Effects of wearing facemasks on the sensation of exertional dyspnea and exercise capacity in healthy subjects

PLoS One. 2021 Sep 30;16(9):e0258104. doi: 10.1371/journal.pone.0258104. eCollection 2021.

Abstract

Due to the currently ongoing pandemic of coronavirus disease 2019 (COVID-19), it is strongly recommended to wear facemasks to minimize transmission risk. Wearing a facemask may have the potential to increase dyspnea and worsen cardiopulmonary parameters during exercise; however, research-based evidence is lacking. We investigated the hypothesis that wearing facemasks affects the sensation of dyspnea, pulse rate, and percutaneous arterial oxygen saturation during exercise. Healthy adults (15 men, 9 women) underwent a progressive treadmill test under 3 conditions in randomized order: wearing a surgical facemask, cloth facemask, or no facemask. Experiment was carried out once daily under each condition, for a total of 3 days. Each subject first sat on a chair for 30 minutes, then walked on a treadmill according to a Bruce protocol that was modified by us. The experiment was discontinued when the subject's pulse rate exceeded 174 beats/min. After discontinuation, the subject immediately sat on a chair and was allowed to rest for 10 minutes. Subjects were required to rate their levels of dyspnea perception on a numerical scale. Pulse rate and percutaneous arterial oxygen saturation were continuously monitored with a pulse oximeter. These parameters were recorded in each trial every 3 minutes after the start of the exercise; the point of discontinuation; and 5 and 10 minutes after discontinuation. The following findings were obtained. Wearing a facemask does not worsen dyspnea during light to moderate exercise but worsens dyspnea during vigorous exercise. Wearing a cloth facemask increases dyspnea more than wearing a surgical facemask during exercise and increases pulse rate during vigorous exercise, but it does not increase pulse rate during less vigorous exercise. Wearing a surgical facemask does not increase pulse rate at any load level. Lastly, wearing a facemask does not affect percutaneous arterial oxygen saturation during exercise at any load level regardless of facemask type.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • COVID-19 / prevention & control*
  • Dyspnea / etiology*
  • Exercise
  • Exercise Test
  • Exercise Tolerance*
  • Female
  • Healthy Volunteers
  • Heart Rate*
  • Humans
  • Male
  • Masks* / adverse effects
  • Young Adult

Grants and funding

This work was supported by JSPS KAKENHI (Grant Numbers: 18K17783, 20K19474) and by the Japanese Physical Therapy Association (JPTA2019 and JPTA2020). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.