Effect of fan-to-face therapy on exertional breathlessness in adults with chronic lung disease.

Background: Exertional breathlessness is a common and disabling symptom for people with COPD and interstitial lung disease (ILD). Fan-to-face (F2F) therapy, which may stimulate trigeminal nerve afferents Methods: In a randomised crossover trial, 32 participants (COPD: n=27; ILD: n=5) completed three 4-min CWR-TTs with F2F, F2L or NF. Breathlessness intensity (primary outcome) and physiological variables were recorded throughout. Results: F2F reduced breathlessness intensity by 0.5 units on the Borg 0-10 scale, compared with NF, but did not reduce breathlessness intensity compared with F2L. F2F resulted in a lower facial skin temperature, but no differences were observed in ventilation, breathing pattern, heart rate or blood oxygen saturation. In an exploratory subgroup analysis of 20 participants with breathlessness intensity of ≥3 Borg units under NF, F2F decreased breathlessness intensity by 0.9 units during the 4-min CWR-TT, compared with NF, but not compared with F2L. Clinically meaningful reductions in exertional breathlessness intensity (≥1 Borg unit) were reported by 31% of the full sample and 45% of the exploratory subgroup under F2F Conclusion: Whether due to stimulation of trigeminal nerve afferents or placebo effects, F2F therapy should reasonably be considered as a potentially effective nonpharmacological intervention for exertional breathlessness, especially among adults with chronic lung disease who report more severe breathlessness on exertion.