Table 1. Fan therapy.
6MWT: six-minute walk test; ECOG: Eastern Cooperative Oncology Group; ESAS-r: Edmonton Symptom Assessment System Revised; FACIT- Pal: Functional Assessment of Chronic Illness Therapy-Palliative Care; ILD: interstitial lung disease; mBorg: modified Borg scale; mMRC: modified Medical Research Council Dyspnea Scale; NR: not recorded; NRS: numerical rating scale; RCT: randomized controlled trial; VAS: visual analog scale.
| Author, year, country | Study type | Phase (Setting) | Disease | Dyspnea at baseline, mean (SD) | Oxygen therapy, N (%) | Fan therapy intervention | Control | Outcome |
| Booth et al. [12], 2016, United Kingdom | Observation trial | Chronic (Ward, Outpatient) | Mixed non- malignant (n=8), Cardiorespiratory disease (n=7), COPD (n=7), Cancer (n=5), Other (n=4) | VAS 48.5 (27.4), NRS 5.5 (2.2) | NR | At a comfortable distance of 15–30 cm from the face, blow air for 5 min across the areas innervated by the second/third branches of the trigeminal nerve. | No intervention | (i) Scores had returned to baseline values of dyspnea, (ii) Relief from breathlessness noted on relief score (VAS and NRS), (ii) Relief from breathlessness noted on relief score (VAS and NRS), (iv) The absolute change in scores from baseline values, (v) The correlation between the changes in VAS, NRS, and relief scores |
| Wong et al. [13], 2017, China | Parallel RCT | Terminal (Palliative care unit) | Lung cancer (n=13), Other cancer (n=17) | NRS 6.1 (2.5) | NR | Patients were given fan therapy, which involved the use of a table fan to blow air to the face for 5 minutes. | Accompanied by their caregivers | (i) NRS, (ii) SpO2, (iii) Respiratory rates |
| Galbraith et al. [18], 2010, United Kingdom | Crossover RCT | Chronic and Terminal (Ward) | COPD (n=26), Heart disease (n=15), Lung cancer (n=11), Asthma (n=8), Bronchiectasis (n=7), Pneumonitis (n=4), Other (n= 20), Multiple diagnoses (up to 4 in any one patient) (n=26) | VAS 31 (36.3) | NR | Use a handheld fan for five minutes directed to their face. | Fan to leg | (i) VAS, (ii) SpO2, (iii) Pulse rate |
| Bausewein et al. [19], 2010, Germany | Parallel RCT | Chronic and Terminal (Ward, home, clinic) | COPD (n=45), Lung cancer (n=25) | Borg score 4 (1.9) | NR | A hand-held fan was directed to the area of the face in nervated by the second and third trigeminal nerve branches for two months. | Wore a wristband | (i) Status of use, (ii) Questions if it is helpful after 2 months, (iii) Change of breathlessness severity (mBorg) after 2 months, (iv) Uptake into the trial |
| Kako et al. [20], 2015, Japan | Case series | Terminal (Palliative care unit) | Cancer (n=9) | VAS 40.2 (11.8) | 6 (67) | Participants used a standing fan to blow air by for 5 minutes across the region innervated by the second/third trigeminal nerve branches. | No intervention | (i) VAS, (ii) Satisfaction with fan therapy, (iii) Pulse rate, (iv) Respiratory rates, (v) SpO2, (vi) pain VAS |
| Kako et al. [21], 2018a, Japan | Non-RCT | Terminal (Palliative care unit) | Lung cancer (n=6), Other cancer (n=3) | NRS 5.9 (1.8) | 6 (67) | Participants used a standing fan to blow air by for 5 minutes across the region innervated by the second/third trigeminal nerve branches. | (i) Fan to leg, (ii) No intervention | (i) Duration required for the dyspnea score to return to baseline after the intervention, (ii) Relief from breathlessness, as measured by the NRS during each intervention, (iii) Patients’ preferred type of therapy, (iv) Change in the patients’ face surface temperature |
| Kako et al. [22], 2018b, Japan | Parallel RCT | Terminal (Palliative care unit) | Lung cancer (n=15), Pancreas cancer (n=4), Colon/rectum cancer (n=3), Breast cancer (n=3), Head and neck cancer (n=3), Stomach cancer (n=2), Prostate cancer (n=2), Esophagus cancer (n=2), Gallbladder/bile duct cancer (n=2), Other cancer (n=4) | NRS 5.3 (1.4) | 9 (45) | Fan therapy constituted of directing a standing fan to blow air for five minutes across the region innervated by the second/third trigeminal nerve branches. | Fan to leg | (i) NRS, (ii) ESAS-r (pain, tiredness, drowsiness, nausea, lack of appetite, depression, anxiety, dyspnea, and well-being), (iii) Facial surface temperature, (iv) Respiratory rate, (v) SpO2, (vi) Pulse rate |
| Khor et al. [23], 2021, Australia | Parallel RCT | Chronic (Ward) | Interstitial lung disease (n=30) | Dyspnea-12 16.1 (2.2) | 2 (13) | The handheld fan should be about 15 cm away from the face, with the airflow directed toward the center of the face, so that it can be felt next to the nose and above the upper lip, and can be used as often as needed for two weeks, when resting after activity, or when feeling suffocated at rest. | No intervention | (i) Change in Dyspnoea-12 scores, (ii) Participants’ perspectives regarding the use of fan for managing their symptoms, (iii) HRQoL, (iv) Self-efficacy, (v) Functional performance, (vi) King's Brief Interstitial Lung Disease Questionnaire, (vii) Self-efficacy for Managing Chronic Disease 6-item Scale |
| Kocatepe et al. [24], 2021, Turkey | Parallel RCT | Terminal (Palliative care unit) | Lung cancer (n=96) | mBorg 6 (1.2) | NR | Use the handheld fan—held 15 cm away from the face—for five minutes three times per day (before breakfast, lunch, and dinner) for 14 days. | No intervention | (i) mBorg, (ii) Respiration rate, (iii) Oxygen saturation, (iv) Heart rate, (v) ECOG performance status scale, (vi) FACIT-Pal, (vii) Pulmonary function test , (viii) Arterial blood gas |
| Long et al. [25], 2021, United Kingdom | Crossover RCT | Chronic (Outpatient) | COPD (n=14) | NRS 5 (1.9) | NR | Patients use the handheld fan: to hold the fan to their face throughout both the walking test (6MWT) and during the recovery period until they reported that breathlessness returned to baseline. | No intervention | (i) NRS, (ii) Breathlessness intensity (NRS), (iii) Perceived breathing difficulty/effort (mBorg), (iv) Distance walked (m) during the 6MWT, (v) Post-exertional recovery time, (vi) Acceptability of using the fan (Likert scale questionnaire) |
| Marchetti et al. [26], 2015, United States of America | Non-RCT | Chronic (Clinic) | COPD (n=10) | NR | 4 (40) | During the exercise in ergometry, a standing fan with a diameter of 12 cm is aimed at the patient's face to blow air. | Fan to leg | (i) Total exercise time, (ii) Less dynamic hyperinflation, (iii) Tidal volume, (iv) Respiratory rate, (v) Heart rate, (vi) Blood pressure |
| O'Driscoll et al. [27], 2011, United Kingdom | Crossover non-RCT | Chronic (Outpatient) | COPD (n=34) | mBorg 1.5 (1.1) | 0 (0) | During a simple step test on an exercise step, a standing fan with 28 cm blades blows cold air on the face from a distance of 1 m. | (i) room air, (ii) compressed air from a face-mask | (i) mBorg, (ii) The mean number of steps climbed, (iii) SpO2, (iv) Pulse rates, (v) Post-exertional recovery time |
| Smith et al. [28], 2022, Australia | Before-after trial | Chronic (Ward) | COPD (n=33) | mMRC 3 | NR | Participants used a hand-held fan, directed at their face for a maximum of 1 minute. | NR | (i) Perceived airflow (NRS), (ii) Pleasantness of airflow (NRS), (iii) Ease of use (NRS), (iv) Noisiness (NRS) |
| Sutherl et al. [29], 2022, United Kingdom | Case reports | Terminal (Palliative care unit) | Metastatic small cell lung cancer (n=1) | NR | NR | The clinical team turned on the table fan, using the oscillating motion setting, angled at 90° to her face and at 50 cm distance for 5min. | NR | The cough frequency after 5 min |
| Ting et al. [30], 2020, Philippines | Crossover RCT | Terminal (Ward) | Lung cancer (n=10), Breast cancer (n=8), Osteosarcoma: leg (n=4), Prostate cancer (n=4), Esophageal cancer (n=3), Head and neck cancer (n=3), Germ cell tumor (n=3), Colorectal cancer (n=2), Bladder cancer (n=2), Lymphoma cancer (n=2), Other cancer (n=7) | mBorg 7.5 (0.5) | 0 (0) | Fan on face therapy involved directing a standing fan to blow air for 5 minutes across the region innervated by the second/third trigeminal nerve branches. | Fan to leg | (i) mBorg, (ii) Oxygen saturation, (iii) Respiratory rates |