Effects of wearing facemasks on the sensation of exertional dyspnea and exercise capacity in healthy subjects

• Published in: PloS one Vol. 16; no. 9; p. e0258104
• Main Authors: Fukushi, Isato, Nakamura, Masatoshi, Kuwana, Shun-ichi
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 30.09.2021; Public Library of Science (PLoS)
• Subjects: Biology and Life Sciences; Cloth; Control; Coronaviruses; COVID-19; Disease transmission; Dyspnea; Engineering and Technology; Epidemics; Fitness equipment; Health sciences; Hospitals; Load distribution; Masks; Medicine and Health Sciences; Men; Oxygen; Oxygen content; Pandemics; Parameters; Physical Sciences; Pulse rate; Respiration; Risk factors; Saturation; Severe acute respiratory syndrome coronavirus 2; Shortness of breath; Social Sciences; Treadmills; Values; Variance analysis; Viral diseases; Walking; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0258104

Due to the currently ongoing pandemic of coronavirus disease 2019 (COVID-19), it is strongly recommended to wear facemasks to minimize transmission risk. Wearing a facemask may have the potential to increase dyspnea and worsen cardiopulmonary parameters during exercise; however, research-based evidence is lacking. We investigated the hypothesis that wearing facemasks affects the sensation of dyspnea, pulse rate, and percutaneous arterial oxygen saturation during exercise. Healthy adults (15 men, 9 women) underwent a progressive treadmill test under 3 conditions in randomized order: wearing a surgical facemask, cloth facemask, or no facemask. Experiment was carried out once daily under each condition, for a total of 3 days. Each subject first sat on a chair for 30 minutes, then walked on a treadmill according to a Bruce protocol that was modified by us. The experiment was discontinued when the subject’s pulse rate exceeded 174 beats/min. After discontinuation, the subject immediately sat on a chair and was allowed to rest for 10 minutes. Subjects were required to rate their levels of dyspnea perception on a numerical scale. Pulse rate and percutaneous arterial oxygen saturation were continuously monitored with a pulse oximeter. These parameters were recorded in each trial every 3 minutes after the start of the exercise; the point of discontinuation; and 5 and 10 minutes after discontinuation. The following findings were obtained. Wearing a facemask does not worsen dyspnea during light to moderate exercise but worsens dyspnea during vigorous exercise. Wearing a cloth facemask increases dyspnea more than wearing a surgical facemask during exercise and increases pulse rate during vigorous exercise, but it does not increase pulse rate during less vigorous exercise. Wearing a surgical facemask does not increase pulse rate at any load level. Lastly, wearing a facemask does not affect percutaneous arterial oxygen saturation during exercise at any load level regardless of facemask type.