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- Title
Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis.
- Authors
Zheng, Chen; Poon, Eric Tsz-Chun; Wan, Kewen; Dai, Zihan; Wong, Stephen Heung-Sang
- Abstract
Background: Wearing face masks in public is an effective strategy for preventing the spread of viruses; however, it may negatively affect exercise responses. Therefore, this review aimed to explore the effects of wearing different types of face masks during exercise on various physiological and psychological outcomes in healthy individuals. Methods: A literature search was conducted using relevant electronic databases, including Medline, PubMed, Embase, SPORTDiscus, Web of Science, and Cochrane Central Register of Controlled Trials on April 05, 2022. Studies examining the effect of mask wearing (surgical mask, cloth mask, and FFP2/N95 respirator) during exercise on various physiological and psychological parameters in apparently healthy individuals were included. For meta-analysis, a random effects model was used. Mean difference (MD) or standardized MD (SMD) with 95% confidence intervals (CI) were calculated to analyze the total effect and the effect in subgroups classified based on face mask and exercise types. The quality of included studies was examined using the revised Cochrane risk-of-bias tool. Results: Forty-five studies with 1264 participants (708 men) were included in the systematic review. Face masks had significant effects on gas exchange when worn during exercise; this included differences in oxygen uptake (SMD − 0.66, 95% CI − 0.87 to − 0.45), end-tidal partial pressure of oxygen (MD − 3.79 mmHg, 95% CI − 5.46 to − 2.12), carbon dioxide production (SMD − 0.77, 95% CI − 1.15 to − 0.39), and end-tidal partial pressure of carbon dioxide (MD 2.93 mmHg, 95% CI 2.01–3.86). While oxygen saturation (MD − 0.48%, 95% CI − 0.71 to − 0.26) decreased slightly, heart rate was not affected. Mask wearing led to higher degrees of rating of perceived exertion, dyspnea, fatigue, and thermal sensation. Moreover, a small effect on exercise performance was observed in individuals wearing FFP2/N95 respirators (SMD − 0.42, 95% CI − 0.76 to − 0.08) and total effect (SMD − 0.23, 95% CI − 0.41 to − 0.04). Conclusion: Wearing face masks during exercise modestly affected both physiological and psychological parameters, including gas exchange, pulmonary function, and subjective discomfort in healthy individuals, although the overall effect on exercise performance appeared to be small. This review provides updated information on optimizing exercise recommendations for the public during the COVID-19 pandemic. Systematic Review Registration Number: This study was registered in the International Prospective Register of Systematic Review (PROSPERO) database (registration number: CRD42021287278).
- Subjects
MEDICAL masks; ONLINE information services; MEDICAL databases; META-analysis; MEDICAL information storage &; retrieval systems; CONFIDENCE intervals; SYSTEMATIC reviews; OXYGEN consumption; EXERCISE physiology; SPORTS; OXYGEN saturation; HEALTH status indicators; RESPIRATORY measurements; DYSPNEA; HEALTH behavior; DESCRIPTIVE statistics; CARBON dioxide; HEART beat; LACTATES; RESPIRATORY organ physiology; PSYCHOPHYSIOLOGY; MEDLINE; INFORMATION storage &; retrieval systems; STATISTICAL models; FATIGUE (Physiology); DATA analysis software; N95 respirators; PULMONARY gas exchange
- Publication
Sports Medicine, 2023, Vol 53, Issue 1, p125
- ISSN
0112-1642
- Publication type
Article
- DOI
10.1007/s40279-022-01746-4