Effects of Wearing Facemasks During Brisk Walks: A COVID-19 Dilemma

Ophir Bar-On, MD; Yulia Gendler, PhD; Patrick Stafler, MD; Hagit Levine, MD; Guy Steuer, MD; Einat Shmueli, MD; Dario Prais, MD; Meir Mei-Zahav, MD

Disclosures

J Am Board Fam Med. 2021;34(4):798-801. 

In This Article

Results

Twenty-one volunteers were recruited into the study. Of the 21 volunteers, 11 were female, with a median age of 38 years (range, 29–57 years), median body mass index of 24.5 (range, 20–33.6), and without underlying cardiopulmonary morbidity. During the rest, all vital signs were within normal limits among the participants, with and without a mask.

During the slow walk, respiratory and heart rates increased equally with and without a mask among the participants. A small yet statistically significant difference in EtCO2 increase was observed while wearing a mask (P = .004). Two examinees showed mild hypercarbia wearing a mask, while none without (P < .001) as shown in Table 1.

During the brisk 5-minute walk, we saw a statistically significant increase in EtCO2, more profoundly while wearing a mask: a mean change of 8.4 ± 3.0 mmHg versus 6.2 ± 4.0 mmHg (P = .009), from baseline of 33.5 ± 3.8 without mask, 33.9 ± 4.3 with mask, respectively (Figure 1). Three participants (14%) showed hypercarbia (EtCO2>45 mmHg; max, 48.5) while walking with a mask, compared with only 1 (5%) (EtCO2=46 mmHg) while walking without a mask (P = .60). Mean oxygen saturation remained stable while walking without a mask (98%) but decreased slightly, yet statistically significant, by 1.2% ± 2.2 while walking with a mask, from 97.9% ± 2.3 to 96.7 %± 1.9 (P = .01) (Figure 1). Nine participants (43%) demonstrated mild desaturation (O2 range, 93% to 96%) while walking with a mask, compared with only 3 (14%) who had mild desaturation (O2 range, 93% to 96%) while walking without a mask (P = .08). As anticipated for physical activity, heart and respiratory rates increased with and without a mask, similarly.

Figure 1.

Mean O2-saturation (%) and EtCO2, during a brisk 5-minute walk, with a mask versus without a mask. Abbreviation: EtCO2, end-tidal carbon dioxide.

There was a statistically significant increase in the Borg Exertion Scale while walking with a mask for both slow and brisk walks (Table 1).

In the subjective perception questionnaire, participants described that walking briskly with a mask, compared with walking without a mask, caused "difficulty breathing" (86%), "shortness of breath" (33%), "choking" feeling (57%), and "dizziness" (19%); none of these were reported while walking without a mask.

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