Data show recreational exercise when wearing a face mask is safe, with some caveats
CHICAGO — In a review of studies that examined performance and safety when participants wore COVID-19 face masks during exercise, researchers found such exercise safe and did not affect or cause significant physiologic changes in athletes.
At the American Academy of Orthopaedic Surgeons Annual Meeting, Cordelia W. Carter, MD, FAAOS, FAOA, associate professor of orthopedic surgery at NYU School of Medicine, and colleagues presented their research into the safety of mask wear during exercise and the ways, if any, that mask wear affects performance.
Carter told Healio, “What we’re comfortable saying after this comprehensive review is it’s safe to exercise in a mask and that is, for the vast majority of the population, without decrement or significant physiologic changes.”
Of 56 full-text articles identified during a search of MEDLINE, Embase, Cochrane CENTRAL and CINAHL databases conducted in February 2021, researchers identified 22 studies related to exercise and physical activity performed wearing an oronasal mask.
From those studies, two co-authors independently extracted data related to physiologic parameters measures, such as respiratory rate, heart rate, oxygen saturation and rating of perceived exertion, when participants performed physical activity wearing a mask.
According to study background, researchers found that among healthy volunteers, use of surgical masks during exercise had no significant effect on these physiological parameters.
Many of the studies demonstrated no difference in parameters when exercise was performed with or without a mask, according to Carter.
nk that is a main takeaway from the study, as well,” she said. “The use of an N95 [mask], which is the most protective mask but also the one that is probably most restrictive, is the one in which, at very high-level exercise performance, we do start to see some decrement in terms of maximal power and maximal output, as well as small, but real, changes in cardiovascular parameters, like respiratory rate and heart rate,” she said.
Study data showed two of the studies that investigated N95 masks in a healthy adult population reported modest, yet statistically significant, changes in physiologic measurements. This was indicative of decreased athletic performance, such as respiratory rate and maximum power output, when participants were exercising at maximum effort.
Carter cautioned that these data are to be applied to recreational athletes and not elite athletes. “Then, you have to draw distinctions between training and competition, as well, and there are no studies of this done in competition.”
A weakness of these findings, she said, concerns the heterogeneity in the studies surveyed, which included various populations, such as children and pregnant women. Furthermore, some of the studies were performed in an exercise physiology lab.
“Nine of the 22 studies did not include any females at all. Of 853 total subjects included across all the studies included, only 184 of them were women,” Carter said.
Future research in this area should include higher-quality studies with diverse study populations, Carter said. “I think we want to craft new a priori questions” that focus on perceived exertion rating, sports performance wearing a mask in a variety of sports and settings, and include endurance sports, high-intensity short-burst activities and other specific sport activities, she said.
Summarizing the findings, Carter said, “Performance, certainly for recreational athletes, is not impaired, with the caveat being that with use of an N95 and exercising to exhaustion, there are demonstrated decreases in maximum output and maximum power.”
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Lott A, et al. Poster 0731. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 22-26, 2022; Chicago.
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