Pulmonary rehabilitation in subterranean chambers combined with neuro-orthopedic activity-dependent plasticity therapy influences patients’ quality of life – A preliminary study

The aim of the study was to evaluate if Neuro-orthopedic Activity-dependent Plasticity (N.A.P.) therapy combined with standard subterranean pulmonary rehabilitation (SPR) conducted in the salt mine influences the health-related quality of life (HRQoL) and chest mobility in patients with asthma or chronic upper respiratory tracts diseases. 54 patients enrolled for the study completed a 3-week SPR. The 15D questionnaire, chest mobility and back scratch flexibility tests were conducted before and after SPR. In the study group (N = 23,16 women, 7 men) the N.A.P. therapy was added to SPR, while the control group (N = 31, 21 women and 10 men) completed the SPR program. After the SPR statistically significant improvements were observed on the 15D dimensions of breathing and vitality dimensions, in the chest mobility and back flexibility in both groups. With the baseline gender distribution, age, generic 15D score, chest mobility and back scratch adjusted, the change in the 15D score was 0.068 greater in the study group than in the control group. This difference is clinically important and statistically significant (p = 0.022). There was no statistically significant difference in the chest mobility and back scratch flexibility between the groups. Adding N.A.P. therapy techniques to the SPR program in the underground part of the ‘Wieliczka’ Salt Mine Health Resort results in a statistically significant and clinically important improvement in the subjects' HRQoL. •PR in the underground surroundings has a positive effect on patient’s HRQoL, chest mobility and upper trunk flexibility.•Adding N.A.P. therapy to the SPR program results in a clinically important improvement in the subjects' HRQoL.•Rehabilitation of patients with respiratory disorders should include the ANS function, postural control and motor learning.