Efeitos da máscara cirúrgica na tolerância ao exercício físico em esteira rolante na era da COVID-19
Abstract
A COVID-19 foi responsável por mais de 5 milhões de mortes em todo o mundo. Apresenta altíssimo poder de contágio e quadro clínico mutável, que pode prejudicar as funções cardiovasculares, metabólicas e pulmonares no ser humano. Assim, o uso de máscaras faciais (MF) foi recomendado visando à contenção da doença. O objetivo deste trabalho foi avaliar a tolerância ao exercício (Tlim) em esteira rolante em pacientes pós-infecção pelo vírus da COVID-19 de apresentação clínica leve com MF cirúrgica e sem uso da máscara (SM). Para tanto, 20 voluntários sedentários que tiveram diagnóstico prévio de COVID-19, mínimo de 30 dias, na forma leve ou assintomática foram selecionados para realizar dois testes de exercício (TE) em dias separados, intervalo de uma semana, em duas situações: com MF cirúrgica e SM. A média de idade dos indivíduos foi de 26,65 + 3,85 anos e o índice de massa corporal (IMC) médio de 24,99 + 3,42 kg/m2. O Tlim foi menor com MF cirúrgica durante o TE (p=0,024) em relação a SM. A SpO2, tanto em repouso quanto no pico do exercício, foi menor com MF cirúrgica (p=0,042 e p<0,001, respectivamente). Sendo assim, o uso da MF cirúrgica levou à redução no Tlim em esteira rolante, e a SpO2 mostrou-se diminuída em repouso e no pico do exercício em comparação a SM. A maioria dos participantes relatou desconforto com o uso da MF cirúrgica. Portanto, o estudo direciona para possíveis limitações fisiológicas do uso da MF cirúrgica frente ao exercício físico.
References
Barret K,Barman, SM, Brooks, HL, Yuan, JX. Ganong’s review of medical physiology. Ed. 25. California. McGraw-Hill Education. 2016.
Bastug A, Bodur H, Erdogan S, Gokcinar D, Kazancioglu S, Kosovali BD, Ozbay BO, Gok G, Turan IO, Yilmaz G, Gonen CC, Yilmaz FM. Clinical and laboratory features of COVID-19: Predictors of severe rognosis. International Immunopharmacology, 88, 1-7, 2020.
Borg GA. Psychophysical Bases of Perceibed Exertion. Medicine & Sports & Exercise, 14, 5, 377-381, 1982.
Cascella M, Rajnik M, Aleem A, Dulebohn SC, Di Napoli R. Features, Evaluation, and Treatment of Coronavirus (COVID-19). In: Stat Pearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2022. Disponível em: https://www.ncbi.nlm.nih.gov/books/NBK554776/. Acesso em: 08 fev. 2023.
Costa CLA, Costa TM, Barbosa Filho VC, Bandeira PFR, Siqueira RCL Influence of social distancing on the level of physical activity during the COVID-19 pandemic. Revista Brasileira de Atividade Física & Saúde, 25, 1-6, 2020.
Dalakoti M, Long C, Bains A, Djohan A, Ahmad I, Chan SP, Kua J, Chan PF, Yeo TJ. Effect of Surgical Mask use on Peak Physical Performance During Exercise Treadmill Testing-A Real World, Crossover Study. Frontiers in Physiology, 13, 2022.
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, 6, 753-762, 2021.
Dirol H, Alkan E, Sindel M, Ozdemir T, Erbas D. The physiological and disturbing effects of surgical face masks in the COVID-19 era. Bratislavské Lekárske Listy, 122, 821-825, 2021.
Driver S, Reynolds M, Brown K, Vingren JL, Hill DW, Bennett M, Gilliland T, McShan E, Callender L, Reynolds E, Borunda N, Mosolf J, Cates C, Jones A. 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, 56, 07-113, 2021.
Epstein D, Korytny A, Isenberg Y, Marcusohn E, Zukermann R, Bishop B, Minha S, Raz A, Miller A. Return to training in the COVID-19 era: The physiological effects of face masks during exercise. Scandinavian Journal of Medicine & Science in Sports, 31, 70-75, 2021.
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, 109, 12, 1522-1530, 2020,
Fischer P, Blumenauer D, Egger F, Fikenzer S, Zimmer A, Kulenthiran S, Laufs U, Bewarder Y, Böhm M, Mahfoud F. Effects of Medical Face Masks on Physical Performance in Patients With Coronary Artery Disease or Hypertension. The American Journal of Cardiology, 173, 1-7, 2022.
Fernandes França E, Monteiro Macedo M, Regina de França T, Figueiredo Cossote D, Gonçalves L, Campos dos Santos PA, Miyake GM. Health screening for participation in Physical Exercise programs after the COVID-19 pandemic: A necessary and emerging action for Physical Education Professionals. InterAmerican Journal of Medicine and Health, 3, 2020.
Gardin JM, Adams DB, Douglas PS, Feigenbaum H, Forst DH, Fraser AG, Grayburn PA, Katz AS, Keller AM, Kerber RE, Khandheria BK, Klein AL, Lang RM, Pierard LA, Quinones MA, Schnittger I; American Society of Echocardiography. Recommendations for a standardized report for adult transthoracic echocardiography: a report from the American Society of Echocardiography's Nomenclature and Standards Committee and Task Force for a Standardized Echocardiography Report. Journal of the American
Society of Echocardiography, 15, 3, 275-90, 2002.
Hopkins SR, Dominelli PB, Davis CK, Guenette JA, Luks AM, Molgat-Seon Y, Sá RC, Sheel AW, Swenson ER, Stickland MK. Face Masks and the Cardiorespiratory Response to Physical Activity in Health and Disease. Annals of th American Thoracic Society, 18, 399-407, 2021.
Jones N, Oke J, Marsh S, Nikbin K, Bowley J, Dijkstra HP, Hobbs FR, Greenhalgh T. Face masks while exercising trial (MERIT): a cross-over randomised controlled study. BMJ Open, 13, e063014, 2023
Jones N, Oke J, Marsh S, Nikbin K, Bowley J, Dijkstra HP, Hobbs FR, Greenhalgh T. The effects of face masks on cardiopulmonary capacity in healthy young individuals. The Journal of Sports Medicine and Physical Fitness. 62, 1301-1305, 2022.
Kwon H, KIM D. Effects of High Intensity Exercise on Physiological Indicators of the Recovery Period Using Face Masks in Elite Athletes. Health (Basel, Switzerland), 11, 268, 2023.
Li Y, Tokura H, Guo YP, Wong AS, Wong T, Chung J, Newton E. Effects of wearing N95 and surgical facemasks on heart rate, thermal stress and subjective sensations. International Archives of Occupational and Environmental Health, 78, 501-509, 2005.
Lin Q, Cai Y, Yu C, Gu W, Tan Y, Wang L, Chen A, Cheng K, Meng T, Li X. Effects of wearing face mask use on exercise capacity and ventilated anaerobic threshold in healthy subjects during the COVID-19 epidemic. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 28, e936069, 2022.
Meneghelo RS. Araújo, CGS Stein, R, Mastrocolla, LE, Albuquerque, PF, Serra, SM. III Diretrizes da Sociedade Brasileira de Cardiologia sobre teste ergométrico. Arquivos Brasileiros de Cardiologia [online], 95, 1-26, 2010.
Organização Mundial da Saúde. Conselhos sobre a doença do coronavírus (COVID-19) para o público. Caçadores de Mito. Disponível em: https://www.who.int/pt/emergencies/diseases/novel-coronavirus-2019/advice-for-public. Acesso em:05 fev. 2023.
Wangüemert Pérez F, Wangüemert Guerra M, Caballero Dorta E, Acosta Materan CJ, Tormo Juarez JP, Godoy Camacho C, Cardenes Leon A, Segura Villalobos F, Medina Gil JM, Perez ML, García Salvador JJ, Mateos Cañero GO, Jiménez Rivero C, Martínez-
Quintana E. Impact of face masks during the treadmill exercise tests. Medicina Clinica (Barc). 24, 255-X, 2022.
Pimenta T, Tavares H, Ramos J, Oliveira M, Reis D, Amorim H, Rocha A. Face masks during aerobic exercise: Implications for cardiac rehabilitation programs during the Covid-19 pandemic. Revista Portuguesa de Cardiologia (Engl Ed), 40, 957-964, 2021.
Poon E, Zheng C, Wong SH. Effect of Wearing Surgical Face Masks During Exercise: does intensity matter? Frontiers In Physiology, 12, 750-775, 2021.
Porcari JP, Probst L, Forrester K, Doberstein S, Foster C, Cress ML, Schmidt K. Effect of Wearing the Elevation Training Mask on Aerobic Capacity, Lung Function, and Hematological Variables. Journal of Sports Science & Medicine, 15, 379-86, 2016
Rosa BV, Rossi FE, Moura HPDSN, Santos AMDS, Véras-Silva AS, Ribeiro SLG, Nakamura FY, Pereira Dos Santos MA. Effects of FFP2/N95 face mask on low- and high-load resistance exercise performance in recreational weight lifters. European Journal of Sport Science, 22, 1326-1334, 2022.
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, 17, 8110, 2020.
Shaw KA, Zello GA, Butcher SJ, Ko JB, Bertrand L, Chilibeck PD. The impact of face masks on performance and physiological outcomes during exercise: a systematic review and meta-analysis. Applied Physiology, Nutrition, and Metabolism Physiologie Appliquee, Nutrition et Metabolism, 46, 693-703, 2021.
Shui L, Yang B, Tang H, Luo Y, Hu S, Zhong X, Duan J. Physiological effects of surgical and N95 masks during exercise in the era of COVID-19. The American Journal of the Medical Sciences, 363, 411-419, 2022.
Shurlock J, Muniz-Pardos B, Tucker R, Bachl N, Papadopoulou T, Holloway G, Jones N, Bigard X, Vonbank K, Niederseer D, Meyer J, Nowak D, Debruyne A, Zupet P, Löllgen H, Steinacker JM, Wolfarth B, Bilzon JLJ, Ionescu A, Dohi M, Swart J, Constantinou D, Badtieva V, Zelenkova I, Casasco M, Geistlinger M, Fossati C, Fagnani F, Di Luigi L, Webborn N, Angeloudis K, Guppy FM, Singleton P, Miller M, Pigozzi F, Pitsiladis YP. Recommendations for Face Coverings While Exercising During the COVID-19 Pandemic. Sports Medicine Open, 7, 19, 2021.
Souza MO, Silva, ACS, Almeida, JR, Santos, JFM, Santana, LF, Nascimento, MBC, Souza, EC. Impacts of COVID-19 on cardiorespiratory fitness: functional exercises and physical activity. Revista Brasileira de Atividade Física & Saúde. 25, 1-5, 2020.
Umutlu G, Acar NE, Sinar DS, Akarsu G, Güven E, Yildirim I. COVID-19 and physical activity in sedentary individuals: differences in metabolic, cardiovascular, and respiratory responses during aerobic exercise performed with and without a surgical face masks. The Journal Of Sports Medicine And Physical Fitness. 62, 851-858, 2022.
Vishwanath V, Favo CL, Tu TH, Anderson B, Erickson C, Scarpulla M, Kern J, DeWinter L, Gawelko A, Bolch C, Al-Nakkash L. Effects of face masks on oxygen saturation at graded exercise intensities. Jornal de Medicina Osteopática, online ahead of print. Oct. 2022. Disponível em :https://pubmed.ncbi.nlm.nih.gov/36259531/. Acessado em: 05 fev. 2023.
Vivacqua R, Hespanha R. Interpretation of the exercise test in ergometry and rehabilitation in cardiology. Rio de Janeiro: Medsi, 1992.
Wang H, Paulson KR, Pease SA, Watson S, Comfort H, Zheng p, Aravkin AY, Bisignano C, Barber RM, Alam T, Fuller JE, May EA. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020-21. The Lancet, 399, 1513-1536, 2022.
Yoshihara A, Dierickx EE, Brewer GJ, Sekiguchi Y, Stearns RL, Casa DJ. Effects of Face Mask Use on Objective and Subjective Measures of Thermoregulation During Exercise in the Heat. Sports Health, 13, 463-470, 2021.
Zhang G, Li M, Zheng M, Cai X, Yang J, Zhang S, Yilifate A, Zheng Y, Lin Q, Liang J, Guo L, Ou H. Effect of Surgical Masks on Cardiopulmonary Function in Healthy Young Subjects: a crossover study. Frontiers in Physiology, 12, 710573, 2021.
Zheng C, Poon ET, Wan K, Dai Z, Wong SH. Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis. Sports Medicine, 53, 125-150, 2023.
Copyright (c) 2023 Gilber Junior Ferreira Gouveia, Leandro Steinhorst Goelzer
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Ao publicar na PECIBES, os direitos de copyright são mantidos pelos autores. Acreditamos que isto permite aos autores ampla divulgação do trabalho, sendo os mesmos responsáveis por todas as informações veiculadas. No entanto, em caso de reuso dos dados, a origem (Revista PECIBES) deve ser citada.