Abstract
Pulmonary rehabilitation (PR) has been recommended as an integral part of treatment for patients with chronic obstructive pulmonary disease (COPD). Climate therapy in salt mine chambers has been found of benefit in chronic respiratory diseases. The study compares long-term effects of underground PR in the Wieliczka Salt Mine with that conducted on the surface. There were 42 COPD patients enrolled in the study, with FEV1/FVC <0.7 predicted and post-bronchodilator reversibility <12%, randomized into pulmonary rehabilitation in the mine (Group I, n = 23) and PR on the surface (Group II, n = 19). The outcomes consisted of lung function variables, exercise performance (6-min walk test – 6MWT), dyspnea (mMRC), and compliance with the disease and quality of life (COPD Assessment Test – CAT) and BODE index, compared at baseline (P0), end (P1), and 6 months after pulmonary rehabilitation (P2). The findings were that subterranean pulmonary rehabilitation significantly reduced CAT score (p < 0.001), BODE index (p = 0.004), and dyspnea (mMRC) (p = 0.001) and increased distance in 6MWT (p < 0.001), compared with its equivalent conducted on the surface. Further, beneficial effect of subterranean treatment was sustained during the following half a year as opposed to the effect noticed on patients treated on the surface. We conclude that subterranean pulmonary rehabilitative treatment reduces symptoms and improves exercise tolerance to a greater and sustained extent, compared to a similar treatment on the surface, in patients suffering from COPD.
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References
Anto JM, Vermeire P, Vestbo J, Sunyer J (2001) Epidemiology of chronic obstructive pulmonary disease. Eur Respir J 17:982–994
ATS (2002) American Thoracic Society Statement: guidelines for the six–minute walk test. Am J Respir Crit Care Med 166:111–117
Beamon SP, Falkenbach A, Fainburg G, Linda K (2001) Speleotherapy for asthma. Cochrane Database Syst Rev 2001(2):CD001741
Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA (1999) Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 54:581–586
Celli BR, Cote CG, Marin JM, Casanova C, De Oca MM, Mendez RA, Plata VP, Cabral HJ (2004) The body–mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 350(10):1005–1012
Gibson GJ, Loddenkemper R, Lunbäck b SY (2013) Respiratory health and disease in Europe: the new European Lung White Book. Eur Respir J 42(3):559–563
GOLD (2019) Global strategy for the diagnosis, management and prevention of COPD. Global Initiative for Chronic Obstructive Lung Disease. https://goldcopd.org/gold–reports. Accessed on 30 Nov 2018
Guerreiro C, Ortiz AG, de Leeuw F, Viana M, Colette A (2018) Air quality in Europe – 2018 report. European Environment Agency. https://www.eea.europa.eu//publications/air–quality–in–europe–2018. Accessed on 30 Nov 2018
Holland AE, Nici L (2013) The return of the minimum clinically important difference for 6–minute walk distance in chronic obstructive pulmonary disease. Am J Respir Crit Care 187(4):335–341
Holland AE, Hill CJ, Jones AY, McDonald CF (2012) Breathing exercises for chronic obstructive pulmonary disease. Cochrane Database Syst Rev (10):CD008250
Horvath T (1986) Speleotherapy: a special kind of climatotherapy, its role in a respiratory rehabilitation. Int Rehabil Med 8:90–92
Jones PW, Harding G, Berry P, Wiklund I, Chen W–H, Kline Leidy A (2009) Development and first validation of the COPD Assessment Test. Eur Respir J 34(3):648–654
Katajisto M, Kupiainen H, Rantanen P, Lindqvist A, Kilpeläinen M, Tikkanen H, Laitinen T (2012) Physical inactivity in COPD and increased patient perception of dyspnea. Int J Chron Obstruct Pulmon Dis 7:743–755
Kendrová L, Takáč P, Kubincová A, Mikuláková W, Nechvátal P (2016) Effect of spa treatment and speleotherapy in the treatment of chronic obstructive pulmonary disease – a pilot study. Clin Soc Work Health Interv 7:7–15
Kostrzon M, Czarnobilski K, Badyda A (2015a) Climate characteristics of salt chambers used for therapeutic purposes in the Wieliczka Salt Mine. Acta Balneol LVII 1(139):52–58
Kostrzon M, Czarnobilski K, Czarnobilska E (2015b) The influence of pulmonary rehabilitation in the Wieliczka Salt Mine on asthma control – preliminary results. Przegląd Lekarski 72(12):716–720
Lăzărescu H, Simionca I, Hoteteu M, Mirescu L (2014) Speleotherapy – modern bio–medical perspectives. J Med Life 7(2):76–79
Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J, ATS/ERS Task Force (2005) Standardisation of spirometry. Eur Respir J 26:319–338
Nici L, Donner C, Wouters E, Zuwallack R, Ambrosino N, Bourbeau J, Carone M, Celli B, Engelen M, Fahy B, Garvey C, Goldstein R, Gosselink R, Lareau S, MacIntyre N, Maltais F, Morgan M, O’Donnell D, Prefault C, Reardon J, Rochester C, Schols A, Singh S, Troosters T, ATS/ERS Pulmonary Rehabilitation Writing Committee (2006) American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med 173:1390–1413
Nurov I (2010) Immunologic features of speleotherapy in patients with chronic obstructive pulmonary disease. Med Health Sci J 2:44–47
Pierobon A, Sini Bottelli E, Ranzini L, Bruschi C, Maestri R, Bertolotti G, Sommaruga M, Torlaschi V, Callegari S, Giardini A (2017) COPD patients’ self–reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation. Int J Chron Obstruct Pulmon Dis 18(12):2059–2067
Rashleigh R, Smith SM, Roberts NJ (2014) A review of halotherapy for chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 21(9):239–246
Reardon J, Casaburi R, Morgan M, Nici L, Rochester C (2005) Pulmonary rehabilitation for COPD. Respir Med 99:S19–S27
Ries AL, Bauldoff GS, Casaburi R, Mahler DA, Rochester CL, Herrerias C (2007) Pulmonary rehabilitation. Joint ACCP/AACVPR evidence–based clinical practice guidelines. Chest 131:4S–42S
Rogula-Kozłowska W, Kostrzon M, Rogula–Kopiec P, Badyda AJ (2017) Particulate matter in the air of the underground chamber complex of the Wieliczka Salt Mine Health Resort. Adv Exp Med Biol 955:9–18
Sterk PJ, Fabbri LM, Quanjer PH et al (1993) Airway responsiveness. Standardized challenge testing with pharmacological, physical and sensitizing stimuli in adults. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl 16:53–83
Tiemensma J, Gaab E, Voorhaar M, Asijee G (2016) Illness perceptions and coping determine quality of life in COPD patients. Int J Chron Obstruct Pulmon Dis 25(11):2001–2007
Troosters T, Casaburi R, Gooselink R, Decramer M (2005) Pulmonary rehabilitation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 172:19–38
van der Molen HF, de Groene GJ, Hulshof CTJ, Frings–Dresen MHW (2018) Association between work and chronic obstructive pulmonary disease (COPD). J Clin Med 7(10):9
Wiszniewski A (2015) Environment of air–ions in healing chambers in the Wieliczka Salt Mine. Acta Physica Polonica Ser A 127(6):1661–1665
Conflicts of Interest
MK, MS, and DA are employees of the Wieliczka Salt Mine. The other authors declare no conflicts of interest related to this article.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Regional Medical Chamber in Cracow, Poland (No. 38/KBL/OIL/2015 dated 15th of April 2015).
Informed Consent
Informed written consent was obtained from all individual participants included in the study.
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Kostrzon, M., Sliwka, A., Wloch, T., Szpunar, M., Ankowska, D., Nowobilski, R. (2019). Subterranean Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease. In: Pokorski, M. (eds) Advances in Biomedicine. Advances in Experimental Medicine and Biology(), vol 1176. Springer, Cham. https://doi.org/10.1007/5584_2019_354
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DOI: https://doi.org/10.1007/5584_2019_354
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