Effects of mask use during exercise on exercise capacity and related factors

The aim of this study is to determine the effects of surgical mask use on cardiorespiratory parameters and hemodynamic responses during maximal exercise in healthy adults, and the outcomes of age and gender on mask use and exercise capacity. A total of 44 healthy participants, 23 female, and 21 male, were included (mean age: 36,25 ± 12,31 years). For each participant, maximal exercise tests were performed twice, with and without a mask, using the Bruce protocol. The hemodynamic responses (blood pressure, heart rate, and SpO2) and Modified Borg Scale (MBS) of the participants were recorded before and after the exercise tests. Cardiorespiratory parameters (peak oxygen consumption-VO2peak, minute ventilation-VE, metabolic equivalent-MET) were measured with a gas analyzer. Mask use was found to increase Systolic Blood Pressure (p= 0,012) and MBS (p= 0,040). With the mask, test time, MET, VO2peak, respiratory frequency, and EE were found to decrease in maximal exercise (p<0,05), but no difference was found at the anaerobic threshold (p>0,05). Test duration, respiratory frequency, and HRpeak decreased in males (p<0,05), and no difference was found between masked and unmasked tests for the same values in females (p >0,05). The decrease in masked exercise test duration was more for the 45-65 age group (p<0,05). The use of surgical masks due to increased respiratory workload during maximal exercise adversely affects cardiorespiratory parameters and decreases exercise performance in healthy individuals, although it does not make a significant difference at the anaerobic threshold. Male gender and advanced age have a more significant negative effect on exercise performance in terms of mask use during maximal exercise. These important results should be taken into account, especially for maximal intensity exercise prescribing in individuals with advanced age and chronic respiratory disease who are at risk of transmission and need mask use.