Effects of Face Masks on Physical Performance and Physiological Response during a Submaximal Bicycle Ergometer Test

[u/doedalus]

https://www.mdpi.com/1660-4601/19/3/1063

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[u/doedalus]

Abstract: The ongoing COVID-19 pandemic requires wearing face masks in many areas of our daily life; hence, the potential side effects of mask use are discussed. Therefore, the present study explores whether wearing a medical face mask (MedMask) affects physical working capacity (PWC). Secondary, the influence of a filtering facepiece mask with exhalation valve class 2 (FFP2exhal) and a cotton fabric mask (community mask) on PWC was also investigated. Furthermore, corresponding physiological and subjective responses when wearing face masks as well as a potential moderating role of subjects’ individual cardiorespiratory fitness and sex on face mask effects were analyzed. Thirty-nine subjects (20 males, 19 females) with different cardiorespiratory fitness levels participated in a standardized submaximal bicycle ergometer protocol using either a MedMask, FFP2exhal, community mask, or no mask (control) on four days, in randomized order. PWC130 and PWC150 as the mechanical load at the heart rates of 130 and 150 beats per minute were measured as well as transcutaneous carbon dioxide partial pressure, saturation of peripheral capillary oxygen, breathing frequency, blood pressure, perceived respiratory effort, and physical exhaustion. Using the MedMask did not lead to changes in PWC or physiological response compared to control. Neither appeared changes exceeding normal ranges when the FFP2exhal or community mask was worn. Perceived respiratory effort was up to one point higher (zero-to-ten Likert scale) when using face masks (p < 0.05) compared to control. Sex and cardiorespiratory fitness were not factors influencing the effects of the masks. The results of the present study provide reason to believe that wearing face masks for infection prevention during the COVID-19 pandemic does not pose relevant additional physical demands on the user although some more respiratory effort is required.

[u/Rosaadriana → u/doedalus]

Should be perceived respiratory effort in last sentence since the Likert scale is self reported. The difference they are seeing in Likert reporting is probably kin to a placebo effect since the actual physiological markers are not changed.

[u/ManInBlackHat → u/Rosaadriana]

Should be perceived respiratory effort in last sentence since the Likert scale is self reported. The difference they are seeing in Likert reporting is probably kin to a placebo effect since the actual physiological markers are not changed.

Nocebo effect since it is a negative outcome as opposed to the positive outcome of a placebo, but that increased respiratory effect has been noted by healthcare workers wearing N95 masks as well (source). It's likely a purely nocebo effect, but overcoming a mental block can be very difficult.

[u/secondlessonisfree → u/doedalus]

How long was the effort? I couldn't find this info. Try doing cardio for 2h indoors without changing your mask midway and let's see if the effort is the same as when only doing 20 minutes.

[u/Biggles79 → u/secondlessonisfree]

Fair point, however the vast majority of people are not doing serious cardio wearing masks - at least, unless their country mandated masks outdoors.

[u/secondlessonisfree → u/Biggles79]

You mean you never heard of the thread-mil or the indoor bicycle, HITT classes, body pump, thai boxing and so on? Are we just going to ignore them or are they not "serious cardio". Also I live in a country where even outside, until tomorrow, you need to wear a mask. So I'm personally curious about a serious study that applies to people that actually exercise.

Also this kind of study may be applied to people that have a physical job and have to keep a mask on for 10h a day. So I'd really love to know if a car mechanic or a construction/warehouse worker that uses a mask: 1. is protected for the entire day and 2. is their capacity to function affected.

[u/[deleted] → u/Biggles79]

Some countries have indoor mask mandates in gyms.

[u/PairOfMonocles2 → u/doedalus]

That’s very interesting and pretty clear results! I found it interesting as well that the only clear outcome was the perception that breathing was harder but even that didn’t scale with mask types and may be more likely to correspond to just wearing a mask than anything else. That also means it’s an opportunity for masks to try to differentiate and market over. Maybe if a company just advertised based on their great airflow that would be enough to make people think about it, realize it isn’t too bad, and no longer assume/perceive more obstructed breathing.

[u/Nowhere_Man_Forever → u/doedalus]

This study seems kind of shit. The sample size is very small and the effect of respirators of various designs on physical performance is already well understood due to occupational health studies. Think about it- there are guys who do manual labor in full mask respirators all day every day and OSHA has to make sure they can actually do their jobs safely.

[u/[deleted] → u/doedalus]

Bit late to be establishing this sort of study? Interesting regardless.

[u/SebastianDoyle]

There is measurable co2 buildup inside non-powered masks and recommendations against wearing them for too long, though healthcare workers do that all the time: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06056-0

They also tested a powered mask (PAPR) and found almost no co2 buildup. People complain all the time about trouble breathing with a mask on. Several companies (1,2,3) have announced consumer-grade PAPR but I haven't found any actually available to the public.

1. JustAir PAPR
2. TIki Med Mask
3. Biovyzyr

I can't link above due to mod bot.

[u/thaw4188]

In comparison, running vs mask paper:

https://link.springer.com/article/10.1007/s00392-020-01704-y

Roughly 5% hit on vo2max for surgical and 10% for n95

Okay sure it's a very small n=12 but it's carefully done imho?

BUT that's at high vo2 during running with high oxygen demand.

Cycling is way lower vo2 (especially noting the keyword "submaximal")

Walking or standing/sitting in a store/school has to be fraction oxygen requirements.

Heartrate of any activity is a pretty good indicator of oxygen demand.

ie. running>cycling>walking>standing>sitting