The influence of pulmonary rehabilitation in the Wieliczka Salt Mine on asthma control--preliminary results.

According to asthma treatment guidelines the main goal of pulmonary rehabilitation is optimum asthma control. The Asthma Control Test (ACT) is a standardised five-item questionnaire for the assessment of asthma control. The study compares the pre- and post-treatment (subterraneotherapy) ACT score with other conventional respiratory parameters. The study included 21 patients with bronchial asthma who underwent a 3-week long subterraneotherapy programme in the 'Wieliczka' Salt Mine. The patients completed the ACT questionnaire before and 2 weeks after subterraneotherapy. At the same time, they underwent testing for concentration of nitric oxide in exhaled breath (FENO), peak expiratory flow (PEF) and spirometry. Subterraneotherapy influenced significantly the change of MEF75 (p = 0.03255) and improvement of ACT score (N = 21, p = 0.0016). The differences in other parameters were not statistically important, but in the case of FEV1 and VC parameters, the differences found were close to the statistical significance (0.05 < p < 0.10). The differences of results before and after subterraneotherapy were higher in the group assigned as patient with poor or moderate asthma control (ACT score < 20, N = 10) than in the group with good control of asthma (ACT score ≥ 20, N = 11). For parameters FEV1, VC, MEF75 and ACT score the improvement was significantly higher in the poor control group. The pulmonary rehabilitation programme combined with subterraneotherapy helps to control asthma especially in patients suffering from poorly or moderate controlled asthma.