Influence of an Exercise-Specific Face Mask on Physiological, Respiratory, and Perceptual Responses to Graded Exercise in Aerobically Fit Individuals
Creators: Comeau, Aidan K
Publisher: name: University of Alberta Library
Year: 2023

<p>Introduction: Research indicates that there are no health risks associated with face mask use during exercise in healthy individuals. However, the impact of a face mask on physiological, perceptual, and performance responses to exercise of all intensities remains equivocal. Evidence suggests mask use during exercise elevates perception of effort with marginal impact on physiological responses, where the influence on performance remains contested. Furthermore, there is limited research on the perceptual, respiratory, and physiological responses to different exercise intensities with masks that have been marketed for “exercise use” (exercise specific face mask - ESFM). There is also evidence to suggest a respiratory protective benefit to wearing a face covering during exercise in those with exercise-induced bronchoconstriction (EIB). Thus, the overall suitability of ESFM use in athletes and other aerobically fit individuals remains unclear.<br>
Objective: To determine the physiological, respiratory, perceptual, and performance effects of an ESFM during submaximal and maximal-intensity exercise in aerobically fit individuals. It was hypothesized that ESFM use would elevate perceptual burden in the absence of physiological changes, impairing exercise performance. Furthermore, it was hypothesized that ESFM use would help to preserve respiratory function in individuals with EIB.<br>
Methods: Twenty-four individuals (11 females) underwent a discontinuous graded exercise test on a treadmill on two separate occasions. These two trials (ESFM and unmasked) were completed in a randomized order at least 72 hours apart. Physiological measures, perceptual measures, and respiratory function were assessed throughout the test, which was performed in ambient indoor conditions (19-20°C, 2-8 mg H2O/L). Heart rate, respiratory rate, blood oxygen saturation (SpO2), dyspnea, rating of perceived exertion (RPE), and respiratory function were measured at the end of each stage and at termination. Performance was assessed by time to exhaustion and based on the last stage of the protocol completed. Linear mixed modeling was used to identify significant differences across 4 submaximal intensities for physiological and perceptual measures. Submaximal spirometry measures were analyzed via repeated measures analysis of variance. Pairwise comparisons were used to analyze responses associated with maximal-intensity exercise. An alpha value of 0.05 was used to indicate significant differences.<br>
Results: Performance was significantly impaired when an ESFM was worn (median= -150.5 s). SpO2 was significantly decreased in the masked condition for both submaximal and maximal intensity (-3.7%) exercise, with no significant differences observed in respiratory rate or heart rate. Perceptions of both air hunger and work of breathing were elevated across both submaximal and maximal exercise intensities. RPE and breathing discomfort were significantly elevated submaximally but not at termination, with no differences in chest tightness, throat tightness, or leg discomfort at any exercise intensity. Spirometry measures were not significantly different at exercise termination, but in the ESFM condition, several measures of respiratory function were significantly elevated submaximally.<br>
Conclusion: Use of an ESFM in fit individuals imposes a perceptual burden via increased perceptual discomfort, which was observed in several measures during both submaximal and maximal exercise intensities. In combination with heightened arterial desaturation in the ESFM condition, exercise performance was also impaired. The combination of these physiological and perceptual changes likely contributed to the observed performance impairment. However, the sizable improvements in respiratory function particularly in spirometry measures sensitive to changes in peripheral airway caliber would indicate that ESFMs are a ‘double-edged sword’, promoting bronchodilation at the cost of elevated perceptual sensations and arterial desaturation in both individuals with and without EIB.</p>