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

Alex Long, Martin Cartwright, Charles C Reilly
ERJ Open Research 2021; DOI: 10.1183/23120541.00211-2021
Alex Long
1Department of Physiotherapy, Kings College Hospital NHS Foundation Trust
2School of Health Sciences, City, University of London
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Martin Cartwright
2School of Health Sciences, City, University of London
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Charles C Reilly
1Department of Physiotherapy, Kings College Hospital NHS Foundation Trust
3Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London
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  • For correspondence: charles.c.reilly@kcl.ac.uk
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Abstract

Background Patients with Chronic Obstructive Pulmonary Disease (COPD) reduce physical activity to avoid the onset of breathlessness. Fan therapy (FT) can reduce breathlessness at rest, but the efficacy of FT during exercise remains unknown in this population.

Aim To investigate 1) the effect of FT on exercise-induced breathlessness and post-exercise recovery time in patients with COPD, 2) the acceptability of FT during exercise 3) to assess the reproducibility of any observed improvements in outcome measures.

Methods A pilot single-centre randomised controlled crossover, open (non-masked) trial (NCT031375424) of FT versus no FT during 6-minute walk test (6MWT) in patients with COPD and a Modified Medical Research Council (mMRC) dyspnoea score ≥2. Breathlessness intensity was quantified pre and on termination of the 6MWT, using the numerical rating scale (NRS) (0–10). Post-exertional recovery time was measured; defined as the time taken to return to baseline NRS breathlessness score. Oxygen saturation and heart rate were measure pre and post the 6MWT.

Results Fourteen patients with COPD completed the trial per protocol (4=male, 10=female; median age (interquartile range)=66.50 (60.75–73.5) years); mMRC dyspoena 3 (2–3)). Fan therapy resulted in lower exercise-induced breathlessness (Δ NRS; Δ mBORG) [within-individual differences in medians (WIDiM)=−1.00, IQR=−2.00 to −0.50, p<0.01; WIDiM=−0.25, IQR=−2.00 to 0.00, p=0.02], greater distance walked (metres) during the 6MWT [WIDiM=21.25, IQR=12.75 to 31.88, p<0.01], and improved post-exertional breathlessness (NRS) recovery time [WIDiM=−10.00, IQR=−78.75 to 50.00, p<0.01]. Fan therapy was deemed to be acceptable by 92% of participants.

Conclusion Fan therapy was acceptable and provided symptomatic relief to patients with COPD during exercise. These data will inform larger pilot studies and efficacy studies of FT during exercise.

Footnotes

This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.

Conflict of interest: Alex Long has nothing to disclose.

Conflict of interest: Dr. Cartwright has nothing to disclose.

Conflict of interest: Dr. Reilly has nothing to disclose.

This is a PDF-only article. Please click on the PDF link above to read it.

  • Copyright ©The authors 2021
http://creativecommons.org/licenses/by-nc/4.0/

This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org

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Impact of fan therapy during exercise on breathlessness and recovery time in patients with chronic obstructive pulmonary disease: a pilot randomised controlled crossover trial
Alex Long, Martin Cartwright, Charles C Reilly
ERJ Open Research Jan 2021, 00211-2021; DOI: 10.1183/23120541.00211-2021

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Impact of fan therapy during exercise on breathlessness and recovery time in patients with chronic obstructive pulmonary disease: a pilot randomised controlled crossover trial
Alex Long, Martin Cartwright, Charles C Reilly
ERJ Open Research Jan 2021, 00211-2021; DOI: 10.1183/23120541.00211-2021
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