliency of these communities.
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Affiliation(s)
- Whitney N. Neal
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (E.A.S.); (K.B.P.); (W.W.C.); (D.W.P.)
| | - Erica A. Schleicher
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (E.A.S.); (K.B.P.); (W.W.C.); (D.W.P.)
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (R.A.O.); (M.P.)
| | - Kerri Baron
- Capstone College of Nursing, University of Alabama, Tuscaloosa, AL 35487, USA;
| | - Robert A. Oster
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (R.A.O.); (M.P.)
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Nashira I. Brown
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA;
| | - Wendy Demark-Wahnefried
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Maria Pisu
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (R.A.O.); (M.P.)
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Monica L. Baskin
- Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Kelsey B. Parrish
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (E.A.S.); (K.B.P.); (W.W.C.); (D.W.P.)
| | - William Walker Cole
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (E.A.S.); (K.B.P.); (W.W.C.); (D.W.P.)
| | - Mohanraj Thirumalai
- Health Services Administration, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Dori W. Pekmezi
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (E.A.S.); (K.B.P.); (W.W.C.); (D.W.P.)
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (R.A.O.); (M.P.)
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13
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Shirata M, Nishioka K, Hamao N, Oi I, Hidaka Y, Ibi Y, Imai S, Sato S, Hirai T, Ito I. Impact of wearing a surgical facemask during exercise on dyspnea in patients with chronic pulmonary infections: A randomized crossover study. Respir Med 2023; 220:107453. [PMID: 37993025 DOI: 10.1016/j.rmed.2023.107453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Wearing facemasks in public is effective in preventing viral transmission. However, no study has evaluated the impact of wearing facemasks during exercise on dyspnea in patients with chronic pulmonary infections from multifaceted aspects, including sensory qualities and emotional responses. The aim of this study was to evaluate facemask-related dyspnea during exercise in this patient population. METHODS We conducted a randomized crossover study involving adult patients with non-tuberculous mycobacterial pulmonary disease (NTM-PD) or bronchiectasis who participated in exercise sessions, both with (mask-on) and without (mask-off) surgical facemasks. The sensory and emotional dimensions of dyspnea during each exercise session were assessed using the Multidimensional Dyspnea Profile. Statistical analyses were performed to identify factors associated with worsening scores for each dimension. RESULTS Thirty-four patients (mean age [standard deviation]: 71.6 [8.6] years) were included in the analysis. The median [interquartile range] total scores for the sensory and emotional dimensions of dyspnea were 3.5 [1, 9.5] (mask-off) vs. 10 [5.5, 23.8] (mask-on) (P < 0.001) and 0 [0, 5] (mask-off) vs. 3 [0.8, 10.3] (mask-on) (P = 0.115), respectively. "Air hunger" was the primary sensory descriptor of mask-related dyspnea. Vital capacity (VC) < 80% of the predicted value was a significant risk factor for worsening sensory dimension scores when wearing masks (odds ratio [95% confidence interval]: 5.5 [1.16-26.1], P = 0.038). CONCLUSIONS The findings of this study indicate that patients with NTM-PD or bronchiectasis, particularly those with VC <80% of the predicted value, are likely to experience the sensory dimension of dyspnea during exercise while wearing surgical facemasks.
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Affiliation(s)
- Masahiro Shirata
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo, Kyoto, 606-8507, Japan
| | - Kensuke Nishioka
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo, Kyoto, 606-8507, Japan
| | - Nobuyoshi Hamao
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo, Kyoto, 606-8507, Japan
| | - Issei Oi
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo, Kyoto, 606-8507, Japan
| | - Yu Hidaka
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo, Kyoto, 606-8507, Japan
| | - Yumiko Ibi
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo, Kyoto, 606-8507, Japan
| | - Seiichiro Imai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo, Kyoto, 606-8507, Japan; Preemptive Medicine and Lifestyle Disease Research Center, Kyoto University Hospital, 53 Shogoin-Kawaharacho, Sakyo, Kyoto, 606-8397, Japan
| | - Susumu Sato
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo, Kyoto, 606-8507, Japan; Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo, Kyoto, 606-8507, Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo, Kyoto, 606-8507, Japan
| | - Isao Ito
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo, Kyoto, 606-8507, Japan.
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14
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Harber P, Beckett WS. Health effects of filtering facepiece respirators: Research and clinical implications of comfort, thermal, skin, psychologic, and workplace effects. Am J Ind Med 2023; 66:1017-1032. [PMID: 37702368 DOI: 10.1002/ajim.23535] [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: 06/08/2023] [Revised: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 09/14/2023]
Abstract
Filtering facepiece respirators (FFR's) such as N95s have become widely used in appropriate settings for personal respiratory protection and are increasingly used beyond workplace settings. Concerns about possible adverse effects have appeared in many publications, particularly since the COVID-19 pandemic led to much more widespread use. This paper synthesizes known effects based upon review of publications in PubMed since 1995, addressing effects other than pulmonary and cardiovascular (reviewed elsewhere). Findings: (1) Subjective discomfort is very frequently reported; this includes general discomfort or organ-system-specific complaints such as respiratory, headache, dermatologic, and heat. Research methods are widely divergent, and we propose a taxonomy to classify such studies by methodology, study population (subjects, experimental vs. observational methodology, comparator, specificity, and timeframe) to facilitate synthesis. (2) Objective measures of increased heat and humidity within the mask are well documented. (3) Frequency and characteristics of dermatologic effects have been insufficiently evaluated. (4) Physical mask designs are varied, making generalizations challenging. (5) More studies of impact on work performance and communication are needed. (6) Studies of effect of FFR design and accompanying training materials on ease and consistency of use are needed.
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Affiliation(s)
- Philip Harber
- Environmental Health Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - William S Beckett
- Mount Auburn Hospital (Emeritus Status), Cambridge, Massachusetts, USA
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15
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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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16
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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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17
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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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18
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Vinetti G, Micarelli A, Falla M, Randi A, Dal Cappello T, Gatterer H, Brugger H, Strapazzon G, Rauch S. Surgical masks and filtering facepiece class 2 respirators (FFP2) have no major physiological effects at rest and during moderate exercise at 3000-m altitude: a randomised controlled trial. J Travel Med 2023; 30:taad031. [PMID: 36881665 PMCID: PMC10481409 DOI: 10.1093/jtm/taad031] [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: 12/23/2022] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, the use of face masks has been recommended or enforced in several situations; however, their effects on physiological parameters and cognitive performance at high altitude are unknown. METHODS Eight healthy participants (four females) rested and exercised (cycling, 1 W/kg) while wearing no mask, a surgical mask or a filtering facepiece class 2 respirator (FFP2), both in normoxia and hypobaric hypoxia corresponding to an altitude of 3000 m. Arterialised oxygen saturation (SaO2), partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2), heart and respiratory rate, pulse oximetry (SpO2), cerebral oxygenation, visual analogue scales for dyspnoea and mask's discomfort were systematically investigated. Resting cognitive performance and exercising tympanic temperature were also assessed. RESULTS Mask use had a significant effect on PaCO2 (overall +1.2 ± 1.7 mmHg). There was no effect of mask use on all other investigated parameters except for dyspnoea and discomfort, which were highest with FFP2. Both masks were associated with a similar non-significant decrease in SaO2 during exercise in normoxia (-0.5 ± 0.4%) and, especially, in hypobaric hypoxia (-1.8 ± 1.5%), with similar trends for PaO2 and SpO2. CONCLUSIONS Although mask use was associated with higher rates of dyspnoea, it had no clinically relevant impact on gas exchange at 3000 m at rest and during moderate exercise, and no detectable effect on resting cognitive performance. Wearing a surgical mask or an FFP2 can be considered safe for healthy people living, working or spending their leisure time in mountains, high-altitude cities or other hypobaric environments (e.g. aircrafts) up to an altitude of 3000 m.
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Affiliation(s)
- Giovanni Vinetti
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | | | - Marika Falla
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto (TN), Italy
- Department of Neurology, General Hospital of Bolzano, Bolzano, Italy
| | - Anna Randi
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto (TN), Italy
| | - Tomas Dal Cappello
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Hannes Gatterer
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT TIROL-Private University for Health Sciences and Health Technology, Hall in Tirol, Austria
| | - Hermann Brugger
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Giacomo Strapazzon
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Simon Rauch
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Department of Anaesthesiology and Intensive Care Medicine, Hospital of Merano (SABES-ASDAA), Merano (BZ), Italy; Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität
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19
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Yang SC, Lee CW. Physiological effects of N95 respirators on rescuers during cardiopulmonary resuscitation. Heliyon 2023; 9:e18970. [PMID: 37600379 PMCID: PMC10432712 DOI: 10.1016/j.heliyon.2023.e18970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 07/14/2023] [Accepted: 08/03/2023] [Indexed: 08/22/2023] Open
Abstract
Objectives There is a lack of evidence in the medical literature reporting the physiological stress imposed by the wearing of N95 respirators during cardiopulmonary resuscitation (CPR) in healthcare providers. The aim of this study is to monitor the changes in hemodynamics and blood gas profiles in rescuers during the performance of CPR while wearing N95 respirators. Methods Thirty-two healthy healthcare workers performed standard CPR on manikins, each participant conducted 2 min of chest compression followed by 2 min of rest for 3 cycles. A non-invasive blood gas measuring device via a fingertip detector was used to collect arterial blood gas and hemodynamic data. Student t-test was used for comparison of various physiologic parameters before and after each session of chest compression. Results There were no significant differences in arterial blood gas profiles including partial pressure of arterial carbon dioxide and partial pressure of arterial oxygen before and after each session of chest compression (p > 0.05 for all). Heart rate and cardiac output were significantly higher after CPR (p < 0.05 for all), but no significant changes were found on blood pressure. Conclusions Our data suggest that healthcare providers wearing N95 respirators during provision of CPR in a short period of time does not cause any significant abnormalities in blood gas profiles and blood pressure. This may provide evidence to reassure the safe use of N95 respirator during performance of CPR.
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Affiliation(s)
- Shih-Chia Yang
- Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi-Wei Lee
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
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20
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Illidi CR, Romer LM, Johnson MA, Williams NC, Rossiter HB, Casaburi R, Tiller NB. Distinguishing science from pseudoscience in commercial respiratory interventions: an evidence-based guide for health and exercise professionals. Eur J Appl Physiol 2023; 123:1599-1625. [PMID: 36917254 PMCID: PMC10013266 DOI: 10.1007/s00421-023-05166-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/19/2023] [Indexed: 03/16/2023]
Abstract
Respiratory function has become a global health priority. Not only is chronic respiratory disease a leading cause of worldwide morbidity and mortality, but the COVID-19 pandemic has heightened attention on respiratory health and the means of enhancing it. Subsequently, and inevitably, the respiratory system has become a target of the multi-trillion-dollar health and wellness industry. Numerous commercial, respiratory-related interventions are now coupled to therapeutic and/or ergogenic claims that vary in their plausibility: from the reasonable to the absurd. Moreover, legitimate and illegitimate claims are often conflated in a wellness space that lacks regulation. The abundance of interventions, the range of potential therapeutic targets in the respiratory system, and the wealth of research that varies in quality, all confound the ability for health and exercise professionals to make informed risk-to-benefit assessments with their patients and clients. This review focuses on numerous commercial interventions that purport to improve respiratory health, including nasal dilators, nasal breathing, and systematized breathing interventions (such as pursed-lips breathing), respiratory muscle training, canned oxygen, nutritional supplements, and inhaled L-menthol. For each intervention we describe the premise, examine the plausibility, and systematically contrast commercial claims against the published literature. The overarching aim is to assist health and exercise professionals to distinguish science from pseudoscience and make pragmatic and safe risk-to-benefit decisions.
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Affiliation(s)
- Camilla R Illidi
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, QC, Canada
| | - Lee M Romer
- Division of Sport, Health and Exercise Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Michael A Johnson
- Exercise and Health Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, Nottinghamshire, UK
| | - Neil C Williams
- Exercise and Health Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, Nottinghamshire, UK
| | - Harry B Rossiter
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, CDCRC Building, Torrance, CA, 90502, USA
| | - Richard Casaburi
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, CDCRC Building, Torrance, CA, 90502, USA
| | - Nicholas B Tiller
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, CDCRC Building, Torrance, CA, 90502, USA.
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21
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Rial-Vázquez J, Nine I, Guerrero-Moreno JM, Rúa-Alonso M, Fariñas J, Márquez G, Giráldez-García MA, Méndez-Bouza KY, López-Pillado H, Coutado-Sánchez E, Losada-Rodríguez A, Iglesias-Soler E. Face Masks at the Gymnasium: Physiological Responses and Mechanical Performance Are Not Compromised by Wearing Surgical or Filtering Facepiece 2 Masks in Healthy Subjects. J Strength Cond Res 2023; 37:1404-1410. [PMID: 37347944 DOI: 10.1519/jsc.0000000000004401] [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: 06/24/2023]
Abstract
ABSTRACT Rial-Vázquez, J, Nine, I, Guerrero-Moreno, JM, Rúa-Alonso, M, Fariñas, J, Márquez, G, Giráldez-García, MA, Méndez-Bouza, KY, López-Pillado, H, Coutado-Sánchez, E, Losada-Rodríguez, A, and Iglesias-Soler, E. Face masks at the gym: physiological responses and mechanical performance are not compromised by wearing surgical or filtering facepiece 2 masks in healthy subjects. J Strength Cond Res 37(7): 1404-1410, 2023-This study explored the effects of wearing 2 types of face masks on mechanical performance and physiological responses during high-intensity resistance exercise. Twelve healthy men performed 3 workout protocols in a randomized order: wearing a surgical or filtering facepiece 2 (FFP2) mask or without a mask. Each workout consisted of 3 sets of 10 repetitions of bench press (BP) and parallel squat (SQ) with a 12 repetition maximum load, including 2 minutes of recovery between sets and exercises. Mechanical performance was evaluated through the mean propulsive velocity and the number of repetitions completed during each session. Physiological responses were the oxygen saturation (SpO2), blood lactate concentration, heart rate (HR), and HR variability. Perceived exertion was recorded after each set, and The Beck Anxiety Inventory scale was completed at the end of each workout. The number of repetitions completed and the session mean propulsive velocity {(BP [m·s-1]: surgical: 0.35 ± 0.05; FFP2: 0.36 ± 0.04; nonmask: 0.38 ± 0.06) and (SQ: surgical: 0.43 ± 0.05; FFP2: 0.40 ± 0.07; nonmask: 0.41 ± 0.05)} were similar between conditions (p > 0.05). Heart rate recorded during sessions was similar across conditions: surgical: 119 ± 14, FFP2: 117 ± 13, and nonmask: 118 ± 10 bpm (p = 0.919). Face masks had no effect on SpO2, blood lactate concentration, HR variability, perceived exertion, and anxiety values (p > 0.05). Face masks do not compromise strength performance, physiological parameters, and perceived comfort of young and healthy individuals during a high-intensity resistance training session.
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Affiliation(s)
- Jessica Rial-Vázquez
- Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruna, A Coruña, Spain; and
| | - Iván Nine
- Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruna, A Coruña, Spain; and
| | - Jose María Guerrero-Moreno
- Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruna, A Coruña, Spain; and
| | - María Rúa-Alonso
- Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruna, A Coruña, Spain; and
| | - Juan Fariñas
- Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruna, A Coruña, Spain; and
| | - Gonzalo Márquez
- Faculty of Sports Sciences and Physical Education, University of A Coruna, A Coruña, Spain
| | - Manuel Avelino Giráldez-García
- Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruna, A Coruña, Spain; and
| | | | - Hugo López-Pillado
- Faculty of Sports Sciences and Physical Education, University of A Coruna, A Coruña, Spain
| | - Etham Coutado-Sánchez
- Faculty of Sports Sciences and Physical Education, University of A Coruna, A Coruña, Spain
| | | | - Eliseo Iglesias-Soler
- Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruna, A Coruña, Spain; and
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22
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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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23
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Benito PJ, Gutiérrez Á, Rojo-Tirado MA. The real bacterial filtration efficiency to evaluate the effective protection of facemasks used for the prevention of respiratory diseases. Sci Rep 2023; 13:8997. [PMID: 37277420 DOI: 10.1038/s41598-023-35071-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/12/2023] [Indexed: 06/07/2023] Open
Abstract
The real protection offered by facemasks to control the transmission of respiratory viruses is still undetermined. Most of the manufacturing regulations, as well as scientific studies, have focused on studying the filtration capacity of the fabrics from which they are made, ignoring the air that escapes through the facial misalignments, and which depends on the respiratory frequencies and volumes. The objective of this work was to define a Real Bacterial Filtration Efficiency for each type of facemask, considering the bacterial filtration efficiency of the manufacturers and the air that passes through them. Nine different facemasks were tested on a mannequin with three gas analyzers (measuring inlet, outlet, and leak volumes) inside a polymethylmethacrylate box. In addition, the differential pressure was measured to determine the resistance offered by the facemasks during the inhalation and exhalation processes. Air was introduced with a manual syringe for 180 s simulating inhalations and exhalations at rest, light, moderate and vigorous activities (10, 60, 80 and 120 L/min, respectively). Statistical analysis showed that practically half of the air entering to the system is not filtered by the facemasks in all intensities (p < 0.001, ηp2 = 0.971). They also showed that the hygienic facemasks filter more than 70% of the air, and their filtration does not depend on the simulated intensity, while the rest of the facemasks show an evidently different response, influenced by the amount of air mobilized. Therefore, the Real Bacterial Filtration Efficiency can be calculated as a modulation of the Bacterial Filtration Efficiencies that depends on the type of facemask. The real filtration capacity of the facemasks has been overestimated during last years since the filtration of the fabrics is not the real filtration when the facemask is worn.
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Affiliation(s)
- Pedro J Benito
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sports Science, Universidad Politécnica de Madrid, 28040, Madrid, Spain.
| | - Álvaro Gutiérrez
- ETSI Telecomunicación, Universidad Politécnica de Madrid, Av. Complutense 30, 28040, Madrid, Spain
| | - Miguel A Rojo-Tirado
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sports Science, Universidad Politécnica de Madrid, 28040, Madrid, Spain
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24
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Yoon S, Hoe PS, Chan A, Malhotra R, Visaria A, Matchar D, Goh H, Seng B, Ramakrishnan C, Koh MS, Yee TP, Nadarajan GD, Bee YM, Graves N, Jafar TH, Ong ME. Impact of COVID-19 on perceived wellbeing, self-management and views of novel modalities of care among medically vulnerable patients in Singapore. Chronic Illn 2023; 19:314-326. [PMID: 34964364 PMCID: PMC9996168 DOI: 10.1177/17423953211067458] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study aims to examine the impact of COVID-19 measures on wellbeing and self-management in medically vulnerable non-COVID patients and their views of novel modalities of care in Singapore. METHODS Patients with cardiovascular disease (CVD), respiratory disease, chronic kidney disease, diabetes and cancer were recruited from the SingHealth cluster and national cohort of older adults. Data on demographics, chronic conditions and perceived wellbeing were collected using questionnaire. We performed multivariable regression to examine factors associated with perceived wellbeing. Qualitative interviews were conducted to elicit patient's experience and thematically analyzed. RESULTS A total of 91 patients participated. Male patients compared with female patients perceived a lower impact of the pandemic on subjective wellbeing. Patients with CVD compared to those having conditions other than CVD perceived a lower impact. Impacts of the pandemic were primarily described in relation to emotional distress and interference in maintaining self-care. Hampering of physical activity featured prominently, but most did not seek alternative ways to maintain activity. Despite general willingness to try novel care modalities, lack of physical interaction and communication difficulties were perceived as main barriers. DISCUSSION Findings underline the need to alleviate emotional distress and develop adaptive strategies to empower patients to maintain wellbeing and self-care.
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Affiliation(s)
- Sungwon Yoon
- Health Services and Systems Research, 121579Duke-NUS Medical School, Singapore
| | - Pei Shan Hoe
- Centre for Ageing Research and Education (CARE), 121579Duke-NUS Medical School, Singapore
| | - Angelique Chan
- Health Services and Systems Research, 121579Duke-NUS Medical School, Singapore.,Centre for Ageing Research and Education (CARE), 121579Duke-NUS Medical School, Singapore
| | - Rahul Malhotra
- Health Services and Systems Research, 121579Duke-NUS Medical School, Singapore.,Centre for Ageing Research and Education (CARE), 121579Duke-NUS Medical School, Singapore
| | - Abhijit Visaria
- Centre for Ageing Research and Education (CARE), 121579Duke-NUS Medical School, Singapore
| | - David Matchar
- Health Services and Systems Research, 121579Duke-NUS Medical School, Singapore.,Department of Medicine (General Internal Medicine), 22957Duke University Medical Center, Durham, North Carolina, USA
| | - Hendra Goh
- Health Services and Systems Research, 121579Duke-NUS Medical School, Singapore
| | - Bridget Seng
- Centre for Ageing Research and Education (CARE), 121579Duke-NUS Medical School, Singapore
| | | | - Mariko S Koh
- 121579Duke-NUS Medical School, Singapore.,Department of Respiratory and Critical Care Medicine, 37581Singapore General Hospital, Singapore
| | - Tiew Pei Yee
- 121579Duke-NUS Medical School, Singapore.,Department of Respiratory and Critical Care Medicine, 37581Singapore General Hospital, Singapore
| | | | - Yong Mong Bee
- Department of Endocrinology, 37581Singapore General Hospital, Singapore
| | - Nicholas Graves
- Health Services and Systems Research, 121579Duke-NUS Medical School, Singapore
| | - Tazeen H Jafar
- Health Services and Systems Research, 121579Duke-NUS Medical School, Singapore.,Department of Medicine, 9615Aga Khan University, Karachi, Pakistan.,Duke Global Health Institute, 3065Duke University, Durham, North Carolina, USA
| | - Marcus Eh Ong
- Health Services and Systems Research, 121579Duke-NUS Medical School, Singapore.,Department of Emergency Medicine, 37581Singapore General Hospital, Singapore
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25
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Bao R, Ning G, Sun Y, Pan S, Wang W. Evaluation of Mask-Induced Cardiopulmonary Stress: A Randomized Crossover Trial. JAMA Netw Open 2023; 6:e2317023. [PMID: 37294572 PMCID: PMC10257095 DOI: 10.1001/jamanetworkopen.2023.17023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/23/2023] [Indexed: 06/10/2023] Open
Abstract
This randomized crossover trial evaluates the cardiopulmonary effects of extended use of the N95 mask during daily life.
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Affiliation(s)
- Riqiang Bao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Yingkai Sun
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
- Shanghai Digital Medicine Innovation Center, Shanghai, China
| | - Shijia Pan
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
- Shanghai Digital Medicine Innovation Center, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
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26
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van Kampen V, Marek EM, Sucker K, Jettkant B, Kendzia B, Strauß B, Ulbrich M, Deckert A, Berresheim H, Eisenhawer C, Hoffmeyer F, Weidhaas S, Behrens T, Brüning T, Bünger J. Influence of face masks on the subjective impairment at different physical workloads. Sci Rep 2023; 13:8133. [PMID: 37208370 DOI: 10.1038/s41598-023-34319-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/27/2023] [Indexed: 05/21/2023] Open
Abstract
To quantify the subjective and cognitive impairment caused by wearing face masks at work, 20 men and 20 women (median age 47 years, range 19-65) were tested under different ergometer workloads while wearing surgical mask, community mask, FFP2 respirator or no mask in a randomized and partially double-blinded design. Masks were worn also at the workplace for four hours. Subjective impairment was recorded by questionnaires. Cognitive performance was tested before and after the workplace examination. Subjective feeling of heat, humidity, and difficult breathing increased with rising physical exertion and wearing time for all three mask types, most notably for FFP2. Even when blinded, participants with FFP2 reported difficult breathing already at rest. During physical exertion, individuals with low tolerance to discomfort reported significantly stronger impairment (OR 1.14, 95% CI 1.02-1.27). Regarding light work, older subjects (OR 0.95, 95% CI 0.92-0.98) and women (OR 0.84, 95% CI 0.72-0.99) showed significantly lower and atopic subjects stronger impairment (OR 1.16, 95% CI 1.06-1.27). No significant influence of mask wearing was detected on cognitive performance. Wearing a mask had no effect on cognitive performance, but led to discomfort which increased with physical exertion and wearing time. Individuals who tolerate discomfort poorly felt more impaired by wearing a mask during physical exertion.
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Affiliation(s)
- Vera van Kampen
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.
| | - Eike-Maximillian Marek
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Kirsten Sucker
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Birger Jettkant
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Benjamin Kendzia
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Bianca Strauß
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Melanie Ulbrich
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Anja Deckert
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Hans Berresheim
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Christian Eisenhawer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Frank Hoffmeyer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Simon Weidhaas
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Jürgen Bünger
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
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27
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Steinhilber B, Seibt R, Gabriel J, Bär M, Dilek Ü, Brandt A, Martus P, Rieger MA. Influence of Face Masks on Physiological and Subjective Response during 130 Min of Simulated Light and Medium Physical Manual Work-An Explorative Study. Healthcare (Basel) 2023; 11:healthcare11091308. [PMID: 37174850 PMCID: PMC10178085 DOI: 10.3390/healthcare11091308] [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: 02/05/2023] [Revised: 04/24/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Undesirable side effects from wearing face masks during the ongoing COVID-19 pandemic continue to be discussed and pose a challenge to occupational health and safety when recommending safe application. Only few studies examined the effects of continuously wearing a face mask for more than one hour. Therefore, the influence of wearing a medical mask (MedMask) and a filtering facepiece class II respirator (FFP2) on the physiological and subjective outcomes in the course of 130 min of manual work was exploratively investigated. Physical work load and cardiorespiratory fitness levels were additionally considered as moderating factors. METHODS Twenty-four healthy subjects (12 females) from three different cardiorespiratory fitness levels each performed 130 min of simulated manual work with light and medium physical workload using either no mask, a MedMask or FFP2. Heart rate, transcutaneous oxygen and carbon dioxide partial pressure (PtcO2, PtcCO2) as well as perceived physical exertion and respiratory effort were assessed continuously at discrete time intervals. Wearing comfort of the masks were additionally rated after the working period. RESULTS There was no difference in time-dependent changes of physiological outcomes when using either a MedMask or a FFP2 compared to not wearing a mask. A stronger increase over time in perceived respiratory effort occurred when the face masks were worn, being more prominent for FFP2. Physical workload level and cardiorespiratory fitness level were no moderating factors and higher wearing comfort was rated for the MedMask. CONCLUSION Our results suggest that using face masks during light and medium physical manual work does not induce detrimental side effects. Prolonged wearing episodes appeared to increase respiratory effort, but without affecting human physiology in a clinically relevant way.
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Affiliation(s)
- Benjamin Steinhilber
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, 72074 Tuebingen, Germany
| | - Robert Seibt
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, 72074 Tuebingen, Germany
| | - Julia Gabriel
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, 72074 Tuebingen, Germany
| | - Mona Bär
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, 72074 Tuebingen, Germany
| | - Ümütyaz Dilek
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, 72074 Tuebingen, Germany
| | - Adrian Brandt
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, 72074 Tuebingen, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry, Medical Faculty, University Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, 72074 Tuebingen, Germany
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Marek EM, van Kampen V, Jettkant B, Kendzia B, Strauß B, Sucker K, Ulbrich M, Deckert A, Berresheim H, Eisenhawer C, Hoffmeyer F, Weidhaas S, Behrens T, Brüning T, Bünger J. Effects of wearing different face masks on cardiopulmonary performance at rest and exercise in a partially double-blinded randomized cross-over study. Sci Rep 2023; 13:6950. [PMID: 37117320 PMCID: PMC10141827 DOI: 10.1038/s41598-023-32180-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/23/2023] [Indexed: 04/30/2023] Open
Abstract
The use of face masks became mandatory during SARS-CoV-2 pandemic. Wearing masks may lead to complaints about laboured breathing and stress. The influence of different masks on cardiopulmonary performance was investigated in a partially double-blinded randomized cross-over design. Forty subjects (19-65 years) underwent body plethysmography, ergometry, cardiopulmonary exercise test and a 4-h wearing period without a mask, with a surgical mask (SM), a community mask (CM), and an FFP2 respirator (FFP2). Cardiopulmonary, physical, capnometric, and blood gas related parameters were recorded. Breathing resistance and work of breathing were significantly increased while wearing a mask. During exercise the increase in minute ventilation tended to be lower and breathing time was significantly longer with mask than without mask. Wearing a mask caused significant minimal decreases in blood oxygen pressure, oxygen saturation, an initial increase in blood and inspiratory carbon dioxide pressure, and a higher perceived physical exertion and temperature and humidity behind the mask under very heavy exercise. All effects were stronger when wearing an FFP2. Wearing face masks at rest and under exercise, changed breathing patterns in the sense of physiological compensation without representing a health risk. Wearing a mask for 4-h during light work had no effect on blood gases.
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Affiliation(s)
- Eike-Maximillian Marek
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany.
| | - Vera van Kampen
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Birger Jettkant
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Benjamin Kendzia
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Bianca Strauß
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Kirsten Sucker
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Melanie Ulbrich
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Anja Deckert
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Hans Berresheim
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Christian Eisenhawer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Frank Hoffmeyer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Simon Weidhaas
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Jürgen Bünger
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
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Beauchesne N, Wagenaar-Tison A, Brousseau-Foley M, Moisan G, Cantin V, Blanchette V. Using a contralateral shoe lift to reduce gait deterioration during an offloading fast-walk setting in diabetic peripheral neuropathy: A comparative feasibility study. Diabetes Res Clin Pract 2023; 199:110647. [PMID: 37003479 DOI: 10.1016/j.diabres.2023.110647] [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] [Received: 01/07/2023] [Revised: 03/10/2023] [Accepted: 03/24/2023] [Indexed: 04/01/2023]
Abstract
AIMS Diabetic peripheral neuropathy (DPN) is a predictor of foot ulcers and leads to sedentary behaviour. This comparative study evaluated gait and feasibility of a 20-minute fast walk, at 40-60% of cardiopulmonary capacity, in individuals with DPN wearing an offloading boot and a contralateral shoe balancer. METHODS Gait parameters were measured with inertial sensors on 32 individuals (group with DPN [n = 16], group with diabetes but without DPN [n = 9], and a group without diabetes/DPN [n = 7]). Feasibility was assessed by feedback on perceived effort and adverse events. Gait outcomes were compared between groups with or without a shoe balancer using one-way ANOVAs. RESULTS The three groups were equivalent in terms of activity level and age and gender except for the body mass index. Both groups with diabetes exhibited minimal decreased gait speed (p > 0.005) and the DPN group exhibited increased double-support percentage (+4.6%, p = 0.01) while walking with an offloading boot and contralateral shoe balancer. The use of a contralateral shoe balancer reduced gait asymmetry. Lower physical activity level was associated with further gait deterioration in all groups. Few adverse events were reported, and 91% of participants reported that the proposed activity would be feasible daily. CONCLUSIONS The offloading boot deteriorated gait function, but a contralateral shoe balancer minimized its impact, especially in the context of physical activity in people with diabetes and DPN.
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Affiliation(s)
- Nikolas Beauchesne
- Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières G9A 5H7, Canada
| | | | - Magali Brousseau-Foley
- Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières G9A 5H7, Canada; Centre intégré universitaire de santé et de services sociaux de la Mauricie et du Centre-du-Québec (CIUSSS-MCQ) affiliated to Université de Montréal, Faculty of Medicine, Trois-Rivières Family Medicine University Clinic, 731, rue Ste-Julie, 2nd Floor, Trois- Rivières G9A 1X9, Canada
| | - Gabriel Moisan
- Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières G9A 5H7, Canada
| | - Vincent Cantin
- Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières G9A 5H7, Canada
| | - Virginie Blanchette
- Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières G9A 5H7, Canada; Centre de recherche du Centre intégré de santé et services sociaux de Chaudière-Appalaches (CISSS-CA), 143 rue Wolfe, Lévis G6V 3Z1, Canada; VITAM - Sustainable Health Research Centre, 2480, Rue de la Carnardière, Québec G1J 2G1, Canada.
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Medical Guidance for Respiratory Protection: Who Should Wear What, Where, and When? Ann Am Thorac Soc 2023; 20:196-199. [PMID: 36315426 DOI: 10.1513/annalsats.202207-599vp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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31
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Harber P, Beckett WS. Health effects of filtering facepiece respirators: Systematic review of pulmonary and cardiovascular effects. Am J Ind Med 2023; 66:181-198. [PMID: 36464991 PMCID: PMC9878161 DOI: 10.1002/ajim.23450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/11/2022]
Abstract
Filtering facepiece respirators (FFRs) were introduced to protect the wearer by removing small particles from inspired air. FFRs are now also used to reduce the spread of transmissible agents from the wearer and are worn outside traditional healthcare and other workplaces. The COVID-19 pandemic increased concerns about potential adverse effects on wearers. A PUBMED query retrieved articles through June 2022. Abstracts and selected full-text articles were systematically reviewed by the authors. This article focuses upon cardiopulmonary physiologic effects (e.g., ventilation, CO2 elimination, oxygen uptake, and respiratory control) with emphasis upon current and potential research methods as well as summarizing results. 1985 records were identified, of which only 26% were published before 2020. FFR effects on CO2 elimination appear more likely to be significant than effects on oxygenation or cardiovascular function. While FFRs appear well tolerated by healthy persons, more research is needed for those with pulmonary or cardiac disorders, and for children. Many traditional pulmonary exercise study methods require special care when applied to filtering facepiece respirators. Studying additional parameters may explain the paradox of many subjective discomfort reports despite very limited physiologic effects.
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Affiliation(s)
- Philip Harber
- University of Arizona‐Mel and Enid Zuckerman College of Public HealthTucsonArizonaUSA
| | - William S. Beckett
- Harvard Medical School and Mount Auburn HospitalCambridgeMassachusettsUSA
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Kanda J, Wakasugi M, Kondo Y, Ueno S, Kaneko H, Okada Y, Okano Y, Kishihara Y, Hamaguchi J, Ishihara T, Igarashi Y, Nakae R, Miyamoto S, Yamada E, Ikechi D, Yamazaki M, Tanaka D, Sawada Y, Suda C, Yoshimura S, Onodera R, Kano K, Hongo T, Endo K, Iwasaki Y, Kodaira H, Yasuo S, Seki N, Okuda H, Nakajima S, Nagato T, Terazumi K, Nakamura S, Yokobori S. Heat stroke management during the COVID-19 pandemic: Recommendations from the experts in Japan (2nd edition). Acute Med Surg 2023; 10:e827. [PMID: 37056485 PMCID: PMC10086676 DOI: 10.1002/ams2.827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/08/2023] [Indexed: 04/15/2023] Open
Abstract
Both coronavirus disease 2019 (COVID-19) and heat stroke have symptoms of fever or hyperthermia and the difficulty in distinguishing them could lead to a strain on emergency medical care. To mitigate the potential confusion that could arise from actions for preventing both COVID-19 spread and heat stroke, particularly in the context of record-breaking summer season temperatures, this work offers new knowledge and evidence that address concerns regarding indoor ventilation and indoor temperatures, mask wearing and heat stroke risk, and the isolation of older adults. Specifically, the current work is the second edition to the previously published guidance for handling heat stroke during the COVID-19 pandemic, prepared by the "Working group on heat stroke medical care during the COVID-19 epidemic," composed of members from four organizations in different medical and related fields. The group was established by the Japanese Association for Acute Medicine Heatstroke and Hypothermia Surveillance Committee. This second edition includes new knowledge, and conventional evidence gleaned from a primary selection of 60 articles from MEDLINE, one article from Cochrane, 13 articles from Ichushi, and a secondary/final selection of 56 articles. This work summarizes the contents that have been clarified in the prevention and treatment of infectious diseases and heat stroke to provide guidance for the prevention, diagnosis, and treatment of heat stroke during the COVID-19 pandemic.
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Affiliation(s)
- Jun Kanda
- Department of Emergency MedicineTeikyo University School of MedicineItabashiJapan
| | - Masahiro Wakasugi
- Department of Emergency and Disaster MedicineUniversity of ToyamaToyamaJapan
| | - Yutaka Kondo
- Department of Emergency and Critical Care MedicineJuntendo University Urayasu HospitalUrayasuJapan
| | - Satoru Ueno
- Japan Organisation of Occupational Health and SafetyNational Institute of Occupational Safety and HealthKiyoseJapan
| | - Hitoshi Kaneko
- Department of Trauma and Emergency MedicineTokyo Metropolitan Tama Medical CenterFuchuJapan
| | - Yohei Okada
- Department of Public Health Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Yuichi Okano
- Department of Emergency MedicineKumamoto Sekijuji HospitalKumamotoJapan
| | - Yuki Kishihara
- Department of Urology, Emergency Room, Jichi Medical University Saitama Medical CenterJichi Medical UniversityShimotsukeJapan
| | - Jun Hamaguchi
- Department of Emergency and Critical Care MedicineTokyo Metropolitan Tama Medical CenterFuchuJapan
| | - Tadashi Ishihara
- Department of Emergency and Critical Care MedicineJuntendo University Urayasu HospitalUrayasuJapan
| | - Yutaka Igarashi
- Department of Emergency and Critical Care MedicineNippon Medical SchoolBunkyo CityJapan
| | - Ryuta Nakae
- Department of Emergency and Critical Care MedicineNippon Medical SchoolBunkyo CityJapan
| | - Sohma Miyamoto
- Department of Emergency and Critical Care MedicineSt. Luke's International HospitalChuo CityJapan
| | - Eri Yamada
- Advanced Medical Emergency Department and Critical Care CenterMaebashi Red Cross HospitalMaebashiJapan
| | - Daisuke Ikechi
- Department of Emergency and Critical Care MedicineHitachi General HospitalHitachiJapan
| | - Maiko Yamazaki
- Department of Emergency MedicineTeikyo University School of MedicineItabashiJapan
| | - Daiki Tanaka
- Department of Emergency MedicineTeikyo University School of MedicineItabashiJapan
| | - Yusuke Sawada
- Department of Emergency MedicineGunma University Graduate School of MedicineMaebashiJapan
| | - Chiaki Suda
- Department of Emergency and Critical Care MedicineSaku Central Hospital Advanced Care CenterSakuJapan
| | | | - Ryuta Onodera
- Department of Preventive ServicesKyoto University School of Public HealthKyotoJapan
| | - Kenichi Kano
- Emergency and Critical Care MedicineKokuritsu Byoin Kiko Kyoto Iryo CenterKyotoJapan
| | - Takashi Hongo
- Emergency DepartmentOkayama Saiseikai General HospitalOkayamaJapan
| | - Kaori Endo
- Orthopaedic Surgery, Sapporo Tokushukai HospitalHokkaido UniversitySapporoJapan
| | - Yohei Iwasaki
- Trauma and Acute Critical Care CenterTokyo Medical and Dental University HospitalTokyoJapan
| | | | | | - Nozomu Seki
- Department of Emergency and Critical Care MedicineJapanese Red Cross Saitama HospitalSaitamaJapan
| | - Hiroshi Okuda
- Division of Comprehensive MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Satoshi Nakajima
- Department of Emergency MedicineKyoto Prefectural University of MedicineKyotoJapan
| | - Tadashi Nagato
- Department of Respiratory MedicineJCHO Tokyo Yamate Medical CenterKyotoJapan
| | - Keiko Terazumi
- Trauma and Critical CareJapanese Red Cross Kumamoto HospitalKumamotoJapan
| | - Satoshi Nakamura
- Department of Emergency MedicineAsahi General HospitalAsahiJapan
| | - Shoji Yokobori
- Department of Emergency and Critical Care MedicineNippon Medical SchoolBunkyo CityJapan
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Sarkhani N, Zarei N, Nikpeyma N. Breathing Rooms: A Strategy to Improve the Performance of Healthcare Workers During COVID-19 and Future Pandemics. SAGE Open Nurs 2023; 9:23779608231187483. [PMID: 37457615 PMCID: PMC10338718 DOI: 10.1177/23779608231187483] [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: 04/04/2023] [Revised: 06/17/2023] [Accepted: 06/26/2023] [Indexed: 07/18/2023] Open
Abstract
Healthcare workers (HCWs), as frontline soldiers in the fight against COVID-19, were more exposed to the risk of contracting this disease. In addition to facing psychological, social, and physical trauma and post-traumatic stress due to the corona pandemic, HCWs were also exposed to complications due to the use of personal protective equipment (PPE). The impermeable and confining nature of some PPE poses complications for HCWs that can endanger their physical health, while also affecting the quality of healthcare they provide. Among the complications of using PPE, respiratory problems are more worrisome than other complications. This article makes a suggestion of a breathing room (BR) to improve the health and performance of HCWs in caring for patients with infectious respiratory diseases. A debate on the strengths of the implementation of a BR in hospitals is described.
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Affiliation(s)
- Naeimeh Sarkhani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nafiseh Zarei
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Nikpeyma
- Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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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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Effects of acute exercise on memory: Considerations of exercise intensity, post-exercise recovery period and aerobic endurance. Mem Cognit 2022; 51:1011-1026. [PMID: 36401115 PMCID: PMC9676734 DOI: 10.3758/s13421-022-01373-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2022] [Indexed: 11/19/2022]
Abstract
Accumulating research demonstrates that acute exercise can enhance long-term episodic memory. However, it is unclear if there is an intensity-specific effect of acute exercise on long-term episodic memory function and whether this is influenced by the post-exercise recovery period, which was the primary objective of this experiment. Another uncertainty in the literature is whether aerobic endurance influences the interaction between exercise intensity and post-exercise recovery period on long-term episodic memory function, which was a secondary objective of this study. With exercise intensity and post-exercise recovery period occurring as within-subject factors, and fitness as a between-subject factor, 59 participants (Mage = 20 years) completed 12 primary laboratory visits. These visits included a 20-min bout of exercise (Control, Moderate, and Vigorous), followed by a recovery period (1, 5, 10, and 15 min) and then a word-list episodic memory task, involving an encoding phase and two long-term recall assessments (20-min and 24-h delayed recall). The primary finding from this experiment was that moderate and vigorous-intensity exercise improved memory function when compared to a non-exercise control. A secondary finding was that individuals with higher levels of aerobic endurance, compared to their lesser fit counterparts, had greater memory performance after exercise (moderate or vigorous) when compared to after a control condition. Additionally, individuals with higher levels of aerobic endurance, compared to their lesser fit counterparts, generally performed better on the memory task with longer post-exercise recovery periods. Future research should carefully consider these parameters when evaluating the effects of acute exercise on long-term episodic memory.
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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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Hong J, Byun J, Choi JO, Shim D, Rha DW. The Effects of Wearing Facemasks during Vigorous Exercise in the Aspect of Cardiopulmonary Response, In-Mask Environment, and Subject Discomfort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114106. [PMID: 36360983 PMCID: PMC9656209 DOI: 10.3390/ijerph192114106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/16/2022] [Accepted: 10/25/2022] [Indexed: 06/01/2023]
Abstract
Non-pharmaceutical intervention such as wearing a mask during the pandemic of SARS-CoV-2 is one of the most important ways to prevent the spread of the virus. However, despite high effectiveness and easy to access, the biggest problem is 'discomfort'. The purpose of this study was to measure the changes of cardiopulmonary response and related factors affecting breathing discomfort when wearing a mask during vigorous exercise. Fifteen healthy male adults participated in this study. The experimental protocol consisted of three conditions: no mask; KF-94 mask; and sports mask. Each condition consisted of three stages: stage I, 2 m/s on even level; stage II, 2 m/s with 5° inclination; and stage III, 3 m/s on even level. Oxygen saturation (SaO2) and heart rate (HR), partial pressure of carbon dioxide (pCO2), energy expenditure index (EEI), in-mask temperature, humidity, and a five-point scale questionnaire to evaluate subjective discomfort were measured. The results show that there was a significantly higher discomfort score in mask conditions compared with no mask (p < 0.05) and only pCO2 change significantly related to subjective discomfort during exercise (p < 0.05). Moreover, the pCO2 washout was significantly disturbed when wearing a sports mask in stages 2 and 3, which was related to wearer subjective discomfort.
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Jarnig G, Kerbl R, van Poppel MNM. Effects of Wearing FFP2 Masks on SARS-CoV-2 Infection Rates in Classrooms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13511. [PMID: 36294092 PMCID: PMC9603337 DOI: 10.3390/ijerph192013511] [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: 09/05/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
In this retrospective cohort study involving 614 secondary school students, the likelihood of becoming infected with SARS-CoV-2 in schools with different focus (sports focus vs. general branch; the only difference in the sports focus school was that PE was allowed at all times without restrictions) and different prevailing restrictions were compared. A significantly higher likelihood of infection with SARS-CoV-2 was found in sports classes during the period with a strict FFP-2 mask requirement compared to general branch classes (for Delta from November 2021 to December 2021, and for Omicron from January 2022 to February 2022). The higher likelihood of infection was observed both during the Delta and the Omicron wave. After the relaxation of the mitigation measures, however, students in general branch classes showed a clear "catch-up" of infections, leading to a higher incidence of infections during this phase. By the end of the observation period (30 April 2022), only a small difference in cumulative SARS-CoV-2 infection rates (p = 0.037, φ = 0.09) was detected between classes with a sports focus and those without a sports focus. The results suggest that SARS-CoV-2 transmission can be reduced in school classes by mandatory FFP-2 mask use. In many cases, however, infection appears to be postponed rather than avoided.
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Affiliation(s)
- Gerald Jarnig
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
| | - Reinhold Kerbl
- Department of Pediatrics and Adolescent Medicine, LKH Hochsteiermark, 8700 Leoben, Austria
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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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Mahmud R, Joy KMNI, Rassel MA, Monayem FB, Datta PK, Hossain MS, Hoque MM, Habib SMHR, Munna NH, Ahmed M, Sayeed SKJB, Rahman M, Chowdhury AH, Hossain MZ, Ahmed KGU, Miah MT, Rahman MM. Health hazards related to using masks and/or personal protective equipment among physicians working in public hospitals in Dhaka: A cross-sectional study. PLoS One 2022; 17:e0274169. [PMID: 36107841 PMCID: PMC9477277 DOI: 10.1371/journal.pone.0274169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 08/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Wearing masks or personal protective equipment (PPE) has become an integral part of the occupational life of physicians due to the coronavirus disease 2019 (COVID-19) pandemic. Most physicians have been developing various health hazards related to the use of different protective gears. This study aimed to determine the burden and spectrum of various health hazards associated with using masks or PPE and their associated risk factors.
Methods
This cross-sectional survey was conducted in Dhaka Medical College from March 01–May 30, 2021, among physicians from different public hospitals in Dhaka, Bangladesh. We analyzed the responses of 506 physicians who completed case record forms through Google forms or hard copies.
Findings
The mean (SD) age of the respondents was 35.4 [7.7], and 69.4% were men. Approximately 40% were using full PPE, and 55% were using N-95 masks. A total of 489 (96.6%) patients experienced at least one health hazard. The reported severe health hazards were syncope, severe dyspnea, severe chest pain, and anaphylaxis. Headache, dizziness, mood irritation, chest pain, excessive sweating, panic attack, and permanent facial disfigurement were the minor health hazards reported. Extended periods of work in the COVID-19-unit, reuse of masks, diabetes, obesity, and mental stress were risk factors for dyspnea. The risk factors for headaches were female sex, diabetes, and previous primary headaches. Furthermore, female sex and reusing masks for an extended period (> 6 h) were risk factors for facial disfigurement. The risk factors for excessive sweating were female sex and additional evening office practice for an extended period.
Conclusions
Healthcare workers experienced several occupational hazards after using masks and PPE. Therefore, an appropriate policy is required to reduce such risks.
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Affiliation(s)
- Reaz Mahmud
- Department of Neurology, Dhaka Medical College, Dhaka, Bangladesh
- * E-mail: ,
| | | | - Mohammad Aftab Rassel
- Department of Neurology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
| | | | | | | | | | | | - Nazmul Hoque Munna
- Assistant professor, Department of Neurology, Mugda Medical College, Dhaka, Bangladesh
| | - Mohiuddin Ahmed
- Department of Neurology, Dhaka Medical College, Dhaka, Bangladesh
| | | | - Motlabur Rahman
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | | | | | | | - Md. Titu Miah
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Md. Mujibur Rahman
- Department of Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka. Bangladesh
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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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Assessment of Cardio-Respiratory Function in Overweight and Obese Children Wearing Face Masks during the COVID-19 Pandemic. CHILDREN 2022; 9:children9071053. [PMID: 35884037 PMCID: PMC9319347 DOI: 10.3390/children9071053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/11/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022]
Abstract
Objective: To evaluate whether the use of a surgical and N95 mask for overweight and obese children was associated with respiratory distress. Methods: We enrolled 15 healthy and 14 overweight or obese children. We performed two sessions: one wearing a surgical, the other an N95 mask. We tracked changes in partial pressure of end-tidal carbon dioxide (PETCO2), oxygen saturation (SaO2), pulse rate (PR), and respiratory rate (RR) during a 72 min test: 30 min without a mask, 30 min wearing a mask, and then during a 12 min walking test. Results: In healthy children, there was no significant change in SaO2 and PETCO2 during the study; there was a significant increase in PR and RR after the walking test with both the masks. In overweight or obese children, there was no significant change in SaO2 during the study period; there was a significant increase in PETCO2 as fast as wearing the mask and an increase in PETCO2, PR, and RR after walking test. After the walking test, we showed a significant correlation between PETCO2 and body mass index. Conclusion: Overweight or Obese children who wear a mask are more prone to developing respiratory distress, which causes them to remove it frequently. In a crowded environment, they are at greater risk of infection. For this reason, it is desirable that they attend environments where everyone uses a mask.
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Ghosh RN, Guglani L, Westbrook AL, Mao CY, Bai S, Keens TG, Kasi AS. Impaired ventilation during 6-min walk test in congenital central hypoventilation syndrome. Pediatr Pulmonol 2022; 57:1660-1667. [PMID: 35460211 DOI: 10.1002/ppul.25940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND Patients with congenital central hypoventilation syndrome (CCHS) can develop hypoxemia and hypercapnia during exercise. However, there is limited literature on cardiorespiratory responses during submaximal exercise and their correlation with paired-like homeobox 2B (PHOX2B) genotype. OBJECTIVES To assess oxygen saturation (SpO2 ), end-tidal carbon dioxide (ETCO2 ), heart rate (HR), and 6-min walk distance (6MWD) during a 6-min walk test (6MWT) in CCHS subjects and to correlate them with PHOX2B genotypes and assisted ventilation (AV) via tracheostomy. METHODS In this cross-sectional study, subjects with CCHS performed 6MWT with continuous pulse oximetry, HR, and capnography recorded before and during the 6MWT. Medical records were reviewed for PHOX2B genotype and phenotype data. Patients were categorized based on PHOX2B genotype and AV via tracheostomy. RESULTS Fifteen subjects aged 10.5 (interquartile range 7.9-16.2) years completed the 6MWT. Nine subjects used AV via tracheostomy. Seven (47%) subjects developed hypoxemia (SpO2 ≤ 90%, n = 7) and hypoventilation (ETCO2 ≥ 50 mmHg, n = 3) during the 6MWT. There was a significant decline from baseline SpO2 , increase from baseline ETCO2 , and increase in HR during the 6MWT (all p < 0.05). Subjects had decreased median percent predicted 6MWD (59.7% [50.6%-62.5%]). Nadir SpO2 (p = 0.029) and peak ETCO2 (p = 0.046) differed significantly between PHOX2B genotype groups but 6MWD did not (p = 0.8). CONCLUSION Despite normal oxygenation and ventilation at rest and during sleep on AV, patients with CCHS can develop hypoxemia and hypercapnia during submaximal exercise. Our study highlights the importance of assessing ventilatory responses during submaximal exercise in patients with CCHS regardless of their PHOX2B genotype.
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Affiliation(s)
- Radhika N Ghosh
- Department of Pediatrics, Division of Pediatric Pulmonology, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA
| | - Lokesh Guglani
- Department of Pediatrics, Division of Pediatric Pulmonology, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA
| | - Adrianna L Westbrook
- Pediatric Biostatistics Core, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA
| | - Chad Y Mao
- Department of Pediatrics, Division of Pediatric Cardiology, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA
| | - Shasha Bai
- Pediatric Biostatistics Core, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA
| | - Thomas G Keens
- Department of Pediatrics, Division of Pediatric Pulmonology and Sleep Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
| | - Ajay S Kasi
- Department of Pediatrics, Division of Pediatric Pulmonology, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA
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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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Ahmadian M, Ghasemi M, Nasrollahi Borujeni N, Afshan S, Fallah M, Ayaseh H, Pahlavan M, Nabavi Chashmi SM, Haeri T, Imani F, Zahedmanesh F, Akbari A, Nasiri K, Dabidi Roshan V. Does wearing a mask while exercising amid COVID-19 pandemic affect hemodynamic and hematologic function among healthy individuals? Implications of mask modality, sex, and exercise intensity. PHYSICIAN SPORTSMED 2022; 50:257-268. [PMID: 33902400 DOI: 10.1080/00913847.2021.1922947] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We investigated how wearing a mask - and its modality (surgical vs. N95) - affect hemodynamic and hematologic function in males and females across two exercise intensities (submaximal (SUB) and maximal (MAX)). METHODS 144 individuals participated in the present study and were randomly allocated to three mask groups of 48 (N95, SURGICAL, and NO MASK) with two exercise subgroups for each mask group (MAX, n = 24; SUB, n = 24) for both sexes. Participants in each experimental group (N95SUB, N95MAX; SURSUB, SURMAX; SUB, MAX) were assessed for their hemodynamic and hematologic function at baseline and during recovery after exercise. RESULTS No significant differences were noted for either hemodynamic or hematologic function at post-exercise as compared to baseline with regard to mask modality (P > 0.05). Heart rate (HR) for maximal intensity were significantly greater at 1 min post-exercise in N95 as compared to SURGICAL (P < 0.05). No differences were noted for hemodynamic and hematologic function with N95 and SURGICAL compared to NOMASK for either intensity (P > 0.05). Females showed significantly greater HR values at 1 min post-exercise in N95 as compared to NO MASK, but no significant differences were noted for hematological function between sexes (P > 0.05). CONCLUSION Our findings show that wearing a face mask (N95/surgical) while exercising has no detrimental effects on hemodynamic/hematologic function in both males and females, and suggest that wearing a mask, particularly a surgical mask, while exercising during the ongoing pandemic is safe and poses no risk to individual's health. Future studies examining physiological responses to chronic exercise with masks are warranted.
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Affiliation(s)
- Mehdi Ahmadian
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Mohammad Ghasemi
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | | | - Samaneh Afshan
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | - Masoumeh Fallah
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | - Hamed Ayaseh
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | - Mohammad Pahlavan
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | | | - Tahereh Haeri
- 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
| | - Foruzan Zahedmanesh
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | - Abolfazl Akbari
- Department of Physiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Khadijeh Nasiri
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Valiollah Dabidi Roshan
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran.,Athletic Performance and Health Research Center, Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
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Schutzmaske und Kopfschmerz. PSYCHOPRAXIS. NEUROPRAXIS 2022. [PMCID: PMC9009278 DOI: 10.1007/s00739-022-00811-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
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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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Scheid JL, Edwards C, Seils M, West SL. Perceived Exertion during Moderate and Vigorous Physical Activity While Mask Wearing: A Quantitative and Qualitative Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095698. [PMID: 35565092 PMCID: PMC9102889 DOI: 10.3390/ijerph19095698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/01/2022] [Accepted: 05/05/2022] [Indexed: 12/10/2022]
Abstract
There is limited research examining the perception of exertion during exercise while wearing a facemask. The current study examined if mask usage during moderate or vigorous physical activity (MVPA) changed the self-reported perception of exertion. Seventy-two adults (18 years and older) who were physically active before the COVID-19 pandemic completed a questionnaire that assessed exercise habits and perceptions of mask wearing during MVPA. Participants reported their ratings of perceived exertion (RPE, on a scale of 1−10) while exercising. Wearing a mask resulted in higher RPE vs. no mask during both vigorous (8.4 ± 0.2 vs. 7.4 ± 0.1; p < 0.001) and moderate PA (6.6 ± 0.2 vs. 5.6 ± 0.2; p < 0.001). Qualitative analysis revealed mostly negative perceptions of exercising while wearing a mask, including respiratory issues, detriments to cardiovascular endurance, and general discomfort. A total of 40% of participants reported that they stopped exercising in an indoor/public setting because of a mask mandate in their region. Participants reported participating in less vigorous PA (4.7 ± 0.4 vs. 4.0 ± 0.4 h/week; p = 0.046), but not less moderate PA (3.3 ± 0.3 vs. 3.0 ± 0.3 h/week; p = 0.443) pre vs. during the pandemic. Our study suggests that facemask usage during MVPA causes an increase in RPE and may be one reason for a decrease in vigorous PA during the COVID-19 pandemic.
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Affiliation(s)
- Jennifer L. Scheid
- Department of Health Promotion, Daemen University, Amherst, NY 14226, USA
- Department of Physical Therapy, Daemen University, Amherst, NY 14226, USA;
- Correspondence: ; Tel.: +1-716-839-7656
| | - Corinne Edwards
- Department of Athletic Training, Daemen University, Amherst, NY 14226, USA;
| | - Michael Seils
- Department of Physical Therapy, Daemen University, Amherst, NY 14226, USA;
| | - Sarah L. West
- Kinesiology Program, Department of Biology & Trent/Fleming School of Nursing, Trent University, Peterborough, ON K9L 0G2, Canada;
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Minoguchi K, Isii A, Nakamura T, Sato H, Abe T, Kawakami H, Nakamura K, Goto T. Effects of wearing surgical masks on fraction of inspired oxygen in spontaneously breathing patients: improving safety for frontline healthcare professionals under pandemic situations. BMC Anesthesiol 2022; 22:108. [PMID: 35436860 PMCID: PMC9014278 DOI: 10.1186/s12871-022-01649-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During pandemic situations, many guidelines recommend that surgical masks be worn by both healthcare professionals and infected patients in healthcare settings. The purpose of this study was to clarify the levels and changes of oxygen concentration over time while oxygen was administered over a surgical mask. METHODS Patients scheduled to undergo general anesthesia (n = 99) were enrolled in this study. First, patients were administered oxygen at 6 L/min via an oxygen mask over a surgical mask for 5 min. The patients removed the surgical mask and then took a 3-min break; thereafter, the same amount of oxygen was administered for another 5 min via the oxygen mask. We measured the fraction of inspired oxygen (FiO2), the end-tidal CO2 (EtCO2), and respiratory frequency every minute for 5 min, both while administering oxygen with and without a surgical mask. The FiO2 was measured at the beginning of inspiration and the EtCO2 was measured at the end of expiration. RESULTS The FiO2 at 5 min was significantly lower when breathing with a surgical mask than that without it (mean difference: 0.08 [95% CI: 0.067-0.10]; p < 0.001). In contrast, the EtCO2 at 5 min was significantly higher when breathing with a surgical mask than that without it (mean difference: 11.9 mmHg [95% CI: 10.9-12.9]; p < 0.001). CONCLUSION The FiO2 was lower when oxygen was administered over surgical masks than when patients did not wear surgical masks. Oxygen flow may need to be adjusted in moderately ill patients requiring oxygen administration.
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Affiliation(s)
- Kazuhiro Minoguchi
- Department of Anesthesiology, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Akira Isii
- Department of Anesthesiology, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Toshiki Nakamura
- Department of Anesthesiology, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Hitoshi Sato
- Department of Anesthesiology, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan. .,Department of Clinical Quality Management, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan. .,Department of Quality and Safety in Healthcare, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan.
| | - Takeru Abe
- Department of Quality and Safety in Healthcare, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Hiromasa Kawakami
- Department of Anesthesiology, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Kyota Nakamura
- Department of Clinical Quality Management, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan.,Department of Quality and Safety in Healthcare, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Takahisa Goto
- Department of Anesthesiology and Intensive Care Unit, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
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