{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:24:32Z","timestamp":1787027072383,"version":"build-2736575974"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,9,10]],"date-time":"2021-09-10T00:00:00Z","timestamp":1631232000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"\n Objective:<\/jats:bold>\n Mask plays an important role in preventing infectious respiratory diseases. The influence of wearing masks in physical exercise on the human body needs to be studied. The purpose of this study is to explore the influence of wearing surgical masks on the cardiopulmonary function of healthy people during exercise.\n <\/jats:p>\n \n Methods:<\/jats:bold>\n The physiological responses of 71 healthy subjects (35 men and 36 women, age 27.77 \u00b1 7.76 years) to exercises with and without surgical masks (mask-on and mask-off) were analyzed. Cardiopulmonary function and metabolic reaction were measured by the cardiopulmonary exercise test (CPET). All tests were carried out in random sequence and should be completed in 1 week.\n <\/jats:p>\n \n Results:<\/jats:bold>\n The CPETs with the mask-on condition were performed undesirably (\n p<\/jats:italic>\n &lt; 0.05), and the Borg scale was higher than the mask-off (\n p<\/jats:italic>\n &lt; 0.001). Rest oxygen uptake (\n \n \n \n \n V<\/mml:mtext>\n .<\/mml:mo>\n <\/mml:mover>\n \n O<\/mml:mtext>\n 2<\/mml:mn>\n <\/mml:msub>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n ) and carbon dioxide production (\n \n \n \n V<\/mml:mtext>\n .<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n CO\n 2<\/jats:sub>\n ) with the mask-on condition were lower than mask-off (\n p<\/jats:italic>\n &lt; 0.01), which were more obvious at peak exercise (\n \n \n \n V<\/mml:mtext>\n .<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n O\n 2<\/jats:sub>\n \n peak<\/jats:italic>\n <\/jats:sub>\n : 1454.8 \u00b1 418.9 vs. 1628.6 \u00b1 447.2 ml\/min,\n p<\/jats:italic>\n &lt; 0.001;\n \n \n \n V<\/mml:mtext>\n .<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n CO\n 2<\/jats:sub>\n \n peak<\/jats:italic>\n <\/jats:sub>\n : 1873.0 \u00b1 578.7 vs. 2169.9 \u00b1 627.8 ml\/min,\n p<\/jats:italic>\n = 0.005), and the anaerobic threshold (AT) brought forward (\n p<\/jats:italic>\n &lt; 0.001). At different stages of CPET with the mask-on condition, inspiratory and expiratory time (Te) was longer (\n p<\/jats:italic>\n &lt; 0.05), and respiratory frequency (Rf) and minute ventilation (\n \n \n \n V<\/mml:mtext>\n .<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n \n E<\/jats:italic>\n <\/jats:sub>\n ) were shorter than mask-off, especially at peak exercise (Rf\n \n peak<\/jats:italic>\n <\/jats:sub>\n : 33.8 \u00b1 7.98 vs. 37.91 \u00b1 6.72 b\/min,\n p<\/jats:italic>\n &lt; 0.001;\n \n \n \n V<\/mml:mtext>\n .<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n \n Epeak<\/jats:italic>\n <\/jats:sub>\n : 55.07 \u00b1 17.28 vs. 66.46 \u00b1 17.93 l\/min,\n p<\/jats:italic>\n &lt; 0.001).\n V<\/jats:italic>\n \n T<\/jats:italic>\n <\/jats:sub>\n was significantly lower than mask-off just at peak exercise (1.66 \u00b1 0.45 vs. 1.79 \u00b1 0.5 l,\n p<\/jats:italic>\n &lt; 0.001). End-tidal oxygen partial pressure (PetO\n 2<\/jats:sub>\n ), end-tidal carbon dioxide partial pressure (PetCO\n 2<\/jats:sub>\n ), oxygen ventilation equivalent (\n \n \n \n V<\/mml:mtext>\n .<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n \n E<\/jats:italic>\n <\/jats:sub>\n \/\n \n \n \n V<\/mml:mtext>\n .<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n O\n 2<\/jats:sub>\n ), and carbon dioxide ventilation equivalent (\n \n \n \n V<\/mml:mtext>\n .<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n \n E<\/jats:italic>\n <\/jats:sub>\n \/\n \n \n \n V<\/mml:mtext>\n .<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n CO\n 2<\/jats:sub>\n ) with mask-on, which reflected pulmonary ventilation efficiency, were significantly different from mask-off at different stages of CPET (\n p<\/jats:italic>\n &lt; 0.05), but no significant difference in percutaneous oxygen saturation (SpO\n 2<\/jats:sub>\n ) was found. Differences in oxygen pulse (\n \n \n \n V<\/mml:mtext>\n .<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n O\n 2<\/jats:sub>\n \/HR), oxygen uptake efficiency slope (OUES), work efficiency (\u25b3\n \n \n \n V<\/mml:mtext>\n .<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n O\n 2<\/jats:sub>\n \/\u25b3W), peak heart rate (HR), and peak systolic blood pressure (BP) existed between two conditions (\n p<\/jats:italic>\n &lt; 0.05).\n <\/jats:p>\n \n Conclusion:<\/jats:bold>\n Wearing surgical masks during aerobic exercise showed certain negative impacts on cardiopulmonary function, especially during high-intensity exercise in healthy young subjects. These results provide an important recommendation for wearing a mask at a pandemic during exercises of varying intensity. Future research should focus on the response of wearing masks in patients with related cardiopulmonary diseases.\n <\/jats:p>","DOI":"10.3389\/fphys.2021.710573","type":"journal-article","created":{"date-parts":[[2021,9,10]],"date-time":"2021-09-10T01:07:26Z","timestamp":1631236046000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":37,"title":["Effect of Surgical Masks on Cardiopulmonary Function in Healthy Young Subjects: A Crossover Study"],"prefix":"10.3389","volume":"12","author":[{"given":"Guolin","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meifeng","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqing","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinyu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengqing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anniwaer","family":"Yilifate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxin","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjie","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haining","family":"Ou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,9,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1080\/001401398186973","article-title":"Exercise performance during inspiratory resistance breathing under exhaustive constant load work.","volume":"41","author":"Caretti","year":"1998","journal-title":"Ergonomics"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2139","DOI":"10.1093\/cid\/ciaa644","article-title":"Surgical masks Partition Reduces the Risk of Non-contact Transmission in a Golden Syrian Hamster Model for Coronavirus Disease 2019 (COVID-19).","volume":"71","author":"Chan","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2020.110002","article-title":"\u201cExercise with facemask; Are we handling a devil\u2019s sword?\u201d - A physiological hypothesis.","volume":"144","author":"Chandrasekaran","year":"2020","journal-title":"Med. Hypotheses"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1152\/japplphysiol.00339.2019","article-title":"Mechanical cardiopulmonary interactions during exercise in health and disease.","volume":"128","author":"Cheyne","year":"2020","journal-title":"J. Appl. Physiol."},{"key":"B5","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.1016\/S0140-6736(20)31142-9","article-title":"Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis.","volume":"395","author":"Chu","year":"2020","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1097\/01.ta.0000221348.82115.a2","article-title":"Human autonomic and cerebrovascular responses to inspiratory impedance.","volume":"60","author":"Cooke","year":"2006","journal-title":"J. Trauma"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.1590\/1414-431x20154692","article-title":"Use of the Wasserman equation in optimization of the duration of the power ramp in a cardiopulmonary exercise test: a study of Brazilian men.","volume":"48","author":"Costa","year":"2015","journal-title":"Braz. J. Med. Biol. Res."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1164\/rccm.201107-1190oc","article-title":"Surgical face masks worn by patients with multidrug-resistant tuberculosis: impact on infectivity of air on a hospital ward.","volume":"185","author":"Dharmadhikari","year":"2012","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"601","DOI":"10.3233\/jad-170576","article-title":"An Objective Method to Accurately Measure Cardiorespiratory Fitness in Older Adults Who Cannot Satisfy Widely Used Oxygen Consumption Criteria.","volume":"61","author":"Dougherty","year":"2018","journal-title":"J. Alzheimers Dis."},{"key":"B10","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1152\/jappl.1977.42.3.444","article-title":"Combined effects of breathing resistance and hyperoxia on aerobic work tolerance.","volume":"42","author":"Dressendorfer","year":"1977","journal-title":"J. Appl. Physiol. Respir. Environ. Exerc. Physiol."},{"key":"B11","doi-asserted-by":"crossref","DOI":"10.1136\/bjsports-2020-103758","article-title":"Effects of wearing a cloth face mask on performance, physiological and perceptual responses during a graded treadmill running exercise test.","author":"Driver","year":"2021","journal-title":"Br. J. Sports Med."},{"key":"B12","first-page":"1","article-title":"Effects of face masks on performance and cardiorespiratory response in well-trained athletes.","author":"Egger","year":"2021","journal-title":"Clin. Res. Cardiol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/j.idm.2020.04.001","article-title":"To mask or not to mask: modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic.","volume":"5","author":"Eikenberry","year":"2020","journal-title":"Infect. Dis. Model"},{"key":"B14","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1111\/sms.13832","article-title":"Return to training in the COVID-19 era: the physiological effects of face masks during exercise.","volume":"31","author":"Epstein","year":"2021","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1522","DOI":"10.1007\/s00392-020-01704-y","article-title":"Effects of surgical and FFP2\/N95 face masks on cardiopulmonary exercise capacity.","volume":"109","author":"Fikenzer","year":"2020","journal-title":"Clin. Res. Cardiol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1089\/jamp.2020.1615","article-title":"Reducing aerosol-related risk of transmission in the Era of COVID-19: an interim guidance endorsed by the International Society of Aerosols in Medicine.","volume":"33","author":"Fink","year":"2020","journal-title":"J. Aerosol Med. Pulm. Drug Deliv."},{"key":"B17","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-019-55451-w","article-title":"A randomised clinical trial to evaluate the safety, fit, comfort of a novel N95 mask in children.","volume":"9","author":"Goh","year":"2019","journal-title":"Sci. Rep."},{"key":"B18","doi-asserted-by":"crossref","first-page":"250","DOI":"10.2460\/ajvr.1996.57.03.250","article-title":"Effect of a mask and pneumotachograph on tracheal and nasopharyngeal pressures, respiratory frequency, and ventilation in horses.","volume":"57","author":"Holcombe","year":"1996","journal-title":"Am. J. Vet. Res."},{"key":"B19","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1513\/annalsats.202008-990cme","article-title":"Face Masks and the Cardiorespiratory Response to Physical Activity in Health and Disease.","volume":"18","author":"Hopkins","year":"2021","journal-title":"Ann. Am. Thorac. Soc."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1856","DOI":"10.1016\/j.jiph.2020.10.015","article-title":"Raltegravir, Indinavir, Tipranavir, Dolutegravir, and Etravirine against main protease and RNA-dependent RNA polymerase of SARS-CoV-2: a molecular docking and drug repurposing approach.","volume":"13","author":"Indu","year":"2020","journal-title":"J. Infect. Public Health"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1196","DOI":"10.1017\/ice.2020.237","article-title":"Current knowledge of COVID-19 and infection prevention and control strategies in healthcare settings: a global analysis.","volume":"41","author":"Islam","year":"2020","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"B22","doi-asserted-by":"crossref","DOI":"10.1186\/s13036-016-0025-4","article-title":"Respirator masks protect health but impact performance: a review.","volume":"10","author":"Johnson","year":"2016","journal-title":"J. Biol. Eng."},{"key":"B23","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1159\/000192827","article-title":"The effect of added dead space on the pulmonary response to exercise.","volume":"28","author":"Jones","year":"1971","journal-title":"Respiration"},{"key":"B24","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.ajic.2012.02.037","article-title":"Pulmonary and heart rate responses to wearing N95 filtering facepiece respirators.","volume":"41","author":"Kim","year":"2013","journal-title":"Am. J. Infect. Control"},{"key":"B25","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-020-78643-1","article-title":"Effects of surgical face masks on cardiopulmonary parameters during steady state exercise.","volume":"10","author":"L\u00e4ssing","year":"2020","journal-title":"Sci. Rep."},{"key":"B26","first-page":"917","article-title":"Objective assessment of increase in breathing resistance of N95 respirators on human subjects.","volume":"55","author":"Lee","year":"2011","journal-title":"Ann. Occup. Hyg."},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2020.101751","article-title":"Efficacy of face mask in preventing respiratory virus transmission: a systematic review and meta-analysis.","volume":"36","author":"Liang","year":"2020","journal-title":"Travel Med. Infect. Dis."},{"key":"B28","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.04473-2020","article-title":"You can leave your mask on\u201d: effects on cardiopulmonary parameters of different airway protection masks at rest and during maximal exercise.","author":"Mapelli","year":"2021","journal-title":"Eur. Respir. J."},{"key":"B29","doi-asserted-by":"crossref","DOI":"10.14198\/jhse.2022.171.03","article-title":"Wearing a surgical masks does not affect the anaerobic threshold during pedaling exercise.","volume":"17","author":"Otsuka","year":"2020","journal-title":"J. Hum. Sport Exerc."},{"key":"B30","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.rmr.2017.01.010","article-title":"[Effect of a surgical masks on six minute walking distance].","volume":"35","author":"Person","year":"2018","journal-title":"Rev. Mal. Respir."},{"key":"B31","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1007\/s11596-012-0075-x","article-title":"Effect of respirator resistance on tolerant capacity during graded load exercise.","volume":"32","author":"Qiu","year":"2012","journal-title":"J. Huazhong Univ. Sci. Technolog. Med. Sci."},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3390\/biology10030213","article-title":"Acute Effects of Surgical and FFP2 Face Masks on Physiological Responses and Strength Performance in Persons with Sarcopenia.","volume":"10","author":"Ramos-Campo","year":"2021","journal-title":"Biology"},{"key":"B33","first-page":"671","article-title":"Effect of exhaled moisture on breathing resistance of N95 filtering facepiece respirators.","volume":"54","author":"Roberge","year":"","journal-title":"Ann. Occup. Hyg."},{"key":"B34","first-page":"569","article-title":"Physiological impact of the N95 filtering facepiece respirator on healthcare workers.","volume":"55","author":"Roberge","year":"","journal-title":"Respir. Care"},{"key":"B35","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.resp.2012.01.010","article-title":"Absence of consequential changes in physiological, thermal and subjective responses from wearing a surgical mask.","volume":"181","author":"Roberge","year":"2012","journal-title":"Respir. Physiol. Neurobiol."},{"key":"B36","doi-asserted-by":"crossref","first-page":"e653","DOI":"10.1161\/CIR.0000000000000461","article-title":"Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association.","volume":"134","author":"Ross","year":"2016","journal-title":"Circulation"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17134624","article-title":"Facial skin temperature and discomfort when wearing protective face masks: thermal infrared imaging evaluation and hands moving the mask.","volume":"17","author":"Scarano","year":"2020","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"B38","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1089\/ham.2017.0103","article-title":"The effect of inspiratory resistance on exercise performance and perception in moderate normobaric hypoxia.","volume":"18","author":"Seo","year":"2017","journal-title":"High Alt. Med. Biol."},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17218110","article-title":"Wearing of Cloth or Disposable Surgical Face Masks has no Effect on Vigorous Exercise Performance in Healthy Individuals.","volume":"17","author":"Shaw","year":"2020","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"B40","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1080\/00140139.2013.777128","article-title":"Carbon dioxide rebreathing in respiratory protective devices: influence of speech and work rate in full-face masks.","volume":"56","author":"Smith","year":"2013","journal-title":"Ergonomics"},{"key":"B41","first-page":"57","article-title":"Comprehensive review of mask utility and challenges during the COVID-19 pandemic.","volume":"28","author":"Tirupathi","year":"2020","journal-title":"Infez. Med."},{"key":"B42","article-title":"Yildirim \u0130. COVID-19 and physical activity in sedentary individuals: differences in metabolic, cardiovascular, and respiratory responses during aerobic exercise performed with and without a surgical face masks.","author":"Umutlu","year":"2021","journal-title":"J. Sports Med. Phys. Fitness"}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2021.710573\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,8]],"date-time":"2024-09-08T00:48:16Z","timestamp":1725756496000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2021.710573\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,10]]},"references-count":42,"alternative-id":["10.3389\/fphys.2021.710573"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2021.710573","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,10]]},"article-number":"710573"}}