March 22 2022

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CHICAGO -The review included studies that looked at performance and safety of participants who wear COVID-19 masks for face training, researchers concluded that this exercise was safe and did not alter or cause any significant physiological changes in athletes.

In the American Academy of Orthopaedic Surgeons Annual Meeting, Cordelia W. Carter, MD, FAAOS, FAOA, associate professor of orthopedic surgery at the NYU School of Medicine, and colleagues presented their work regarding the safety of wearing a wearing a mask during exercise and the ways the mask wear can affect performance.

Carter stated to Healio “What we’re able to say following this thorough review is that it’s safe to train in masks, and that’s most of people, with no reduction in fitness or any major physiologic changes.”



Cordelia W. Carter

Of the 56 full-text articles found in an examination in the MEDLINE, Embase, Cochrane CENTRAL and CINAHL databases in February 2021, researchers discovered 22 research studies that dealt with physical and exercise with an oronasal face mask.

In these research, two co-authors independently obtained data related to physiological parameters like heart rate, respiratory speed, saturation of oxygen, and ratings of perceived exertion during physical activities with the mask.

Based on the study’s background, researchers discovered that in healthy volunteers, using surgical masks for training had no effect on the physiological parameters.

A number of the studies found the same parameters regardless of whether exercising with or without masks as per Carter.

The nk mask is a major conclusion from the study in addition,” she said. “The application of the N95 mask one of the most effective mask, however, it also is most likely to be the most restrictive, is the one that when we exercise at a high level of performance, we start to notice a decrease in terms of maximum power and output, in addition to tiny, but significant, changes in cardiovascular parameters such as respiratory rate and heart rate” she added.

The study data revealed that two studies that looked at N95 masks in healthy adults population, showed minor, but statistically significant changes in physiologic measures. This indicates a decrease in performance in athletics, for example, respiration rate and maximum power output when the athletes were working at their the maximum level of effort.

Carter warned that the data can only be applied to the recreational athlete, not to elite athletes. “Then you must make distinctions between competition and training also, and there aren’t any studies on this conducted during competition.”

One of the weaknesses of these findings, she noted was the heterogeneity of the studies studied that included a variety of types of people, including pregnant women and children. In addition, some studies were conducted in a lab for exercise physiology.

“Nine from the studies didn’t include females in any way. Of the 853 subjects across all studies only 184 were females,” Carter said.

The future research in this field will require higher-quality studies that include various study subjects, Carter said. “I believe we need to create new apriori questions” which focus on perception levels of exertion, the performance of athletes when wearing a mask, and in various situations and sports. These encompass endurance-based sports as well as high-intensity short-bursts of activity and various other sports activities according to her.

In a summary of the findings, Carter stated, “Performance, certainly for recreation athletes, is not diminished, with the caution that when using of N95 and working to exhaustion, there have been evidenced decreases in max output and power.”



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