Several COPD patients in Brighton and Hove reported to the Community Respiratory Service (CRS) that they had experienced benefit from halotherapy in commercial salt treatment rooms.
Nebulised hypertonic saline is used therapeutically to aid airway clearance in bronchiectasis so the treatment makes sense pharmaceutically. Clinicians were interested in assessing response objectively.
50 patients with COPD decided to attend Salt Space, Hove. They agreed to record Chronic Respiratory Questionnaire (CRQ) and COPD Assessment Test (CAT) scores before and after a course of treatment.
The treatment course involved two sessions a week for eight sessions. At each session, 70g dry salt aerosol was introduced via our Prizma+ halogenerator – the equipment that transforms the space into a treatment room by grinding salt into micro-particles and distributing by a fan.
After the course of treatment at Salt Space, the scores for both CRQ and CAT showed a highly statistically significant improvement; using a statistical procedure called a paired t-test.
COPD Assessment Test
The COPD Assessment Test (CAT) is a validated short questionnaire measuring the effects of COPD: cough, phlegm, chest tightness, difficulty breathing, activity limitation, confidence, sleep and energy.
Patients score answers to eight questions on a scale of 0-5, where ‘0’ reflects no symptoms and ‘5’ reflects ‘severe symptoms’. A score of:
- 30+ is ‘very high’
- 20+ is ‘high’
- 10-20 is ‘medium’
- 5-10 is ‘low’.
Results from the group of 50 patients receiving treatment at the Salt Space, Hove, showed:
- 13 patients reduced CAT score from ‘high’ to ‘medium’, with improvements allowing them to have ‘a few good days a week’ from previously being stopped from ‘doing one or more things they would like to’.
- 9 patients reduced CAT score to less than 10 = ‘Low Level’ symptoms, i.e. ‘most days are good’.
- 2 patients with ‘very high’ CAT scores reduced them by more than 50% (24 points),
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- reporting improvements including:pre-treatment having ‘no energy at all’
- pre-treatment ‘not at all confident leaving the home’, post-treatment ‘I am confident’.
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Chronic Respiratory Questionnaire (CRQ)
CRQ is interviewer administrated with 20 questions covering physical and emotional function divided into four dimensions:
- Difficulty breathing
- Fatigue
- Emotion (feeling frustration, fear, embarrassment, worry, depression)
- Self management behaviours (confident in dealing with symptoms, control over breathing problems).
Results from the group of 50 patients receiving treatment at the Salt Space, Hove, showed:
- 22 patients had 25% or more improvement in scores around ‘difficulty breathing’, with 3 having more than 50% improvement, including reporting: ‘moderate shortness of breath’ from previously ‘extremely short of breath’ when doing housework, carrying (e.g. groceries) and shopping.
- 13 patients had 25% or more improvement in total scores across all dimensions.
- 12 patients had 25% or more improvement in scores around fatigue, including reporting feeling: ‘somewhat tired’ from previously being ‘very tired’.
- 13 patients had 25% or more improvement in scores around emotion, including reporting feeling upset, worried or depressed during the past two weeks: ‘a little of the time’ from previously ‘most of the time’ .
- 9 patients had 25% or more improvement in scores around control over breathing problems, including reporting having felt that had complete control: ‘almost all of the time’ from previously only ‘some of the time’.
Although not a controlled study, the improvements in scores in the trial evaluation were highly statistically significant. This reflects individual reports of benefit from patients who have attended Salt Space outside of this audit.
There is potential for formal research into the effect of salt therapy centers in COPD, the audit concludes.
