Department of Internal Medicine, University Hospitals Cleveland Medical Center, and Case Western Reserve University, School of Medicine, Cleveland, Ohio (Drs Haraf and Josephson); Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, Illinois (Drs Haraf, Faghy, and Josephson); Human Science Research Centre, University of Derby, Derby, England, United Kingdom (Dr Faghy); Sleep Medicine and Lung Health Consultants, Pittsburgh Critical Care Associates, Pittsburgh, Pennsylvania (Dr Carlin); and Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Dr Josephson).
J Cardiopulm Rehabil Prev. 2021 Jan 1;41(1):1-5. doi: 10.1097/HCR.0000000000000577.
Masking has been employed as a strategy for reducing transmission of a variety of communicable diseases. With the outbreak of SARS-CoV-2, many countries have implemented mandatory public masking. However, the perceived impact of mask use on pulmonary function has been a deterrent to public compliance with recommendations. COVID-19 has shed light on the impact that comorbid cardiac and pulmonary conditions may have on disease severity. This knowledge has led to increased primary and secondary prevention efforts for which exercise and rehabilitation are central. The importance of safe methods of exercise while mitigating risk of viral transmission is paramount to global recovery from the pandemic and prevention of future outbreaks.
We constructed a focused literature review of the impact of various masks on pulmonary function at rest and with exercise. This was then incorporated into recommendations for the integration of masks with exercise and rehabilitation in the COVID-19 era.
While there is a paucity of evidence, we identified the physiological effects of masking at rest and during exercise to be negligible. The perceived impact appears to be far greater than the measured impact, and increased frequency of mask use leads to a physiological and psychological adaptive response.
Masking during daily activities, exercise, and rehabilitation is safe in both healthy individuals and those with underlying cardiopulmonary disease. Rehabilitation participants should be reassured that the benefits of masking during COVID-19 far outweigh the risks, and increased frequency of mask use invokes adaptive responses that make long-term masking tolerable.
掩蔽已被用作减少多种传染病传播的策略。随着 SARS-CoV-2 的爆发，许多国家已经实施了强制性的公众掩蔽。然而，公众对口罩使用对肺功能的影响的认识一直是对建议遵守的阻碍。COVID-19 揭示了心脏和肺部合并症可能对疾病严重程度的影响。这一知识促使人们加大了一级和二级预防力度，运动和康复是其中的核心。在减轻病毒传播风险的同时进行安全运动的重要性对全球从大流行中恢复和预防未来的爆发至关重要。
我们对各种口罩在休息和运动时对肺功能的影响进行了重点文献回顾。然后，将其纳入了在 COVID-19 时代将口罩与运动和康复相结合的建议中。
尽管证据不足，但我们发现掩蔽在休息和运动时的生理影响可以忽略不计。感知到的影响似乎远远大于测量到的影响，并且增加口罩的使用频率会导致生理和心理适应性反应。
在日常活动、运动和康复期间佩戴口罩对于健康个体和患有潜在心肺疾病的个体都是安全的。康复参与者应该放心，在 COVID-19 期间佩戴口罩的好处远远超过风险，并且增加口罩的使用频率会引起适应性反应，使长期佩戴口罩变得可以忍受。
