Facial airflow enhances the benefits of exercise training in people with chronic lung disease: a randomised...

Breathlessness limits exercise training intensity in people with chronic lung disease (CLD). Stimulation of the trigeminal nerve via fan-to-face (F2F) therapy (facial airflow) can reduce exertional breathlessness and improve exercise endurance in CLD. This randomised controlled trial tested the hypothesis that adding F2F therapy to an exercise training programme could enhance the benefits of exercise training on exercise endurance time (EET) and exertional breathlessness in adults with CLD by allowing them to train at higher intensities.

23 participants with COPD (n=19) or interstitial lung disease (n=4) were randomised to 5 weeks of thrice weekly supervised exercise training with (F2F; n=12) or without (no fan (NF); n=11) facial airflow. Primary outcomes were baseline to post-exercise training change in EET and isotime breathlessness intensity ratings assessed using constant work-rate cardiopulmonary treadmill exercise testing.

Cumulative exercise training volume over the 5-week exercise training programme was similar in the F2F and NF groups, whereas breathlessness intensity ratings were consistently lower across all exercise training sessions in the F2F group. Both the F2F and NF groups showed significant increases in EET (mean±sd 7.2±9.1 min, 95% CI 3.0-13.6 min, versus 8.6±8.5 min, 95% CI 6.3-9.0 min, respectively) and decreases in isotime breathlessness intensity ratings (-2.1±1.5 min, 95% CI 0.6-3.2 min, versus -1.5±1.1 min, 95% CI 0.8-4.0 min, respectively) from baseline to post-exercise training, with similar magnitudes of change observed between groups.

F2F therapy (facial airflow) is a simple, feasible, low-cost, low-resource nonpharmacological approach to reduce exertional breathlessness during an exercise training programme in people with CLD.