Ventilatory and perceptual responses to surgical and FFP2 face mask use during submaximal cycle ergometer exercise

INTRODUCTION: Although masks reduce pathogen spread during exercise, their physiological impact remains debated. PURPOSE: This study aimed to assess the physiological effect of wearing surgical and FFP2 masks on ventilatory function and perceived effort during a wide range of submaximal aerobic exercise intensities. METHODS: Twelve participants completed three randomized and counterbalanced trials: a) without mask; b) wearing surgical mask; c) wearing FFP2 mask. In each trial, participants performed an incremental intensity cycle ergometer test, consisting of 3-min stages ranging from 30% to 80% of maximal aerobic power. Ventilatory and metabolic variables were continuously measured using a breath-by-breath gas analyser. Heart rate was monitored via telemetry, blood lactate concentration obtained through fingertip samples, and perceived exertion recorded using the Borg 6–20 scale. Data were analysed using two-way repeated-measures ANOVA (mask × load), with Bonferroni post hoc tests applied when significant effects were detected (p<.050). RESULTS: Mask use significantly reduced ventilation, tidal volume, respiratory rate, VO2, VCO2, and end-tidal O2 pressure, while increasing end-tidal CO2 pressure and perceived exertion (p<.050). The surgical mask impaired these variables mainly at higher intensities (60–80% of maximal aerobic power; p<.050), whereas the FFP2 mask caused reductions across the full submaximal range in several ventilatory variables (p<.050), with consistently larger decreases than the surgical mask (0.17≤d≤0.69). Heart rate and blood lactate concentration were unaffected. CONCLUSION: Face masks during submaximal aerobic exercise impairs ventilatory function and increases perceived exertion, with greater effects from FFP2 than surgical masks. When required, surgical masks are preferable as they cause less respiratory restriction and discomfort.