Face Masks and the Cardiorespiratory Response to Physical Activity in Health and Disease

Question 1

What was the Rationale for the Study on Face Masks and Physical Activity?

Answer 1

• COVID-19 infects millions
• Mask mandates in effect
• Masks during indoor exercise were not enforced due to possible negative effects

Question 2

What were the purported reasons for not wearing a mask?

Answer 2

• Increased dyspnea
• Increased work of breathing
• Alterations in pulmonary gas exchange
• Reduced ventilation
• Rebreathing of exhaled carbon dioxide

Question 3

What is the work of breathing during rest of a healthy adult? What happens during high intensity exercise?

Answer 3

At Rest
- 1-3% of whole body oxygen consumption
HI Exercise
- 20-30x the work

Question 4

What happened when a Respirator was used during 1hr of exercise?

Answer 4

• HR increased +5beats/min
• Respiratory rate +1-2breath/min
• CO2 +1mmHg
• No change in SaO2

Question 5

What is the conclusion of the study on masks during exercise?

Answer 5

• Pulmonary and Heart Rate responses are relatively small and easily tolerated by healthy adult during light-moderate exercise

Question 6

What was the purpose of the study of placebo and nocebo of dyspnea for mask breathing?

Answer 6

• Could placebo and nocebo effect alter RPE and dyspnea of patients
• Could patients change breathing patterns based on perception of own breathing

Question 7

What were the participants in the Placebo/Nocebo Study?

Answer 7

N=30
- Healthy individuals
- Age Range: 19-44

Question 8

What happened during the first visit of the P/N study?

Answer 8

• Pulmonary Function Testing
• Incremental Cycling Test to Max

Question 9

What happened at the second visit of the P/N study?

Answer 9

Work Rate = 60% max
- Five, 5min cycling bouts (told breathing different O2%)

Question 10

What is the Priming Effect?

Answer 10

• Exposure that influence the behaviour of a subject later on, without that individual being aware that their behaviour is being guided to a certain extent

Question 11

What were the Findings of the P/N study?

Answer 11

• Subjects perception of breathing effort changed with perception of different oxygen concentration (not leg effort)
• Dyspnea changed in dose-response
• No difference in breathing pattern based on perceived own breathing efforts

Question 12

What reasoning does the study on P/N give for their conclusion? what is their conclusion?

Answer 12

Reasoning
- Treatments that improve dyspnea rating by 1-unit represent clinically meaningful change (Witek & Mahler, 2003)
Conclusion
- Clinicians and scientist should be careful when interpreting dysnpea and RPE ratings