Effect of Wearing Face Masks During Exercise on Pulmonary Function in Healthy Non-Athlete Young Men During the Covid-19 Epidemic: Cloth Masks vs. Medical Masks

Document Type : Original Article


1 Assistant Professor, Department of Sports Physiology and Immunology, Faculty of Literature and Human Sciences, University of Qom, Qom, Iran.

2 Department of Sports Physiology and Immunology, Faculty of Literature and Human Sciences, University of Qom, Qom, Iran


Background and Objectives One of the safety methods to prevent the spread of Covid-19 is to wear face masks. The aim of the current research was to compare the effect of wearing cloth vs. medical masks during exercise on lung function in healthy non-athlete young men during the Covid-19 epidemic. Subjects and Methods In this quasi-experimental research, 40 healthy men (mean age: 29.40 years, mean height: 175.30 cm, mean weight: 73.37 kg, and mean body mass index: 23.56 kg/m2) were selected by purposive sampling method and randomly allocated into 4 groups: 1- combined exercises + medical mask, 2-combined exercises + cloth mask, 3- combined exercises, and 4- control. Pulmonary function was measured using a spirometer. The training intervention included three sessions of combined training (aerobic-resistance) continued for eight weeks. Statistical analysis involved paired sample t-tests, analysis of covariance, and Benferroni's post hoc test. Results A significant increase in tidal volume (VT), vital capacity (VC), total lung capacity (TLC), and peak expiratory flow (PEF) was observed after exercise training (P <0.01). However, using medical or cloth masks led to a significant decrease in VT, VC, TLC and PEF indices compared to the activity group not wearing masks (P <0.01). Other results also showed that there is no significant difference between cloth and medical masks in terms of the pulmonary indices of the healthy young men studied (P>0.05). Conclusion The results of this research show that wearing masks during exercise reduces lung function by increasing airway resistance.


Main Subjects

[1] Ghalavand A, Fathi K, Ghobadi MR, Jafari M, Moslehi M, Mafakher L, Zeighami F. The role of physical activity in modulating COVID-19 neuropsychological complications: a narrative review. Razi Journal of Medical Sciences. 2022. [Link]
[2] Li T, Liu Y, Li M, Qian X, Dai SY. Mask or no mask for COVID-19: A public health and market study. PloS one. 2020 Aug 14;15(8):e0237691. [10.1371/journal.pone.0237691] [PMID]
[3] Ju JT, Boisvert LN, Zuo YY. Face masks against COVID-19: Standards, efficacy, testing and decontamination methods. Advances in Colloid and Interface Science. 2021 Jun 1;292:102435. [10.1016/j.cis.2021.102435 ] [PMID]
[4] Tirupathi R, Bharathidasan K, Palabindala V, Salim SA, Al-Tawfiq JA. Comprehensive review of mask utility and challenges during the COVID-19 pandemic. Infez Med. 2020 Jun 1;28(suppl 1):57-63. [] [PMID]
[5] Driver S, Reynolds M, Brown K, Vingren JL, Hill DW, Bennett M, Gilliland T, McShan E, Callender L, Reynolds E, Borunda N. Effects of wearing a cloth face mask on performance, physiological and perceptual responses during a graded treadmill running exercise test. British journal of sports medicine. 2022 Jan 1;56(2):107-13. [10.1136/bjsports-2020-103758 ] [PMID]
[6] Füzéki E, Groneberg DA, Banzer W. Physical activity during COVID-19 induced lockdown: recommendations. Journal of Occupational Medicine and Toxicology. 2020 Dec;15(1):1-5.
[10.1186/s12995-020-00278-9 ] [PMID]
[7] Epstein D, Korytny A, Isenberg Y, Marcusohn E, Zukermann R, Bishop B, Minha SA, Raz A, Miller A. Return to training in the COVIDÔÇÉ19 era: the physiological effects of face masks during exercise. Scandinavian journal of medicine & science in sports. 2021 Jan;31(1):70-5. [10.1111/sms.13832 ] [PMID]
[8] Person E, Lemercier C, Royer A, Reychler G. Effect of a surgical mask on six minute walking distance. Revue des maladies respiratoires. 2018 Feb 1;35(3):264-8. [10.1016/j.rmr.2017. 01.010 ] [PMID]
[9] Mapelli M, Salvioni E, De Martino F, Mattavelli I, Gugliandolo P, Vignati C, Farina S, Palermo P, Campodonico J, Maragna R, Russo GL. “You can leave your mask on”: effects on cardiopulmonary parameters of different airway protective masks at rest and during maximal exercise. European Respiratory Journal. 2021 Sep 1;58(3). [10.1183/13993003. 04473-2020 ] [PMID]
[10] Dana A, Fallah Z, Moradi J, Ghalavand A. The effect of cognitive and aerobic training on cognitive and motor function, and brain-derived neurotrophic factors in elderly men. Journal of Sports and Motor Development and Learning. 2019 Jan 21;10(4):537-52. [10.22059/jmlm.2018.252689.1352]
[11] Afshonpour MT, Ghalavand A, Rezaee R, Habibi A. The effect of exercise training on pulmonary function in type 2 diabetic men. Alborz university medical journal. 2015 Nov 10;4(4):255-65. [Link]
[12] Ghalavand A, Delaramnasab M, Ghanaati S. Comparison of the effect of telenursing and aerobic training on cardiometabolic and anthropometric indices in patients with type 2 diabetes. Razi Journal of Medical Sciences. 2021 Jul 10;28(4):34-45.
[13] Ghalavand A, Saki H, Nazem F, Khademitab N, Behzadi Nezhad H, Behbodi M, Zeighami F. The effect of ganoderma supplementation and selected exercise training on glycemic control in boys with type 1 diabetes. Jundishapur Scientific Medical Journal. 2021 Sep 23;20(4):356-65. [10.32598/JSMJ. 20.4.2426]
[14] Hosseinpour Delavar S, Boyerahmadi A, Soleymani A, Ghalavand A. Effect of eight weeks of aerobic interval training and Urtica dioica supplement on some inflammatory indicators and glycemic control in men with type 2 diabetes. Jundishapur Scientific Medical Journal. 2020 Jun 21;19(2):123-35. [Link]
[15] Mohammadi F, Ghalavand A, Delaramnasab M. Effect of circuit resistance training and L-carnitine supplementation on body composition and liver function in men with non-alcoholic fatty liver disease. Jundishapur Journal of Chronic Disease Care. 2019 Oct 31;8(4). [Link]
[16] Tahan P, Ghalavand A, Heydarzadi S, Maleki E, Delaramnasab M. Effects of aerobic interval training on iron stores and glycemic control in men with type 2 diabetes. Razi Journal of Medical Sciences. 2020 Oct 10;27(8):105-14. [Link]
[17] Ghalavand A, Shakeriyan S, Monazamnezhad A, Delaramnasab M. The effect of resistance training on cardio-metabolic factors in males with type 2 diabetes. Jundishapur Journal of Chronic Disease Care. 2014 Oct 1;3(4). [10.17795/jjcdc-23346]
[18] Habibi A, Maleki F, Rami M, Ghalavand A, Jahanbakhsh H, Dehghan M, Asare E. The relationship between physical activities with some of physical and physiologic indexes of the citizens of Khuzestan province. Sport physiology. 2018 Jul 23;10(38):215-34. [10.22089/spj.2018.4773.1642]
[19] Ghalavand A, Azadi M, Mohammadpour Z, Ghalavand N, Ghalavand M, Ghalavand M, et al. A review of cognitive complications of type 1 diabetes: a narrative review. Jundishapur Scientific Medical Journal. 2023;21(6):1-10. [10. 32598/JSMJ.21.6.2884]
[20] Fikenzer S, Uhe T, Lavall D, Rudolph U, Falz R, Busse M, Hepp P, Laufs U. Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clinical research in cardiology. 2020 Dec;109(12):1522-30. [10.1007 / s00392-020-01704-y ] [PMID]
[21] Lee PH, Macfarlane DJ, Lam TH, Stewart SM. Validity of the international physical activity questionnaire short form (IPAQ-SF): A systematic review. International journal of behavioral nutrition and physical activity. 2011 Dec;8(1):1-1.[ 10.1186/ 1479-5868-8-115] [PMID]
[22] Moghaddam MB, Aghdam FB, Jafarabadi MA, Allahverdipour H, Nikookheslat SD, Safarpour S. The Iranian Version of International Physical Activity Questionnaire (IPAQ) in Iran: content and construct validity, factor structure, internal consistency and stability. World Appl Sci J. 2012;18(8):1073-80. [10.5829/idosi.wasj.2012.18.08.754] [Link]
[23] Rashidian S, Fathi K, Ghalavand A. Comparison of quality of life, thyroid hormones and blood glucose in active and inactive pregnant women. Jundishapur Scientific Medical Journal. 2023 May 22;22(2). [Link]
[24] Mahmoodinezhad S, Shakerian S, Ghalavand A, Motamedi P, Delaramnasab M. The Effect of acute training and circadian rhythm on blood hemostasis in female athletes. International
Delshad A, et al. Effect of Wearing Face Masks During Exercise on Pulmonary Function. JSMJ. 2023; 22(3): 366-376
Journal of Medical Sciences
July & August 2023. Vol 22. No 3
Journal of Basic Science in Medicine. 2016 Jun 22;1(1):8-12. [10.15171/ijbsm.2016.03] [Link]
[25] Mongin D, Chabert C, Uribe Caparros A, Collado A, Hermand E, Hue O, Alvero Cruz JR, Courvoisier DS. Validity of dynamical analysis to characterize heart rate and oxygen consumption during effort tests. Scientific Reports. 2020 Jul 24;10(1):12420. [10.1038/s41598-020-69218-1] [PMID]
[26] Ghalavand A, Delaramnasab M, Afshounpour M, Zare A. Effects of continuous aerobic exercise and circuit resistance training on fasting blood glucose control and plasma lipid profile in male patients with type II diabetes mellitus. Journal of Diabetes Nursing. 2016 Jan 10;4(1):8-19. [Link]
[27] Alkan B, Ozalevli S, Akkoyun Sert O. Maximal exercise outcomes with a face mask: the effects of gender and age differences on cardiorespiratory responses. Irish Journal of Medical Science (1971-). 2022 Oct;191(5):2231-7. [10.1007/ s11845-021-02861-3 ] [PMID]
[28] Lässing J, Falz R, Pökel C, Fikenzer S, Laufs U, Schulze A, Hölldobler N, Rüdrich P, Busse M. Effects of surgical face masks on cardiopulmonary parameters during steady state exercise. Scientific Reports. 2020 Dec 21;10(1):22363. [10.1038/s41598-020-78643-1 ] [PMID]
[29] Doherty CJ, Mann LM, Angus SA, Chan JS, Molgat-Seon Y, Dominelli PB. Impact of wearing a surgical and cloth mask during cycle exercise. Applied Physiology, Nutrition, and Metabolism. 2021;46(7):753-62. [10.1139/apnm-2021-0190] [PMID]
[30] Shaw K, Butcher S, Ko J, Zello GA, Chilibeck PD. Wearing of cloth or disposable surgical face masks has no effect on vigorous exercise performance in healthy individuals. International Journal of Environmental Research and Public Health. 2020 Jan;17(21):8110. [10.3390/ijerph17218110 ] [PMID]
[31] Boyle KG, Napoleone G, Ramsook AH, Mitchell RA, Guenette JA. Effects of the Elevation Training Mask® 2.0 on dyspnea and respiratory muscle mechanics, electromyography, and fatigue during exhaustive cycling in healthy humans. Journal of Science and Medicine in Sport. 2022 Feb 1;25(2):167-72. [10.1016/j.jsams.2021.08.022 ] [PMID]
[32] Sheel AW, Derchak PA, Morgan BJ, Pegelow DF, Jacques AJ, Dempsey JA. Fatiguing inspiratory muscle work causes reflex reduction in resting leg blood flow in humans. The Journal of physiology. 2001 Nov;537(1):277-89. [10.1111/j.1469-7793. 2001.0277k.x ] [PMID]
[33] Harms CA, Wetter TJ, McClaran SR, Pegelow DF, Nickele GA, Nelson WB, Hanson P, Dempsey JA. Effects of respiratory muscle work on cardiac output and its distribution during maximal exercise. Journal of applied physiology. 1998 Aug 1;85(2):609-18. [10.1152/jappl.1998.85.2.609]
[34] Lee HP, Wang DY. Objective assessment of increase in breathing resistance of N95 respirators on human subjects. Annals of occupational hygiene. 2011 Oct 1;55(8):917-21. [] [PMID]
[35] Melissant CF, Lammers JW, Demedts M. Relationship between external resistances, lung function changes and maximal exercise capacity. European Respiratory Journal. 1998 Jun 1;11(6):1369-75. [] [PMID]
[36] Kyung SY, Kim Y, Hwang H, Park JW, Jeong SH. Risks of N95 face
mask use in subjects with COPD. Respiratory care. 2020 May 1;65(5):658-64. [] [PMID]