Skip to main content

Main menu

  • Home
  • Current issue
  • Early View
  • Archive
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • COVID-19 submission information
    • Institutional open access agreements
    • Peer reviewer login
  • Alerts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us
  • My Cart

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • Early View
  • Archive
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • COVID-19 submission information
    • Institutional open access agreements
    • Peer reviewer login
  • Alerts
  • Subscriptions

Impact of fan therapy during exercise on breathlessness and recovery time in patients with COPD: a pilot randomised controlled crossover trial

Alex Long, Martin Cartwright, Charles C. Reilly
ERJ Open Research 2021 7: 00211-2021; DOI: 10.1183/23120541.00211-2021
Alex Long
1Dept of Physiotherapy, King's College Hospital NHS Foundation Trust, London, UK
2School of Health Sciences, City, University of London, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Martin Cartwright
2School of Health Sciences, City, University of London, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Charles C. Reilly
1Dept of Physiotherapy, King's College Hospital NHS Foundation Trust, London, UK
3Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Charles C. Reilly
  • For correspondence: charles.c.reilly@kcl.ac.uk
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Figures

  • Tables
  • FIGURE 1
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 1

    Study design and flow of patient through the study protocol: a pilot single-centre randomised controlled crossover open (nonmasked) trial of hand-held fan therapy (HHFT) versus no HHFT during 6-min walk test (6MWT) in patients with COPD and modified Medical Research Council dyspnoea score ≥2.

Tables

  • Figures
  • TABLE 1

    Patient characteristics of the 14 patients who completed the randomised controlled crossover trial of fan therapy versus no fan therapy during 6-min walk test

    Age (years)66.50 (60.75–73.50)
    BMI (kg·m−2)25.85 (20.60–30.25)
    Male/female4/10
    Smoking status
     Current smoker6
     Ex-smoker8
    Smoking (pack-years)48.00 (25.75–82.60)
    mMRC dyspnoea score3.00 (2.00–3.00)
    FEV1 (L)1.30 (0.94–1.59)
    FEV1 (%)63.00 (38.75–74.0)
    FVC (L)2.30 (1.90–2.75)
    FVC (%)82.00 (71.00–93.25)
    FEV1/FVC ratio56.75 (47.43–63.50)
    CAT score21.00 (12.25–29.75)

    Data are presented as median (interquartile range) or n. BMI: body mass index; mMRC: modified Medical Research Council; FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity; CAT: COPD Assessment Test.

    • TABLE 2

      Results observed in the primary randomised controlled crossover trial of fan therapy versus no fan therapy during 6-min walk test (6MWT) in patients with COPD

      Allocation sequence AB (fan/no fan)Allocation sequence BA (no fan/fan)Overall treatment effect
      Group-level median (IQR)WIDiM (IQR)Group-level median (IQR)WIDiM (IQR)WIDiM (IQR)
      Period 1
      fan
      Period 2
      no fan
      WIDiM#Wilcoxon signed rank test¶Period 1
      no fan
      Period 2
      fan
      WIDiM#Wilcoxon signed rank test¶WIDiM#Wilcoxon signed rank test¶
      Patients (n)77766613
      Subjective measures of breathlessness
       NRS+5.00 (3.75 to 6.25)7.00 (6.25 to 8.25)−2.00 (−2.00 to −1.00)0.024.00 (2.50 to 5.75)3.00 (2.00 to 4.75)−0.50 (−1.25 to 0.00)0.25−1.00 (−2.00 to −0.50)<0.01
       ΔNRS§3.00 (1.25 to 4.25)5.00 (3.00 to 6.75)−1.50 (−2.00 to −1.00)0.023.50 (2.25 to 4.75)3.00 (1.75 to 3.25)−0.50 (−1.25 to 0.00)0.25−1.00 (−2.00 to −0.50)<0.01
       NRS recovery time+110.00 (15.00 to 135.00)210.00 (160.00 to 295.00)−90.00 (−205.00 to −32.50)0.03150.00 (75.00 to 195.00)210.00 (165.00 to 227.50)60.00 (10.00 to 65.00)0.09−10.00 (−78.75 to 50.00)<0.01
       mBorg+3.00 (0.75 to 3.50)4.00 (4.00 to 5.00)−1.00 (−2.50 to 0.25)0.063.00 (2.00 to 4.50)3.00 (1.00 to 3.50)0.00 (−1.00 to 0.00)0.50−0.25 (−2.00 to 0.00)0.02
       ΔmBorg§2.00 (0.25 to 3.00)3.50 (3.50 to 4.00)−1.00 (−2.50 to −0.25)0.063.00 (1.75 to 3.50)2.00 (0.75 to 3.00)0.00 (−1.00 to 0.00)0.50−0.25 (−2.00. 0.00)0.02
      Objective measures of physiology
       HR+84.00 (74.00 to 89.50)82.00 (79.00 to 96.00)−4.00 (−12.00 to 4.00)0.3896.00 (94.00 to 106.50)92.00 (85.50 to 97.50)−3.00 (−5.50 to −2.00)0.14−3.50 (−7.50 to 1.00)0.11
       ΔHR§11.00 (5.50 to 14.00)12.00 (8.50 to 19.00)−3.00 (−5.50 to −1.00)0.2015.00 (4.00 to 18.00)2.00 (0.50 to 14.00)−3.00 (−5.50 to −1.00)0.47−3.00 (−5.75 to −0.25)0.13
       SpO2+96.00 (94.50 to 98.50)97.00 (96.50 to 98.00)0.00 (−1.00 to 1.00)1.0096.00 (95.00 to 96.50)97.00 (95.00 to 97.00)0.00 (−1.00 to 1.00)0.940.00 (−1.00 to 1.00)0.70
       Δ SpO2§0.00 (−1.00 to 1.50)0.00 (−1.00 to 1.00)0.00 (−0.50 to 1.00)1.000.00 (−1.50 to 0.50)0.00 (−1.50 to 1.00)0.00 (-1.00 to 1.00)1.000.00 (−0.75 to 1.00)1.00
      Objective measures of functional response
       6MWT distanceƒ (m)404.00 (336.25 to 465.00)400.00 (312.50 to 420.00)25.00 (17.50 to 30.00)0.02330.00 (223.75 to 517.50)383.00 (247.50 to 561.25)15.00 (11.00 to 42.75)0.0221.25 (12.75 to 31.88)<0.01
       6MWT stopsƒ (n)0.00 (0.00 to 0.00)0.00 (0.00 to 1.00)0.00 (−0.50 to 0.00)1.000.00 (0.00 to 2.00)0.00 (0.00 to 1.50)0.00 (0.00 to 0.00)1.0000.00 (0.00 to 0.00)0.63

      Only within-individual differences in the medians (WIDiMs) are used for estimating treatment effects; group-level medians are helpful in assessing carryover and order effects (see methods section). IQR: interquartile range; NRS: numerical rating scale; Δ: change; mBorg: modified Borg scale for breathlessness; HR: heart rate; SpO2: oxygen saturation measured by pulse oximetry. #: calculated so that positive values indicate higher scores for the fan condition and negative values indicate higher scores for the no-fan condition; ¶: exact significant, two-tailed; +: assessed post-exercise; §: change from pre- to post-exercise; ƒ: assessed during the exercise period.

      • TABLE 3

        Results observed in the repeated randomised controlled crossover trial of fan therapy versus no fan therapy during 6-min walk test (6MWT) in patients with COPD

        Allocation sequence AB (fan/no fan)Allocation sequence BA (no fan/fan)Overall treatment effect
        Group-level median (IQR)WIDiM (IQR)Group-level median (IQR)WIDiM (IQR)WIDiM (IQR)
        Period 1
        fan
        Period 2
        no fan
        WIDiM#Wilcoxon signed rank test¶Period 1
        no fan
        Period 2
        fan
        WIDiM#Wilcoxon signed rank test¶WIDiM#Wilcoxon signed rank test¶
        Patients (n)77777713
        Subjective measures of breathlessness
         NRS+5.00 (3.50 to 5.50)5.50 (4.25 to 7.00)−1.00 (−1.00 to −0.75)0.033.80 (0.75 to 6.00)1.80 (0.38 to 5.00)−0.25 (−0.88 to 0.00)0.25−1.00 (−1.00 to 0.00)<0.01
         ΔNRS§3.50 (2.25 to 3.75)4.00 (2.75 to 4.75)−1.00 (−1.00 to −0.75)0.031.80 (0.75 to 2.75)1.80 (0.38 to 2.00)−0.25 (−0.88 to 0.00)0.25−1.00 (−1.00 to 0.00)<0.01
         NRS recovery time+120.00 (75.00 to 180.00)185.00 (152.50 to 277.50)−110.00 (−127.00 to −62.50)0.02175.00 (43.75 to 227.50)105.00 (25.75 to 185.00)−17.00 (−102.50 to −11.00)0.06−65.00 (−130.00 to −20.00)<0.01
         mBorg+3.00 (2.00 to 4.00)4.00 (3.00 to 4.50)−1.00 (−2.00 to −0.50)0.062.50 (0.88 to 5.25)1.50 (0.25 to 5.00)−0.25 (−0.88 to 0.00)0.250−1.00 (−2.00 to 0.00)<0.01
         ΔmBorg§3.00 (1.00 to 3.00)3.00 (2.50 to 3.50)−1.00 (−2.00 to −0.50)0.062.50 (0.88 to 3.00)1.50 (0.25 to 2.00)−0.25 (−0.88 to 0.00)0.25−1.00 (−2.00 to 0.00)<0.08
        Objective measures of physiology
         HR+89.00 (84.50 to 99.50)87.00 (85.00 to 99.50)0.00 (−4.50 to 1.50)0.6989.50 (86.75 to 91.50)84.50 (81.75 to 90.25)−1.50 (−6.50 to 2.75)0.690.00 (−6.00 to 2.00)0.49
         ΔHR§10.00 (5.00 to 15.00)10.00 (10.00 to 12.00)0.00 (−6.00 to 4.00)0.886.00 (2.50 to 12.50)5.50 (2.75 to 12.75)1.00 (−2.00 to 2.50)0.851.00 (−3.00 to 3.00)0.96
         SpO2+94.00 (92.50 to 95.50)94.00 (93.00 to 97.00)0.00 (−3.00 to 0.00)0.2598.0 (96.50 to 98.00)96.50 (96.00 to 97.75)0.00 (−0.75 to 0.00)0.750.00 (−2.00 to 0.00)0.16
         Δ SpO2§0.00 (−3.50 to 1.00)−1.00 (−1.50–0.50)−1.00 (−2.50 to 1.50)0.520.50 (−1.50 to 2.50)−0.50 (−1.00 to 0.00)−1.00 (−1.75 to 0.50)0.53−1.00 (−2.00 to 1.00)0.29
        Objective measures of functional response
         6MWT distanceƒ (m)282.50 (233.75 to 470.25)265.00 (209.75 to 430.00)28.00 (20.00 to 38.75)0.06432.50 (399.38 to 516.25)531.30 (421.25 to 560.63)22.50 (11.25 to 71.25)0.0628.00 (17.50 to 45.00)<0.01
         6MWT stopsƒ (n)0.00 (0.00 to 2.00)1.00 (0.00 to 1.50)0.00 (0.00 to 0.00)1.000.00 (0.00 to 0.00)0.00 (0.00 to 0.00)0.00 (0.00 to 0.00)1.000.00 (0.00 to 0.00)0.75

        Only within-individual differences in the medians (WIDiMs) are used for estimating treatment effects; group-level medians are helpful in assessing carryover and order effects (see methods section). IQR: interquartile range; NRS: numerical rating scale; Δ: change; mBorg: modified Borg scale for breathlessness; HR: heart rate; SpO2: oxygen saturation measured by pulse oximetry. #: calculated so that positive values indicate higher scores for the fan condition and negative values indicate higher scores for the no-fan condition; ¶: exact significant, two-tailed; +: assessed post-exercise; §: change from pre- to post-exercise; ƒ: assessed during the exercise period.

        • TABLE 4

          Patient-reported acceptability of hand-held fan (HHF) therapy during exercise

          QuestionMedian (IQR)Range (min–max)
          Overall acceptabilityHow acceptable was it to use the HHF during the exercise test?
          (1=completely unacceptable, 5=completely acceptable)
          4 (4–5)3–5
          Affective attitudeHow much did you like using the HHF during the walking test?
          (1=strongly dislike, 5=strongly like)
          4 (3–5)3–5
          BurdenHow much additional effort was required to use the HHF during the walking test?
          (1=no additional effort, 5=a huge additional effort)
          1 (1–3)1–4
          Self-efficacyHow confident were you about using the HHF as instructed during the walking test?
          (1=very unconfident, 5=very confident)
          5 (4–5)1–5
          Intervention coherenceDo you understand how the HHF therapy was supposed to work?
          (1=definitely do not understand, 5=completely understand)
          4 (3–5)2–5
          Perceived effectivenessHow effective was the HHF in reducing breathlessness when walking?
          (1=very ineffective, 5=very effective)
          4 (3–4)3–5
          How effective was the HHF therapy in helping you to recover your breathing after you finished walking?
          (1=very ineffective, 5=very effective)
          4 (3–4)3–5
          Would you use a HHF to help with breathlessness in your everyday life?
          (1=I definitely would not use it, 5=I definitely would use it)
          5 (4–5)2–5

          IQR: interquartile range.

          PreviousNext
          Back to top
          Vol 7 Issue 4 Table of Contents
          ERJ Open Research: 7 (4)
          • Table of Contents
          • Index by author
          Email

          Thank you for your interest in spreading the word on European Respiratory Society .

          NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

          Enter multiple addresses on separate lines or separate them with commas.
          Impact of fan therapy during exercise on breathlessness and recovery time in patients with COPD: a pilot randomised controlled crossover trial
          (Your Name) has sent you a message from European Respiratory Society
          (Your Name) thought you would like to see the European Respiratory Society web site.
          CAPTCHA
          This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
          Print
          Citation Tools
          Impact of fan therapy during exercise on breathlessness and recovery time in patients with COPD: a pilot randomised controlled crossover trial
          Alex Long, Martin Cartwright, Charles C. Reilly
          ERJ Open Research Oct 2021, 7 (4) 00211-2021; DOI: 10.1183/23120541.00211-2021

          Citation Manager Formats

          • BibTeX
          • Bookends
          • EasyBib
          • EndNote (tagged)
          • EndNote 8 (xml)
          • Medlars
          • Mendeley
          • Papers
          • RefWorks Tagged
          • Ref Manager
          • RIS
          • Zotero
          Share
          Impact of fan therapy during exercise on breathlessness and recovery time in patients with COPD: a pilot randomised controlled crossover trial
          Alex Long, Martin Cartwright, Charles C. Reilly
          ERJ Open Research Oct 2021, 7 (4) 00211-2021; DOI: 10.1183/23120541.00211-2021
          del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
          Full Text (PDF)

          Jump To

          • Article
            • Abstract
            • Abstract
            • Introduction
            • Methods
            • Results
            • Discussion
            • Acknowledgement
            • Footnotes
            • References
          • Figures & Data
          • Info & Metrics
          • PDF

          Subjects

          • COPD and smoking
          • Tweet Widget
          • Facebook Like
          • Google Plus One

          More in this TOC Section

          Original research articles

          • Functional assay in CF organoids allows drug repurposing
          • Bacterial DNA amplifies neutrophilic inflammation in IL-17-exposed airways
          • PERSPIRE: a cohort study
          Show more Original research articles

          COPD

          • Admissions following first exacerbation-related hospitalisation
          • Improving the wellbeing of caregivers of patients with COPD
          • Arterial remodelling in smokers, and patients with small airway disease and COPD
          Show more COPD

          Related Articles

          Navigate

          • Home
          • Current issue
          • Archive

          About ERJ Open Research

          • Editorial board
          • Journal information
          • Press
          • Permissions and reprints
          • Advertising

          The European Respiratory Society

          • Society home
          • myERS
          • Privacy policy
          • Accessibility

          ERS publications

          • European Respiratory Journal
          • ERJ Open Research
          • European Respiratory Review
          • Breathe
          • ERS books online
          • ERS Bookshop

          Help

          • Feedback

          For authors

          • Instructions for authors
          • Publication ethics and malpractice
          • Submit a manuscript

          For readers

          • Alerts
          • Subjects
          • RSS

          Subscriptions

          • Accessing the ERS publications

          Contact us

          European Respiratory Society
          442 Glossop Road
          Sheffield S10 2PX
          United Kingdom
          Tel: +44 114 2672860
          Email: journals@ersnet.org

          ISSN

          Online ISSN: 2312-0541

          Copyright © 2023 by the European Respiratory Society