. 2022 Nov 2;13:994454. doi: 10.3389/fphys.2022.994454

TABLE 1.

Summary of studies on the acute effects of comparison between use of mask versus no-mask wearing during exercise.

Study	Design/Mask type	Participants	Exercise protocol	Outcomes
Ade et al. (2021)	RCT	Healthy and physically active adults.	Incremental cycle ergometer exercise to exhaustion (increases of 20 W/min; until the participant could not maintain the pedal cadence of 60 rpm for 5 consecutive revolutions).	-Affective/psychological responses -Dyspnea: ↑9%
	Crossover design	(n = 11; M = 5; W = 6)
	1: CON	30 ± 11 years		RPE: ns
	2: CM			-Exercise performance responses
	3: SM			PO_MAX: ns
	4: FFP2/N95
Bar-On et al. (2021)	RCT	Healthy adults.	Constant load treadmill walking for 5 min: a) slow walk (4 km/h at 0° inclination); b) brisk walk (7 km/h at 0° inclination).	-Affective/psychological responses
	Crossover design	(n = 10; M = 5; W = 5)		RPE: ^ab↑39%
	1: CON	28 ± 5 years
	2: SM
Cabanillas-Barea et al. (2022)	RCT	Healthy adults., (n = 50; M = 26; W = 24), 21 ± 5 years	6 MWT	-Affective/psychological responses, Dyspnea: ↑61%–129%, -Exercise performance responses, Distance traveled: ns
	Crossover design
	1: CON
	2: SM
	3: FFP2/N95
Chen et al. (2016)	RCT	Healthy adults., (n = 15; M = 15; W = 0), 28 ± 2 years	Constant load treadmill walking for 5 min (treadmill speed of 1.6 m/s and 0° inclination).	-Affective/psychological responses, Dyspnea: ↑369%–431%
	Crossover design
	1: CON
	2: FFP2/N95
	3: FFP2/N95 + EV
Dantas et al. (2021)	RCT	Track and field athletes., (n = 10; M = 7; W = 3), 23 ± 4 years	Outdoor track field running test (five maximal 30 m sprints, with 4 min rest between runs); and vertical jump (countermovement jump).	-Affective/psychological responses, Affect: ↓114%–148%, RPE: ↑46%, -Exercise performance responses, Sprint time: ns, Sprint acceleration: ns, Jump height: ns
	Crossover design
	1: CON
	2: CM
Doherty et al. (2021)	RCT	Healthy adults., (n = 12; M = 7; W = 5), 26 ± 3 years	Constant load cycle ergometer submaximal exercise for 8 min (submaximal exercise at 70% HR_MAX).	-Affective/psychological responses, Dyspnea: ↑42%
	Crossover design
	1: CON (MP)
	2: CON
	3: CM
	4: SM
Driver et al. (2021)	RCT	Healthy adults., (n = 31; M = 17; W = 14), 23 ± 3 years	Incremental treadmill cardiopulmonary exercise test (Bruce’s standard protocol).	-Affective/psychological responses, RPE: ns, Dyspnea: ↑31%, -Exercise performance responses, TTE: ↓14%
	Crossover design
	1: CON
	2: CM
Egger et al. (2021)	RCT	Well-trained healthy athletes (2 road cyclists; 8 mountain bikers, and 6 triathletes), (n = 16; M = 16; W = 0), 27 ± 7 years	Incremental cycle ergometer exercise to exhaustion (starting at 100–150 W; increases of 50 W every 3 min until voluntary exhaustion or when subjects were unable to maintain a pedaling cadence of 50 rpm for more than 10 s).	-Affective/psychological responses, RPE: ns, -Exercise performance responses, PO_MAX: ↓4%–6%
	Crossover design
	1: CON
	2: SM
	3: FFP2/N95
Epstein et al. (2021)	RCT	Healthy and physically active adults., (n = 10; M = 5; W = 5), 28 ± 5 years	Incremental cycle ergometer exercise to exhaustion (starting at 25 W; increases of 25 W every 3 min until voluntary exhaustion; cadence of 55–65 rpm).	-Affective/psychological responses, RPE: ns, -Exercise performance responses, TTE: ns
	Crossover design
	1: CON
	2: SM
	3: FFP2/N95
Fikenzer et al. (2020)	RCT	Healthy and physically active adults., (n = 12; M = 12; W = 0), 38 ± 6 years	Incremental cycle ergometer exercise to exhaustion (starting at 50 W; increases of 50 W every 3 min until voluntary exhaustion; cadence of 60–70 rpm).	-Affective/psychological responses, Overall discomfort: ↑86%–150%, -Exercise performance responses, PO_MAX: ↓5%
	Crossover design
	1: CON
	2: SM
	3: FFP2/N95
Fukushi et al. (2021)	RCT	Healthy adults., (n = 24; M = 15; W = 9), 21 ± 1 years	Incremental treadmill cardiopulmonary exercise test (Modified Bruce’s standard protocol).	-Affective/psychological responses, RPE: ↑25%–44%
	Crossover design
	1: CON
	2: CM
	3: SM
Jesus et al. (2022)	RCT	Healthy adults., (n = 32; M = 16; W = 16), 24 ± 3 years	Constant load cycle ergometer exercise [two different intensities: a) moderate exercise at 25% below VT; and b) severe exercise at 25% above VT].	-Exercise performance responses, TTE: ^ans ^b↓10%
	Crossover design
	1: CON
	2: SM
Kampert et al. (2021)	RCT	Healthy and physically active adults., (n = 20; M = 11; W = 9), M: 39 ± 11 years, W: 35 ± 11 years	Incremental treadmill cardiopulmonary exercise test (constant speed; treadmill grade increased from 0% to 2% at 2 min; and continuous increases by 1% every minute until voluntary exhaustion).	-Affective/psychological responses, RPE: ns, Overall discomfort: ↑60%, -Exercise performance responses, TTE: ns
	Crossover design
	1: CON
	2: CM
	3: FFP2/N95
Kim et al. (2016)	RCT	Healthy adults., (n = 12; M = 12; W = 0), 24 ± 2 years	Constant load treadmill walking for 1 h (low-moderate work rate at 5.6 km/h and 0° inclination).	-Affective/psychological responses, RPE: ns, Dyspnea: ↑23%–41%, Thermal sensation: ns
	Crossover design
	1: CON
	2: FFP2/N95
	3: FFP2/N95 + EV
Lässing et al. (2020)	RCT	Healthy adults., (n = 14; M = 14; W = 0), 26 ± 4 years	Constant load cycle ergometer exercise for 30 min (50% of PO_MAX; cadence of 60–70 rpm).	-Affective/psychological responses, RPE: ns
	Crossover design
	1: CON
	2: SM
Mapelli et al. (2021)	RCT	Healthy adults., (n = 12; M = 6; W = 6), 41 ± 12 years	Incremental cycle ergometer exercise (aimed to achieving peak exercise in ∼10 min).	-Affective/psychological responses, Dyspnea: ud, -Exercise performance responses, PO_MAX: ↓4%–5%
	Crossover design
	1: CON
	2: SM
	3: FFP2/N95
Modena et al. (2021)	RCT	Amateur soccer players., (n = 21; M = 21; W = 0), 25 ± 5 years	Running protocol [4 min running at: a) 8 km/h; and b) 10 km/h; 8 bouts of 90 m intermittent running; and YoYo-Intermittent Recovery Test Level-1].	-Affective/psychological responses, RPE: ns, Dyspnea: ns, -Exercise performance responses, Distance traveled: ↓11%–13%
	Crossover design
	1: CON
	2: CM
	3: SM
Morris et al. (2020)	RCT	Healthy adults., (n = 8; M = 8; W = 0), 35 ± 7 years	Light exercise simulating work in healthcare and related settings for 45 min (100 W; equivalent to ∼5 METs).	-Affective/psychological responses, Dyspnea: ↑140%, Facial thermal discomfort: ↑22%
	Crossover design
	1: CON
	2: FFP2/N95
Ng et al. (2022)	RCT	Healthy and trained adults., (n = 8; M = 4; W = 4), 25 ± 3 years	Incremental cycle ergometer exercise to exhaustion (starting at 50 W; increases of 25 W every 3 min until voluntary exhaustion).	-Affective/psychological responses, Dyspnea: ns, -Exercise performance responses, TTE: ↓6%, PO_MAX: ns
	Crossover design
	1: CON
	2: SM
Otsuka et al. (2022)	RCT	Healthy and sedentary adults., (n = 6; M = 6; W = 0), 24 ± 2 years	Incremental cycle ergometer exercise to exhaustion (increases of 20 W every minute until voluntary exhaustion).	-Affective/psychological responses, RPE: ns, Dyspnea: ↑30%
	Crossover design
	1: CON
	2: SM
Person et al. (2018)	RCT	Healthy adults., (n = 44; M = 18; W = 26), 22 ± 3 years	6 MWT	-Affective/psychological responses, Dyspnea: ↑22%, -Exercise performance responses, Distance traveled: ns
	Crossover design
	1: CON
	2: SM
Reychler et al. (2021)	RCT	Healthy adults., (n = 20; M = 11; W = 9), 22 ± 2 years	STS^1min	-Affective/psychological responses, Dyspnea: ↑100%, Overall discomfort: ↑3%–4%, -Exercise performance responses, T-REPS: ns
	Crossover design
	1: CON
	2: CM
	3: SM
Roberge et al. (2010)	RCT	Healthy adults., (n = 10; M = 3; W = 7), 25 (20–45) years	Constant load treadmill walking for 1 h: a) 1.7 mph; b) 2.5 mph.	-Affective/psychological responses, Overall discomfort: ^abns, RPE: ^abns
	Crossover design
	1: CON
	2: FFP2/N95
	3: FFP2/N95 + EV
Roberge et al. (2012b)	CT	Healthy adults., (n = 20; M = 13; W = 7), 23 ± 3 years	Constant load treadmill walking for 1 h (low-moderate work rate at 5.6 km/h and 0° inclination)	-Affective/psychological responses, RPE: ns
	1: CON
	2: SM
Roberge et al. (2012a)	CT	Healthy adults., (n = 20; M = 13; W = 7), 23 ± 3 years	Constant load treadmill walking for 1 h (low-moderate work rate at 5.6 km/h and 0° inclination)	-Affective/psychological responses, RPE: ↑8%
	1: CON
	2: FFP2/N95
	3: FFP2/N95 + EV
	4: FFP2/N95
	5: FFP2/N95 + EV
Rojo-Tirado et al. (2021)	RCT	Healthy sportswomen., (n = 13; M = 0; W = 13), 22 ± 2 years	Incremental treadmill cardiopulmonary exercise test [treadmill grade of 1%; warm-up of 6 km/h for 3 min; starting the incremental phase with 8 km/h of running, with increases of 0.2 km/h every 12 s (1 km/h/min) until it was possible to maintain the treadmill speed].	-Affective/psychological responses, RPE: ns, Dyspnea: ns, -Exercise performance responses, TTE: ns
	Crossover design
	1: CON
	2: CM
	3: FFP2/N95
Rosa et al. (2022)	RCT	Healthy and resistance-trained adults., (n = 17; M = 17; W = 0), 28 ± 4 years	Resistance training with BP exercise [4 sets to failure with resting interval of 2 min between sets, performed at different intensities: a) moderate—50% 1RM; and b) high—70% 1RM; with a wash-out of 72 h between sessions].	-Affective/psychological responses, RPE^a: ns, RPE^b: ns, -Exercise performance responses, Maximal BPV_BP: ^ans ^b↓10%, Mean BPV_BP: ^ans ^b↓14%, T-REPS_BP: ^abns, T-VOL_BP: ^abns
	Crossover design
	1: CON^a
	2: CON^b
	3: FFP2/N95^a
	4: FFP2/N95^b
Ryu and Jong-Geun , (2021)	RCT	Healthy adults., (n = 11; M = 11; W = 0), 23 ± 3 years	Incremental treadmill cardiopulmonary exercise test (Bruce’s standard protocol).	-Exercise performance responses, TTE: ns
	Crossover design
	1: CON
	2: SM
	3: FFP2/N95
Shaw et al. (2020)	RCT	Healthy and physically active adults., (n = 14; M = 7; W = 7), 28 ± 9 years	Incremental cycle ergometer exercise to exhaustion (starting at 35–100 W; increases of 35 W every 2 min until voluntary exhaustion; cadence of 70–75 rpm).	-Affective/psychological responses, RPE: ns, -Exercise performance responses, TTE: ns, PO_MAX: ns
	Crossover design
	1: CON
	2: CM
	3: SM
Slimani et al. (2021)	RCT	Healthy adults., (n = 17; M = 9; W = 8), 18 years	Warm-up exercises for 15 min [light runs (4 min); arm circles, jumping jacks, high knees jog, and back kicking (2.5 min); stretching exercises (1.5 min); and 4 sets of each exercise—push-up, sit-up, and squat (30 s of work per 30 s of rest)].	-Affective/psychological responses, RPE: ↑27%
	Crossover design
	1: CON
	2: CM
Steinhilber et al. (2022)	RCT	Healthy adults., (n = 39; M = 20; W = 19), 38 ± 14 years	Constant load cycle ergometer exercise until exhaustion [two different intensities according to HR: a) 130 bpm; and b) 150 bpm].	-Affective/psychological responses, RPE: ^abns, Dyspnea: ^a↑22%–35% ^b↑29–35%, -Exercise performance responses, PO_MAX: ^a↓9% ^bns
	Crossover design
	1: CON
	2: CM
	3: SM
	4: FFP2/N95 + EV
Tornero-Aguilera et al. (2021)	RCT	Recreational athletes., (n = 72; M = 45; W = 27), 28 ± 6 years	Outdoor track field running tests: a) 50 m; b) 400 m.	-Affective/psychological responses, RPE: ^ans ^b↑7%, Subjective stress responses: ^ans ^b↑18%, -Exercise performance responses, Sprint time: ^a↑13% ^b↑19%
	Crossover design
	1: CON
	2: SM
Wong et al. (2020)	RCT	Healthy and physically active adults., (n = 23; M = 10; W = 13), 34 ± 11 years	Constant load treadmill walking for 6 min (4 km/h at 10° incline).	-Affective/psychological responses, RPE: ↑13%–20%
	Crossover design
	1: CON
	2: SM
Yoshihara et al. (2021)	RCT	Healthy and physically active adults., (n = 12; M = 8; W = 4), 24 ± 3 years	Constant load treadmill walking/jogging for 1 h (speed increases of 0.5–1.0 mph every 2 min until voluntary exhaustion).	-Affective/psychological responses, RPE: ns, Dyspnea: ↑379%–761%, Thermal sensation: ns, Fatigue level: ns
	Crossover design
	1: CON
	2: CM
	3: SM
	4: FFP2/N95
Zhang et al. (2021)	RCT	Healthy adults., (n = 71; M = 35; W = 36), 28 ± 8 years	Incremental cycle ergometer exercise to exhaustion (incremental power of 15–25 W/min until exhaustion calculated to let subjects finish the exercise load test between 8 and 12 min; cadence of 60 rpm).	-Affective/psychological responses, RPE: ↑19%, Dyspnea: ↑19, -Exercise performance responses, TTE: ns, PO_MAX: ↓5%
	Crossover design
	1: CON
	2: SM
Zimmerman et al. (1991)	RCT	Healthy adults., (n = 12; M = 12; W = 0), 21 (18–24) years	Constant load cycle ergometer exercise (280–350 W; constant rate).	-Functional responses, Hand grip strength: ns
	Crossover design
	1: CON
	2: SM

RCT, randomized controlled trial; CON, control condition (non-fascial mask wearing); CM, clothing mask; SM, surgical mask; FFP2/N95, facepiece respirator type 2; MP, mouthpiece; EV, exhalation valve; a: lower exercise intensity condition; b: higher exercise intensity condition; n: sample size; M, men; W, women; ± standard deviation values; min, minute; rpm, revolutions per minute; mph, miles per hour; h, hour; km/h, kilometers per hour; m, meters; RM, maximum repetitions; sec, seconds; BP, bench press exercise; VO₂max, maximal oxygen uptake; METs, metabolic equivalent of task; PO_MAX, maximal power output; HR, heart rate; HR_MAX, predicted maximum heart rate; VT, ventilatory threshold; 6 MWT, six-minute walk test; STS^1min, one-min sit-to-stand test; ns, statistically non-significant; ud, unavailable data; ↓ statistically significant lesser compared to the condition without mask; ↑ statistically significant greater compared to the condition without mask; RPE, rate of perceived exertion; T-REP, total number of repetitions; T-VOL, total volume of repetitions; TTE, time-to-exhaustion; BPV, bar propulsive velocity.