Effects of surgical face masks on cardiopulmonary parameters during steady state exercise

Abstract

Wearing face masks reduce the maximum physical performance. Sports and occupational activities are often associated with submaximal constant intensities. This prospective crossover study examined the effects of medical face masks during constant-load exercise. Fourteen healthy men (age 25.7 ± 3.5 years; height 183.8 ± 8.4 cm; weight 83.6 ± 8.4 kg) performed a lactate minimum test and a body plethysmography with and without masks. They were randomly assigned to two constant load tests at maximal lactate steady state with and without masks. The cardiopulmonary and metabolic responses were monitored using impedance cardiography and ergo-spirometry. The airway resistance was two-fold higher with the surgical mask (SM) than without the mask (SM 0.58 ± 0.16 kPa l-1 vs. control [Co] 0.32 ± 0.08 kPa l-1; p < 0.01). The constant load tests with masks compared with those without masks resulted in a significantly different ventilation (77.1 ± 9.3 l min-1 vs. 82.4 ± 10.7 l min-1; p < 0.01), oxygen uptake (33.1 ± 5 ml min-1 kg-1 vs. 34.5 ± 6 ml min-1 kg-1; p = 0.04), and heart rate (160.1 ± 11.2 bpm vs. 154.5 ± 11.4 bpm; p < 0.01). The mean cardiac output tended to be higher with a mask (28.6 ± 3.9 l min-1 vs. 25.9 ± 4.0 l min-1; p = 0.06). Similar blood pressure (177.2 ± 17.6 mmHg vs. 172.3 ± 15.8 mmHg; p = 0.33), delta lactate (4.7 ± 1.5 mmol l-1 vs. 4.3 ± 1.5 mmol l-1; p = 0.15), and rating of perceived exertion (6.9 ± 1.1 vs. 6.6 ± 1.1; p = 0.16) were observed with and without masks. Surgical face masks increase airway resistance and heart rate during steady state exercise in healthy volunteers. The perceived exertion and endurance performance were unchanged. These results may improve the assessment of wearing face masks during work and physical training.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1

Timeline of the study; Pre-examination: informed consent, medical history, body plethysmography, DIET double incremental cycle ergometer test to detect the lactate minimum, Constant-load-test with and without mask: in randomized order, impedance cardiography, blood pressure, ergo-spirometry and blood lactate concentration.

Figure 2

Body plethysmography measurements with spirometry masks.

Figure 3

Graphs showing the mean cardiac responses (n = 13) during the continuous load test with (SM) and without (Co) a surgical mask. (A) HR: heart rate; (B) SV: stroke volume; (C) CO: cardiac output; (D) SBP & DBP: systolic & diastolic blood pressure. Rest values were determined immediately prior to exercise.

Figure 4

The graphs show the mean cardiac responses (n = 13) during the continuous load test with and without a surgical mask. (A) VE: minute ventilation; (B) VO2: oxygen uptake; (C) LAC: blood lactate concentration; (D) RPE: rating of perceived exertion (D). The rest values were determined immediately prior to exercise.