title: Air Current Applied to the Face Improves Exercise Performance in Patients with COPD.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Thoracic Medicine and Surgery, Temple University School of Medicine, 3401 N. Broad Street, Philadelphia, PA, 19140, USA. nathaniel.marchetti@tuhs.temple.edu.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Marchetti
authors.affiliation: Section of Pulmonary/Critical Care and Allergy/Immunology, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Lammi
authors.affiliation: Department of Thoracic Medicine and Surgery, Temple University School of Medicine, 3401 N. Broad Street, Philadelphia, PA, 19140, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Travaline
authors.affiliation: Department of Thoracic Medicine and Surgery, Temple University School of Medicine, 3401 N. Broad Street, Philadelphia, PA, 19140, USA.
authors.forename: David
authors.initials: D
authors.lastname: Ciccolella
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Lehigh Valley Health Network, Allentown, PA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Civic
authors.affiliation: Department of Thoracic Medicine and Surgery, Temple University School of Medicine, 3401 N. Broad Street, Philadelphia, PA, 19140, USA.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Criner
mesh_terms: D000368:Aged; D000392:Air Movements; D001794:Blood Pressure; D018592:Cross-Over Studies; D004417:Dyspnea / Q000209:etiology / Q000517:prevention & control*; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D005145:Face; D005260:Female; D005541:Forced Expiratory Volume; D006339:Heart Rate; D006801:Humans; D007320:Inspiratory Capacity; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D015656:Respiratory Mechanics / Q000502:physiology; D013997:Time Factors
keywords: COPD; Dynamic hyperinflation; Emphysema; Exercise physiology