Facial mask acute effects on affective/psychological and exercise performance responses during exercise: A meta-analytical review

Glänzel, Marcelo Henrique; Barbosa, Igor Martins; Machado, Esthevan; Prusch, Samuel Klippel; Barbosa, Ariadine Rodrigues; Lemos, Luiz Fernando Cuozzo; Schuch, Felipe Barreto; Lanferdini, Fábio Juner

doi:10.3389/fphys.2022.994454

Cited by 8 publications

(4 citation statements)

References 70 publications

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“…The increase in Dys when wearing a mask in our study is consistent with a 2022 meta-analysis that found a moderate effect of surgical masks on subjective Dys with physical exertion (22). A recent review proposed several potential mechanisms for this effect, including possible CO 2 rebreathing with mask use, as well as influences related to changes in temperature and/or moisture of the face and mask (23).…”

Section: Discussionsupporting

confidence: 92%

The Physiological and Subjective Effects of Exercising with a Face Mask at Different Intensities

2023

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Introduction Face masks are used to reduce the spread of respiratory diseases. Physical exertion increases distance traveled by expelled particles, so masking while exercising is recommended to help prevent disease transmission. However, there is limited literature assessing masking during higher-intensity exercise. Purpose This study aimed to compare the impact of surgical masks on physiological and subjective measures during 45 min of a progressive exercise protocol as compared with unmasked exercise. Methods Each subject completed two random 45-min exercise trials (15 min each at 40%, 60%, and 80% of their oxygen uptake reserve) with and without a surgical mask in random order. Heart rate, oxygen saturation, respiratory rate (RR), ratings of perceived exertion, and dyspnea (Dys) were measured at each intensity. Repeated-measures ANOVA was utilized, and significance was set at P < 0.05. Results Thirty subjects (age, 20.4 ± 1.2 yr; peak oxygen uptake, 40.12 ± 11.05 mL·kg−1·min−1; 57% female) completed the study. When comparing masked and unmasked trials at each exercise intensity, differences were found only in RR (40%: 17.6 ± 4.9 vs 15.8 ± 4.9, P < 0.02, d = 0.4; 60%: 23.7 ± 5.5 vs 21.3 ± 6.2, P < 0.01, d = 0.4; 80%: 35.8 ± 9.0 vs 30.1 ± 8.8, P < 0.01, d = 0.6). When comparing masked with unmasked trials across all intensities, a difference was found in Dys (3.5 ± 2.4 vs 2.9 ± 2.2, respectively; P < 0.001, d = 0.3). Conclusions The use of surgical masks seems to impact RR and one’s perception of Dys, but has minimal influences on heart rate, oxygen saturation, and rating of perceived exertion. Other than increasing one’s RR and perceptions of Dys, it seems that exercising with a mask at moderate and vigorous intensities is acceptable in healthy individuals.

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Section: Discussionsupporting

confidence: 92%

The Physiological and Subjective Effects of Exercising with a Face Mask at Different Intensities

2023

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“…This study provides several future research questions that could not be clarified within its scope. Based on recent reviews [9][10][11][12] and our results, the physiological effect of mask wearing is probably insignificant or small for short-term walking. However, the multitask gait was found to have an effect on the correct answer rate of the calculation task, as well as on the gait pattern, in the present study; however, varying results have been reported.…”

Section: Discussionsupporting

confidence: 60%

“…However, adverse effects of wearing face masks have been reported, including perceived breathlessness or dyspnea 1) , thermal changing (i.e., increase in skin temperature under the mask or exertion and heat perception) [2][3][4] , headaches 5,6) , skin reactions (i.e., acne, itches) 7) . Dyspnea or breathlessness is most likely caused by increased breathing resistance 1,8,9) , reinspiration of CO2 in exhaled air built up in the mask 9) , and an increase in the dead space, depending on mask type 8,10) . Therefore, although masks are worn for a variety of purposes, various adverse effects have also been observed.…”

Section: Introductionmentioning

confidence: 99%

“…Owing to the increased demand for ventilation during exercise, the effects of wearing masks during exercise on performance and/or physiological responses have been widely reported. Several recent reviews have demonstrated that wearing a mask during low-intensity exercises, such as walking, increases subjective breathlessness even in healthy adults, although there is no greater or significant effect on physiological responses or exercise performance, except for breathing patterns [9][10][11][12] . Some masks (tightly fitted masks or particular respirators) may have a significant negative effect on physiological responses and performance during exercise [12][13][14] .…”

Section: Introductionmentioning

confidence: 99%

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Effects of wearing non-woven face mask and performing calculation task while walking on gait pattern, breathlessness, and calculation performance

Oshita,

Imayoshi,

Suzue

2023

JPFSM

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The present study investigated the effects of wearing a non-woven face mask and performing a calculation task, while walking, on gait pattern, breathlessness, and calculation performance. Twenty-one healthy adult males walked 4.0 km/h and 6.0 km/h on a treadmill with and without wearing a face mask. A calculation task using a smartphone was added to the gait task, and the participants were asked to perform two-digit addition calculation tasks displayed on the screen as quickly and accurately as possible. Heart rate, perceived exercise intensity, breathlessness, and cadence during gait tasks were measured. Although wearing the mask did not significantly affect heart rate or cadence during gait, breathlessness and perceived exercise intensity were significantly increased. When the calculation task was performed during gait, wearing the mask significantly decreased the correct answer rate, although the number of responses was not affected. Wearing the mask therefore reduced the calculation performance during gait. These results suggest that wearing a mask during gait may increase breathlessness and may worsen mental demands such as performing a calculation task, even if it does not affect physiological responses or gait patterns. As walking in daily life requires a variety of cognitive/mental demands, the impact of wearing a mask on the implementation of these demands may need to be considered.

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Sports despite masks: no negative effects of FFP2 face masks on cardiopulmonary exercise capacity in children

Weigelt,

Schöffl,

Rottermann

et al. 2023

Eur J Pediatr

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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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Facial mask acute effects on affective/psychological and exercise performance responses during exercise: A meta-analytical review

Cited by 8 publications

References 70 publications

The Physiological and Subjective Effects of Exercising with a Face Mask at Different Intensities

The Physiological and Subjective Effects of Exercising with a Face Mask at Different Intensities

Effects of wearing non-woven face mask and performing calculation task while walking on gait pattern, breathlessness, and calculation performance

Sports despite masks: no negative effects of FFP2 face masks on cardiopulmonary exercise capacity in children

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