All prospective randomized controlled trials were included where trials compared halotherapy or speleotherapy with a control group. Reference lists in retrieved papers were hand-searched for other possible studies. The literature review search strategy (Supplementary material) used a combination of MeSH terms found in the title and/or abstract for halotherapy and chronic obstructive pulmonary disease and the following search terms were used: COPD chronic bronchitis emphysema halotherapy halochamber speleotherapy spelaeotherapy cave salt mine potash mine vital air room climate chamber saltpipe and sopipa. The electronic databases searched were the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE, EMBASE, CINAHL, and Google Scholar. Therefore, this review sought to investigate halotherapy as a therapeutic intervention for people with COPD to determine the effectiveness of this therapy.Ī search of electronic databases was conducted from January 2013 to February 2013. An extensive search of a number of databases did not identify any published systematic reviews that assessed halotherapy as an intervention for people with COPD. With the increase in the commercial availability of halotherapy as an alternative complementary treatment, it is timely to undertake a review of this therapy for COPD to appraise the evidence for the complementary therapy. The assertion behind these reports is that inhaled dry salt therapy may assist people with COPD by increasing the liquefaction of airway secretions, which, in turn, enhances the expectoration of airway mucous secretions. 19 National and international media current affair and news reports 14 – 16, 19 suggest that halotherapy may help with a variety of respiratory illnesses including relieving the symptoms of COPD. Halotherapy has received prominent television media coverage in Australia from Channel 9’s A Current Affair 8, 14, 15 and Channel 7’s Today Tonight 7, 16 and abroad from Cable Network News’ Vital Signs, 17 as well as from other television program providers such as the British Broadcasting Corporation 18 and the National Broadcasting Corporation. 13 Despite these findings, there appears to be an increasing number of commercial halotherapy treatment centers in Australia, the United States of America, Europe, and Canada that are aimed at treating respiratory and other medical conditions. 9, 11 A recent study of bronchiectasis patients found halotherapy to be of little benefit. Halotherapy treatment has been associated with relief of respiratory conditions such as asthma, cystic fibrosis, and COPD, as well as relieving integumentary conditions such as eczema and dermatitis. 11, 12 This room is designed to replicate the natural microclimate of a salt cave. 12 Halotherapy is a treatment consisting of inhalation of small salt particles in a controlled environment of a halochamber. 11 Halotherapy builds on this premise and is used as an above-ground alternative for speleotherapy. 10 The unique characteristics of the microclimate within the caves are stable air temperature, moderate to high humidity, the presence of fine aerosol elements (sodium, potassium, magnesium and calcium), as well as a lack of airborne pollutants and pollens. 9 This therapy is known as speleotherapy, where a natural salt cave climate is used as a therapy for ill health. 8 In Eastern Europe, natural salt caves have been used to help relieve symptoms of chest conditions. 5, 6 However, other therapies such as speleotherapy and halotherapy are being recommended in the wider community 7 and are often described as well-researched treatments for people with COPD. Pulmonary rehabilitation is recommended for those patients with Medical Research Council dyspnea score of 3 or more 1 as there is substantial evidence of its benefit to these patients. 1, 3, 4ĬOPD is managed with inhaled medication with the view to optimize the patient’s pulmonary function and reduce symptoms. 3 With this significant burden, the impact of this disease on individuals, families’ quality of life, and the associated health care expense, COPD is recognized as an international health priority. 1 In 2008, the World Health Organization estimated that COPD was the tenth most prevalent cause for moderate to severe disability, 2 and was the fourth leading cause of death, worldwide. Chronic obstructive pulmonary disease (COPD) is a chronic, progressive disease with symptoms of dyspnea, increased respiration rate, sputum production, and a reduced exercise intolerance.
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