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Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis

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 psyc...

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Autores principales: Zheng, Chen, Poon, Eric Tsz-Chun, Wan, Kewen, Dai, Zihan, Wong, Stephen Heung-Sang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9400006/
https://www.ncbi.nlm.nih.gov/pubmed/36001290
http://dx.doi.org/10.1007/s40279-022-01746-4
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author Zheng, Chen
Poon, Eric Tsz-Chun
Wan, Kewen
Dai, Zihan
Wong, Stephen Heung-Sang
author_facet Zheng, Chen
Poon, Eric Tsz-Chun
Wan, Kewen
Dai, Zihan
Wong, Stephen Heung-Sang
author_sort Zheng, Chen
collection PubMed
description 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). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40279-022-01746-4.
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spelling pubmed-94000062022-08-24 Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis Zheng, Chen Poon, Eric Tsz-Chun Wan, Kewen Dai, Zihan Wong, Stephen Heung-Sang Sports Med Systematic Review 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). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40279-022-01746-4. Springer International Publishing 2022-08-24 2023 /pmc/articles/PMC9400006/ /pubmed/36001290 http://dx.doi.org/10.1007/s40279-022-01746-4 Text en © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Systematic Review
Zheng, Chen
Poon, Eric Tsz-Chun
Wan, Kewen
Dai, Zihan
Wong, Stephen Heung-Sang
Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis
title Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis
title_full Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis
title_fullStr Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis
title_full_unstemmed Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis
title_short Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis
title_sort effects of wearing a mask during exercise on physiological and psychological outcomes in healthy individuals: a systematic review and meta-analysis
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9400006/
https://www.ncbi.nlm.nih.gov/pubmed/36001290
http://dx.doi.org/10.1007/s40279-022-01746-4
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