Plain English Summary
Background and study aims
The prevalence of allergic rhinitis (hay fever) and asthma has increased during the last decades. Therefore, allergies have become an enormous economic burden. Allergic diseases influence the quality of life of patients negatively, and in particular quality of sleep is impaired, which is leading to daytime sleepiness, reduced work productivity and worse school performance. The conservative treatment of allergic includes several drugs like antihistamines, bronchodilators and glucocorticoids. Next to this, travels to and/or stays at high altitude have a long tradition in the therapy of asthma and have been described to have positive long-term effects. Another natural treatment method for allergies and asthma is the so-called speleotherapy. Speleptherapy uses the specific microclimate of old mines and caves to treat respiratory diseases. Although, physicians very often recommend regular exercise for patients with allergies and asthma, scientific evidence and evidence-based guidelines are lacking about recreational winter exercise. The aim of this study is to assess the effects of winter exercise and of speleotherapy in combination with winter exercise on patients with allergies and asthma.
Who can participate?
Men and women aged 18-55 with a house dust mite allergy and controlled allergic rhinitis and/or allergic asthma, and moderate skiing skills to meet the demands of the winter exercise program.
What does the study involve?
Participants are randomly allocated into three groups: a control group and two intervention groups (speleo- and exercise group). The intervention groups spent a 10-day winter holiday in the holiday region National Park Hohe Tauern (Austria). The exercise group participated in a whole-day winter sports program and the speleo group spent 1.5 hours every day in a mine and participated in half-day winter sports program. Medical examinations (lung function, blood tests, endurance etc) are performed at the beginning of the study, after the 10-day holiday and after 2 months.
What are the possible benefits and risks of participating?
The direct benefit for the participants is a ten-day winter holiday with exercise and/or speleo therapy. A vacation improves mood and quality of life. As a negative side effect of physical activity, exercise-induced bronchoconstriction (constriction of the airways) may occur.
Where is the study run from?
The Paracelsus Medical University of Salzburg performed this study. All medical examinations were performed by members of the Institute of Ecomedicine from the Paracelsus Medical University of Salzburg. The speleo and exercise program took place in region National Park Hohe Tauern (Austria), the control group receive no intervention and stay at home (Austria).
When is the study starting and how long is it expected to run for?
Intervention group with winter exercise and speleotherapy & control group: March-May 2013
Intervention group with winter exercise: December 2013- February 2014
Who is funding the study?
This research was funded by Lighthouse projects in tourism award 2011 “Year-round destination Hohe Tauern Health", Winner of the 1st price, Austrian Federal Ministry of Economic Affairs, Family and Youth
Who is the main contact?
Dr Arnulf Hartl
Winter exercise and speleotherapy for allergy and asthma - the WESPAA study
Winter exercise and winter exercise in combination with the healing climate of mines/caves (speleotherapy) improve allergic airway inflammation in adults suffering from allergic rhinitis and/or allergic asthma.
Winter exercise and winter exercise in combination the healing climate of mines/caves improve health related quality of life in adults suffering from allergic rhinitis and/or allergic asthma.
Ethics Committee of Salzburg, Amt der Salzburger Landesregierung, Postfach 527, 5010 Salzburg, Tel: +43 (0)662 8042 2375, Email: email@example.com, 15/11/2012, ref: E1987/5-2016
Randomized controlled trial
Primary study design
Secondary study design
Randomised controlled trial
Patient information sheet
Not available in web format, please use contact details to request a participant information sheet
Allergy, asthma, respiratory allergies, house dust mite allergy
The intervention groups spent a 10-day winter holiday in the Holiday region National Park Hohe Tauern (Austria). The exercise group participated in a whole-day winter sports program and the speleotherapy group spent every day 1.5h in a mine and participated in half-day winter sports program. The control group did not received any intervention.
Primary outcome measure
Measured at baseline (day 0), day 10 and day 60:
1. Allergic airway inflammation assessed using exhaled nitric oxide
2. Health related quality of life assessed using RhinAsthma Quality of Life Scale
Secondary outcome measures
Measured at baseline (day 0), day 10 and day 60:
1. Inflammation/allergic inflammation assessed using differential blood count
2. Cardiorespiratory fitness assessed using the 6-Minute Walk Test
3. Lung function assessed using spirometry
4. Allergic inflammation in the upper airways assessed using eosinophilic cell count from nasal lavage
5. Cleaning rate of the upper airways assessed using mucociliary clearance (saccharin test)
6. Allergic symptoms and health status assessed using the Visual Analogue Scale
7. Chronic stress level assessed using the Trierer Inventory for chronic stress (TICS)
8. General health/health-related quality of life assessed using SF-36
9. Asthma control status assessed using Asthma Control Test
10. Health related quality of life for asthma assessed using Asthma Quality of Life Questionnaire
11. Disease-specific health related quality of life assessed using Sinonasale Outcome Test
Overall trial start date
Overall trial end date
Reason abandoned (if study stopped)
Participant inclusion criteria
1. Age between 18-55 years
2. House dust mite sensitization (RAST > 2; positive PRICK-Test or total IgE > 0.7 kU/l)
3. Controlled allergic rhinitis and/or allergic asthma
4. Physical ability, including moderate skiing skills, to meet the demands of the exercise program
Target number of participants
Participant exclusion criteria
1. Uncontrolled asthma (Asthma Control Test < 20)
2. Malignant neoplastic disorders
3. Exercise induced bronchoconstriction
4. Cardiovascular diseases
5. Orthopedic diseases
6. Lung function disorder
7. Acute infection or fever
8. Uncontrolled metabolic diseases
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Paracelsus Medical University Salzburg
Institute of Ecomedicine Strubergasse 22
Paracelsus Medical University
Austrian Federal Ministry of Economic Affairs, Family and Youth
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Study protocol is not published yet – as the protocol is only available in German, it will not be shared. One publication will focus on the effects of winter exercise on people with allergies and asthma and a second publication will focus on the combined effects of speleotherapy and winter exercise.
IPD sharing statement
The datasets generated during and/or analysed during the current study are/will be available upon request from Dr Arnulf Hartl (firstname.lastname@example.org). Data will be shared after publication; data will be shared for meta-analysis, data will be shared upon request via e-mail; data will be shared only for research purpose; consent from participants was obtained; no ethical or legal restrictions.
Intention to publish date
Participant level data
Available on request
Basic results (scientific)