Tolerability of facemask during physical exercises during COVID-19 pandemic: A systematic review

Background: Available evidence supports the use of facemasks by all groups to prevent respiratory infections, particularly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, it is not clear whether these masks can be used safely during various intensities of physical exercise. A...

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Main Authors: Akwagiobe F. Odey, Iwara I. Arikpo, Joshua Meremikwu, Mavis A. Otonkue, Nkwachukwu N. Chukwu, Freedman Ita-Lincoln
Format: Article
Language:English
Published: AOSIS 2025-03-01
Series:Journal of Public Health in Africa
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Online Access:https://publichealthinafrica.org/index.php/jphia/article/view/610
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author Akwagiobe F. Odey
Iwara I. Arikpo
Joshua Meremikwu
Mavis A. Otonkue
Nkwachukwu N. Chukwu
Freedman Ita-Lincoln
author_facet Akwagiobe F. Odey
Iwara I. Arikpo
Joshua Meremikwu
Mavis A. Otonkue
Nkwachukwu N. Chukwu
Freedman Ita-Lincoln
author_sort Akwagiobe F. Odey
collection DOAJ
description Background: Available evidence supports the use of facemasks by all groups to prevent respiratory infections, particularly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, it is not clear whether these masks can be used safely during various intensities of physical exercise. Aim: To evaluate the impact of different types of facemasks on oxygen saturation, oxygen uptake, rate of perceived exertion and performance during different physical exercises. Setting: Healthcare databases. Method: We searched for articles published between 2020 to 05 September 2022. There was no restriction in age, language or setting. Electronic databases including The Cochrane Library - Central Register of Controlled Trials and Cochrane Database of systematic review and EPOC; MEDLINE; EMBASE were searched for articles for the period stated above. Risk of Bias in included studies was assessed using Cochrane risk of bias tool for RCTs. Results: Twenty-four randomised control trials with cross-over design were included. There was a total of 617 participants (373 males and 244 females). None of studies reported on prevention of SARS-CoV-2 infection by mask. The pooled effect estimate shows that wearing surgical mask did not affect oxygen saturation and oxygen uptake. Masks are tolerated during mild and moderate exercise, but reduce maximal exercise capacity. Children tolerate masks for submaximal exercise better than adults. Conclusion: During physical exercises, masks should be used with caution by healthy adults and children but should be avoided by elderly and ill patients. Contribution: This review offers current evidence on tolerability of facemask during physical exercises.
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2038-9930
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spelling doaj-art-19827cc38e55428292c8ce773bfdca6e2025-08-20T03:48:52ZengAOSISJournal of Public Health in Africa2038-99222038-99302025-03-01162e1e1410.4102/jphia.v16i2.610818Tolerability of facemask during physical exercises during COVID-19 pandemic: A systematic reviewAkwagiobe F. Odey0Iwara I. Arikpo1Joshua Meremikwu2Mavis A. Otonkue3Nkwachukwu N. Chukwu4Freedman Ita-Lincoln5Department of Paediatrics, Faculty of Clinical Sciences, University of Calabar Teaching Hospital, CalabarDepartment of Computer Sciences, Faculty of Science, University of Calabar, CalabarCochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, CalabarCochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, CalabarCochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, CalabarDepartment of Public Health and Community Medicine, University of Calabar Teaching Hospital, CalabarBackground: Available evidence supports the use of facemasks by all groups to prevent respiratory infections, particularly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, it is not clear whether these masks can be used safely during various intensities of physical exercise. Aim: To evaluate the impact of different types of facemasks on oxygen saturation, oxygen uptake, rate of perceived exertion and performance during different physical exercises. Setting: Healthcare databases. Method: We searched for articles published between 2020 to 05 September 2022. There was no restriction in age, language or setting. Electronic databases including The Cochrane Library - Central Register of Controlled Trials and Cochrane Database of systematic review and EPOC; MEDLINE; EMBASE were searched for articles for the period stated above. Risk of Bias in included studies was assessed using Cochrane risk of bias tool for RCTs. Results: Twenty-four randomised control trials with cross-over design were included. There was a total of 617 participants (373 males and 244 females). None of studies reported on prevention of SARS-CoV-2 infection by mask. The pooled effect estimate shows that wearing surgical mask did not affect oxygen saturation and oxygen uptake. Masks are tolerated during mild and moderate exercise, but reduce maximal exercise capacity. Children tolerate masks for submaximal exercise better than adults. Conclusion: During physical exercises, masks should be used with caution by healthy adults and children but should be avoided by elderly and ill patients. Contribution: This review offers current evidence on tolerability of facemask during physical exercises.https://publichealthinafrica.org/index.php/jphia/article/view/610masksduring physical activitypreventionsars-cov2infection
spellingShingle Akwagiobe F. Odey
Iwara I. Arikpo
Joshua Meremikwu
Mavis A. Otonkue
Nkwachukwu N. Chukwu
Freedman Ita-Lincoln
Tolerability of facemask during physical exercises during COVID-19 pandemic: A systematic review
Journal of Public Health in Africa
masks
during physical activity
prevention
sars-cov2
infection
title Tolerability of facemask during physical exercises during COVID-19 pandemic: A systematic review
title_full Tolerability of facemask during physical exercises during COVID-19 pandemic: A systematic review
title_fullStr Tolerability of facemask during physical exercises during COVID-19 pandemic: A systematic review
title_full_unstemmed Tolerability of facemask during physical exercises during COVID-19 pandemic: A systematic review
title_short Tolerability of facemask during physical exercises during COVID-19 pandemic: A systematic review
title_sort tolerability of facemask during physical exercises during covid 19 pandemic a systematic review
topic masks
during physical activity
prevention
sars-cov2
infection
url https://publichealthinafrica.org/index.php/jphia/article/view/610
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