Nathaniel Marchetti1, Matthew R Lammi2, John M Travaline3, David Ciccolella3, Brian Civic4, Gerard J Criner3. 1. Department of Thoracic Medicine and Surgery, Temple University School of Medicine, 3401 N. Broad Street, Philadelphia, PA, 19140, USA. nathaniel.marchetti@tuhs.temple.edu. 2. Section of Pulmonary/Critical Care and Allergy/Immunology, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA. 3. Department of Thoracic Medicine and Surgery, Temple University School of Medicine, 3401 N. Broad Street, Philadelphia, PA, 19140, USA. 4. Section of Pulmonary and Critical Care Medicine, Lehigh Valley Health Network, Allentown, PA, USA.
Abstract
PURPOSE: Improving dyspnea and exercise performance are goals of COPD therapy. We tested the hypothesis that air current applied to the face would lessen dyspnea and improve exercise performance in moderate-severe COPD patients. METHODS: We recruited 10 COPD patients (5 men, age 62 ± 6 years, FEV1 0.93 ± 0.11 L (34 ± 3% predicted), TLC 107 ± 6%, RV 172 ± 18%) naïve to the study hypothesis. Each patient was randomized in a crossover fashion to lower extremity ergometry at constant submaximal workload with a 12-diameter fan directed at the patients face or exposed leg. Each patients' studies were separated by at least 1 week. Inspiratory capacity and Borg dyspnea score were measured every 2 min and at maximal exercise. RESULTS:Total exercise time was longer when the fan was directed to the face (14.3 ± 12 vs. 9.4 ± 7.6 min, face vs. leg, respectively, p = 0.03). Inspiratory capacity tended to be greater with the fan directed to the face (1.4 (0.6-3.25) vs. 1.26 (0.56-2.89) L, p = 0.06). There was a reduction in dynamic hyperinflation, as reflected by higher IRV area in the fan on face group (553 ± 562 a.u. vs. 328± 319 a.u., p = 0.047). There was a significant improvement in the Borg dyspnea score at maximal exercise (5.0 (0-10) vs. 6.5 (0-10), p = 0.03), despite exercising for 34 % longer with the fan directed to the face. CONCLUSIONS: Air current applied to the face improves exercise performance in COPD. Possible mechanisms include an alteration in breathing pattern that diminishes development of dynamic hyperinflation or to a change in perception of breathlessness.
RCT Entities:
PURPOSE: Improving dyspnea and exercise performance are goals of COPD therapy. We tested the hypothesis that air current applied to the face would lessen dyspnea and improve exercise performance in moderate-severe COPDpatients. METHODS: We recruited 10 COPDpatients (5 men, age 62 ± 6 years, FEV1 0.93 ± 0.11 L (34 ± 3% predicted), TLC 107 ± 6%, RV 172 ± 18%) naïve to the study hypothesis. Each patient was randomized in a crossover fashion to lower extremity ergometry at constant submaximal workload with a 12-diameter fan directed at the patients face or exposed leg. Each patients' studies were separated by at least 1 week. Inspiratory capacity and Borg dyspnea score were measured every 2 min and at maximal exercise. RESULTS: Total exercise time was longer when the fan was directed to the face (14.3 ± 12 vs. 9.4 ± 7.6 min, face vs. leg, respectively, p = 0.03). Inspiratory capacity tended to be greater with the fan directed to the face (1.4 (0.6-3.25) vs. 1.26 (0.56-2.89) L, p = 0.06). There was a reduction in dynamic hyperinflation, as reflected by higher IRV area in the fan on face group (553 ± 562 a.u. vs. 328 ± 319 a.u., p = 0.047). There was a significant improvement in the Borg dyspnea score at maximal exercise (5.0 (0-10) vs. 6.5 (0-10), p = 0.03), despite exercising for 34 % longer with the fan directed to the face. CONCLUSIONS: Air current applied to the face improves exercise performance in COPD. Possible mechanisms include an alteration in breathing pattern that diminishes development of dynamic hyperinflation or to a change in perception of breathlessness.
Authors: D E O'Donnell; T Flüge; F Gerken; A Hamilton; K Webb; B Aguilaniu; B Make; H Magnussen Journal: Eur Respir J Date: 2004-06 Impact factor: 16.671
Authors: Tim Luckett; Mary Roberts; Tracy Smith; Maja Garcia; Sarah Dunn; Flavia Swan; Caleb Ferguson; Slavica Kochovska; Jane L Phillips; Mark Pearson; David C Currow; Miriam J Johnson Journal: BMC Pulm Med Date: 2022-04-06 Impact factor: 3.317