Çankırı Tuz Mağarası'nda uygulanan speleoterapi ve tuz odasında uygulanan haloaeresolterapinin KOAH ve bronşiyal astım hastaları üzerindeki etkileri: öncü (hafif) deneysel pilot çalışma

Abstract

Amaç: Bu çalışma, Çankırı Tuz Mağarası'nda uygulanan speleoterapi ve tuz odasında uygulanan haloaerosol terapinin Kronik Obstrüktif Akciğer Hastalığı (KOAH) ve bronşiyal astım hastaları üzerindeki etkilerini değerlendirmek amacıyla yapılmıştır. Yöntemler: Çalışmaya, 15 gün boyunca günde bir kez mağarada speleoterapi ve günde bir kez yapay tuz odasında haloaerosol tedavisi alan toplam 33 kişi (14 katılımcı 1. grup, 19 katılımcı 2 grup) dahil edilmiştir. Katılımcılar, müdahale öncesi ve sonrası Tıbbi Araştırma Konseyi (mMRC) Dispne Ölçeği, KOAH Değerlendirme Testi (CAT), SF12 Yaşam Kalitesi Ölçeği (SF-12 QoL), Altı Dakika Yürüme Testi (6MWT), Borg Dispne Ölçeği (BDS), Akciğer Fonksiyon Testleri (Spirometri) ve BODE İndeksi ölçüm araçları kullanılarak değerlendirilmiştir. Speleoterapi ve haloaerosolterapi müdahalesi önce ve sonrası anlamlılık düzeyleri, öntest ve sontest ortalamalarına dayalı parametrik olmayan analizler kullanılarak belirlenmiştir. Bulgular: 1. grup ve 2. grupta mMRC dispne ölçeği (p=,001, p=,000), CAT skalası (p=,001, p=,001) ve BODE indeksi (p=,003, p=,004) skorlarında müdahale sonrası başlangıç değerlerine göre anlamlı bir azalma gözlenmiştir. Müdahale sonrasında SF-12 yaşam kalitesi ölçeği puanlarında (PCS-12 için p=,002, p=,001; MCS-12 için p=,001, p=,004) anlamlı bir artış gözlendi. 6MWT'de ise müdahale sonrasında yürüme mesafesinde anlamlı bir artış görüldü (p=,003, p=,017). Sonuç: KOAH ve astım bronşiti hastalarında speleoterapi ve haloaerosolterapinin kombinasyonu, nefes darlığını azalttı, CAT skalasıyla belirlenen öksürük, göğüste daralma, hareket kısıtlılığı, uyuma güçlüğü gibi KOAH semptomlarını hafifletti, egzersiz kapasitesini ve yürüme mesafesini artırdı, yaşam kalitesini yükseltti.

Keywords

• Astım
• Mağara
• Kronik Obstruktif Akciğer Hastalığı
• Tuz
• Speleoterapi
• Mağara Terapisi

Effects of speleotherapy in Çankırı Salt Cave and haloaeresoltherapy in the salt chamber on COPD and bronchial asthma patients: a preliminary experimental pilot study

Abstract

Objective: The study was conducted to evaluate the effects of speleotherapy in the Çankırı Salt Cave and haloaerosoltherapy in a salt room on patients with Chronic Obstructive Pulmonary Disease (COPD) and bronchial asthma. Methods: A total of 33 individuals (14 participants in Group 1, 19 participants in Group 2) received speleotherapy in the cave and haloaerosoltherapy in an artificial salt chamber once daily for 15 days. Participants were evaluated before and after the intervention using the Medical Research Council (mMRC) Dyspnea Scale, COPD Assessment Test (CAT), SF-12 Quality of Life Scale (SF-12 QoL), Six-Minute Walk Test (6MWT), Borg Dyspnea Scale (BDS), Pulmonary Function Tests (Spiriometry), and BODE Index. The significance levels of speleotherapy and haloaerosoltherapy interventions before and after were determined using non-parametric analyses based on pre-test and post-test means. Results: In both groups 1 and 2, a significant decrease was observed in mMRC dyspnea scale (p=.001, p=.000), CAT (p=.001, p=.001), and BODE index (p=.003, p=.004) scores compared to baseline values after the intervention. A significant increase was observed in SF-12 quality of life scale scores after the intervention (p=.002, p=.001 for PCS-12; p=.001, p=.004 for MCS-12). In 6MWT, a significant increase in walking distance was observed after the intervention (p=.003, p=.017). Conclusion: In patients with COPD and asthmatic bronchitis, the combination of speleotherapy and haloaerosoltherapy reduced shortness of breath, alleviated COPD symptoms such as cough, chest tightness, limited mobility, and difficulty sleeping as determined by the CAT scale, increased exercise capacity and walking distance, and improved quality of life.

Keywords

• Asthma
• Caves
• Chronic Obstructive Pulmonary Disease
• Salts
• Speleotherapy

Supporting Institution

No cash payment was received for the study. All expenses of the study were covered by the resources of the 8 institutions that signed the joint protocol.

Ethical Statement

This study was approved by the Çankırı Karatekin University Ethics Committee prior to implementation (Approval No: 15; Date: 03-07-2024).

Thanks

We would like to thank the Governor of Çankırı, Mr. Fırat Taşolar, the Çankırı Municipality, Çankırı Karatekin University, the Çankırı Provincial Health Directorate, the Çankırı Provincial Directorate of Youth and Sports, the Çankırı Yeşilay Association, the Çankırı Salt Rehabilitation Association, and the Çankırı Private Karatekin Hospital for their support in carrying out this study.

References

1. Alexescu, T. G., Maierean, A., Ciumarnean, L., Budin, C., Dogaru, G., & Todea, D. A. (2019). Rehabilitation therapies in stable chronic obstructive pulmonary disease. Balneo Research Journal, 10(1), 37–44. https://doi.org/10.12680/balneo.2019.237.
2. Barber, D., Malyshev, Y., Oluyadi, F., Andreev, A., & Sahni, S. (2022). Halotherapy for chronic respiratory disorders: from the cave to the clinical. Alternative Therapies in Health and Medicine, 28(3), 52–56.
3. Beamon, S., Falkenbach, A., Fainburg, G., & Linde, K. (2001). Speleotherapy for asthma. Cochrane Database of Systematic Reviews, 2, CD001741. https://doi.org/10.1002/14651858.CD00 1741.
4. Bestall, J. C., Paul, E. A., & Garrod, R. (1999). Usefulness of the Medical Research Council (MRC) dyspnea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax, 54, 581–586. https://doi.org/10.1136/thx.54.7.581
5. Chervinskaya, A. V., & Zilber, N. A. (1995). Halotherapy for treatment of respiratory diseases. Journal of Aerosol Medicine, 8(3), 221–232. https://doi.org/10.1089/jam.1995.8.221
6. Crisan-Dabija, R., & Mihaescu, T. (2012). Halotherapy – a possible method to enhance airway treatment on patients with obstructive pathology. European respiratory journal, 40, P2165.
7. Ercoşkun, H. (2025). Gourmet salts and molecular gastronomy. Aydın Gastronomy, 9(1), 233–247.
8. Freidl, J., Huber, D., Braunschmid, H., Romodow, C., Pichler, C., Weisböck-Erdheim, R., Mayr, M., & Hartl, A. (2020). Winter exercise and speleotherapy for allergy and asthma: A randomized controlled clinical trial. Journal of Clinical Medicine, 9(10), 3311. https://doi.org/10.3390/jcm9103311.

9. Güneş, Ü. Y., Kara, D., & Erbağcı, A. (2012). Comparison of the different dyspnea scales in patients with complaints of dyspnea. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi, 5(2), 65–71.
10. Hedman, J., Hugg, T., Sandell, J., & Haahtela, T. (2006). The effect of salt chamber treatment on bronchial hyperresponsiveness in asthmatics. Allergy, 61(5), 605–610. https://doi.org/10.1111/j.1 398-9995.2006.01073.x.
11. Kendrick, K. R., Baxi, S. C., & Smith, R. M. (2000). Usefulness of the modified 0–10 Borg scale in assessing the degree of dyspnea in patients with COPD and asthma. Journal of Emergency Nursing, 26(3), 216–222. https://doi.org/10.1016/S0099-1767(00)90093-X
12. Kendrova, L., Takac, P., Kubincova, A., Mikulakova, W., & Nechvatal, P. (2016). Effect of spa treatment and speleotherapy in the treatment of chronic obstructive pulmonary disease – a pilot study. Clinical Social Work and Health Intervention, 7(2), 7–15.
13. Kılıç, S. (2014). Etki büyüklüğü. Journal of Mood Disorders, 4(1), 44–46. https://doi.org/10.5455/jmood.20140228012836
14. Kostrzon, M., Sliwka, A., Wloch, T., Szpunar, M., Ankowska, D., & Nowobilski, R. (2019). Subterranean pulmonary rehabilitation in chronic obstructive pulmonary disease. Advances in Experimental Medicine and Biology, 1176, 35–46. https://doi.org/10.1007/5 584_2019_354
15. Kuran, G., Yeldan, İ., İşsever, H., Erkan, F., & Gürses, H. N. (2009). Assessment of the relationship between pulmonary functions, duration and severity of disease with walking and BODE Index in COPD. Solunum, 11(1), 22–25.
16. Kwon, D. S., Choi, Y. J., Kim, T. H., Byun, M. K., Cho, J. H., Kim, H. J., & Park, H. J. (2020). FEF25-75% values in patients with normal lung function can predict the development of chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease, 15, 2913–2921. https://doi.org/10.2147/C OPD.S261732
17. Lazarescu, H., Simionca, I., Hoteteu, M., Munteanu, A., Rizea, I., Iliuta, A., Dumitrascu, D., & Dumitrescu, E. (2014). Surveys on therapeutic effects of 'halotherapy chamber with artificial salt-mine environment' on patients with certain chronic allergenic respiratory pathologies and infectious-inflammatory pathologies. Journal of Medicine and Life, 7(2), 83–87.
18. Levchenko, P. A., Dubovik, N. N., & Delendik, R. I. (2014). Our experience with the application of the speleotherapeutic treatment based at the state healthcare facility Republican Speleotherapeutic Hospital. Voprosy Kurortologii, Fizioterapii, I Lechebnoi Fizicheskoi Kultury, (6), 26–29.
19. Liou, T. G., & Kanner, R. E. (2009). Spirometry. Clinical Reviews in Allergy & Immunology, 37(3), 137–152. https://doi.org/10.1007/s12016-009-8128-z
20. Matos Casano, H. A., & Anjum, F. (Ed.). (2023). Six-minute walk test. StatPearls Publishing.
21. Mazloomzadeh, S., Bakhshi, N., Ahmadiafshar, A., & Gholami, M. (2017). The effect of salt space on clinical findings and peak expiratory flow in children with mild to moderate asthma: A randomized crossover trial. Iranian Journal of Allergy, Asthma and Immunology, 16(3), 198–204.
22. Mętel, S., Kostrzon, M., Adamiak, J., & Janus, P. (2023). Respiratory muscle function in older adults with chronic respiratory diseases after pulmonary rehabilitation in subterranean salt chambers. Journal of Clinical Medicine, 12(15), 5120. https://doi.org/10.3390/jcm1 2155120
23. Mętel, S., Kostrzon, M., Adamiak, J., Gattner, H., Kościelecka, D., Sosulska, A., Szczygieł, E., & Golec, J. (2020). The influence of speleotherapy combined with pulmonary rehabilitation on functional fitness in older adults – preliminary report. Therapeutic Advances in Respiratory Disease, 14, 1753466620926952. https://doi.org/ 10.1177/1753466620926952
24. Ministry of Culture and Tourism. (2025, July 13). Official website of Çankırı Provincial Directorate of Culture and Tourism. https://cankiri.ktb.gov.tr
25. Oleksa, P., Więsyk, P., Spozowski, K., & Wójcik, P. (2022). Effectiveness of the salt therapy – current knowledge status. Journal of Education, health and sport, 13(1), 51–55. https://doi.org/10.12775/JEHS.20 23.13.01.007.
26. Rashleigh, R., Smith, S. M., & Roberts, N. J. (2014). A review of halotherapy for chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease, 9, 239–246. https://doi. org/10.2147/COPD.S57511.
27. Sarker, H. N., Alam, M. M., Vadury, S. C., & Hossain, L. (2022). Use of BODE Index to assess prognosis of patients with COPD. Mymensingh Medical Journal, 31(2), 443–448.
28. Soylu, C., & Kütük, B. (2022). Reliability and validity of the Turkish version of SF-12 health survey. Turkish Journal of Psychiatry, 33(2), 108–117. https://doi.org/10.5080/u25700
29. Ulubay, G., Dilektaşlı, A. G., Börekçi, Ş., Yıldız, Ö., Kıyan, E., Gemicioğlu, B., & Saryal, S. (2019). Turkish Thoracic Society Consensus Report: Interpretation of Spirometry. Turkish Thoracic Journal, 20(1), 69–89. https://doi.org/10.5152/TurkThoracJ.2018.180175
30. Wasik, A. A., & Tuuminen, T. (2021). Salt therapy as a complementary method for the treatment of respiratory tract diseases, with a focus on mold-related illness. Alternative Therapies in Health and Medicine, 27(S1), 223–239.
31. Weinreich, U. M., Nilsson, T., Mylund, L., Christiansen, H. T., & Laursen, B. S. (2014). Salt halo therapy and saline inhalation administered to patients with chronic obstructive pulmonary disease: A pilot study. Journal of Palliative Care & Medicine, 4(4), 2.
32. Yorgancıoğlu, A., Polatlı, M., Aydemir, Ö., Yılmaz Demirci, N., Kırkıl, G., Naycı Atış, S., Köktürk, N., Uysal, A., Akdemir, S. E., Özgür, E. S., & Günakan, G. (2012). KOAH değerlendirme testinin Türkçe geçerlilik ve güvenilirliği. Tuberkuloz ve Toraks, 60(4), 314–320. https://doi.org/10.5578/tt.4321
33. Zajac, J., Bojar, I., Helbin, J., Kolarzyk, E., & Owoc, A. (2014). Salt caves as simulation of natural environment and significance of halotherapy. Annals of Agricultural and Environmental Medicine, 21(1), 124–127.