Wieliczka Salt Mine Health Resort, Wieliczka, Poland.
Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland.
Adv Exp Med Biol. 2019;1176:35-46. doi: 10.1007/5584_2019_354.
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 FEV/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.
肺康复（PR）已被推荐为慢性阻塞性肺疾病（COPD）患者治疗的一个组成部分。在盐矿洞穴中进行气候疗法已被证明对慢性呼吸道疾病有益。本研究比较了在维利奇卡盐矿地下进行的长期 PR 与在地面进行的 PR 的效果。共有 42 名 COPD 患者入组，FEV/FVC<0.7 预测值和支气管扩张剂后可逆性<12%，随机分为在矿山进行的肺康复组（I 组，n=23）和在地面进行的肺康复组（II 组，n=19）。结果包括肺功能变量、运动表现（6 分钟步行试验-6MWT）、呼吸困难（mMRC）、疾病和生活质量的依从性（COPD 评估测试-CAT）和 BODE 指数，在基线（P0）、结束（P1）和肺康复后 6 个月（P2）时进行比较。结果表明，与在地面进行的等效治疗相比，地下肺康复显著降低了 CAT 评分（p<0.001）、BODE 指数（p=0.004）和呼吸困难（mMRC）（p=0.001），并增加了 6MWT 的距离（p<0.001）。此外，与在地面上治疗的患者相比，地下治疗的有益效果在接下来的半年内持续存在。我们得出结论，与在地面上进行的类似治疗相比，地下肺康复治疗在 COPD 患者中能更大程度地减轻症状和提高运动耐量，并能持续更长时间。
