Advertisement

pp 1-12 | Cite as

Subterranean Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease

  • Magdalena KostrzonEmail author
  • Agnieszka Sliwka
  • Tomasz Wloch
  • Małgorzata Szpunar
  • Dorota Ankowska
  • Roman Nowobilski
Chapter
Part of the Advances in Experimental Medicine and Biology book series

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.

Keywords

COPD Pulmonary rehabilitation Speleotherapy Subterranean therapy 

Notes

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.

References

  1. Anto JM, Vermeire P, Vestbo J, Sunyer J (2001) Epidemiology of chronic obstructive pulmonary disease. Eur Respir J 17:982–994Google Scholar
  2. ATS (2002) American Thoracic Society Statement: guidelines for the six–minute walk test. Am J Respir Crit Care Med 166:111–117Google Scholar
  3. Beamon SP, Falkenbach A, Fainburg G, Linda K (2001) Speleotherapy for asthma. Cochrane Database Syst Rev 2001(2):CD001741Google Scholar
  4. 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 54:581–586Google Scholar
  5. 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):1005–1012Google Scholar
  6. 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):559–563Google Scholar
  7. 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
  8. 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
  9. 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):335–341Google Scholar
  10. Holland AE, Hill CJ, Jones AY, McDonald CF (2012) Breathing exercises for chronic obstructive pulmonary disease. Cochrane Database Syst Rev (10):CD008250Google Scholar
  11. Horvath T (1986) Speleotherapy: a special kind of climatotherapy, its role in a respiratory rehabilitation. Int Rehabil Med 8:90–92Google Scholar
  12. 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):648–654Google Scholar
  13. 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 7:743–755Google Scholar
  14. 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 7:7–15Google Scholar
  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):52–58Google Scholar
  16. 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):716–720Google Scholar
  17. Lăzărescu H, Simionca I, Hoteteu M, Mirescu L (2014) Speleotherapy – modern bio–medical perspectives. J Med Life 7(2):76–79Google Scholar
  18. 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 26:319–338Google Scholar
  19. 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 173:1390–1413Google Scholar
  20. Nurov I (2010) Immunologic features of speleotherapy in patients with chronic obstructive pulmonary disease. Med Health Sci J 2:44–47Google Scholar
  21. 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):2059–2067Google Scholar
  22. Rashleigh R, Smith SM, Roberts NJ (2014) A review of halotherapy for chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 21(9):239–246Google Scholar
  23. Reardon J, Casaburi R, Morgan M, Nici L, Rochester C (2005) Pulmonary rehabilitation for COPD. Respir Med 99:S19–S27Google Scholar
  24. 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–42SGoogle Scholar
  25. 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 955:9–18Google Scholar
  26. 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 16:53–83Google Scholar
  27. 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):2001–2007Google Scholar
  28. Troosters T, Casaburi R, Gooselink R, Decramer M (2005) Pulmonary rehabilitation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 172:19–38Google Scholar
  29. 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):9Google Scholar
  30. Wiszniewski A (2015) Environment of air–ions in healing chambers in the Wieliczka Salt Mine. Acta Physica Polonica Ser A 127(6):1661–1665Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Magdalena Kostrzon
    • 1
    Email author
  • Agnieszka Sliwka
    • 2
  • Tomasz Wloch
    • 3
  • Małgorzata Szpunar
    • 1
  • Dorota Ankowska
    • 1
  • Roman Nowobilski
    • 2
  1. 1.Wieliczka Salt Mine Health ResortWieliczkaPoland
  2. 2.Institute of Physiotherapy, Faculty of Health SciencesJagiellonian University Medical CollegeCracowPoland
  3. 3.Faculty of Motor RehabilitationUniversity of Physical EducationCracowPoland

Personalised recommendations