Login Register Cart 0
Generic placeholder image

Current Respiratory Medicine Reviews

Editor-in-Chief

ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Influence of Surgical Mask on Exertion Perception and Select Physiological Parameters During an Incremental Test in Healthy Subjects

Author(s): Jose Luis Piñeros-Alvarez*, Nelson Esteban Portuguez-Jaramillo, Hamilton Elias Rosero- Carvajal, Mayra Liliana Pizarro-Loaiza, Monica Andrea Murillo-Ortiz and Stefanie Tonguino-Rosero

Volume 21, Issue 3, 2025

Published on: 13 September, 2024

Page: [243 - 250] Pages: 8

DOI: 10.2174/011573398X314753240830045714

Price: $65

TIMBC 2025
Abstract

Background: During cardiac or pulmonary rehabilitation exercises, the use of a surgical mask may not be well tolerated by patients, especially those experiencing dyspnea during certain activities due to their underlying health conditions. The purpose of this study was to describe the influence of a surgical mask on exertion perception and some physiological parameters during an incremental test in healthy subjects.

Methods: A descriptive study involving 16 healthy adult individuals was conducted. The BRUCE incremental protocol was performed twice, with and without the use of a surgical mask.

Results: No significant changes were found in vital signs, such as heart rate (p: 0.8684), mean arterial pressure (p: 0.2781), and peripheral oxygen saturation (p: 0.5314). However, the respiratory rate showed a significant difference (p: 0.023). Furthermore, significant differences were observed in the distance covered (p: 0.0005), duration (p: 0.0003), and measured intensity (METs) (p: 0.0117). Metabolic acidosis (p: 0.032), hypocapnia (p: 0.238), and hyperlactatemia (p: 0.024) were detected in the analysis of arterial gases. Oxygenation parameters, such as PaO2 (p: 0.038) and PaO2/FiO2 ratio (p: 0.038), were higher in the mask-off trial.

Conclusion: Surgical masks induce negative changes in METs, distance covered, and duration during an incremental treadmill test. Although no significant impact on vital signs was observed, the use of a surgical mask resulted in statistically significant but not clinically relevant decreases in oxygenation parameters. The stages of the Bruce protocol were achieved differently when participants wore a surgical mask.

Keywords: Surgical mask, perception of effort, exercise, rehabilitation, exercise tolerance, dyspnea.

« Previous Next »
Graphical Abstract

[1]
Dbouk T, Drikakis D. On respiratory droplets and face masks. Phys Fluids 2020; 32(6): 063303.
[http://dx.doi.org/10.1063/5.0015044] [PMID: 32574231]
[2]
Worby CJ, Chang HH. Face mask use in the general population and optimal resource allocation during the COVID-19 pandemic. Nat Commun 2020; 11(1): 4049.
[http://dx.doi.org/10.1038/s41467-020-17922-x] [PMID: 32792562]
[3]
Hansstein FV, Echegaray F. Exploring motivations behind pollution-mask use in a sample of young adults in urban China. Global Health 2018; 14(1): 122.
[http://dx.doi.org/10.1186/s12992-018-0441-y] [PMID: 30514342]
[4]
Davis BA, Tsen LC. Wearing an N95 respiratory mask. Anesthesiology 2020; 133(3): 684-6.
[http://dx.doi.org/10.1097/ALN.0000000000003421] [PMID: 32467450]
[5]
Lässing J, Falz R, Pökel C, et al. Effects of surgical face masks on cardiopulmonary parameters during steady state exercise. Sci Rep 2020; 10(1): 22363.
[http://dx.doi.org/10.1038/s41598-020-78643-1] [PMID: 33349641]
[6]
Fikenzer S, Uhe T, Lavall D, et al. Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clin Res Cardiol 2020; 109(12): 1522-30.
[http://dx.doi.org/10.1007/s00392-020-01704-y] [PMID: 32632523]
[7]
Person E, Lemercier C, Royer A, Reychler G. Effet du port d’un masque de soins lors d’un test de marche de six minutes chez des sujets sains. Rev Mal Respir 2018; 35(3): 264-8.
[http://dx.doi.org/10.1016/j.rmr.2017.01.010] [PMID: 29395560]
[8]
Sinkule EJ, Powell JB, Goss FL. Evaluation of N95 respirator use with a surgical mask cover: effects on breathing resistance and inhaled carbon dioxide. Ann Occup Hyg 2013; 57(3): 384-98.
[http://dx.doi.org/10.1093/annhyg/mes068] [PMID: 23108786]
[9]
Harber P, Beck J, Brown C, Luo J. Physiologic and subjective effects of respirator mask type. Am Ind Hyg Assoc J 1991; 52(9): 357-62.
[http://dx.doi.org/10.1080/15298669191364875] [PMID: 1781441]
[10]
Ministerio de Salud y Protección Social. Guidelines for the Return of Girls, Boys and Adolescents to In-Person Practices Related to Recreation. 2020. Available from:https://www-medbox-org.translate.goog/document/lineamiento-para-el-retorno-de-ninas-ninos-y-adolescentes-a-practicas-presenciales-relacionadas-con-recreacion?_x_tr_sl=es&_x_tr_tl=en&_x_tr_hl=en&_x_tr_pto=sc(accessed on 20-8-2024)
[11]
Cornier MA. A review of current guidelines for the treatment of obesity. Am J Manag Care 2022; 28(15) (Suppl.): S288-96.
[PMID: 36525676]
[12]
Bruce RA, Blackmon JR, Jones JW, Strait G. Exercising testing in adult normal subjects and cardiac patients. Pediatrics 1963; 32(4): 742-56.
[http://dx.doi.org/10.1542/peds.32.4.742] [PMID: 14070531]
[13]
Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982; 14(5): 377-81.
[http://dx.doi.org/10.1249/00005768-198205000-00012] [PMID: 7154893]
[14]
Williams N. The borg rating of perceived exertion (RPE) scale. Occup Med 2017; 67(5): 404-5.
[http://dx.doi.org/10.1093/occmed/kqx063]
[15]
Dubé BP, Vermeulen F, Laveneziana P. Disnea de esfuerzo en las enfermedades respiratorias crónicas: de la fisiología a la aplicación clínica. Arch Bronconeumol 2017; 53(2): 62-70.
[http://dx.doi.org/10.1016/j.arbres.2016.09.005] [PMID: 27818024]
[16]
Giraldo R. Estudio de firmas espectrales de palmas de aceite afectadas con la Marchitez letal, usando análisis estadísticos de datos funcionales. Palmas 2016; 37: 131-9.
[17]
Gastwirth JL, Gel YR, Miao W. The impact of Levene’s test of equality of variances on statistical theory and practice. Statist Sci 2009; 24(3): 343-60.
[http://dx.doi.org/10.1214/09-STS301]
[18]
StatSoft, Inc. (2011) STATISTICA (Data Analysis Software System), Version 10. Available from: http://www.statsoft.com(accessed on 20-8-2024)
[19]
Motulsky HJ. Equation: log(agonist) vs. response -- Variable slope. Available from: https://www.graphpad.com/guides/prism/latest/curve-fitting/reg_dr_stim_variable.htm(accessed on 20-8-2024)
[20]
Ahmadian M, Ghasemi M, Nasrollahi Borujeni N, et al. 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. Phys Sportsmed 2022; 50(3): 257-68.
[http://dx.doi.org/10.1080/00913847.2021.1922947] [PMID: 33902400]
[21]
Dubé F, Croteau E, Richard G, Allard C, Mampuya WM. Exercise capacity and perceived exertion on treadmill stress test performed while wearing vs without a surgical mask: A randomized clinical trial in healthy adults. CJC Open 2022; 4(12): 1036-42.
[http://dx.doi.org/10.1016/j.cjco.2022.07.009] [PMID: 36124078]
[22]
Siggaard-Andersen O. The van slyke equation. Scand J Clin Lab Invest 1977; 37(sup146): 15-20.
[http://dx.doi.org/10.3109/00365517709098927]
[23]
Stringer W, Casaburi R, Wasserman K. Acid-base regulation during exercise and recovery in humans. J Appl Physiol 1992; 72(3): 954-61.
[http://dx.doi.org/10.1152/jappl.1992.72.3.954] [PMID: 1568991]
[24]
Magder S, Emami A. Practical approach to physical-chemical acid-base management. Stewart at the bedside. Ann Am Thorac Soc 2015; 12(1): 111-7.
[http://dx.doi.org/10.1513/AnnalsATS.201409-426OI] [PMID: 25496220]
[25]
Lühker O, Berger MM, Pohlmann A, Hotz L, Gruhlke T, Hochreiter M. Changes in acid–base and ion balance during exercise in normoxia and normobaric hypoxia. Eur J Appl Physiol 2017; 117(11): 2251-61.
[http://dx.doi.org/10.1007/s00421-017-3712-z] [PMID: 28914359]
[26]
Laviolette L, Laveneziana P. Dyspnoea: A multidimensional and multidisciplinary approach. Eur Respir J 2014; 43(6): 1750-62.
[http://dx.doi.org/10.1183/09031936.00092613] [PMID: 24525437]
[27]
Romer LM, Haverkamp HC, Lovering AT, Pegelow DF, Dempsey JA. Effect of exercise-induced arterial hypoxemia on quadriceps muscle fatigue in healthy humans. Am J Physiol Regul Integr Comp Physiol 2006; 290(2): R365-75.
[http://dx.doi.org/10.1152/ajpregu.00332.2005] [PMID: 16166208]
[28]
Hopkins SR, Dominelli PB, Davis CK, et al. Face masks and the cardiorespiratory response to physical activity in health and disease. Ann Am Thorac Soc 2021; 18(3): 399-407.
[http://dx.doi.org/10.1513/AnnalsATS.202008-990CME] [PMID: 33196294]

Rights & Permissions Print Cite
Article Metrics
9
1
Wayfinder Image
TIMBC 2025
© 2025 Bentham Science Publishers | Privacy Policy