Maximal exercise outcomes with a face mask: the effects of gender and age differences on cardiorespiratory responses

Background Surgical masks have become an important accessory of physical activity in daily life due to the COVID-19 pandemic. Aims To determine the effects of the surgical mask on respiratory gas exchange parameters, dyspnoea, and hemodynamic responses during maximal exercise in different age groups and gender. Methods Twenty-six healthy participants between 18 and 65 years (mean 37.35 +/- 15.99) performed a maximal exercise test twice randomly, with and without a mask. To determine the respiratory gas exchange parameters (peak oxygen consumption (VO2peak), minute ventilation (V-E), energy expenditure (EE), respiratory rate), and hemodynamic responses, each participant underwent a maximal exercise test with Bruce protocol on the treadmill. The modified Borg scale (MBS) was used to determine the dyspnoea before and after exercise test. Results Test duration (min), metabolic equivalents (MET), VO2(peak) ml/kg/min, respiratory rate, and peak heart rate (HRpeak) of young participants after exercise test with and without a mask were higher than in middle-aged participants (p < 0.01). There was no significant difference between males and females in test duration, VO2peak ml/kg/min, VO2peak ml/min, MET, V-E l/min, respiratory rate, MBS, and EE in masked tests (p > 0.05). Conclusion The surgical mask use affected the maximal exercise capacity of middle-aged participants more than young participants. Although males performed better than females in tests without masks, the decrease in exercise capacity with mask use was greater than in females. Advanced age and male gender may be factors that need more attention during exercise with mask use.