Introduction: Evidence on undesirable side effects of face masks worn during the COVID-19 pandemic is controversial. Materials and Methods: The present study, explores whether wearing a medical face mask (MedMask) affects physical working capacity (PWC) at the heart rate of 130 and 150 beats per minute in comparison to no mask, a filtering face piece mask with exhalation valve class 2 (FFP2exhal), and a cotton fibric mask (community mask). Secondary, physiological and subjective responses were analyzed such as a potential moderating role of subjects’ individual physical fitness level and gender on face mask effects. A submaximal bicycle ergometer protocol was applied in an intra-individual cross-over design using either no mask, a MedMask, FFP2exhal, or a community mask on four days in randomized order. PWC130 and PWC150 were measured as well as transcutaneous carbon dioxide partial pressure, oxygen saturation, breathing rate, blood pressure, perceived respiratory effort and perceived physical exhaustion. Results: Using the MedMask did not lead to a reduction in PWC and a systematic or relevant change in physiological response, neither was this the case when the FFP2exhal or community mask were worn. Perceived respiratory effort was up to one point higher on a zero to ten scale when using face masks p<0.05) compared to the no mask condition. No differences occured in general perceived exertion. Conclusion: These results provide reason to believe that physical performance and physiological responses when wearing face masks are similar to not wearing a face mask, although some more respiratory effort is required.
Effects of face masks on physical performance, physiological response and subjective respiratory effort during a submaximal bicycle ergometer test