A Cloth Facemask Causes No Major Respiratory or Cardiovascular Perturbations During Moderate to Heavy Exercise

  1. Natália Mendes Guardieiro
  2. Gabriel Barreto
  3. Felipe Miguel Marticorena
  4. Tamires Nunes Oliveira
  5. Luana Farias de Oliveira
  6. Ana Lucia de Sá Pinto
  7. Danilo Marcelo Leite do Prado
  8. Bryan Saunders
  9. Bruno Gualano

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Abstract

Purpose : Investigate whether a cloth facemask could affect physiological and perceptual responses to exercise at distinct exercise intensities in untrained individuals. Methods : Healthy participants (n = 35; 17 men, age 30 [4] y, and 18 women, age 28 [5] y) underwent a progressive square wave test at 4 intensities: (1) 80% of ventilatory anaerobic threshold; (2) ventilatory anaerobic threshold; (3) respiratory compensation point; and (4) exercise peak (Peak) to exhaustion, 5-minute stages, with or without a triple-layered cloth facemask (Mask or No-Mask). Several physiological and perceptual measures were analyzed. Results : Mask reduced inspiratory capacity at all exercise intensities ( P  < .0001). Mask reduced respiratory frequency ( P  = .001) at Peak (−8.3 breaths·min −1 ; 95% confidence interval [CI], −5.8 to −10.8), respiratory compensation point (−6.9 breaths·min −1 ; 95% CI, −4.6 to −9.2), and ventilatory anaerobic threshold (−6.5 breaths·min −1 ; 95% CI, −4.1 to −8.8), but not at Baseline or 80% of ventilatory anaerobic threshold. Mask reduced tidal volume ( P  < .0001) only at respiratory compensation point (−0.5 L; 95% CI, −0.3 to −0.6) and Peak (−0.8 L; 95% CI, −0.6 to −0.9). Shallow breathing index was increased with Mask only at Peak (11.3; 95% CI, 7.5 to 15.1). Mask did not change HR, lactate, ratings of perceived exertion, blood pressure, or oxygen saturation. Conclusions : A cloth facemask reduced time to exhaustion but had no major impact on cardiorespiratory parameters and had a slight but clinically meaningless impact on respiratory variables at higher intensities. Moderate to heavy activity is safe and tolerable for healthy individuals while wearing a cloth facemask. ClinicalTrials.gov: NCT04887714.

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  1. Version published to 10.1123/jpah.2022-0145
  2. Version published to 10.1101/2021.12.14.21267800v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.12.14.21267800: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethics statement: The protocol was approved by the institutional ethics committee.
    Consent: Written informed consent was obtained before participants’ enrollment.
    Sex as a biological variableStudy design and setting: This was crossover study (clinicaltrials.gov: NCT04887714) performed at an intrahospital, exercise physiology laboratory in São Paulo, Brazil. Participants: Men and women not engaged in competitive sports (e.g., non-trained) were eligible for this study.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All analyses were performed with the RStudio software (Rstudio 1.4.11003, PBC, Boston, MA)
    RStudio
    suggested: (RStudio, RRID:SCR_000432)
    Mixed models were analyzed using the lmer function of the lmerTest package.
    lmerTest
    suggested: (R package: lmerTest, RRID:SCR_015656)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are several strengths and limitations with the current study. Although the measurement of respiratory variables during the PSWT provided novel information regarding the respiratory response during different intensities, this meant that participants were required to wear a facemask for breath-by-breath measures over the cloth facemask. This may have increased the discomfort felt by the participants and may also have led to some inaccuracies in measurements due to air escaping. We ensured that the masks were fitted as comfortably and tightly as possible to avoid these issues as best as possible, but it cannot be ruled out that this contributed somewhat to the current results. The current data cannot be directly extrapolated to trained individuals; however, we felt it important to investigate this matter among a non-trained population, as there has been an intense debate on the physiological repercussions and potential adverse effects of face masks in recreationally trained individuals. Since sufficient levels of physical activity prevent morbidities and mortality [29-31] and improve vaccine immunogenicity [32], it is important that mask mandates do not lead to a reduction in physical activity. In this regard, the present data provide relevant information that wearing a cloth facemask may have some impact at severe to extreme exercise intensities, but it will not have a negative impact during exercise at moderate-to-heavy intensities, which are associated with a plethora o...

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04887714Not yet recruitingPhysiological Impact of Cloth Mask During Exercise

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2021.12.14.21267800v1 on medRxiv