Open AccessThe impact of face masks on performance and physiological outcomes during exercise: a systematic review and meta-analysis
Author(s) -
Keely A. Shaw,
Gordon A. Zello,
Scotty Butcher,
Jong Bum Ko,
L Bertrand,
Philip D. Chilibeck
Publication year - 2021
Publication title -
applied physiology, nutrition and metabolism/applied physiology, nutrition, and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 89
eISSN - 1715-5320
pISSN - 1715-5312
DOI - 10.1139/apnm-2021-0143
Subject(s) - face masks , medicine , meta analysis , heart rate , confidence interval , subgroup analysis , strictly standardized mean difference , perceived exertion , physical therapy , covid-19 , blood pressure , disease , infectious disease (medical specialty)
Face masks are promoted for preventing spread of viruses; however, wearing a mask during exercise might increase CO 2 rebreathing, decrease arterial oxygenation, and decrease exercise performance. A systematic review and meta-analysis was conducted on the impact of wearing a mask during exercise. Data sources included SPORTDiscus, PubMed, and Medline. Eligibility criteria included all study designs comparing surgical, N95, or cloth masks to a no mask condition during any type of exercise where exercise performance and/or physiological parameters were evaluated. Healthy and clinical participants were included. Mean differences (MD) or standardized mean differences (SMD) with 95% confidence intervals were calculated and pooled effects assessed. Twenty-two studies involving 1573 participants (620 females, 953 males) were included. Surgical, or N95 masks did not impact exercise performance (SMD −0.05 [−0.16, 0.07] and −0.16 [−0.54, 0.22], respectively) but increased ratings of perceived exertion (SMD 0.33 [0.09, 0.58] and 0.61 [0.23, 0.99]) and dyspnea (SMD 0.6 [0.3, 0.9] for all masks). End-tidal CO 2 (MD 3.3 [1.0, 5.6] and 3.7 [3.0, 4.4] mm Hg), and heart rate (MD 2 [0,4] beats/min with N95 masks) slightly increased. Face masks can be worn during exercise with no influences on performance and minimal impacts on physiological variables. PROSPERO registration: CRD42020224988. Novelty: Face masks can be worn during exercise with no impacts on performance and minimal impacts on physiological variables.