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Randomized Controlled Trial
. 2015 Oct;193(5):725-31.
doi: 10.1007/s00408-015-9780-0. Epub 2015 Aug 9.

Air Current Applied to the Face Improves Exercise Performance in Patients with COPD

Nathaniel Marchetti  1 , Matthew R Lammi  2 , John M Travaline  3 , David Ciccolella  3 , Brian Civic  4 , Gerard J Criner  3
Affiliations
Randomized Controlled Trial

Air Current Applied to the Face Improves Exercise Performance in Patients with COPD

Nathaniel Marchetti et al. Lung. 2015 Oct.

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.

Keywords: COPD; Dynamic hyperinflation; Emphysema; Exercise physiology.

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Figures

Fig. 1
Fig. 1
Area under the curve (AUC). A representative patient showing the AUC for the parameter VT/Ti. AUC was calculated over the exercise isotime (160 s in this example) and is expressed as arbitrary units (a.u.)
Fig. 2
Fig. 2
Exercise time. Patients exercised 34 % longer with the air current directed to the face as compared to the leg. Data bars are mean ± standard deviation. *p<0.05, fan directed to fan compared to fan directed to legs
Fig. 3
Fig. 3
Borg scores during exercise. Filled circle air current directed to the face. Open circle air current directed to the leg. Data are mean ± standard error of the mean. *p≤0.05, fan directed to fan compared to fan directed to legs
Fig. 4
Fig. 4
Inspiratory reserve area (IRV) with fan on leg (a) compared to fan on face( b). The IRV area was significantly greater with the fan on the face (see text for details). The shaded area represents the IRV
See this image and copyright information in PMC

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