COVID-19 PANDEMİSİNDE EGZERSİZDE FARKLI MASKE KULLANIMININ DİSPNE VE ÖZNEL ALGILAR ÜZERİNE ETKİSİ
Year 2022,
Volume: 20 Issue: 1, 48 - 59, 30.03.2022
Necdet Eray Pişkin
,
Zait Burak Aktuğ
,
Serkan İbiş
,
Hasan Aka
,
Zeynep Kutlu
,
Gönül Yavuz
Abstract
COVID-19 pandemisi günümüzde insan sağlığını etkileyen ve çözüm bulunmaya çalışılan en önemli sorunlardan birisidir. COVID-19 pandemisi esnasında insanlar günlük yaşamlarına devam edebilmek için uzmanların belirttikleri korunma yöntemlerini uygulamaktadır. Bu yöntemlerden birisi de maske kullanımıdır. Egzersiz esnasında farklı maske tercihleri ve bu maskelerin etkilerini araştıran sınırlı sayıda çalışma bulunmaktadır. Bu düşünce ile yapılan çalışmada kuvvet egzersizi esnasında kullanılan cerrahi maske ile N95 maskesinin dispne ve öznel algılar üzerine etkilerinin karşılaştırılması amaçlanmıştır. Çalışmaya haftada üç gün düzenli olarak fitness merkezine giden, 20-25 yaşları (20,28±1,76) arasında sağlıklı 32 gönüllü erkek birey katılmıştır. Katılımcıların maske kullanımındaki öznel algılarını belirlemek için rahat/rahatsızlık algısı ölçeği, dispne şiddetini belirlemek için vizüel analog skalası kullanılmıştır. Maske kullanımında öznel algılar ve vizüel analog skalası yorgunluk sorgulamasının maske tiplerine göre karşılaştırılması Mann Whitney U testi ile, vizüel analog skalası yorgunluk sorgulamasının tekrarlı ölçümlerinin karşılaştırılması Friedman testi ile, farkın hangi gruptan kaynaklandığı ise Wilcoxon testi ile belirlenmiştir. İstatiksel analiz sonucunda vizüel analog skalası yorgunluk sorgulamasının N95 maske kullanımında cerrahi maske kullanımına göre istatiksel olarak anlamlı şekilde yüksek olduğu tespit edilmiştir (p<0,05). Ayrıca hem cerrahi maskede hem de N95 maskede vizüel analog skalası yorgunluk sorgulamasının süre ile birbirine paralel olarak arttığı belirlenmiştir (p<0,05). Sonuç olarak, egzersizde maske kullanımının hem öznel rahatsızlıkları hem de dispneleri artırdığı ayrıca N95 maske kullanımında bu problemlerin daha fazla görüldüğü söylenebilir. Bu nedenle egzersizde maske kullanımının doğru olmadığı, maske kullanmadan egzersiz yapmak istemeyen kişilerin ise cerrahi maskeleri tercih etmeleri önerilebilir.
References
- Aktug, Z. B., Demir, N. A. (2020). An exercise prescription for COVID-19 pandemic. Pakistan Journal of Medical Sciences, 36(7), 1732. doi: https://doi.org/10.12669/pjms.36.7.2929
- Akyüz, G., Çelenlioğlu, A. E. (2015). Pulmoner rehabilitasyon. M. Yüksel, A. E. Balcı (Ed.), Göğüs Cerrahisi, (195). İstanbul: Nobel Tıp Kitabevi.
- Amann, M., Blain, G. M., Proctor, L. T., Sebranek, J. J., Pegelow, D. F., Dempsey, J. A. (2011). Implications of group III and IV muscle afferents for high-intensity endurance exercise performance in humans. The Journal of Physiology, 589(21), 5299-5309. doi:10.1113/ jphys iol.2011.213769.
- Aydın, K., Karlı, Ü., Sözbir, K., Kocaağa, T. (2021). Sağlıklı erişkin erkeklerde şiddeti artan egzersiz sırasında tıbbi maske kullanımının kalp atım hızı, egzersiz süresi ve egzersiz zorluk algısına etkisi: Randomize klinik çalışma. Türkiye Klinikleri Spor Bilimleri Dergisi, 13(3), 434-441. doi:10.5336/sportsci.2021-83737
- Banzett, R. B., Lansing, R. W., Brown, R., Topulos, G. P., Yager, D., Steele, S. M., et al. (1990). ‘Air hunger’ from increased PCO2 persists after complete neuromuscular block in humans. Respiration Physiology, 81(1), 1-17.
- Bartoszko, J. J., Farooqi, M. A. M., Alhazzani, W., Loeb, M. (2020). Medical masks vs N95 respirators for preventing COVID‐19 in healthcare workers: A systematic review and meta‐analysis of randomized trials. Influenza and Other Respiratory Viruses, 14(4), 365-373.
- Bausewein, C., Farquar, M., Booth, S., Gysels, M., Higginson, I. J. (2007). Measurement of breathlessness in advanced disease: A systematic review. Respiratory Medicine, 101(3), 399- 410. doi: 10.1016/j.rmed.2006.07.003.
- Bein, B., Bachmann, M., Huggett, S., Wegermann, P. (2020). SARS-CoV-2/COVID-19: Empfehlungen zu diagnostik und therapie [SARS CoV-2/COVID-19: Evidence-Based Recommendation on Diagnosis and Therapy]. Anasthesiol Intensivmed Notfallmed Schmerzther, 55(4), 257-265. doi: 10.1055/a-1146-8674
- Biçen, Ç., Ertürk, E. (2020). COVID-19 Pandemi sürecinde sağlık çalışanlarında maske kullanımının etkilerinin değerlendirilmesi. Electronic Turkish Studies, 15(6), 205-218. doi: http://dx.doi.org/10.7827/TurkishStudies.44128
- Bijur, P. E., Silver, W., Gallagher, E. J. (2001). Reliability of the visual analog scale for measurement of acute pain. Academic Emergency Medicine, 8(12), 1153-1157. doi: 10.1111/j.1553-2712.2001.tb01132.x.
- Blain, G. M., Mangum, T. S., Sidhu, S. K., Weavil, J. C., Hureau, T. J., Jessop, J. E., et al. (2016). Group III/IV muscle afferents limit the intramuscular metabolic perturbation during whole body exercise in humans. The Journal of Physiology, 594(18), 5303-5315. doi: 10.1113/jp272 283
- Burke, R. M., Midgley, C. M., Dratch, A., Fenstersheib, M., Haupt, T., Holshue, M. et al. (2020). Active monitoring of persons exposed to patients with confirmed COVID-19-United States, january-february 2020. Morbidity and Mortality Weekly Report, 69(9), 245-246. doi: 10.15585/mmwr.mm6909e1externalicon
- Burki, N. K. (1987). Dyspnea. Lung, 165(1), 269-277. doi: 10.1007/BF02714443.
- Chen, Y., Physiological and subjective responses to breathing resistance of N95 filtering facepiece respirators in still-sitting and walking. Yang, Z., Wang, J., Gong, H. (2016). International Journal of Industrial Ergonomics, 53, 93-101. doi.org/10.1016/j.ergon.2015.11.002
- Cohen, L., Manion, L., Morrison, K. (2007). Research methods in education. NY, Routledge.
- Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.
Damasio, A., Carvalho, G. B. (2013). The nature of feelings: evolutionary and neurobiological origins. Nature Reviews Neuroscience, 14(2), 143-152.
- Das, O., Neisiany, R. E., Capezza, A. J., Hedenqvist, M. S., Forsth, M., Xu, Q. et al. (2020). The need for fully bio-based facemasks to counter coronavirus outbreaks: a perspective. Science of the Total Environment, 736, 139611. doi: 10.1016/j.scitotenv.2020.139611.
- Dharmaraj, S., Ashokkumar, V., Hariharan, S., Manibharathi, A., Show, P. L., Chong, C. T., et al. (2021). The COVID-19 pandemic face mask waste: a blooming threat to the marine environment. Chemosphere, 272, 129601.
doi: 10.1016/j.chemosphere.2021.129601.
- Dressler, T., Stoff, J., Di Pietro, T., Cavadini, G. B., Büsser, G., Büsser, X., et al. (2020). Masks for sports: Development project of protective respiratory masks for ice hockey teams during the COVID-19 pandemic. ETH Zurich.
- Eijsvogels, T. M., Molossi, S., Lee, D. C., Emery, M. S., Thompson, P. D. (2016). Exercise at the extremes: the amount of exercise to reduce cardiovascular events. Journal of the American College of Cardiology, 67(3), 316-329. doi: 10.1016/j.jacc.2015.11.034.
- Epstein, D., Korytny, A., Isenberg, Y., Marcusohn, E., Zukermann, R., Bishop, B., et al. (2021). Return to training in the COVID-19 era: The physiological effects of face masks during exercise. Scandinavian Journal of Medicine Science in Sports, 31(1), 70-75. doi: 10.1111/sms.13832
- Field, M. H., Rashbrook, J. P., Rodrigues, J. N. (2020). Hydrocolloid dressing strip over bridge of nose to relieve pain and pressure from Filtered Face Piece (FFP) masks during the coronavirus (COVID-19) pandemic. The Annals of The Royal College of Surgeons of England, 102(5), 394-396. doi: 10.1308/rcsann.2020.0095
- Fikenzer, S., Uhe, T., Lavall, D., Rudolph, U., Falz, R., Busse, M. et al. (2020). Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clinical research in cardiology: Official Journal of The German Cardiac Society, 109(12), 1522–1530. doi: 10.1007/s00392-020-01704
- Ganong, W. F. (1997). Review of medical physiology. Appleton and Lange, Stamford, 565-566.
- Georgi, C., Haase-Fielitz, A., Meretz, D., Gäsert, L., Butter, C. (2020). The impact of commonly-worn face masks on physiological parameters and on discomfort during standard work-related physical effort. Deutsches Arzteblatt International, 117(40), 674-675. doi: 10.3238/ arztebl. 2020.0674
- Hayen, A., Herigstad, M., Pattinson, K. T. (2013). Understanding dyspnea as a complex individual experience. Maturitas, 76(1), 45-50. doi: 10.1016/j.maturitas.2013.06.005
- Ho, K. F., Lin, L. Y., Weng, S. P., Chuang, K. J. (2020). Medical mask versus cotton mask for preventing respiratory droplet transmission in micro environments. Science of the Total Environment, 15(735), 139510. doi: 10.1016/j.scitotenv.2020.139510.
- Iannone, P., Castellini, G., Coclite, D., Napoletano, A., Fauci, A. J., Iacorossi, L. et al. (2020). The need of health policy perspective to protect Healthcare Workers during COVID-19 pandemic. A grade rapid review on the N95 respirators effectiveness. Plos One, 15(6), e0234025. doi: 10.1371/journal.pone.0234025
- Kyung, S. Y., Kim, Y., Hwang, H., Park, J. W., Jeong, S. H. (2020). Risks of N95 face mask use in subjects with COPD. Respiratory Care, 65(5), 658-664. doi: 10.4187/respcare.06713.
- Laird, I. S., Goldsmith, R., Pack, R. J., Vitalis, A. (2002). The effect on heart rate and facial skin temperature of wearing respiratory protection at work. Annals of Occupational Hygiene, 46(2), 143-148. doi: 10.1093/annhyg/mef015.
- Lazzarino, A. I., Steptoe, A., Hamer, M., Michie, S. (2020). COVID-19: important potential side effects of wearing face masks that we should bear in mind. The BMJ, 369, m2003 doi: https://doi.org/10.1136/bmj.m2003
- Lepelletier, D., Grandbastien, B., Romano-Bertrand, S., Aho, S., Chidiac, C., Géhanno J. F. et al. (2020). What face mask for what use in the context of COVID-19 pandemic? The French guidelines. Journal of Hospital Infection, 105(3), 414-418. doi: 10.1016/j.jhin.2020.04.036
- Li, Q., Guan, X., Wu, P., Wang, X., Lei Z, L., Tong Y. et al. (2020). Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. New England Journal of Medicine, 382(13), 1199-1207 doi:10.1056/NEJMoa2001316.
Li, Y., Tokura, H., Guo, Y. P., Wong, A. S. W., Wong, T., Chung, J. et al. (2005). Effects of wearing N95 and surgical facemasks on heart rate, thermal stress and subjective sensations. International Archives of Occupational and Environmental Health, 78(6), 501-509. doi: 10.1007/s00420-004-0584-4
- Liu, J., Liao, X., Qian, S., Yuan, J., Wang, F., Liu, Y. et al. (2020). Community transmission of severe acute respiratory syndrome coronavirus 2, Shenzhen, China. Emerging Infectious Diseases, 26(6), 1320-1323. doi:10.3201/eid2606.200239.
- Mahler, D. A., Horowitz, M. B. (1994). Clinical evaluation of exertional dyspnea. Clincs in Chest Medicine, 15(2), 259-269.
- Morishima, M., Kishida, K. (2018). Understanding attitudes toward hygiene mask use in Japanese daily life by using a repeated cross-sectional survey. Work, 61(2), 303-311. doi: 10.3233/WOR-182801
- Nevill, M. E., Holmyard, D.J., Hall, G. M., Allsop, P., van Oosterhout, A., Burrinet, J. M. et al. (1996). Growth hormone responses to treadmill sprinting in sprint and endurance trained athletes. European Journal of Applied Physiology, 72(5-6), 460-467. doi: 10.1007/BF00242276.
- O'Donnell, D. E. (1994). Breathlessness in patients with chronic airflow limitation: mechanisms and management. Chest, 106(3), 904-912. doi: 10.1378/chest.106.3.904.
- Özel, M. S., Özer, K. M. (2017). Maksimum aerobik aktivitede antrenman maskesi kullanımının akut etkilerinin incelenmesi. İstanbul Üniversitesi Spor Bilimleri Dergisi, 7(1), 12-27.
- Powell, J. B., Kim, J. H., Roberge, R. J. (2017). Powered air-purifying respirator use in healthcare: effects on thermal sensations and comfort. Journal of Occupational and Environmental Hygiene, 14(12), 947-954. doi: 10.1080/15459624.2017.1358817.
- Rehabilitation, P. (1999). Official statement of the American thoracic society. Am J Respir Crit Care Med, 159, 1662-82.
- Roberge, R. J., Kim, J. H., Benson, S. M. (2012). Absence of consequential changes in physiological, thermal and subjective responses from wearing a surgical mask. Respiratory Physiology Neurobiology, 181(1), 29-35.
- Scarano, A., Inchingolo, F., Lorusso, F. (2020). Facial skin temperature and discomfort when wearing protective face masks: Thermal infrared imaging evaluation and hands moving the mask. International Journal of Environmental Research and Public Health, 17(13), 4624. doi:10.3390/ ijerph17134624
- Shereen, M. A., Khan, S., Kazmi, A., Bashir, N., Siddique, R., (2020). COVID-19 infection: origin, transmission, and characteristics of human coronaviruses. Journal of Advanced Research, 24, 91-98. doi: org/10.1016/j.jare.2020.03.005
- Silveira, A. L. B., Carvalho, L. M., Seara, F. A. C., Olivares, E. L. (2020). Wear a mask to reduce COVID-19 transmission while exercising at the gym: belief or evidence-based?. Research, Society and Development, 9(10), e8499109259. doi: 10.33448/rsd-v9i10.9259
- Strigo, I. A., Craig, A. D. (2016). Interoception, homeostatic emotions and sympathovagal balance. Philosophical Transactions of the Royal Society B: Biological Sciences, 371(1708), 20160010. doi: 10.1098/rstb.2016.0010
- Weiser, P. C., Mahler, D. A., Ryan, K. P. (1999). Dyspnea: Symptom assessment and management. Pulmonary Rehabilitation. https://www.uptodate.com/contents/assessment-and-management-of-dyspnea-in-palliative-care [Erişim tarihi: 29.12.2021]
- Yıldız, S. A., Arzuman, P. (2009). Sıcak ortamda egzersiz. Klinik Gelişim Dergisi, 22(1), 10-15.
- Yip, W. L., Leung, L. P., Lau, P. F., Tong, H. K. (2005). The effect of wearing a face mask on body temperature. Hong Kong Journal of Emergency Medicine, 12(1), 23-7. doi: 10. 1177%2F 10249079 0501200102
- Zuo, Y., Hua, W., Luo, Y., Li, L. (2020). Skin reactions of N95 masks and medial masks among health-care personnel: A self-report questionnaire survey in China. Contact Dermatitis, 83(2), 145-147. doi: 10.1111/cod.13555
THE EFFECT OF USE OF DIFFERENT MASKS IN EXERCISE ON DYSPNEA AND SUBJECTIVE PERCEPTIONS IN THE COVID-19 PANDEMIC
Year 2022,
Volume: 20 Issue: 1, 48 - 59, 30.03.2022
Necdet Eray Pişkin
,
Zait Burak Aktuğ
,
Serkan İbiş
,
Hasan Aka
,
Zeynep Kutlu
,
Gönül Yavuz
Abstract
The COVID-19 pandemic is one of the most important problems affecting human health today and trying to find a solution. During the COVID-19 pandemic, people apply the means of protection methods specified by experts in order to continue their daily lives. One of these methods is the use of masks. There are a limited number of studies investigating different mask preferences and the effects of these masks during exercise. In this study, it was aimed to compare the effects of surgical mask and N95 mask on dyspnea and subjective perceptions during strength exercise. Thirty-two healthy male volunteers between the ages of 20 and 25, who regularly going to fitness center three days a week, participated in the study. The comfortable/discomfort perception scale was used to determine the subjective perceptions of the participants in mask use, and the visual analog scale was used to determine the severity of dyspnea. Subjective perceptions in mask use and comparison of visual analog scale fatigue questioning according to mask types were determined with Mann Whitney U test, comparison of repeated measurements of visual analog scale fatigue questioning was determined with Friedman test, and Wilcoxon test was used to determine which group the difference originated from. As a result of the statistical analysis, it was determined that the visual analog scale fatigue query was statistically significantly higher in the N95 mask than in the use of surgical mask (p<0.05). In addition, it was determined that the visual analog scale fatigue query increased in parallel with each other with time in both the surgical mask and the N95 mask (p<0.05). As a result, it can be said that the use of masks in exercise increases both subjective discomfort and dyspnea, and these problems are more common in the use of N95 masks. For this reason, it can be suggested that the use of masks in exercise is not correct and people who do not want to exercise without using a mask should prefer surgical masks.
References
- Aktug, Z. B., Demir, N. A. (2020). An exercise prescription for COVID-19 pandemic. Pakistan Journal of Medical Sciences, 36(7), 1732. doi: https://doi.org/10.12669/pjms.36.7.2929
- Akyüz, G., Çelenlioğlu, A. E. (2015). Pulmoner rehabilitasyon. M. Yüksel, A. E. Balcı (Ed.), Göğüs Cerrahisi, (195). İstanbul: Nobel Tıp Kitabevi.
- Amann, M., Blain, G. M., Proctor, L. T., Sebranek, J. J., Pegelow, D. F., Dempsey, J. A. (2011). Implications of group III and IV muscle afferents for high-intensity endurance exercise performance in humans. The Journal of Physiology, 589(21), 5299-5309. doi:10.1113/ jphys iol.2011.213769.
- Aydın, K., Karlı, Ü., Sözbir, K., Kocaağa, T. (2021). Sağlıklı erişkin erkeklerde şiddeti artan egzersiz sırasında tıbbi maske kullanımının kalp atım hızı, egzersiz süresi ve egzersiz zorluk algısına etkisi: Randomize klinik çalışma. Türkiye Klinikleri Spor Bilimleri Dergisi, 13(3), 434-441. doi:10.5336/sportsci.2021-83737
- Banzett, R. B., Lansing, R. W., Brown, R., Topulos, G. P., Yager, D., Steele, S. M., et al. (1990). ‘Air hunger’ from increased PCO2 persists after complete neuromuscular block in humans. Respiration Physiology, 81(1), 1-17.
- Bartoszko, J. J., Farooqi, M. A. M., Alhazzani, W., Loeb, M. (2020). Medical masks vs N95 respirators for preventing COVID‐19 in healthcare workers: A systematic review and meta‐analysis of randomized trials. Influenza and Other Respiratory Viruses, 14(4), 365-373.
- Bausewein, C., Farquar, M., Booth, S., Gysels, M., Higginson, I. J. (2007). Measurement of breathlessness in advanced disease: A systematic review. Respiratory Medicine, 101(3), 399- 410. doi: 10.1016/j.rmed.2006.07.003.
- Bein, B., Bachmann, M., Huggett, S., Wegermann, P. (2020). SARS-CoV-2/COVID-19: Empfehlungen zu diagnostik und therapie [SARS CoV-2/COVID-19: Evidence-Based Recommendation on Diagnosis and Therapy]. Anasthesiol Intensivmed Notfallmed Schmerzther, 55(4), 257-265. doi: 10.1055/a-1146-8674
- Biçen, Ç., Ertürk, E. (2020). COVID-19 Pandemi sürecinde sağlık çalışanlarında maske kullanımının etkilerinin değerlendirilmesi. Electronic Turkish Studies, 15(6), 205-218. doi: http://dx.doi.org/10.7827/TurkishStudies.44128
- Bijur, P. E., Silver, W., Gallagher, E. J. (2001). Reliability of the visual analog scale for measurement of acute pain. Academic Emergency Medicine, 8(12), 1153-1157. doi: 10.1111/j.1553-2712.2001.tb01132.x.
- Blain, G. M., Mangum, T. S., Sidhu, S. K., Weavil, J. C., Hureau, T. J., Jessop, J. E., et al. (2016). Group III/IV muscle afferents limit the intramuscular metabolic perturbation during whole body exercise in humans. The Journal of Physiology, 594(18), 5303-5315. doi: 10.1113/jp272 283
- Burke, R. M., Midgley, C. M., Dratch, A., Fenstersheib, M., Haupt, T., Holshue, M. et al. (2020). Active monitoring of persons exposed to patients with confirmed COVID-19-United States, january-february 2020. Morbidity and Mortality Weekly Report, 69(9), 245-246. doi: 10.15585/mmwr.mm6909e1externalicon
- Burki, N. K. (1987). Dyspnea. Lung, 165(1), 269-277. doi: 10.1007/BF02714443.
- Chen, Y., Physiological and subjective responses to breathing resistance of N95 filtering facepiece respirators in still-sitting and walking. Yang, Z., Wang, J., Gong, H. (2016). International Journal of Industrial Ergonomics, 53, 93-101. doi.org/10.1016/j.ergon.2015.11.002
- Cohen, L., Manion, L., Morrison, K. (2007). Research methods in education. NY, Routledge.
- Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.
Damasio, A., Carvalho, G. B. (2013). The nature of feelings: evolutionary and neurobiological origins. Nature Reviews Neuroscience, 14(2), 143-152.
- Das, O., Neisiany, R. E., Capezza, A. J., Hedenqvist, M. S., Forsth, M., Xu, Q. et al. (2020). The need for fully bio-based facemasks to counter coronavirus outbreaks: a perspective. Science of the Total Environment, 736, 139611. doi: 10.1016/j.scitotenv.2020.139611.
- Dharmaraj, S., Ashokkumar, V., Hariharan, S., Manibharathi, A., Show, P. L., Chong, C. T., et al. (2021). The COVID-19 pandemic face mask waste: a blooming threat to the marine environment. Chemosphere, 272, 129601.
doi: 10.1016/j.chemosphere.2021.129601.
- Dressler, T., Stoff, J., Di Pietro, T., Cavadini, G. B., Büsser, G., Büsser, X., et al. (2020). Masks for sports: Development project of protective respiratory masks for ice hockey teams during the COVID-19 pandemic. ETH Zurich.
- Eijsvogels, T. M., Molossi, S., Lee, D. C., Emery, M. S., Thompson, P. D. (2016). Exercise at the extremes: the amount of exercise to reduce cardiovascular events. Journal of the American College of Cardiology, 67(3), 316-329. doi: 10.1016/j.jacc.2015.11.034.
- Epstein, D., Korytny, A., Isenberg, Y., Marcusohn, E., Zukermann, R., Bishop, B., et al. (2021). Return to training in the COVID-19 era: The physiological effects of face masks during exercise. Scandinavian Journal of Medicine Science in Sports, 31(1), 70-75. doi: 10.1111/sms.13832
- Field, M. H., Rashbrook, J. P., Rodrigues, J. N. (2020). Hydrocolloid dressing strip over bridge of nose to relieve pain and pressure from Filtered Face Piece (FFP) masks during the coronavirus (COVID-19) pandemic. The Annals of The Royal College of Surgeons of England, 102(5), 394-396. doi: 10.1308/rcsann.2020.0095
- Fikenzer, S., Uhe, T., Lavall, D., Rudolph, U., Falz, R., Busse, M. et al. (2020). Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clinical research in cardiology: Official Journal of The German Cardiac Society, 109(12), 1522–1530. doi: 10.1007/s00392-020-01704
- Ganong, W. F. (1997). Review of medical physiology. Appleton and Lange, Stamford, 565-566.
- Georgi, C., Haase-Fielitz, A., Meretz, D., Gäsert, L., Butter, C. (2020). The impact of commonly-worn face masks on physiological parameters and on discomfort during standard work-related physical effort. Deutsches Arzteblatt International, 117(40), 674-675. doi: 10.3238/ arztebl. 2020.0674
- Hayen, A., Herigstad, M., Pattinson, K. T. (2013). Understanding dyspnea as a complex individual experience. Maturitas, 76(1), 45-50. doi: 10.1016/j.maturitas.2013.06.005
- Ho, K. F., Lin, L. Y., Weng, S. P., Chuang, K. J. (2020). Medical mask versus cotton mask for preventing respiratory droplet transmission in micro environments. Science of the Total Environment, 15(735), 139510. doi: 10.1016/j.scitotenv.2020.139510.
- Iannone, P., Castellini, G., Coclite, D., Napoletano, A., Fauci, A. J., Iacorossi, L. et al. (2020). The need of health policy perspective to protect Healthcare Workers during COVID-19 pandemic. A grade rapid review on the N95 respirators effectiveness. Plos One, 15(6), e0234025. doi: 10.1371/journal.pone.0234025
- Kyung, S. Y., Kim, Y., Hwang, H., Park, J. W., Jeong, S. H. (2020). Risks of N95 face mask use in subjects with COPD. Respiratory Care, 65(5), 658-664. doi: 10.4187/respcare.06713.
- Laird, I. S., Goldsmith, R., Pack, R. J., Vitalis, A. (2002). The effect on heart rate and facial skin temperature of wearing respiratory protection at work. Annals of Occupational Hygiene, 46(2), 143-148. doi: 10.1093/annhyg/mef015.
- Lazzarino, A. I., Steptoe, A., Hamer, M., Michie, S. (2020). COVID-19: important potential side effects of wearing face masks that we should bear in mind. The BMJ, 369, m2003 doi: https://doi.org/10.1136/bmj.m2003
- Lepelletier, D., Grandbastien, B., Romano-Bertrand, S., Aho, S., Chidiac, C., Géhanno J. F. et al. (2020). What face mask for what use in the context of COVID-19 pandemic? The French guidelines. Journal of Hospital Infection, 105(3), 414-418. doi: 10.1016/j.jhin.2020.04.036
- Li, Q., Guan, X., Wu, P., Wang, X., Lei Z, L., Tong Y. et al. (2020). Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. New England Journal of Medicine, 382(13), 1199-1207 doi:10.1056/NEJMoa2001316.
Li, Y., Tokura, H., Guo, Y. P., Wong, A. S. W., Wong, T., Chung, J. et al. (2005). Effects of wearing N95 and surgical facemasks on heart rate, thermal stress and subjective sensations. International Archives of Occupational and Environmental Health, 78(6), 501-509. doi: 10.1007/s00420-004-0584-4
- Liu, J., Liao, X., Qian, S., Yuan, J., Wang, F., Liu, Y. et al. (2020). Community transmission of severe acute respiratory syndrome coronavirus 2, Shenzhen, China. Emerging Infectious Diseases, 26(6), 1320-1323. doi:10.3201/eid2606.200239.
- Mahler, D. A., Horowitz, M. B. (1994). Clinical evaluation of exertional dyspnea. Clincs in Chest Medicine, 15(2), 259-269.
- Morishima, M., Kishida, K. (2018). Understanding attitudes toward hygiene mask use in Japanese daily life by using a repeated cross-sectional survey. Work, 61(2), 303-311. doi: 10.3233/WOR-182801
- Nevill, M. E., Holmyard, D.J., Hall, G. M., Allsop, P., van Oosterhout, A., Burrinet, J. M. et al. (1996). Growth hormone responses to treadmill sprinting in sprint and endurance trained athletes. European Journal of Applied Physiology, 72(5-6), 460-467. doi: 10.1007/BF00242276.
- O'Donnell, D. E. (1994). Breathlessness in patients with chronic airflow limitation: mechanisms and management. Chest, 106(3), 904-912. doi: 10.1378/chest.106.3.904.
- Özel, M. S., Özer, K. M. (2017). Maksimum aerobik aktivitede antrenman maskesi kullanımının akut etkilerinin incelenmesi. İstanbul Üniversitesi Spor Bilimleri Dergisi, 7(1), 12-27.
- Powell, J. B., Kim, J. H., Roberge, R. J. (2017). Powered air-purifying respirator use in healthcare: effects on thermal sensations and comfort. Journal of Occupational and Environmental Hygiene, 14(12), 947-954. doi: 10.1080/15459624.2017.1358817.
- Rehabilitation, P. (1999). Official statement of the American thoracic society. Am J Respir Crit Care Med, 159, 1662-82.
- Roberge, R. J., Kim, J. H., Benson, S. M. (2012). Absence of consequential changes in physiological, thermal and subjective responses from wearing a surgical mask. Respiratory Physiology Neurobiology, 181(1), 29-35.
- Scarano, A., Inchingolo, F., Lorusso, F. (2020). Facial skin temperature and discomfort when wearing protective face masks: Thermal infrared imaging evaluation and hands moving the mask. International Journal of Environmental Research and Public Health, 17(13), 4624. doi:10.3390/ ijerph17134624
- Shereen, M. A., Khan, S., Kazmi, A., Bashir, N., Siddique, R., (2020). COVID-19 infection: origin, transmission, and characteristics of human coronaviruses. Journal of Advanced Research, 24, 91-98. doi: org/10.1016/j.jare.2020.03.005
- Silveira, A. L. B., Carvalho, L. M., Seara, F. A. C., Olivares, E. L. (2020). Wear a mask to reduce COVID-19 transmission while exercising at the gym: belief or evidence-based?. Research, Society and Development, 9(10), e8499109259. doi: 10.33448/rsd-v9i10.9259
- Strigo, I. A., Craig, A. D. (2016). Interoception, homeostatic emotions and sympathovagal balance. Philosophical Transactions of the Royal Society B: Biological Sciences, 371(1708), 20160010. doi: 10.1098/rstb.2016.0010
- Weiser, P. C., Mahler, D. A., Ryan, K. P. (1999). Dyspnea: Symptom assessment and management. Pulmonary Rehabilitation. https://www.uptodate.com/contents/assessment-and-management-of-dyspnea-in-palliative-care [Erişim tarihi: 29.12.2021]
- Yıldız, S. A., Arzuman, P. (2009). Sıcak ortamda egzersiz. Klinik Gelişim Dergisi, 22(1), 10-15.
- Yip, W. L., Leung, L. P., Lau, P. F., Tong, H. K. (2005). The effect of wearing a face mask on body temperature. Hong Kong Journal of Emergency Medicine, 12(1), 23-7. doi: 10. 1177%2F 10249079 0501200102
- Zuo, Y., Hua, W., Luo, Y., Li, L. (2020). Skin reactions of N95 masks and medial masks among health-care personnel: A self-report questionnaire survey in China. Contact Dermatitis, 83(2), 145-147. doi: 10.1111/cod.13555