Balneotherapeutic Rehabilitation for Hemiplegic Patients

Abstract

Foreword:
From olden times Japan has had in various places the so-called “hot springs for apoplexy, ” which even now as ever are well frequented by hemiplegic patients seeking anxiously for their cure. In addition to it, after World War II the American idea of rehabilitation for invalids has come to prevail that Japan now shows an increasing interest in promoting such institutions, in which are treated various chronic diseases and dysfunctions through injuries and especially the cerebrovascular stroke, which really imposes a very high morbidity upon our nation. And as such kinds of institutions in Japan are mostly, as they are, established in an intimate connection with the respective local spring resorts, it is rather imperative for hemiplegic rehabilitation to be studied from the balneological point of view, and we hope our present report of experimental study about the balneotherapeutics' role in the treatment of cerebrovascular disorders can be one contribution to this field of medicine.
I. Fact-finding Survey through Questionaires dispatched to the other various Balneotherapeutic Institutions
Survey were made through enquêtes sent back from thirty such hot spring institutions throughout Japan, enquiring about the results of rehabilitation of hemiplegic inpatients who were registered during January through December of 1966. Our summary findings are:
1) 30.6% of the in-patients in the internal section of the balneotherapeutic institutions were the hemiplegics, whose total number being ca, 3, 000, and of whom the ratio of the male was 77% against the female 23%.
2) According to the one-year records of their hospitalization, 42 of 2669 (or 1.6%) had a relapse or some other troubles, including 14 deaths, 28 survivals, thus showing a very low rate in relapsing and mortality.
3) All the institutions on our list applied to the patients their local thermal minerals, whose diversity of mineral water nature covers simple thermals, and mostly salt springs, being followed by the minerals of hydrogen sulfide as well as sulfur springs. Their principal application was for bathing, but sometimes it was administered for internal use and also some peloid found, though less frequently, its external application.
The temperature ranged from 37° to 42°C., but dominant was such a tepid water as of 39°C., in which they bathed once or twice a day.
The third day after the stroke was the earliest application; most of the patients, however, visited the institutions not later than one month.
II. Experiments at Noboribetsu Spa
Some hemiplegic patients were experimentally treated in salt springs of Noboribetsu Spa.
1) The first one month of hospitalization showed 54% improvements in their ADL (Activity of Daily Living), followed, however, by no further remarkable result.
2) There was a gain in their grasping power in the second month of bath treatment.
3) The blood pressure was seen to decrease at their early admission, and so it was with both the systolic and diastolic pressures, nevertheless with no outstanding change later on.
4) With the serum cholesterol, there was seen no particular change soon after their admission, but its average in the third month showed a slight decrease.
5) As for the normal electrocardiographical investigation during their hospitalization, the patients had each their E. C. G. checked more than two times at least and revealed a favorable normalization of their otherwise more or less abnormal P-Q interval, S-T segment as well as T wave; besides the disappearance of extrasystole, when it had existed.