Effect of respiratory protection mask use on exercise performance and certainty of evidence
| Outcome | Systematic review | Population | Comparison | Participants (included studies) | Effect size (95% CI) | Risk of bias | Certainty of evidence |
| Exercise performance | Zheng et al12 | Healthy adults | Surgical mask versus no mask | 541 (20 RCTs/crossover trials) | SMD −0.12 (−0.39 to 0.15) | Moderate | ⊕⊕◯◯* Low |
| N95 respirator versus no mask | 232 (11 RCTs/crossover trials) | SMD −0.42 (−0.76 to −0.08) | Moderate | ⊕⊕◯◯* Low | |||
| Cloth mask versus no mask | 114 (5 RCTs/crossover trials) | SMD −0.26 (−0.54 to 0.02) | Moderate | ⊕⊕◯◯* Low | |||
| Mask versus no mask (progressive exercise state) | 917 (34 RCTs/crossover trials) | SMD −0.34 (−0.52 to −0.15) | Moderate | ⊕⊕◯◯* Low | |||
| Mask versus no mask (steady-state exercise) | 283 (7 RCTs/crossover trials) | SMD 0.16 (−0.32 to 0.65) | Moderate | ⊕⊕◯◯* Low | |||
| Chen et al32 | Patients with COPD | Face mask versus no mask | 27 (1 crossover trial) | MD −9.90 (−28.20 to 8.40) | Moderate | ⊕⊕◯◯† Low | |
| Rating of perceived exertion | Zheng et al12 | Healthy adults | Surgical mask versus no mask | 424 (20 crossover trials/RCTs) | SMD 0.36 (0.21 to 0.52) | Moderate | ⊕⊕◯◯† Low |
| N95 respirator versus no mask | 174 (10 crossover trials/RCTs) | SMD 0.17 (−0.01 to 0.35) | Moderate | ⊕⊕◯◯† Low | |||
| Cloth mask versus no mask | 161 (7crossover trials/RCTs) | SMD 0.22 (−0.13 to 0.57) | Moderate | ⊕⊕◯◯* Low | |||
| Time to exhaustion | Glänzel et al34 | Healthy adults | Face mask versus no mask | 210 (9 crossover trials/RCTs) | MD −0.29 (−0.48 to −0.10) | Moderate | ⊕⊕◯◯† Low |
| Thermal sensation | Zheng et al12 | Healthy adults | Surgical mask versus no mask | 56 (4 RCTs/crossover trials) | SMD 0.46 (0.06 to 0.85) | Moderate | ⊕⊕◯◯† Low |
| N95 respirator versus no mask | 36 (3 RCTs/crossover trials) | SMD 0.97 (−0.05 to 2.00) | Moderate | ⊕⊕◯◯† Low | |||
| Mask versus no mask (progressive exercise state) | 24 (2 RCTs/crossover trials) | SMD 1.59 (0.55 to 2.64) | Moderate | ⊕⊕◯◯* Low | |||
| Mask versus no mask (steady-state exercise) | 68 (5 RCTs/crossover trials) | SMD 0.35 (0.01 to 0.69) | Moderate | ⊕⊕◯◯* Low | |||
| Facial skin temperature | Litwinowicz et al6 | Healthy adults | N95 respirator versus no mask | 86 (5 RCTs/crossover trials) | SMD 1.05 (0.48 to 1.63) | Moderate | ⊕⊕◯◯† Low |
| Subjective rating of heat perception | Litwinowicz et al6 | Healthy adults | N95 respirator versus no mask | 54 (4 RCTs/crossover trials) | SMD 1.04 (−0.12 to 2.19) | Moderate | ⊕⊕◯◯† Low |
*Low quality of evidence is due to unexplained inconsistency and imprecise results due to small magnitude of change and wide CI.
†Low quality of evidence is due to imprecise results due to small magnitude of change and wide CI.
COPD, chronic obstructive pulmonary disease; MD, mean difference; RCT, randomised controlled trial; SMD, standardised mean difference.