Cardiovascular recovery after running on a treadmill with different intensities with N95 and surgery masks in men

Document Type : Research Paper

Authors

1 Department of Exercise Physiology, Faculty of Sport Sciences, University of Mazandaran, Babolsar, Iran

2 Department of Physiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran

10.22080/jaep.2021.22036.2058

Abstract

Background and Purpose: The aim of this study was to evaluate cardiovascular recovery after running on a treadmill with different intensities with N95 and surgery masks in men.
Methodology: 72 healthy men were randomly divided into six groups: 1. Surgery + submaximal, 2. N95 + submaximal, 3. Surgery + maximal, 4. N95 + maximal, 5. Sub maximal without mask, 6. Maximal without mask. The sub-maximal and maximal exercise protocols included running at a speed of 1.34 m / s with 5% for 20 minutes on a treadmill and a modified Bruce test, respectively.
Results: Hemodynamic factors were measured before, immediately, 1, 3 and 5 minutes after exercise. In the analysis of data, analysis of variance in repeated measures were used. During the recovery period after exercise, Changes in heart rate, systolic pressure, and myocardial oxygen consumption were not significant in groups with the same exercise (maximal or submaximal) with or without masking conditions. Heart rate was higher in SURMAX vs. N95MAX at 1 min after maximal exercise. HR, SBP, and DP were significantly lower immediately after anaerobic exercise within 1 and 3 min of the post recovery period.
Conclusion: Results showed that facial masks with exercise in healthy individuals can be used during COVID-19 pandemic disease, without having negative effects on postoperative cardiac recovery performance.

Keywords

##Nishiga M, Wang DW, Han Y, Lewis DB, Wu JC. COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives. Nature Reviews Cardiology. 2020; 17(9):543-58. ##Karmacharya M, Kumar S, Gulenko O, Cho Y-K. Advances in Facemasks during the COVID-19 Pandemic Era. ACS Applied Bio Materials. 2021;4(5):3891-908. ##Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, Schünemann HJ, et al. 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. The lancet. 2020;395(10242):1973-87. ##Hopkins SR, Dominelli PB, Davis CK, Guenette JA, Luks AM, Molgat-Seon Y, et al. Face masks and the cardiorespiratory response to physical activity in health and disease. Annals of the American Thoracic Society. 2021; 18(3):399-407##.Atangana E, Atangana A. Facemask’s simple but powerful weapons to protect against COVID-19 spread: Can they have side’s effects? Results in physics. 2020:103425. ##Ong JJ, Bharatendu C, Goh Y, Tang JZ, Sooi KW, Tan YL, et al. Headaches associated with personal protective equipment–A cross‐sectional study among frontline healthcare workers during COVID‐19. Headache: The Journal of Head and Face Pain. 2020;60(5):864-77. ##Scarano A, Inchingolo F, Rapone B, Festa F, Tari SR, Lorusso F. Protective face masks: Effect on the oxygenation and heart rate status of oral surgeons during surgery. International Journal of Environmental Research and Public Health. 2021;18(5):2363. ##Ting, F., & Villanueva, J. (2020). Wearing of face masks while jogging during the COVID-19 pandemic: will my oxygenation decrease? International Journal of Community Medicine and Public Health, 7(8), 3249-3250.. ##Cordeiro R, Mira PA, Monteiro W, Cunha F, Laterza MC, Pescatello LS, et al. Hemodynamics and cardiac autonomic modulation after an acute concurrent exercise circuit in older individuals with pre-to established hypertension. Clinics. 2021;76. ##Guensch DP, Fischer K, Jung C, Hurni S, Winkler BM, Jung B, et al. Relationship between myocardial oxygenation and blood pressure: Experimental validation using oxygenation-sensitive cardiovascular magnetic resonance. PloS one. 2019;14(1):e0210098. ##Barbeito‐Caamaño C, Bouzas‐Mosquera A, Peteiro J, López‐Vázquez D, Quintas‐Guzmán M, Varela‐Cancelo A, et al. Exercise testing in COVID‐19 era: Clinical profile, results and feasibility wearing a facemask. European Journal of Clinical Investigation. 2021;51(4):e13509. ##Fikenzer S, Uhe T, Lavall D, Rudolph U, Falz R, Busse M, et al. Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clin Res Cardiol [online ahead of print] 6 Jul 2020; DOI: 10.1007/s00392-020-01704-y. ##Morshedi‐Meibodi A, Larson MG, Levy D, O'Donnell CJ, Vasan RS. Heart rate recovery after treadmill exercise testing and risk of cardiovascular disease events (the Framingham Heart Study). Am J Cardiol. 2002; 90:848–852. ##El‐Amrawy F, Nounou MI. Are currently available wearable devices for activity tracking and heart rate monitoring accurate, precise, and medically beneficial?Healthc Inform Res. 2015; 21:315–320. ##McCrory C, Berkman LF, Nolan H, O'Leary N, Foley M, Kenny RA. Speed of heart rate recovery in response to orthostatic challenge. Circ Res. 2016; 119:666–675. ##Teijeiro T, Felix P, Presedo J, Castro D. Heartbeat classification using abstract features from the abductive interpretation of the ECG. IEEE J Biomed Health Inform. 2018; 22:409–420. ##Watanabe J, Thamilarasan M, Blackstone EH, Thomas JD, Lauer MS. Heart rate recovery immediately after treadmill exercise and left ventricular systolic dysfunction as predictors of mortality: the case of stress echocardiography. Circulation 2001;104:1911–1916. ##Scheid, J.L.; Lupien, S.P.; Ford, G.S.; West, S.L. Commentary: Physiological and psychological impact of face mask usage during the covid-19 pandemic. Int. J. Environ. Res. Public Health 2020, 17, 6655. ## Chandrasekaran, B.; Fernandes, S. “Exercise with face mask; Are we handling a devil’s sword?”—A physiological hypothesis. Med. Hypotheses 2020, 144, 110002. ##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. ##Noonan V, Dean E. Submaximal exercise testing: clinical application and interpretation. Physical therapy. 2000;80(8):782-807. ##Canini L, Andréoletti L, Ferrari P, D'Angelo R, Blanchon T, Lemaitre M, et al. Surgical mask to prevent influenza transmission in households: a cluster randomized trial. PloS one. 2010;5(11):e13998. ##Blocken B, Malizia F, Van Druenen T, Marchal T. Towards aerodynamically equivalent COVID19 1.5 m social distancing for walking and running. Preprint. 2020. ##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. ##Chen Y, Yang Z, Wang J, Gong H. Physiological and subjective responses to breathing resistance of N95 filtering facepiece respirators in still-sitting and walking. International Journal of Industrial Ergonomics. 2016;53:93-101. ##Person E, Lemercier C, Royer A, Reychler G. Effect of a surgical mask on six minute walking distance. Revue des maladies respiratoires. 2018;35(3):264-8. ##Smith PB, Agostini G, Mitchell JC. A scoping review of surgical masks and N95 filtering facepiece respirators: learning from the past to guide the future of dentistry. Saf Sci. 2020; 131:104920. ##Fikenzer S, Uhe T, Lavall D, et al. Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clin Res Cardiol. 2020; 109(12):1522–1530##.Hua Zhu J, Jin Lee S, Yun Wang D, et al. Evaluation of rebreathed air in human nasal cavity with N95 respirator: a CFD study. Trauma Emerg Care. 2016; 1(2):15–18. ##Brown S, Barnes MJ, Mündel T. Effects of hypoxia and hypercapnia on human HRV and respiratory sinus arrhythmia. Acta Physiol Hung. 2014;101(3):263–272. ##Goudis CA, Ketikoglou DG. Obstructive sleep and atrial fibrillation: pathophysiological mechanisms and therapeutic implications. Int J Cardiol. 2017;230:293–300. ##

References

##Nishiga M, Wang DW, Han Y, Lewis DB, Wu JC. COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives. Nature Reviews Cardiology. 2020; 17(9):543-58. ##Karmacharya M, Kumar S, Gulenko O, Cho Y-K. Advances in Facemasks during the COVID-19 Pandemic Era. ACS Applied Bio Materials. 2021;4(5):3891-908. ##Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, Schünemann HJ, et al. 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. The lancet. 2020;395(10242):1973-87. ##Hopkins SR, Dominelli PB, Davis CK, Guenette JA, Luks AM, Molgat-Seon Y, et al. Face masks and the cardiorespiratory response to physical activity in health and disease. Annals of the American Thoracic Society. 2021; 18(3):399-407##.Atangana E, Atangana A. Facemask’s simple but powerful weapons to protect against COVID-19 spread: Can they have side’s effects? Results in physics. 2020:103425. ##Ong JJ, Bharatendu C, Goh Y, Tang JZ, Sooi KW, Tan YL, et al. Headaches associated with personal protective equipment–A cross‐sectional study among frontline healthcare workers during COVID‐19. Headache: The Journal of Head and Face Pain. 2020;60(5):864-77. ##Scarano A, Inchingolo F, Rapone B, Festa F, Tari SR, Lorusso F. Protective face masks: Effect on the oxygenation and heart rate status of oral surgeons during surgery. International Journal of Environmental Research and Public Health. 2021;18(5):2363. ##Ting, F., & Villanueva, J. (2020). Wearing of face masks while jogging during the COVID-19 pandemic: will my oxygenation decrease? International Journal of Community Medicine and Public Health, 7(8), 3249-3250.. ##Cordeiro R, Mira PA, Monteiro W, Cunha F, Laterza MC, Pescatello LS, et al. Hemodynamics and cardiac autonomic modulation after an acute concurrent exercise circuit in older individuals with pre-to established hypertension. Clinics. 2021;76. ##Guensch DP, Fischer K, Jung C, Hurni S, Winkler BM, Jung B, et al. Relationship between myocardial oxygenation and blood pressure: Experimental validation using oxygenation-sensitive cardiovascular magnetic resonance. PloS one. 2019;14(1):e0210098. ##Barbeito‐Caamaño C, Bouzas‐Mosquera A, Peteiro J, López‐Vázquez D, Quintas‐Guzmán M, Varela‐Cancelo A, et al. Exercise testing in COVID‐19 era: Clinical profile, results and feasibility wearing a facemask. European Journal of Clinical Investigation. 2021;51(4):e13509. ##Fikenzer S, Uhe T, Lavall D, Rudolph U, Falz R, Busse M, et al. Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clin Res Cardiol [online ahead of print] 6 Jul 2020; DOI: 10.1007/s00392-020-01704-y. ##Morshedi‐Meibodi A, Larson MG, Levy D, O'Donnell CJ, Vasan RS. Heart rate recovery after treadmill exercise testing and risk of cardiovascular disease events (the Framingham Heart Study). Am J Cardiol. 2002; 90:848–852. ##El‐Amrawy F, Nounou MI. Are currently available wearable devices for activity tracking and heart rate monitoring accurate, precise, and medically beneficial?Healthc Inform Res. 2015; 21:315–320. ##McCrory C, Berkman LF, Nolan H, O'Leary N, Foley M, Kenny RA. Speed of heart rate recovery in response to orthostatic challenge. Circ Res. 2016; 119:666–675. ##Teijeiro T, Felix P, Presedo J, Castro D. Heartbeat classification using abstract features from the abductive interpretation of the ECG. IEEE J Biomed Health Inform. 2018; 22:409–420. ##Watanabe J, Thamilarasan M, Blackstone EH, Thomas JD, Lauer MS. Heart rate recovery immediately after treadmill exercise and left ventricular systolic dysfunction as predictors of mortality: the case of stress echocardiography. Circulation 2001;104:1911–1916. ##Scheid, J.L.; Lupien, S.P.; Ford, G.S.; West, S.L. Commentary: Physiological and psychological impact of face mask usage during the covid-19 pandemic. Int. J. Environ. Res. Public Health 2020, 17, 6655. ## Chandrasekaran, B.; Fernandes, S. “Exercise with face mask; Are we handling a devil’s sword?”—A physiological hypothesis. Med. Hypotheses 2020, 144, 110002. ##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. ##Noonan V, Dean E. Submaximal exercise testing: clinical application and interpretation. Physical therapy. 2000;80(8):782-807. ##Canini L, Andréoletti L, Ferrari P, D'Angelo R, Blanchon T, Lemaitre M, et al. Surgical mask to prevent influenza transmission in households: a cluster randomized trial. PloS one. 2010;5(11):e13998. ##Blocken B, Malizia F, Van Druenen T, Marchal T. Towards aerodynamically equivalent COVID19 1.5 m social distancing for walking and running. Preprint. 2020. ##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. ##Chen Y, Yang Z, Wang J, Gong H. Physiological and subjective responses to breathing resistance of N95 filtering facepiece respirators in still-sitting and walking. International Journal of Industrial Ergonomics. 2016;53:93-101. ##Person E, Lemercier C, Royer A, Reychler G. Effect of a surgical mask on six minute walking distance. Revue des maladies respiratoires. 2018;35(3):264-8. ##Smith PB, Agostini G, Mitchell JC. A scoping review of surgical masks and N95 filtering facepiece respirators: learning from the past to guide the future of dentistry. Saf Sci. 2020; 131:104920. ##Fikenzer S, Uhe T, Lavall D, et al. Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clin Res Cardiol. 2020; 109(12):1522–1530##.Hua Zhu J, Jin Lee S, Yun Wang D, et al. Evaluation of rebreathed air in human nasal cavity with N95 respirator: a CFD study. Trauma Emerg Care. 2016; 1(2):15–18. ##Brown S, Barnes MJ, Mündel T. Effects of hypoxia and hypercapnia on human HRV and respiratory sinus arrhythmia. Acta Physiol Hung. 2014;101(3):263–272. ##Goudis CA, Ketikoglou DG. Obstructive sleep and atrial fibrillation: pathophysiological mechanisms and therapeutic implications. Int J Cardiol. 2017;230:293–300. ##

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History

  • Receive Date: 27 July 2021
  • Revise Date: 02 August 2021
  • Accept Date: 22 August 2021

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