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

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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
Sports Medicine ( IF 9.3 ) Pub Date : 2022-08-24 , DOI: 10.1007/s40279-022-01746-4
Chen Zheng ₁ , Eric Tsz-Chun Poon _{1,

2} , Kewen Wan ₁ , Zihan Dai ₁ , Stephen Heung-Sang Wong ₁

Affiliation

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).

中文翻译：

运动时戴口罩对健康个体生理和心理结果的影响：系统评价和荟萃分析

背景

在公共场所佩戴口罩是预防病毒传播的有效策略；然而，它可能会对运动反应产生负面影响。因此，本综述旨在探讨运动时佩戴不同类型口罩对健康个体各种生理和心理结果的影响。

方法

使用相关电子数据库进行文献检索，包括 Medline、PubMed、Embase、SPORTDiscus、Web of Science 和 Cochrane Central Register of Controlled Trials 于 2022 年 4 月 5 日进行的研究。研究检验了佩戴口罩（外科口罩、布口罩、包括运动期间对表面健康个体的各种生理和心理参数的影响。对于荟萃分析，使用随机效应模型。计算具有 95% 置信区间 (CI) 的平均差 (MD) 或标准化 MD (SMD)，以分析总效果以及根据面罩和运动类型分类的亚组效果。使用修订后的 Cochrane 偏倚风险工具检查纳入研究的质量。

结果

系统评价纳入了 45 项研究，涉及 1264 名参与者（708 名男性）。运动时佩戴口罩对气体交换有显着影响；这包括摄氧量的差异（SMD − 0.66，95% CI − 0.87 至 − 0.45）、潮气末氧分压（MD − 3.79 mmHg，95% CI − 5.46 至 − 2.12）、二氧化碳产生量（SMD − 0.77，95% CI - 1.15 至 - 0.39），呼气末二氧化碳分压（MD 2.93 mmHg，95% CI 2.01–3.86）。虽然氧饱和度（MD − 0.48%，95% CI − 0.71 至 − 0.26）略有下降，但心率并未受到影响。戴口罩会导致对劳累、呼吸困难、疲劳和热感的感知程度更高。此外，在佩戴 FFP2/N95 呼吸器的个体中观察到对运动表现的影响较小（SMD - 0.42，95% CI - 0.76 至 - 0.08）和总效果（SMD - 0.23，95% CI - 0.41 至 - 0.04）。