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BIOKLlMATOLOGIA
Halotherapy in Controlled Salt ChamberMicroclimate for Recovering Medicine
Prof. dr med. ALlNA CHERVINSKAYA *
Clinical Research Respiratory Center of Central Clinical Hospital 122 of FederalMedical and Biological Agency, St. Petersburg
Summary
The review presents the method of halo therapy which models the microclimateparameters of salt speleoclinics. It gives historical data on the method development, principles and advantages of halo therapy by means of controlled microclimate. The influence of the main curing factor - the dry fine-grained sodiumchloride aerosol, and pathophysiological basis of curing effect of the halotherapymethod are under review in the article. The article describes the method of controlled halotherapy and its technology, that is the halo complex equipped witha controlled halogenerator.Data on clinical efficacy and the grounds for the method usage in the recoveringtreatment for bronchopulmonary and otorhinolaryngologic pathologies, skindiseases and combined cardiovascular pathology, as well as preventive measuresagainst respiratory diseases are cited. Efficacy of halotherapy in treatment andrecovery of children is under review. Foundations for perspective usage of halotherapy in all kinds of medical and recovering establishments are given.
Key words: halotherapy, speleotherapy, drug free method, salt room, salt cave,salt chamber, halochamber, halocomplex, halogenerator, dry sodium chloride aerosol, respiratory diseases.
Balneol. Pal. TOm 49 Nr 2 (108) str. 133-141
Balneologia 11 .. , . 2007IIi!l!1ID <WleClen-czerWlec
Beginnings of halotherapy
In the last decade the usage of therapeutic air withthe modeling of natural factors has become notableamong physical methods used in recovering andresort medicine.
Speleotherapy (ST) is one of the methods whichhave given rise to further development of thewhole trend in modern recovering medicine. ST«<speleon»- Greek - «cave») - means usage of theunderground caves micro climate for treatment.The most perspective and popular trend ofST is thetreatment in the microclimate of salt caves(as a rulethey are former salt mines). The overwhelming massof all rock-salt deposit was formed in the Permiangeological epoch. Ancient underground salt depositis used for salt extraction (halite, sylvinite).In 1843 a Polish doctor F.Bochkowski was the first
133
to assume, that air sated with particles of salt hasa therapeutic action. In 1958 in the salt mines ofVelichka, Krakow province, the first salt medicalresort for patients with lung diseases was founded.Today speleotherapy has become a conventionaleffective non-drug method of treatment. In manycountries they created speleotheraputic clinics onthe basis of natural caves - Austria (SalzebadSalzeman), Poland (Velichka), Romania (Siget),Azerbaijan (Nakhichevan), Kirgistan (Chon-Tuz),Russia -Perm area (Berezniki), Carpatho-Ukraine(Solotvino), Ukraine (Artemovsk, Donetsk area),Byelorussia (Soligorsk). Speleotherapeutic clinicsare mainly located at a depth of 200 - 300 meters.Some of them (Duz-Dag, Chon-Tuz) are situatedat a height of midmontane above sea level.The microclimate of different speleotherapeuticclinics (temperature, humidity, air composition,
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HALOTHERAPY IN CONTROLLED SALT CHAMBER MICROCLlMATE FOR RECOVERING MEDICINE
presence of aeroions and others) has specificfeatures. It is characterized by temperature andpressure constancy, gas corn position of the air, lowrelativehumidity, increased content of negativeions,absence of bacterial flora and allergens, slightlyincreased content of carbonic acid. The main
component that determines special efficacy oftreatment especially in salt caves is the presence ofthe finest salt particles in the air - dry salt aerosolof certain density (concentration) and particle size.The salt speleoclinics treat patients with chroniclung diseases (CLD) with the medical action ofair sated with particles of rock salt.Aerosol composition in speleoclinics depends onthe structure of speleo forming rocks. The maincomponent of aerosol in salt caves is sodiumchloride. It is the main component of halitespeleoclinics (Solotvino, Velichka, Chon-Tuzand others) and constitutes the major part (6080%) of aerosol in sylvinite speleoclinincs (PermRegion). Density (concentration) of salt aerosol indifferent speleoclinics varies within 1 to 20 mg/m3, (often from 2 to 5 mg/m3). The fact that thenatural salt aerosol contains considerable amount
of respirable particles (1-5fLm) which are the mosteffective in respiratory tract is of high significance.Moreover, it is the salt aerosol which cleans the airof underground clinics by creating nonbacterialand almost sterile atmosphere.
ST in the microclimate of saltmines has a nonspecifichyposensitizing effect, leads to reduction ofinfectious and inflammatory process in respiratoryapparatus, and stimulates different units oflocal andgeneral protective mechanisms. In the process oftreatment the organism adapts to specific propertiesof microclimate which causes reorganization offunctioning of all body systems. Research held indifferent speleoclinics made possible to determinethe ST prescriptions and to develop differentiatedcomplexes of its usage (1, 27, 37).ST in salt caves has won the recognition ofpatients and physicians as an efficient drug-freemethod. However, undoubted exclusiveness of themethod and related to it small number of beds,high price of treatment and necessity to move toother climatic zones have naturally restricted itsspreading. ST prescription is also restricted withcontra-indications which considerably constrictthe circle of patients.Tendency to use medicinal quality of salt cavesmicroclimate for treatment of the wider circle
of patients has motivated for the search for waysof reconstruction of artificial microclimate inmedical establishments. ST has underlain themethods which use micro climatic factors of
salt speleoclinics in ground-based premises. Themethod of usage the salt caves microclimate inground-based premises in mid 80s was given thename of «halotherapy» in St. Petersburg, Russia«<hals»-Greek- «salt»). Later while using premisesfor treatment they started to apply other names,such as «speleoclimatotherapy», «speleotherapy»and others. In the scientific publications methodhalotherapy (HT) is called «haloaerosol therapy»as well.Aggregate usage of active factors of salt caves, andnamely dry sodium chloride aerosol as the mainfactor, certain stable comfortable room temperatureand optimum air moisture have recently got thedefinition of «speleo impact».
Technique of the method
While modeling the salt cavemicroclimate varioustechniques have been used. Long since the firstattempts to create the microclimate it has beendetermined that indoors it is impossible to createthe atmosphere of fine sodium chloride aerosolwith the only use of such passive methods as saltcoating of walls(halite or sylvinite)(23).This methodturned out to be ineffective. Salt bricks which cover
the walls can be used only in decorative purposes.In the premises where along with salt blocks socalled filters -saturators, labyrinth partitions andventilation systems served as presumable sourcesof sodium chloride aerosol, the concentration ofaerosol particles has been insignificant or theywere absent; that is the necessary concentration anddispersion of particles has not reproduced.Modern theoretical ideas and accumulated practicalexperience on the formation means and modeof behavior of aerosols have revealed that for
indoor reproduction of therapeutically significantparameters of aerosol (concentration, necessarycontents of respirable particles) special aerosolequipment is needed, that is halogenerators - thegenerators of sodium chloride aerosol. Walls withsalt coating may fulfill only auxiliary functionslike mental and emotional impact on patients,some maintenance of temperature and moistureconditions and air purity (due to interactionwith sodium chloride aerosol produced by thehalogenerator), contribute to noise absorbing.Air saturation with moist aerosol as a result of
saline solution dispersion by means of inhalersis sometimes used to create the microclimate. The
essence of such method is a group inhalation ofsaline solutions. Besides, because ofinstability ofmoist aerosol in the indoor air it is almost impossibleto measure it. Inhalations of saline solutions aremore well-handled through nebuliser.
Balneologial1 .... 200m!'ID {WleClen-czerWlec 7 134
Alina Chervinskaya
Fig. 1. Sample plan of controlled halocomplex.
A- Main room (halochamber) for patients to stayin Band C - Auxiliary premises - Operator's room(A) and cloakroom (B)
Main treatment factors ofhalotherapy in controlledmicroclimate
5. Elements of design
6. Heating appliances7. Amlchairs for patients
A, B, C, D - doors
1. Halogenerator2, Sensor of salt aerosol3. Vacuum fan
4. Lamps of general lighting
~
"h3 IT7l4" - ]iJi] :11' B
~2 n:I=71 6:J1 '"
--j A .../'1 ~C
I LI - I -1 ~_ '~,'. __ -§-:: I.
Dry fine-grained sodium chloride aerosol ofcertain ranges with controllable medicinal concentrations (modes).The main mass of particles in aerodispersed environment (over 80%) consists of respirable fraction(1-5ILm), and it is because of that the aerosol effectively influence all sections of respiratory tract.
treatment modes in the treatment room a sensor ofcontinuous control of aerosol mass concentration
is installed. The halogenerator's microprocessorprocesses sensor's signals by feed back coupling andmaintains the prescribed salt aerosol parametersby means of automatic tuning to different space ofthe room. Microprocessor block can also providefor lightning and ventilation systems between thetreatments. In the treatment room the sensorsmaintain the microclimate with the temperatureof 20-24°C and humidity of 40-60%. As it wasmentioned earlier salt coated walls are of auxiliarysignificance.Halorooms where the halogenerator is locateddirectly in the treatment room have been usedfor HT recently. Halorooms can also function intheir full value without salt coating. Such a variantwhich is the most cost-effective has been widelyused in pediatric practice, preschool institutionsand schools where playing environment and specialinterior design are created.
Another important function of the dry sodiumchloride aerosol is to maintain hypobacterialand allergen-free air. Indoors, where there is nonecessary level of dry sodium chloride aerosol, noair purification occurs, and during the treatmentpatients run the risk ofinfectious contaminationconcerned with accumulation of products fromexpired air and secretion of respiratory tract. Theproblem also occurs when spraying moist sodiumchloride aerosol which does not possess bactericidalactivity.Analysis of the impact of sodium chloridemicro climate has revealed that for optimizationof the one treatment and the whole course duration,its high efficacy and safety it is necessary to measureout the level of the dry sodium chloride aerosolconcentration taking into account the characteristicfeatures of respiratory diseases as well as thoseof other pathologies. With regard to modernrequirements for representation the microclimateof salt speleoclinics the method of controlled HT isnow used (12, 29). The controlled HT provides forcreation and maintenance of all the parameters ofthe method, differentiated dosing and controllingthe level of sodium chloride aerosol in the processof treatment.Together with studies of the method acting theequipment for its implementation has been developedand improved. The method of controlled HT iscarried outwith the halocomplex equipment basedon the halogeneratorwhich creates and maintainsthe level of natural concentration and parametersof sodium chloride aerosol with several modes oftreatment by monitoring in the medical facilitieslike halochamber, haloroom, haloward. Someinstitutions with the aim of attraction of clients
call the facility equipped with the halocomplex«salt room», «salt grotto», «salt cave» etc. Suchnames are often used for rooms with salt coatingof walls bu t not equi pped with halogenerators. Themain difference is in the fact that without specialaerosol equipment it is impossible to create naturalenvironment of sodium chloride aerosol.
The halocomplex with controllable microclimateconsists of two equipped rooms as a rule. The maintreatment room is meant for patients sitting incomfortable armchairs. In the adjacent room, theoperator's room is for the staff, the operator, whooperates the halogenerator and registers patients(fig.!). The halogenerator provides for feeding ofthe dry fine-grained aerosol composed of prevailingrespirable particles fraction (over 80%).At present halogenerators GDA 01.17,HALOSPAOl (UAB Halomed, Lithuania) and ASA-01.3(JSCAeromed, Russia) is used to equip halocomplexes.For the purpose of maintenance of prescribed
135 Balneologial .. ,~ kWleClen-czerwiec 2007
HALOTHERAPY IN CONTROLLED SALT CHAMBER MICROCLlMATE FOR RECOVERING MEDICINE
Due to dispersant method of dry aerosol formation by means of heavy mechanical effect on saltcrystals, particles obtain high surface energy andnegativeelectric charge. Physicochemical propertiesof dry aerosol determines the specific character ofthe HT method which characteristic feature is in
multi component curing effect of extremely smalldoses of the substance. The concentration of fine-grained sodium chloride aerosol in treatmentroom is from 1 to 10 mg/m3 and is maintainedwithin certain limits (modes): the 1st mode - 1,0mg/m3; 2nd mode -1,0-3,0 mg/m3; 3rd mode - 3,0-5,0 mg/m3; 4th mode - 7,0-10,0 mg/m3 (12).Dosing and management of salt aerosol parameters are necessary for efficient and safe usage ofthe method taking into account variety of nosological forms. It makes optimization of treatment and course duration possible which becomesmore and more topical for medical and sanitaryins ti tu tions.
Hypobacterial and allergen-free air.Particles of dry salt aerosol which interconnect dueto electrostatic interacting forces with particles ofaerial contamination quicken their settling thuspurifying the air in the room.Aeroionization. At decomposition of salt particlesas a result of heavy mechanical effect in the halogenerator obtain high surface energy and negativeelectric charge. When aerosol particles interactwith air molecules it causes aeroionization of air
(6-10 nK/m3). Light negative ions are accessoryfactors of therapeutic impact on the organismand purification of indoor air.Stability of optimal microclimatic parameters.Curing air has stable humidity of 40-60% and constant temperature of20 -24°C which are the mostfavorable and comfortable for respiratory organsand stability of aerodispersion environment.Design of natural salt cave, aesthetic attraction.Have positive influence on mental and emotionalsphere, create comfortable conditions for carryingout treatment.
Action mechanisms
According to experimental and clinical studies,among salt aerosols the dry sodium chloride aerosol(haloaerosol) is the most effectivefor the respiratorytract. Action mechanisms of dry sodium chlorideaerosol present in underground clinics and used inthe HT method are well founded in the series ofstudies (3, 7,8,17,18). Physical characteristics ofhaloaerosol are of great importance. Prevalence ofrespirable particles in its composition guaranteesthe efficiency of action and penetration of all
sections of respiratory tract right up to the deepest.Surface energy of dry salt aerosol produced in thehalogenerator is higher if compared with aerosolproduced by dispersion ofliquid. Particlesof negativecharged aerosol possessonemore important property,and namely they stimulate the work of respiratoryepithelium cilia. Studies of absorption ofliquiddroplet (moist) and dry aerosol of sodium chloridein respiratory organs ascertained that the extent ofdelay of particles with equal dispersity is higherin dry aerosol. Moist sodium chloride aerosolwhich is fed indoors by means of different typesof nebulisers (jet, ultrasound etc.) is less effective ascompared with the dry one (31,38). Moreover, highhumidity indoors can cause respiratory discomfortand other side effects.
. Experimental and clinical data have allowedformulating the idea of mechanisms of HT action.The main acting factor is the dry fine-grainedsodium chloride aerosol which:- acts as a physiological osmolar stimulus, improvesrheological properties of bronchial mucus andassists in ciliated epithelium function;-causes fluid outflow from vessels to bronchus gapthus assisting in decrease of edema in bronchuswalls and stagnation in their vessels;-stimulates elimination of opportunistic microflora(5. neumoniae, H. influenzae and etc.);- has a bacteriostatic effect;- increases the number of phagocytes of respiratorytract and intensify phagocytic activity (increase inmacrophages activity);-positively influences local immune and metabolicprocesses (increase in SIgA and lactoferrin inpharyngeal and bronchial wash-outs, normalizationof serotonin secretion;decreasein initially heightenedlevel of catecholamines, serotonin, and histaminein bronchoalveolar lavage;- enhances electrophysiological cell activity ofmucosa epithelium;- increases colonization resistance of epitheliumcells regarding to opportunistic microflora;- assists in restoring ofbiocenosis in respiratorytract;- improves condition of systemic immunity.Thus, the dry fine-grainedsodium chloride aerosolhasmucolytic, bronchodrainage, antiinflammatory andimmune-response modulating effect on respiratorytract. It has airway«cleansing»(enhance host defense)effect and indirectly improves general host defense(fig. 2). Haloaerosol has an antiphlogistic andsanitating influence on airway surface liquid at itsaffection caused by infection and inflammation aswell as by irritation due to pollutants. Improvementof drainage function and decrease in inflammationof respiratory tract contribute to abatement of
Balneologial1 .... 2007IIi!ll'ID (WleClen-czerWlec 136
Alina Chervinskaya
hyperreactivity and decreaseofbronchospastic obstructioncomponent (9).Light negative aeroions thatare present in halochamberactivate metabolism and localdefense of biological tissues,stabilize processesof vegetativeregulation, have favourableeffect on cardio-vascular
system, endocrine system,gastrointestinal tract, mucosa ofrespiratory apparatus and haveadaptogenic effect on centraland peripheral stress-limitingsystems of the organism .Staying in the halochamberbreaks the contact withexternal unfavourable effects
as allergens and pollutants,stabilizes vegetative nervoussystem and has a positivepsycho- emotional effect.Taking into consideration allcuring factors itwas ascertainedthat the micro climate created
by halocomplex influencesthe respiratory tract, immuneand cardio-vascular system,cutaneous covering, vegetativenervous system and psychoemotional sphere.
PreventivePathogenesis components
Treatment
action
action
~Bacteriostatic effect
Antiedematous effect
•..•...0Enhance of colonization
~q0:
Sresistance of epithelial cellsS
.•...
~~
~~ '=0 .5-= Improvement ofbiocenosis•..
.•...
c•...~0 .•...~•... '" Enhance of local immune.~ ~ Q..c and biological defense~~ •... '"~"O'" IActivation of phagocytesu c activity
'"
~
~qeJI
-=~
CC
f;J;l
.;Activation of ciliated
•...
"0
epithelium function
-;:Euc
Improvement of mucus~
0•...
rheological properties
i:l:l
Fig. 2. Action of dry fine-grained sodium chloride aerosol on respiratory tract (Chervinskaya A. v., 1998).
Description of the methodDuring HT procedure patients (asa rule 4-6persons)sit in comfortable armchairs in the treatmentroom (halochamber, haloroom). HT treatmentusually is accompanied by tranquil music and/or psycho-suggestological programs; for childrentales and calm musical entertainment programs arebroadcasted. During the day several HT sessions(4 -5 on average) are held. Between the sessionsrooms have an airing for half an hour.HT course consists of 10-20 daily treatmentsessions of 30 minutes for children and 40-60minutes for adults. HT courses with rehabilitation
and preventive purposes are advisable to get 1-2times a year. HT courses are expedient in workcollectives during unfavorable weather seasonswith the aim of prevention of acute respiratoryviral infections and exacerbations of respiratorydiseases. Preventive HT is also advisable for pollenallergy. It is appropriate to start treatment shortlybefore or with the appearance ofits first symptoms.In that case HT contributes to interruption of
contact and elimination of pollen allergens outof respiratory tract.Controlled HT provides for differentiated applicationof certain concentration (modes) of dry fine-grainedsodium chloride aerosol according to clinicalfeatures of the disease and characteristics of the i
external respiration function (12, 16).
Areas of application
Possibility of choosing parameters of aerosolspeleoimpactwhich is brought about when usingcontrolled HT ensures the method adaptationto conditions of various fields of medicine and
hygiene.HT is described for all the most widespreadrespiratory diseases. As a rehabilitation methodHT is prescribed to patients with acute bronchitis,prolonged pneumonia, chronic obstructivepulmonary diseases (COPD), asthma of differentstagesand different clinical and pathogenetic variantsof their course including hormone dependent
137 Balneologia IIi!lIiD kwiecien-czerwiec 2007
HALOTHERAPY IN CONTROLLED SALT CHAMBER MICROCLlMATE FOR RECOVERING MEDICINE
forms, bronchiectasia, cystic fibrosis. Dosing oftreatment taking into account concentration ofsalt aerosol allows applying the method at heavyforms of diseases with considerable obstructive
dysfunction. Controlled randomized placebo studiesshowed (3,7, 9, 10,25) that method inclusion in thecomplex of recovering treatment and rehabilitationof patients with chronic bronchopulmonarypathology (asthma, COPD) allows achievingmaximum clinical effect at 82 - 96% of patientsat the most optimal doses of medicament therapyand contributes to raising efficiency of treatmentand prolongation of remission.In pediatric practice HT is most frequently usedin treatment and rehabilitation of children withasthma in post-attack period and in betweenattacks (efficiency of 75-85%). High efficacy wasachieved in treatment of children with recurrent
bronchitis especially in obstructive forms. Scope ofHT therapeu tic effect allows considerably decreaseprescription of antibacterial medicine which preventsdysbacteriosis and allergic reactions in children(22,26,30). Preventive courses for frequently sickchildren diminish the risk of recurring diseasesand contribute to speeding up of recovery (24).Long-term clinical application of HT methodin various fields of medicine (pulmonology,allergology,paediatrics, otolaryngology, dermatologyand others) as well as studies of its mechanismshas brought to understanding that the methodhas pronounced recovering effect. In Russiahalocomplexes are used in hundreds of healthcenters. Recently halocomplexes have been usedin SPA-industry. Method usage in the recoveringcomplex in health and preventive centers in patientswith lung diseases and with risk factors (thoseworking in adverse conditions) makes possible toachieve respiratory sickness rate o?1,5-2 times lessand prevents exacerbation of main disease (13).HT is used in a complex treatment of patientswith occupational lung diseases (25).Applicationof HT is effective in 82% of patients with pollenallergy (2). Preventive HT treatment for smokersand patients with exogenous risk factors allowsrecovering of mucociliary clearance, liquidatesfirst manifestations of obstruction and restores
respiratory tract defense (5, 6). With the help ofpreventive usage of 2 times weekly HT treatmentduring three months decrease in sickness rate ofacute respiratory viral infections was attained inpatients with chronic pulmonary diseases as well asconditionally healthy but threatened with COPDdevelopment (15).Application of special modes of salt aerosolconcentration makes it possible to use HT notonly for respiratory diseases but also in the fields
of otolaryngology and dermatocosmetology.Dry aerosol of sodium chloride has an antiphlogisticand antiedematous effect on nasal and pharyngealmucosa as well as that of accessory sinuses of nosein chronic pharyngitis, rhinitis and sinusitis.Immune-modeling effect of halo aerosol has beenproved in otolaringological pathologies (35). HTusage as a method of conservative treatment ofnasal pathology allows attaining positive results in72% - 87% of cases with the largest effectiveness invasomotor and allergic rhinitis (4). Dry aerosol ofsodium chloride has a favorable effect on mucosaof nose and accessory sinuses in chronic sinusitis(21). In 90% of patients with acute sinusitis 2-3inhalations of aerosol of dry sodium chlorideaerosol prescribed after initial puncture havesanifying effect (28, 31).Controlled HT is successful for treatment ofskin diseases (diffusive neurodermatitis, allergicdermatitis, eczema, psoriasis and others) (32, 36).Staying in halochamber has a positive cleansingeffect and restores biocenosis of skin covering,and improves microcirculation, all of which isused in cosmetological programs (19).Long-term usage of HT has shown the safety ofthe method as for side effects on cardio-vascular
system which allowsusing it in patients with COPDhaving associated cardio-vascular pathology, oldage group included. HT usage in patients withasthma and COPD with associated cardio-vascular
pathology (ischemia,hypertension and discirculatoryencephalopathy) at the old age allowed attainingpositive clinical effect in the absence of any negativereactions (11, 34). Positive results of HT usagehave been achieved in patients in postoperativeperiod after coronary artery bypass grafting (14).Insuch patients rehabilitation complexes includingtherapeutic physical training, thorax massage,balneotherapy and local treatment of magnettherapy, ultrasound and aeroion therapy alongwith HT are advisable.Research and clinical experience of controlledmicroclimate application with the ability to chooseappropriate mode of curing concentration ofdry sodium chloride aerosol on the whole havedemonstrated positive effect of HT on the state ofcardio-vascular system. At present controlled HT isincluded cardia-vascular pathology in the cardiovascular pathology programs of rehabilitation ofpatients with cardio-vascular pathology (20,33).
Practical application of halotherapy
HT can be successfully combined with otherphysiotherapeutic and drug-freemethods. HT efficacyincreases in conjunction with drainage gymnastics, ~
Balneologial ...IImIlD kWleClen-czerwiec 2007 138
__ Alina Chervinskaya
vacuum thorax massage and kinesiotherapy. HTusage together with aeroionotherapy, aromatherapy,phytotherapy, magneto therapy, laser therapy,ultrasound, low-frequency electromagnetic field,and normobarometric hypoxitherapy has madea god showing.In Russian Federation HT has been officiallyauthorized for medical usage by the Ministry ofPublic Health. At present controlled halo complexeshave been installed in more than 1000 medicaland sanitary institutions.The analysis of HT application during the last7 years (2000 - 2006) has shown that the methodis being used by various medical, preventive andsanitary institutions. In the most demand HTis in sanatoria and health resorts (43%). Duringthe last years the method has been introduced insanitary programs in SPAfacilities. Halocomplexes(halochambers and halorooms) are widely usedin out-patient department, physiotherapeutic,therapeutic, pulmonological, rehabilitation andENT- department in hospitals, medical unitsof industrial enterprises (34%). In out-patientdepartment and hospitals the most reasonableorganizational form for HT application is a dailyclinic. Practical experience has shown that HT usageis advisable for children and adolescent practice inchildren pre-school facilities and schools (23%).Because of wide possibilities of preventive effectthis segment continues growing.
Conclusion
Thus the ST method has been further developedinto a new medical technique - the controlled HTThe achievement of the method is in the principleof controlling the parameters which ensures dosingand control of employed natural factor - dry sodiumchloride aerosol. Scientific grounds for actionmechanism, proven clinical efficiency verified byresearch on standards of evidence-based medicine
and practical application in various fields of publichealth determine broad prospect of the methodin rehabilitation, sanatoria and health resorts andpreventive medicine. Numerous research and wideexperience of practical application confirm theefficacy and broad opportunities of HT usage asrehabilitation and preventive medicine in all kindsof medical and recovering establishments.
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Artykul nadeslano: 11. 05. 07
Zaakceptowano do druku: 28. 05. 07
••••••••••••••••••••• e ••
Address of author:
':'Prof dr med. Alina Chervinskaya
Clinical-Research Respiratory Center,
Hospital-122, Kultury, 4
St. Petersburg 194291, RussiaPhone: +7 921 9346498
Fax: + 7 (812) 336 9081
E-mail: [email protected]
141 Balneologia I k ' , . '2007~ WleClen-czerWlec
