Cloth Face Covering Reduces Exercise Performance and Physical Capacity

Increasing shortness of breath and claustrophobia have been reported with higher exercise intensities.

A cloth face cover decreases exercise performance and physical capacity, reveals results of a small clinical trial published online in the British Journal of Sports Medicine.

Wearers also reported increasing shortness of breath and claustrophobia with higher exercise intensities, prompting the researchers to adjust the frequency, intensity, duration, and type of exercise done when wearing a cloth face mask.

Recommendations for wearing face masks while exercising vary globally, and the physiological impact of wearing cloth face masks while exercising is poorly understood, the researchers say.

Several studies have studied the impact of wearing surgical masks on cardiovascular and subjective responses to exercise. But these masks are not widely available for general use, and few studies have examined the impact of fabric face masks.

To close this knowledge gap, the researchers compared the sports performance of 31 healthy adults, ages 18 to 29, while running exhausted on a treadmill, once wearing a cloth face mask and once not.

Their blood pressure, heart rate, oxygen saturation, exercise, and shortness of breath were measured and recorded after a 3-minute warm-up, during the exercise test, and 7 minutes after they completed it (recovery period).

They were asked to rate their experiences wearing a face mask, including comfort, temperature, and breathability, immediately after they completed the masked test.

Participants usually did an average of 170 minutes / week of moderate and 206 minutes / week of heavy physical activity. None of them smoked cigarettes, although three said they smoked marijuana and five participants reported a history of medically controlled asthma.

Three out of four said they had worn a face mask during exercise before entering the study (n = 24; 77%) and 19 (61%) said their training facility required it.

Analysis of the recorded data showed that compared to not wearing a cloth face mask, wearing a face mask significantly reduced exercise time (14%) and physiological measurements of capacity, including maximum oxygen consumption (VO2 max; 29% reduction) and maximum heart rate, as well as increased shortness of breath.

These changes reflected exercise intensity attributed to the discomfort experienced with wearing a mask. They disappeared after the 7-minute recovery period when the results of the two tests were no longer different.

Compared to not wearing a cloth face mask, the participants reported becoming increasingly short of breath and claustrophobic with higher exercise intensities while wearing one. Most participants (30) agreed or strongly agreed that it was more difficult to make maximum effort during the trial while wearing a mask.

Answers included: ‘more difficult than last time’, ‘I got tired more quickly; no effect when walking, affected me when jogging ‘, especially at higher intensity’ running was more difficult than normal, breathing became more difficult as speed / incline increased, ‘felt hard to breathe, felt like I couldn’t take a deep breath’ and “had to breathe deeper to get the same amount of air.”

Participants also cited feeling ‘claustrophobic’, ‘suffocated’ and ‘anxious’ while wearing the mask and ‘shorter, more shallow breaths with the face covering.’ None of them reported that moisture or mask weight hindered their performance or forced them to stop the exercise test.

“Because our results do not fully explain how wearing a mask can directly limit cardiovascular function, our conclusion is that the discomfort associated with wearing a mask, as evidenced by the higher scores of dyspnoea in the mask condition and the qualitative feedback from the participants, directly on the reduction in performance, ”say the researchers.

“Our results have different implications for training and performance when wearing a cloth face mask,” they add.

“First, since wearing a cloth mask reduces exercise performance, VO2 peak and related variables, exercise variables of frequency, intensity, time and type of activity should be adjusted accordingly.

“Second, training goals can be modified to reflect the reduced performance and psychological impact of wearing a cloth mask, while still promoting safe goal achievement.”

Reference: “Effects of Wearing a Cloth Face Mask on Performance, Physiological, and Perceptual Responses During a Treadmill Test During a Running Exercise” April 14, 2021, British Journal of Sports of Medicine.
DOI: 10.1136 / bjsports-2020-103758