O N Ferguson, M R Flynn, R A Mitchell, A S Hind, J I Arnold, S S Dhillon, P B Dominelli, Y Molgat-Seon, J A Guenette
{"title":"Sex differences in the physiological and perceptual responses to face masks during exercise.","authors":"O N Ferguson, M R Flynn, R A Mitchell, A S Hind, J I Arnold, S S Dhillon, P B Dominelli, Y Molgat-Seon, J A Guenette","doi":"10.1152/japplphysiol.00679.2024","DOIUrl":null,"url":null,"abstract":"<p><p>Despite consistent evidence that face masks (FMs) increase dyspnea during exercise, few studies have examined the sex differences in the physiological and perceptual responses to FMs. In a randomized, crossover design, 32 healthy individuals (16 females; 23 ± 3 yr) completed incremental cycling tests on two visits with either no mask or a surgical FM. Dyspnea intensity and unpleasantness were assessed using the 0-10 category-ratio Borg scale. Diaphragmatic electromyography, esophageal pressure (P<sub>eso</sub>), and transdiaphragmatic pressure (P<sub>di</sub>) were measured using a nasogastric catheter to estimate neural inspiratory drive and respiratory muscle effort. Surface electromyography (EMG) was measured on the sternocleidomastoid and scalene muscles. FMs resulted in a steeper increase in dyspnea unpleasantness in males compared with females across the 0%-100% work rate (estimate = 1.5 CR10, <i>P</i> = 0.0048), with no significant difference in the effect of the FM on dyspnea intensity between sexes (<i>P</i> > 0.05). Males had a greater increase in P<sub>eso</sub> and P<sub>di</sub> with FMs compared with females across work rate (-3.8 cmH<sub>2</sub>O, <i>P</i> = 0.0088; -4.7 cmH<sub>2</sub>O, <i>P</i> = 0.011, respectively) and a greater increase in sternocleidomastoid activation from 40%-60% work rate (WR) (all <i>P</i> < 0.05). In addition, moisture accumulation pre- versus postexercise (<i>P</i> = 0.01) was significantly greater in males compared with females. FMs resulted in a similar absolute reduction in exercise time in both sexes although it was only statistically significant in females (<i>P</i> = 0.006). This study highlights that males likely experience greater dyspnea unpleasantness with FMs due to higher flows and ventilations, which increase mask resistance and, combined with greater moisture accumulation, elevate respiratory muscle effort and accessory muscle activation. Nonetheless, the absolute impact on exercise duration appears similar between sexes.<b>NEW & NOTEWORTHY</b> During the coronavirus disease 2019 pandemic, numerous studies evaluated the effects of face masks on the physiological and perceptual responses to exercise. However, the symptoms of breathlessness and associated physiological mechanisms were largely neglected. In addition, our understanding of whether face masks affected males and females differently was particularly limited. We found that sex-specific physiological responses can guide exercise and face mask strategies to improve comfort and performance for individuals engaging in prolonged, intense workouts.</p>","PeriodicalId":15160,"journal":{"name":"Journal of applied physiology","volume":" ","pages":"926-938"},"PeriodicalIF":3.3000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of applied physiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1152/japplphysiol.00679.2024","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/27 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PHYSIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Despite consistent evidence that face masks (FMs) increase dyspnea during exercise, few studies have examined the sex differences in the physiological and perceptual responses to FMs. In a randomized, crossover design, 32 healthy individuals (16 females; 23 ± 3 yr) completed incremental cycling tests on two visits with either no mask or a surgical FM. Dyspnea intensity and unpleasantness were assessed using the 0-10 category-ratio Borg scale. Diaphragmatic electromyography, esophageal pressure (Peso), and transdiaphragmatic pressure (Pdi) were measured using a nasogastric catheter to estimate neural inspiratory drive and respiratory muscle effort. Surface electromyography (EMG) was measured on the sternocleidomastoid and scalene muscles. FMs resulted in a steeper increase in dyspnea unpleasantness in males compared with females across the 0%-100% work rate (estimate = 1.5 CR10, P = 0.0048), with no significant difference in the effect of the FM on dyspnea intensity between sexes (P > 0.05). Males had a greater increase in Peso and Pdi with FMs compared with females across work rate (-3.8 cmH2O, P = 0.0088; -4.7 cmH2O, P = 0.011, respectively) and a greater increase in sternocleidomastoid activation from 40%-60% work rate (WR) (all P < 0.05). In addition, moisture accumulation pre- versus postexercise (P = 0.01) was significantly greater in males compared with females. FMs resulted in a similar absolute reduction in exercise time in both sexes although it was only statistically significant in females (P = 0.006). This study highlights that males likely experience greater dyspnea unpleasantness with FMs due to higher flows and ventilations, which increase mask resistance and, combined with greater moisture accumulation, elevate respiratory muscle effort and accessory muscle activation. Nonetheless, the absolute impact on exercise duration appears similar between sexes.NEW & NOTEWORTHY During the coronavirus disease 2019 pandemic, numerous studies evaluated the effects of face masks on the physiological and perceptual responses to exercise. However, the symptoms of breathlessness and associated physiological mechanisms were largely neglected. In addition, our understanding of whether face masks affected males and females differently was particularly limited. We found that sex-specific physiological responses can guide exercise and face mask strategies to improve comfort and performance for individuals engaging in prolonged, intense workouts.
期刊介绍:
The Journal of Applied Physiology publishes the highest quality original research and reviews that examine novel adaptive and integrative physiological mechanisms in humans and animals that advance the field. The journal encourages the submission of manuscripts that examine the acute and adaptive responses of various organs, tissues, cells and/or molecular pathways to environmental, physiological and/or pathophysiological stressors. As an applied physiology journal, topics of interest are not limited to a particular organ system. The journal, therefore, considers a wide array of integrative and translational research topics examining the mechanisms involved in disease processes and mitigation strategies, as well as the promotion of health and well-being throughout the lifespan. Priority is given to manuscripts that provide mechanistic insight deemed to exert an impact on the field.