Evaluation of performance measures during the Six-Minute Walk Test (6MWT) with and without a facemask

Abstract

Background: Throughout the COVID-19 pandemic, health officials have been setting various personal protective equipment recommendations for different populations to prevent the spread of these highly contagious viral particles. There is limited research comparing performance measures with and without wearing a surgical mask (SM) or an N95 mask among college age individuals while completing a submaximal exercise test, such as the 6MWT. Purpose: The purpose of this study was to compare Six-Minute Walk Distance (6MWD), heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2), rating of perceived exertion (RPE), and rating of perceived dyspnea (RPD) when performing the 6MWT with and without the use of a SM and an N95 mask. Study Design: This was a prospective, randomized, and counterbalanced repeated measures design with three testing conditions (no mask, SM, and N95 mask). Methods: Twelve college aged individuals (3 males, 9 females), ranging from 23-25 years of age, completed a familiarization 6MWT and three separate 6MWTs. All testing was performed outside on a 30-meter long, flat corridor. Prior to being tested, subjects completed the PAR-Q+, ACSM Exercise Pre-Participation Health Screening Questionnaire, COVID-19 Screening Questionnaire, and had their temperature, height, weight and blood pressure measured. Six-Minute Walk Distance, HR, RR, SpO2, RPE and RPD were compared between conditions and across time using a two-way analysis of variance (ANOVA) with repeated measures. If there was a significant F ratio, Bonferoni post-hoc tests were used to assess pairwise comparison. Alpha was set at p < .05 to achieve statistical significance. Results: No significant difference was found in 6MWD between testing conditions. HR, RR, and RPE significantly increased across time but there was no difference between conditions. No significant difference was found in SpO2 values. The N95 mask elicited significantly higher RPD scores. Conclusions: Wearing a SM or an N95 mask had no significant effect on 6MWD, HR, RR, RPE and SpO2 values among healthy college aged individuals when performing the 6MWT. The N95 mask was associated with significantly higher RPD scores when completing the 6MWT. This could be due to the tighter face seal, increased breathing resistance, an increase in heat/humidity levels, and the trapping of carbon dioxide inside the N95 mask.