Efficacy and Safety of Speleotherapy in Children with Asthma Bronchiale

Spending time in a natural cave or a disused mine is a type of inhalation therapy called speleotherapy. The efficacy and safety of speleotherapy was investigated in a controlled, randomized multicentre study. Children aged 4-10 who were diagnosed with asthma bronchiale by a GP or pneumologist were eligible to take part in the study. In a 1-week pre-treatment phase, 3 spirometry tests were carried out and a diary was kept. During the 3-week treatment phase the children had a 2-h kindergarten programme every day except for Sundays. Children who were randomly placed in the speleotherapy group had their kindergarten programme in a natural cave or disused mine. Children who were randomly placed in the control group had the same programme at the same location - but aboveground. In a 1-week post-treatment phase, 3 spirometry tests were once again carried out and a diary was kept. The primary outcomes were the improvement in FEV 1 and the reduction in the use of sprays for acute treatment. 133 patients were enrolled in the study. Twelve children dropped out so a total of 121 patients were evaluated - 68 in the speleotherapy group and 53 in the control group. Most children had relatives with asthma and were on long-term medication. The median FEV 1 was 85% of normal values, and the median VC was 65% of normal values. The median improvement in FEV 1 during treatment was 10.5 percentage points in the speleotherapy group and 0.0 in the control group (adjusted p=0.0002). There was a reduction of acute spray applications in the speleotherapy group, but this was not significant (p=0.56). Twenty-four of 25 secondary outcome variables faired better in the speleotherapy group compared to the control group, and 12 of these were exploratively significant. The study demonstrated the efficacy and safety of speleotherapy in children with asthma. The outcome variables had a high degree of concordance. Our study had only one week of follow-up, so we do not know how long the observed effect lasted without continued therapy.