Facial Airflow Enhances Exercise Training Benefits in chronic lung disease: A Randomised Trial

05 Mar 20264 min read0 viewsJournal Feed

GIST

Introduction 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. Methods 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. Results 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.

Clinical Editorial

Context and study design

A randomized controlled trial assessed whether adding facial airflow via fan-to-face (F2F) therapy to a structured exercise programme could enhance exercise endurance and reduce exertional breathlessness in adults with chronic lung disease (CLD).
Participant population included 23 adults with chronic lung disease: COPD (n=19) and interstitial lung disease (n=4).
Intervention: five weeks of thrice-weekly supervised exercise training, with F2F therapy (n=12) or without it (no fan, NF; n=11).
Primary outcomes focused on change from baseline to post-training in exercise endurance time (EET) and isotime breathlessness intensity ratings, measured during constant-work-rate treadmill testing.

Key findings on efficacy and tolerance

Reported 95% confidence intervals indicate overlapping magnitude of change between groups.

Training exposure: cumulative exercise training volume over the 5 weeks was similar between the F2F and NF groups.
Breathlessness during training: across sessions, participants receiving F2F reported consistently lower breathlessness intensity.
Endurance gains: both groups demonstrated significant improvements in EET from baseline to post-training (F2F: 7.2 ± 9.1 minutes; NF: 8.6 ± 8.5 minutes).
Isotime breathlessness: both groups showed reductions in breathlessness at isotime during training (F2F: −2.1 ± 1.5; NF: −1.5 ± 1.1; with respective 95% CIs indicating similar improvement).

Implications and interpretation

The addition of facial airflow to an exercise programme is associated with lower exertional breathlessness during sessions without altering the total training volume or the magnitude of endurance improvements relative to exercise alone.
The intervention is described as simple, feasible, low-cost, and low-resource, suggesting practical relevance for CLD rehabilitation settings.

Context and limitations

The sample size was modest (n=23), spanning two CLD etiologies (COPD and ILD), potentially limiting generalizability.
While both groups improved EET, the study reports similar magnitudes of change between groups, and thus the additive effect on endurance beyond standard training requires cautious interpretation.