Use of cloth face masks may reduce exercise performance because of discomfort

by Nicholas Ng Fat Hing, Avneesh Bhangu

Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. Use of a cloth face masks reduced exercise time by 14% and maximal oxygen consumption by 29% compared to no face mask in the same subjects during a maximal treadmill test.

2. Reduction in exercise performance was attributed to perceived discomfort with mask wearing, as majority of the sample agreed that it was harder to give maximum effort during exercise while wearing a cloth face mask.

Evidence Rating Level: 1 (Excellent)

Surgical face masks have become the most common type of mask used by the public ever since the release of current recommendations regarding mask wearing by the US Centers for Disease Control and Prevention. It would be useful to determine if masks significantly affect key variables during exercise performance as well as document the participant’s experiences while wearing a face mask during exercise.

This prospective, randomized crossover trial included 31 adult participants between 18-29 years of age. Participants were only included if they had no contraindications to maximal treadmill exercise testing. Participants performed an exhaustive incremental cardiopulmonary exercise test using a Bruce treadmill protocol in a masked and unmasked condition. The primary outcome was to determine if there were significant differences in measured physiological variables (e.g., oxygen consumption) in the masked vs. unmasked condition.

Results demonstrated that during the masked trial, there was a significant reduction in exercise time (by 14%) and oxygen consumption (by 29%) compared to the unmasked trial in the same participants. Furthermore, the majority of the sample either “agreed” or “strongly agreed” that it was harder to exert a maximal effort during the trial in which they were wearing a cloth mask. This study’s main strength was it’s adequate power, which was achieved through prior sample size calculations. The main limitation was the study’s recruitment of young, apparently healthy, physical active adults which may not be broadly applied to other patient populations. Nonetheless, this study was significant in suggesting that wearing a mask may reduce exercise performance in young healthy adults due to mask-wearing discomfort.

©2021 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.