BackgroundPatients 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.AimTo 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.MethodsA 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.ResultsFourteen 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.ConclusionFan 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.
Lack of effect of inhaled morphine on exercise-induced breathlessness in chronic obstructive pulmonary disease.