Impact of wearing surgical face masks on heart rate and oxygen saturation levels during the Chester Step Test exercise

Objective: Wearing a mask is recommended during COVID-19 outbreaks as a means of source control. However, controversies persist regarding wearing masks during exercise. This study aimed to assess the impact of surgical mask use on heart rate and oxygen saturation during the Chester Step Test (CST). Methods: This is a prospective crossover study involving 24 individuals (12 females and 12 males) aged 35.4 ± 3.9 years with prior ethical clearance obtained. All healthy participants underwent the CST with and without wearing the surgical mask. The CST comprised five stages, each lasting two minutes, progressively intensifying from low to vigorous levels. Measurements of heart rate, oxygen saturation using MIR Spirodoc, and perceived exertion based on the Borg Scale were obtained every two minutes throughout the exercise stages. Statistical analysis utilized the paired sample T-test and Wilcoxon signed-rank test. Results: Six females and three males couldn't complete up to stage V of the test. Wearing a surgical mask resulted in significant variations than without a mask. During CST, wearing a mask resulted in reduced oxygen saturation (mean ± SD) (94.8 ± 1.8 vs. 96.0 ± 1.9, p=0.01) in stage III, increased heart rate (123 ± 16 vs. 117 ± 14, p=0.02) in stage II, and higher perceived exertion on the Borg scale in stage II [Q2(Q1-Q3)] [8(7-9) vs. 7(7-8.8), p=0.01)], stage IV [12(10-13) vs. 11(10-12), p=0.03] and stage V [13(12-13) vs. 12(10-13), p=0.01]. Conclusion: Wearing surgical masks affected heart rate in stage II, oxygen saturation in stage III and perceived exertion in stage II, IV, and V during the Chester Step Test. These findings emphasize the potential impact of mask use on physiological responses during exercise.