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. 2022 May 24:13:913974.
doi: 10.3389/fphys.2022.913974. eCollection 2022.

Effect of Surgical Mask use on Peak Physical Performance During Exercise Treadmill Testing-A Real World, Crossover Study

Mayank Dalakoti  1 , Cheryl Long  2 , Arshia Bains  1 , Andie Djohan  1 , Isabel Ahmad  1 , Siew Pang Chan  2 , Jieli Kua  1 , Po Fun Chan  1 , Tee Joo Yeo  1
Affiliations

Effect of Surgical Mask use on Peak Physical Performance During Exercise Treadmill Testing-A Real World, Crossover Study

Mayank Dalakoti et al. Front Physiol. .

Abstract

Background: Mask wearing is an essential strategy to combat the spread of SARS-CoV-2. Some individuals may wear masks during physical activity to reduce disease transmission. This study aimed to investigate the real-world effect of wearing a surgical face mask on physiological parameters at peak exercise in healthy individuals. Methods: In this crossover design study, participants underwent maximal treadmill electrocardiogram exercise tests using the Bruce protocol on two separate occasions, once with a standard 3-ply surgical face mask and once without. Heart rate, oxygen saturation, blood pressure, rate pressure product, metabolic equivalents (METS) and total exercise time were measured. Subjective rate of perceived exertion was also assessed using the modified Borg Scale. Results: 50 adults (mean age = 31.7 ± 6.5 years; 27 males) completed both treadmill tests. Mask wearing resulted in a significant reduction in peak METS by 1.5 units, maximum speed by 0.5 km/h, exercise time by 68.4 s with a significantly lower peak heart rate by 4.4 bpm, and lower percentage of age-predicted maximum heart rate by 2.5% (p < 0.001 for all parameters). During each corresponding stage of the Bruce protocol, the average modified Borg score was found to be significantly higher in subjects exercising with mask after adjusting for age, gender and body mass index (p < 0.03). Conclusion: In a cohort of healthy individuals, wearing of a surgical face mask during maximal treadmill exercise lead to reduced physical performance and increased rate of perceived exertion. Individuals exercising with surgical masks need to be mindful of these limitations while undergoing physical training in order to differentiate these physiological responses from symptoms of early respiratory illness.

Keywords: COVID–19; environmental physiology; exercise testing; physiological stress; surgical mask.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Modified Borg scores at respective Bruce stages of unmasked vs. masked exercise treadmill test.
FIGURE 2
FIGURE 2
Exercise time (seconds), peak metabolic equivalents (METS), maximum speed (km/hour), peak heart rate (beats per minute), percentage of age-predicted maximum heart rate (%), in masked and unmasked individuals.
See this image and copyright information in PMC

References

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