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Original Research

Open Access

The effects of wearing KF94 masks on cardiorespiratory function and hemorheological response during moderate intensity exercise in adult males

  • Chang-Hee Park1
  • Je-Seung Lee1
  • Sung-Min Kim2
  • Yu-Kyung Kim3
  • Seong-No Lee2,*,

1Department of Physical Education, Hanyang University, 04763 Seoul, Republic of Korea

2Department of Physical Education & Human-Tech, Hanyang University, 04763 Seoul, Republic of Korea

3Head of Health Management, Hanyang University Future Talent Education Center, 04763 Seoul, Republic of Korea

DOI: 10.22514/jomh.2023.023 Vol.19,Issue 5,May 2023 pp.29-35

Submitted: 23 August 2022 Accepted: 03 February 2023

Published: 30 May 2023

*Corresponding Author(s): Seong-No Lee E-mail:


The purpose of this study was to examine the effect of wearing a Korea filter 94 (KF94) mask on cardiorespiratory function and hemorheological responses during moderate intensity exercise in men during the Coronavirus disease 2019 (COVID-19) pandemic. 12 healthy males aged 20 to 29 years (28.3 ± 3.6 yr) were recruited for this study. The exercise intensity corresponding to the anaerobic threshold level was determined following a maximum graded exercise test, and exercise was performed for 40 minutes with a cycle ergometer at the target exercise intensity. Cardiorespiratory function, blood pressure, and hemorheological responses were measured every 10 minutes at rest and during exercise. Our results indicated no differences between conditions in respiratory frequency (Rf), tidal volume (TV), minute ventilation (VE), carbon dioxide production (V̇ CO2), and partial pressure of arterial oxygen (PaO2). However, oxygen consumption (V̇ O2) was significantly lower in the KF94 mask group compared to the control. There were no differences in systolic blood pressure (SBP), diastolic blood pressure (DBP), rate pressure product (RPP), aggregation index (AI), and blood critical stress (BCS) between the two groups. The mask group had a significant respiratory exchange ratio (R) at rest and during 10 minutes exercise compared to the control. The elongation index was higher at rest, 10 minutes, and 30 minutes in the mask group than control group (p < 0.05). Overall, our results suggest that although V̇ O2 was decreased and R values were increased, the effects of other physiological parameters and hemorheological responses imposed by face masks during moderate intensity exercise are small. Thus, although negative effects of using face masks affect exercise capacity (i.e., exercise tolerance), our findings suggest that individuals wearing KF94 could safely exercise and get some health benefits from physical activities during the COVID-19 pandemic.


COVID-19; Cardiorespiratory function; Hemorheological responses; KF94 masks

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Chang-Hee Park,Je-Seung Lee,Sung-Min Kim,Yu-Kyung Kim,Seong-No Lee. The effects of wearing KF94 masks on cardiorespiratory function and hemorheological response during moderate intensity exercise in adult males. Journal of Men's Health. 2023. 19(5);29-35.


[1] Ung COL. Community pharmacist in public health emergencies: quick to action against the coronavirus 2019-nCoV outbreak. Research in Social and Administrative Pharmacy. 2020; 16: 583–586.

[2] Malm C, Jakobsson J, Isaksson A. Physical activity and sports-real health benefits: a review with insight into the public health of Sweden. Sports. 2019; 7: 127.

[3] Brawner CA, Ehrman JK, Bole S, Kerrigan DJ, Parikh SS, Lewis BK, et al. Inverse relationship of maximal exercise capacity to hospitalization secondary to coronavirus disease 2019. Mayo Clinic Proceedings. 2021; 96: 32–39.

[4] Christensen RAG, Arneja J, St Cyr K, Sturrock SL, Brooks JD. The association of estimated cardiorespiratory fitness with COVID-19 incidence and mortality: a cohort study. Plos One. 2021; 16: e0250508.

[5] Grande AJ, Keogh J, Silva V, Scott AM. Exercise versus no exercise for the occurrence, severity, and duration of acute respiratory infections. Cochrane Database of Systematic Reviews. 2020; 4: CD010596.

[6] Roberge RJ, Coca A, Williams WJ, Powell JB, Palmiero AJ. Physiological impact of the N95 filtering facepiece respirator on healthcare workers. Respiratory Care. 2010; 55: 569–577.

[7] Naeije R. Physiological adaptation of the cardiovascular system to high altitude. Progress in Cardiovascular Diseases. 2010; 52: 456–466.

[8] Bassett DR. Limiting factors for maximum oxygen uptake and determinants of endurance performance. Medicine & Science in Sports & Exercise. 2000; 32: 70–84.

[9] Scholz PM, Karis JH, Gump FE, Kinney JM, Chien S. Correlation of blood rheology with vascular resistance in critically ill patients. Journal of Applied Physiology. 1975; 39: 1008–1011.

[10] Doyle MP, Walker BR. Stiffened erythrocytes augment the pulmonary hemodynamic response to hypoxia. Journal of Applied Physiology. 1990; 69: 1270–1275.

[11] Jacobson TA, Kler JS, Hernke MT, Braun RK, Meyer KC, Funk WE. Direct human health risks of increased atmospheric carbon dioxide. Nature Sustainability. 2019; 2: 691–701.

[12] Smith CL, Whitelaw JL, Davies B. Carbon dioxide rebreathing in respiratory protective devices: influence of speech and work rate in full-face masks. Ergonomics. 2013; 56: 781–790.

[13] Martín-Valero R, Jimenez-Cebrian AM, Moral-Munoz JA, de-la-Casa-Almeida M, Rodriguez-Huguet M, Casuso-Holgado MJ. The efficacy of therapeutic respiratory muscle training interventions in people with bronchiectasis: a systematic review and meta-analysis. Journal of Clinical Medicine. 2020; 9: 231.

[14] Lee JS, Stebbins CL, Jung E, Nho H, Kim JK, Chang MJ, et al. Effects of chronic dietary nitrate supplementation on the hemodynamic response to dynamic exercise. American Journal of Physiology-Regulatory Integrative and Comparative Physiology. 2015; 309: R459–R466.

[15] Evans HJ, Parfitt G, Eston RG. The perceptually regulated exercise test is sensitive to increases in maximal oxygen uptake. European Journal of Applied Physiology. 2013; 113: 1233–1239.

[16] American College of Sports Medicine. Riebe D, Ehrman JK, Liguori G, Magal M. ACSM’s guidelines for exercise testing and prescription. 10th ed. Wolters Kluwer: Philadelphia. 2018.

[17] Wasserman K, Whipp BJ, Koyl SN, Beaver WL. Anaerobic threshold and respiratory gas exchange during exercise. Journal of Applied Physiology. 1973; 35: 236–243.

[18] McArdle WD, Katch FI, Katch VL. Exercise physiology: energy, nutrition, and human performance. 5th edn. Lippincott Williams and Wilkins: Philadelphia. 2004.

[19] Raven PB, Stevens GHJ. Cardiovascular function and prolonged exercise. Perspectives in exercise science and sports medicine: prolonged exercise (pp. 43–74). 1st edn. Brown and Benchmark Publishers: Indianapolis. 1988.

[20] Tucker R, Noakes TD. The physiological regulation of pacing strategy during exercise: a critical review. British Journal of Sports Medicine. 2009; 43: e1.

[21] Shin S, Yang Y, Suh JS. Measurement of erythrocyte aggregation in a microchip stirring system by light transmission. Clinical Hemorheology and Microcirculation. 2009; 41: 197–207.

[22] Lässing J, Falz R, Pökel C, Fikenzer S, Laufs U, Schulze A, et al. Effects of surgical face masks on cardiopulmonary parameters during steady state exercise. Scientific Reports. 2020; 10: 22363.

[23] Epstein D, Korytny A, Isenberg Y, Marcusohn E, Zukermann R, Bishop B, et al. Return to training in the COVID-19 era: the physiological effects of face masks during exercise. Scandinavian Journal of Medicine & Science in Sports. 2021; 31: 70–75.

[24] Zhang T, Zhang T, Liu S. A modified surgical face mask to improve protection and wearing comfort. Buildings. 2022; 12: 663.

[25] Cheyne WS, Harper MI, Gelinas JC, Sasso JP, Eves ND. Mechanical cardiopulmonary interactions during exercise in health and disease. Journal of Applied Physiology. 2020; 128: 1271–1279.

[26] Gollnick PD. Energy metabolism and prolonged exercise. Perspectives in exercise science and sports medicine: prolonged exercise (pp. 1–42). 1st edn. Brown and Benchmark Publishers: Indianapolis. 1988.

[27] Somers VK, Mark AL, Zavala DC, Abboud FM. Contrasting effects of hypoxia and hypercapnia on ventilation and sympathetic activity in humans. Journal of Applied Physiology. 1989; 67: 2101–2106.

[28] Driver S, Reynolds M, Brown K, Vingren JL, Hill DW, Bennett M, et al. 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. 2022; 56: 107–113.

[29] Mairbäurl H. Red blood cells in sports: effects of exercise and training on oxygen supply by red blood cells. Frontiers in Physiology. 2013; 4: 332.

[30] Ernst E, Daburger L, Saradeth T. The kinetics of blood rheology during and after prolonged standardized exercise. Clinical Hemorheology and Microcirculation. 1991; 11: 429–439.

[31] Yalcin O, Erman A, Muratli S, Bor-Kucukatay M, Baskurt OK. Time course of hemorheological alterations after heavy anaerobic exercise in untrained human subjects. Journal of Applied Physiology. 2003; 94: 997–1002.

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