Document Type : Research Paper
Authors
1 Ph.D. student in Exercise Physiology, University of Mazandaran, Babolsar, Iran
2 Professor, Department of Exercise Physiology, Physical Education Faculty, University of Mazandaran, Babolsar, Iran
3 Assistant Professor, Department of Exercise Physiology, Physical Education Faculty, University of Mazandaran, Babolsar, Iran
Abstract
The World Health Organization recommends wearing facemasks in public. Some have reported detrimental concern that these may affect the cardiovascular (CV) system during physical activity. The current study aims to evaluate the effect of two weeks of high- (HIIT) or moderate-intensity interval training (MIIT) with respiratory masks on women’s CV function. Thirty six healthy female volunteers were randomly divided into 6 groups (age; 25-45 years and BMI; 23 kg/m2) including: HIIT with N95 (HIIT-N95 mask), and surgical (HIIT-SUR mask) masks, MIIT with N95 (MIIT-N95 mask), and surgical (MIIT-SUR mask) masks, and HIIT (Nomask + HIIT) or MIIT (Nomask + MIIT) without masks groups. Three-weekly HIIT (2-4 bouts of 20-60 second intervals at 80–90% and or 60-70% of HRmax, interspersed by 4 min at 65% HRmax), MIIT (4 bouts of 4 min intervals at 55–75 HRmax, interspersed by 15-60 seconds between intervals) was performed for 2 weeks. Cardiovascular parameters were devalued by ECG and Oximeter pulse systems. A bout of the moderate and high intensity running on treadmill, while women wearing surgical and in particular, N95 face masks, causes significant transiently increase in HR, SBP, rate pressure product (RPP) and insignificant change in SPo2% at first and after two weeks of HIIT and MIIT, as compared to control group. Two weeks of HIIT led to greater improvement in exhaustion time and VO2max on treadmill and insignificant reduction in resting cardiovascular parameters, when compared to MIIT groups. In healthy women, wearing respiratory masks during exercise is safe, and associated with only temporary changes of cardiovascular parameters. Overall, performing two weeks of HIIT with respiratory masks improved performance, and wearing respiratory masks during exercise training was safe in healthy women and was associated with only transient changes in CV parameters.
Keywords
- Chen P, Mao L, Nassis GP, Harmer P, Ainsworth BE, Li F. Coronavirus disease (COVID-19): the need to maintain regular physical activity while taking precautions. Journal of Sport and Health Science. 2020;9(2):103.
- Epstein D, Korytny A, Isenberg Y, Marcusohn E, Zukermann R, Bishop B, et al. Return to training in the COVID‐19 era: the physiological effects of face masks during exercise. Scandinavian Journal of Medicine & Science in Sports. 2021;31(1):70-5.
- Cheng KK, Lam TH, Leung CC. Wearing face masks in the community during the COVID-19 pandemic: altruism and solidarity. The Lancet. 2020 Apr 16;S0140-6736(20)30918-1.
- Balducci P, Clémençon M, Morel B, Quiniou G, Saboul D, Hautier CA. Comparison of level and graded treadmill tests to evaluate endurance mountain runners. Journal of Sports Science & Medicine. 2016;15(2):239.
- Wong AY, Ling SK, Louie LH, Law GY, So RC, Lee DC, et al. Impact of the COVID-19 pandemic on sports and exercise. Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology. 2020;22:39-44.
- Kyung SY, Kim Y, Hwang H, Park JW, Jeong SH. Risks of N95 face mask use in subjects with COPD. Respiratory Care. 2020;65(5):658-64.
- Roberge RJ, Coca A, Williams WJ, Powell JB, Palmiero AJ. Physiological impact of the N95 filtering facepiece respirator on healthcare workers. Respiratory care. 2010;55(5):569- 77.
- Beder A, Büyükkoçak Ü, Sabuncuoğlu H, Keskil ZA, Keskil S. Preliminary report on surgical mask induced deoxygenation during major surgery. Neurocirugia. 2008;19(2):121-6.
- Molanouri Shamsi M, Amani Shalamzari S. Exercise training, immune system, and coronavirus. Sport Physiology. 2020;12(46):17-40. (in Persian).
- Lee S, Li G, Liu T, Tse G. COVID-19: Electrophysiological mechanisms underlying sudden cardiac death during exercise with facemasks. Medical Hypotheses. 2020;144:110177.
- Scheid JL, Lupien SP, Ford GS, West SL. Commentary: physiological and psychological impact of face mask usage during the COVID-19 pandemic. International Journal of Environmental Research and Public Health. 2020;17(18):6655.
- Tong PS, Kale AS, Ng K, Loke AP, Choolani MA, Lim CL, et al. Respiratory consequences of N95-type Mask usage in pregnant healthcare worker: a controlled clinical study. Antimicrobial Resistance & Infection Control. 2015;4(1):1-0.
- Luks AM, Swenson ER. Pulse oximetry for monitoring patients with COVID-19 at home. potential pitfalls and practical guidance. Annals of the American Thoracic Society. 2020;17(9):1040-6.
- Buekers J, Theunis J, De Boever P, Vaes AW, Koopman M, Janssen EV, et al. Wearable finger pulse oximetry for continuous oxygen saturation measurements during daily home routines of patients with chronic obstructive pulmonary disease (COPD) over one week: observational study. JMIR Mhealth and Uhealth. 2019;7(6):e12866.
- Menz V, Marterer N, Amin SB, Faulhaber M, Hansen AB, Lawley JS. Functional vs. Running low-volume high-intensity interval training: effects on vo2max and muscular endurance. Journal of Sports Science & Medicine. 2019;18(3):497.
- Machado AF, Miranda ML, Rica RL, Figueira A, Bocalini DS. Bodyweight high-intensity interval training: a systematic review. Revista Brasileira de Medicina do Esporte. 2018;24:234-7.
- Żebrowska A, Jastrzębski D, Sadowska-Krępa E, Sikora M, Di Giulio C. Comparison of the effectiveness of high-intensity interval training in hypoxia and normoxia in healthy male volunteers: a pilot study. Biomed Res Int. 2019;2019:7315714.
- Gibbons RJ Jr. A report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee to update the 1997 exercise testing guidelines). J Am Coll Cardiol. 2002;40:1531-40
- Bazgir B, Valojerdi MR, Rajabi H, Fathi R, Ojaghi SM, Meybodi MK, et al. Acute cardiovascular and hemodynamic responses to low intensity eccentric resistance exercise with blood flow restriction. Asian Journal of Sports Medicine. 2016 Sep 14;7(4):e38458 .
- O’Dowd K, Nair KM, Forouzandeh P, Mathew S, Grant J, Moran R, et al. Face masks and respirators in the fight against the COVID-19 pandemic: a review of current materials, advances and future perspectives. Materials. 2020;13(15):3363
- Zhang M, Emery AR, Tannyhill RJ, Zheng H, Wang J. Masks or N95 respirators during COVID-19 pandemic–which one should I wear? Journal of Oral and Maxillofacial Surgery. 2020;78(12):2114-27.
- Feoli AM, Macagnan FE, Piovesan CH, Bodanese LC, Siqueira IR. Xanthine oxidase activity is associated with risk factors for cardiovascular disease and inflammatory and oxidative status markers in metabolic syndrome: effects of a single exercise session. Oxid Med Cell Longev. 2014;2014:587083.
- Chandrasekaran B, Fernandes S. Exercise with facemask; Are we handling a devil’s sword?–a physiological hypothesis. Medical Hypotheses. 2020;144:110002.
- Melnikov VN, Divert VE, Komlyagina TG, Consedine NS, Krivoschekov SG. Baseline values of cardiovascular and respiratory parameters predict response to acute hypoxia in young healthy men. Physiological Research. 2017 Jul 18;66(3):467-479.
- Bertrand L, Shaw KA, Ko J, Deprez D, Chilibeck PD, Zello GA. The impact of the coronavirus disease 2019 (COVID-19) pandemic on university students’ dietary intake, physical activity, and sedentary behaviour. Applied Physiology, Nutrition, and Metabolism. 2021;46(3):265-72.
- Nugraha AD, Yudanto Y, Bahri S. The impact of using surgical masks and non-masks when exercising on heart rate, calories and VO2max during the Covid-19 pandemic. Jurnal SPORTIF: Jurnal Penelitian Pembelajaran. 2021;7(1):84-92.
- MoraGonzalez J, Esteban-Cornejo I, Cadenas-Sanchez C, Migueles JH, Rodriguez-Ayllon M, Molina-García P, et al. Fitness, physical activity, working memory, and neuroelectric activity in children with overweight/obesity. Scandinavian Journal of Medicine & Science in Sports. 2019;29(9):1352-63.
- Shein SL, Whitticar S, Mascho KK, Pace E, Speicher R, Deakins K. The effects of wearing facemasks on oxygenation and ventilation at rest and during physical activity. PloS One. 2021;16(2):e0247414.
- Lässing J, Falz R, Pökel C, Fikenzer S, Laufs U, Schulze A, et al. Effects of surgical face masks on cardiopulmonary parameters during steady state exercise. Scientific Reports. 2020 Dec 21;10(1):22363.
- Ramos-Campo DJ, Pérez-Piñero S, Muñoz-Carrillo JC, López-Román FJ, García-Sánchez E, Ávila-Gandía V. Acute effects of surgical and FFP2 face masks on physiological responses and strength performance in persons with sarcopenia. Biology. 2021 Mar 11;10(3):213.
- Islam MS, Rahman MH, De A. Exercising with face mask during the pandemic: a qualitative analysis. Saudi Journal of Sports Medicine. 2020;20(3):59.
- Doherty C, Mann L, Angus SA, Chan J, Molgat-Seon Y, Dominelli PB. Impact of wearing a surgical and cloth mask during cycle exercise. Applied Physiology, Nutrition, and Metabolism. 2021 Jul;46(7):753-762 .
- Harms CA, Wetter TJ, McClaran SR, Pegelow DF, Nickele GA, Nelson WB, et al. Effects of respiratory muscle work on cardiac output and its distribution during maximal exercise. Journal of Applied Physiology. 1998;85(2):609-18.
- Cheyne WS, Harper MI, Gelinas JC, Sasso JP, Eves ND. Mechanical cardiopulmonary interactions during exercise in health and disease. Journal of Applied Physiology. 2020 May 1;128(5):1271-9.
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