Article RETRACTED due to malpractice The effect of surgical face mask on heart rate recovery and endurance parameters in amateur runners
DOI:
https://doi.org/10.47197/retos.v82.108031Keywords:
Aerobic fitness, Cardiorespiratory, Recovery, RespiratoryAbstract
The use of protective face masks (PFM) has increased significantly since the advent of the COVID-19 pandemic. Their use is growing steadily, not only among healthcare personnel but also the general population. While PFMs are important for protection against airborne contaminants, their effect on physiological and autonomic responses during running has not been fully investigated. This study aimed to assess the impact of wearing a surgical mask on physiological indicators of endurance performance and heart rate recovery following aerobic exercise in amateur runners. Nine young males underwent a cardiopulmonary exercise test (CPET) and progressive square wave test (PSWT) on a treadmill with and without a surgical mask (SM). Cardiorespiratory parameters were evaluated during both CPET and PSWT, and autonomic parameters were measured during the 60-minute post-exercise recovery. The aerobic performance index showed that SM use resulted in lower peak VO2 (ml/kg/min) (p < 0.02). However, no significant differences were found in anaerobic threshold, respiratory compensation point, and running economy with SM use (p > 0.05). Similarly, SM use did not affect heart rate recovery (HRR), RR intervals, and rMSSD during recovery compared to no mask (NM) use (p > 0.05). In conclusion, using a surgical mask may decrease aerobic performance under maximal conditions. However, its use did not limit physiological indicators of endurance performance or heart rate recovery in amateur runners during submaximal aerobic running.
References
Barner, K. R., & Kilding, A. E. (2015). Running economy: measurement, norms, and determing factors. Sports Medicine, 1(8).
Borg, G. A. (1982). Psychophysical bases of perceived exertion. Med Sci Sports Exerc, 14(5), 377–381.
Boullosa, D., Esteve-Lanao, J., Casado, A., Peyré-Tartaruga, L. A., Gomes da Rosa, R., & Del Coso, J. (2020). Factors Affecting Training and Physical Performance in Recreational Endurance Runners. Sports, 8(3), 35. https://doi.org/10.3390/sports8030035
Brito, G. M., Prado, D. M. L. do, Rezende, D. A., de Matos, L. D. N. J., Loturco, I., Vieira, M. L. C., de Sá Pinto, A. L., Alô, R. O. B., de Albuquerque, L. C. A., Bianchini, F. R., Pinto, A. J., Roschel, H., Lemes, Í. R., & Gualano, B. (2023). The utility of cardiopulmonary exercise testing in athletes and physically active individuals with or without persistent symptoms after COVID-19. Frontiers in Medicine, 10(April), 1–9. https://doi.org/10.3389/fmed.2023.1128414
di Prampero, P. E. (1986). Energy Cost of Human Locomotion on Land and in Water. International Journal of Sports Medicine, 7, 55–72. https://doi.org/10.1055/s-2008-1025736
Doherty, C. J., Mann, L. M., Angus, S. A., Chan, J. S., Molgat-Seon, Y., & Dominelli, P. B. (2021). Impact of wearing a surgical and cloth mask during cycle exercise. Applied Physiology, Nutrition and Metabolism, 46(7), 753–762. https://doi.org/10.1139/apnm-2021-0190
Epstein, D., Korytny, A., Isenberg, Y., Marcusohn, E., Zukermann, R., Bishop, B., Minha, S., Raz, A., & Miller, A. (2020). Return to training in the COVID-19 era: The physiological effects of face masks during exercise. Scandinavian Journal of Medicine and Science in Sports. https://doi.org/10.1111/sms.13832
Fikenzer, S., Lavall, T. U. D., Falz, U. R. R., & Hepp, M. B. P. (2020). Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clinical Research in Cardiology, 1–9. https://doi.org/10.1007/s00392-020-01704-y
Fukushi, I., Nakamura, M., & Kuwana, S. I. (2021). Effects of wearing facemasks on the sensation of exertional dyspnea and exercise capacity in healthy subjects. PLoS ONE, 16(9 September), 1–10. https://doi.org/10.1371/journal.pone.0258104
Graham, B. L., Steenbruggen, I., Barjaktarevic, I. Z., Cooper, B. G., Hall, G. L., Hallstrand, T. S., Kaminsky, D. A., McCarthy, K., McCormack, M. C., Miller, M. R., Oropez, C. E., Rosenfeld, M., Stanojevic, S., Swanney, M. P., & Thompson, B. R. (2019). Standardization of spirometry 2019 update an official American Thoracic Society and European Respiratory Society technical statement. American Journal of Respiratory and Critical Care Medicine, 200(8), E70–E88. https://doi.org/10.1164/rccm.201908-1590ST
Hautala, A. J., Kiviniemi, A. M., & Tulppo, M. P. (2009). Individual responses to aerobic exercise: The role of the autonomic nervous system. Neuroscience and Biobehavioral Reviews, 33(2), 107–115. https://doi.org/10.1016/j.neubiorev.2008.04.009
Herdy, A. H., Ritt, L. E. F., Stein, R., de Araújo, C. G. S., Milani, M., Meneghelo, R. S., Ferraz, A. S., Hossri, C., de Almeida, A. E. M., da Silva, M. M. F., & Serra, S. M. (2016). Cardiopulmonary exercise test: Background, applicability and interpretation. Arquivos Brasileiros de Cardiologia, 107(5), 467–481. https://doi.org/10.5935/abc.20160171
Hopkins, S. R., Dominelli, P. B., Davis, C. K., Guenette, J. A., Luks, A. M., Molgat-Seon, Y., Sá, R. C., Sheel, A. W., Swenson, E. R., & Stickland, M. K. (2021). Face Masks and the Cardiorespiratory Response to Physical Activity in Health and Disease. Annals of the American Thoracic Society, 18(3), 399–407. https://doi.org/10.1513/AnnalsATS.202008-990CME
Howley, E. T., Bassett, D. R., & Welch, H. G. (1995). Criteria for maximal oxygen uptake: review and commentary. Med Sci Sports Exerc, 27(9), 1292–1301.
Jafarnezhadgero, A. A., Noroozi, R., Fakhri, E., Granacher, U., & Oliveira, A. S. (2022). The Impact of COVID-19 and Muscle Fatigue on Cardiorespiratory Fitness and Running Kinetics in Female Recreational Runners. Frontiers in Physiology, 13. https://doi.org/10.3389/fphys.2022.942589
John Hopkins University. (2023). COVID-19 Dashboard by the Center for Systems Science and Engineering. https://coronavirus.jhu.edu/map.html
Lee, D. C., Brellenthin, A. G., Thompson, P. D., Sui, X., Lee, I. M., & Lavie, C. J. (2017). Running as a key lifestyle medicine for longevity. Progress in Cardiovascular Diseases, 60(1), 45–55. https://doi.org/10.1016/j.pcad.2017.03.005
Maeder, M. T., Ammann, P., Rickli, H., & Brunner-La Rocca, H. P. (2009). Impact of the exercise mode on heart rate recovery after maximal exercise. European Journal of Applied Physiology, 105(2), 247–255. https://doi.org/10.1007/s00421-008-0896-2
McArdle. D William, Katch. I Frank, & Katch. L Victor. (2019). Sports and Exercise Nutrition Third Edition. In Sports and Exercise Nutrition 3rd ed.
Morris, N. B., Piil, J. F., Christiansen, L., Flouris, A. D., & Nybo, L. (2020). Prolonged facemask use in the heat worsens dyspnea without compromising motor-cognitive performance. Temperature. https://doi.org/10.1080/23328940.2020.1826840
Peçanha, T., Silva-Júnior, N. D., & Forjaz, C. L. de M. (2014). Heart rate recovery: Autonomic determinants, methods of assessment and association with mortality and cardiovascular diseases. Clinical Physiology and Functional Imaging, 34(5), 327–339. http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L52878030%5Cnhttp://dx.doi.org/10.1111/cpf.12102
Plews, D. J., Scott, B., Altini, M., Wood, M., Kilding, A. E., & Laursen, P. B. (2017). Comparison of heart-rate-variability recording with smartphone photoplethysmography, polar H7 chest strap, and electrocardiography. International Journal of Sports Physiology and Performance, 12(10), 1324–1328. https://doi.org/10.1123/ijspp.2016-0668
Poole, D. C., & Richardson, R. S. (1997). Determinants of oxygen uptake: Implications for exercise testing. Sports Medicine, 24(5), 308–320. https://doi.org/10.2165/00007256-199724050-00003
Prado, D. M. L., Rocco, E. A., Silva, A. G., Rocco, D. F., Pacheco, M. T., & Furlan, V. (2016). Effect of exercise training on ventilatory efficiency in patients with heart disease: A review. Brazilian Journal of Medical and Biological Research, 49(7), 1–10. https://doi.org/10.1590/1414-431X20165180
Prado, D. M. L., Silvino, V. O., Motta‐Santos, D., & dos Santos, M. A. P. (2022). The effect of the protective face mask on cardiorespiratory response during aerobic exercise. Clinical and Experimental Pharmacology and Physiology, 00, 1–9. https://doi.org/10.1111/1440-1681.13624
Prado, D. M. L. Do, Dragone, F., Silva, A. S. V. e, Ribeiro, S. L. G., Machado, D., Ferreira, C. P., Silvino, V. O., & Santos, M. A. P. dos. (2021). The effect of respiratory protective masks on ventilatory efficiency and operating lung volumes in a recreational runner. Gazzetta Medica Italiana - Archivio per Le Scienze Mediche EDIZIONI MINERVA MEDICA.
Ramos-Campo, D. J., Pérez-Piñero, S., Muñoz-Carrillo, J. C., López-Román, F. J., García-Sánchez, E., & Ávila-Gandía, V. (2021). Acute effects of surgical and FFP2 face masks on physiological responses and strength performance in persons with sarcopenia. Biology, 10(3), 1–9. https://doi.org/10.3390/biology10030213
Rosa, B. V., Rossi, F. E., Moura, H. P. dos S. N. de, Santos, A. M. da S., Véras-Silva, A. S., Ribeiro, S. L. G., Nakamura, F. Y., Santos, M. A. P. dos, & Pereira dos Santos, M. A. (2021). Effects of FFP2/N95 face mask on low- and high-load resistance exercise performance in recreational weight lifters. European Journal of Sport Science. https://doi.org/10.1080/17461391.2021.1953613
Scheer, V., Valero, D., Villiger, E., Rosemann, T., & Knechtle, B. (2021). The impact of the covid-19 pandemic on endurance and ultra-endurance running. Medicina (Lithuania), 57(1), 1–8. https://doi.org/10.3390/medicina57010052
Shaw, K. A., Butcher, S., Ko, J. B., Absher, A., Gordon, J., Tkachuk, C., Zello, G. A., & Chilibeck, P. D. (2021). Wearing a surgical face mask has minimal effect on performance and physiological measures during high-intensity exercise in youth ice-hockey players: A randomized cross-over trial. International Journal of Environmental Research and Public Health, 18(20). https://doi.org/10.3390/ijerph182010766
Shaw, K. A., Zello, G. A., Butcher, S. J., Ko, J. B., Bertrand, L., & Chilibeck, P. D. (2021). The impact of face masks on performance and physiological outcomes during exercise: a systematic review and meta-analysis. Applied Physiology, Nutrition, and Metabolism, 703, 1–11. https://doi.org/10.1139/apnm-2021-0143
Shaw, K., Butcher, S., Ko, J., Zello, G. A., & Chilibeck, P. D. (2020). 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, 17(21), 1–9. https://doi.org/10.3390/ijerph17218110
Shein, S. L., Whitticar, S., Mascho, K. K., Pace, E., Speicher, R., & Deakins, K. (2021). The effects of wearing facemasks on oxygenation and ventilation at rest and during physical activity. PLoS ONE, 16(2 February), 1–7. https://doi.org/10.1371/journal.pone.0247414
Śliż, D., Wiecha, S., Gąsior, J. S., Kasiak, P. S., Ulaszewska, K., Postuła, M., Małek, Ł. A., & Mamcarz, A. (2022). The Influence of Nutrition and Physical Activity on Exercise Performance after Mild COVID-19 Infection in Endurance Athletes-CESAR Study. Nutrients, 14(24). https://doi.org/10.3390/nu14245381
Steinhilber, B., Seibt, R., Gabriel, J., Brountsou, J., Muljono, M., Downar, T., Bär, M., Bonsch, R., Brandt, A., Martus, P., & Rieger, M. A. (2022). Effects of Face Masks on Physical Performance and Physiological Response during a Submaximal Bicycle Ergometer Test. International Journal of Environmental Research and Public Health, 19(3), 1–26. https://doi.org/10.3390/ijerph19031063
Trevizani, G. A., Benchimol-Barbosa, P. R., & Nadal, J. (2012). Effects of age and aerobic fitness on heart rate recovery in adult men. Arquivos Brasileiros de Cardiologia, 99(3), 802–810. http://www.ncbi.nlm.nih.gov/pubmed/22836359
Vincent, M., & Edwards, P. (2016). Disposable surgical face masks for preventing surgical wound infection in clean surgery. Cochrane Database of Systematic Reviews, 2016(4), 1–14. https://doi.org/10.1002/14651858.CD002929.pub3
World Health Organization. (2020). Advice on the use of masks in the context of COVID-19. Interim Guidance, 1–5. https://doi.org/10.1093/jiaa077
Zhang, G., Li, M., Zheng, M., Cai, X., Yang, J., Zhang, S., Yilifate, A., Zheng, Y., Lin, Q., Liang, J., Guo, L., & Ou, H. (2021). Effect of Surgical Masks on Cardiopulmonary Function in Healthy Young Subjects: A Crossover Study. Frontiers in Physiology, 12(September), 1–12. https://doi.org/10.3389/fphys.2021.710573
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Marcos Antônio Pereira dos Santos, Valmir Oliveira Silvino, Sérgio Luís Galan Ribeiro, Felipe Machado Brito, Acácio Salvador Veras-Silva, Fábio Yuzo Nakamura, Bruno Viana Rosa, Daisy Motta-Santos, Danilo Marcelo Leite do Prado

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and ensure the magazine the right to be the first publication of the work as licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of authorship of the work and the initial publication in this magazine.
- Authors can establish separate additional agreements for non-exclusive distribution of the version of the work published in the journal (eg, to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Is allowed and authors are encouraged to disseminate their work electronically (eg, in institutional repositories or on their own website) prior to and during the submission process, as it can lead to productive exchanges, as well as to a subpoena more Early and more of published work (See The Effect of Open Access) (in English).
This journal provides immediate open access to its content (BOAI, http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess) on the principle that making research freely available to the public supports a greater global exchange of knowledge. The authors may download the papers from the journal website, or will be provided with the PDF version of the article via e-mail.