The purposes of this study were to evaluate the evidence of spa therapy, as well as spa effects, on health promotion, and to discuss the proper applications of spa to leisure activities that are focused on fitness.
A relatively small number of highly evidence-graded studies, such as randomized controlled trials (RCTs), were identified from a literature search, and many had problems in methodology. Results showed that aquatic exercises conducted in hot water, including hot spa, obviously alleviated pain in locomotorium diseases. However, few RCTs are currently available concerning other diseases, and consequently, there is no evidence on aquatic exercise efficacy in those diseases.
An increasing number of people enjoy leisure activities, particularly hot spa bathing, primarily for fitness. Obviously, hot spa has pain-relieving effects on locomotorium diseases, which are prevalent in middle-aged or elderly people. Therefore, hot spa bathing, as well as a change of air, and other complex factors associated with hot spa visits, are expected to promote health.
It is hoped that people will learn more about hot spa, and enjoy it as a regular leisure activity.

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The purpose of this research was to investigate if three different foot positions affected the knee joint forces during sit to stand. Subjects were 7 healthy adult volunteers. Sit-to-stand was performed in the following three foot positions: abduction, neutral and adduction. A motion analysis system and force plate were used to collect the data of knee joint forces. Knee joint forces during sit to stand was analyzed in either component of perpendicular, back and forth and lateral side. Result demonstrated that the knee joint forces was found to greater toward compression, anteriorly and medially in the beginning of the sit-to-stand. Also, in the adducted foot position, the knee joint forces toward the lateral side during the sit to stand showed a significantly lower value than the other two foot positions. In the beginning of the sit to stand at all foot positions, compression force and shear force of anteriorly and medially of the tibia became greater. After twenty percent of the sit to stand, knee joint forces became greater laterally, and by the adduction of the foot position, knee joint forces laterally was significantly lower. The different foot positions in the sit to stand affected the knee joint forces in the frontal plane.

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This study aimed to elucidate the relationship between fear of falling and ability to sit on the floor in frail elderly people. The subjects were 62 frail elderly people living at home who used day-care facilities regularly. Their ages ranged from 60 to 92 years, with an average age of 73.9±7.4 years. An interview was conducted to assess knee joint pain, lower back pain, fall history within 1 year, habit of sitting on the floor at home, and the Falls Efficacy Scale (FES, Japanese edition) score. The timed “Up and Go” Test, timed sit on the floor, timed stand from the floor, and the Barthel Index score were also measured. The results were compared. Only women showed a significant difference in FES (p=0.01) to the habit of sitting on the floor. A partial correlation analysis controlling for age revealed a significant correlation between FES score and timed sit on the floor (men : r=-0.41, p=0.04 ; women : r=-0.46, p=0.02). Ability to sit on the floor appears to be one of the factors related to fear of falling in frail elderly people.

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We have been conducting research to develop an effective program of oral health promotion for older people. As the first step, this study was done with the aim of understanding the actual oral health behavior among older people and considering ways to support them. The participants in this study were 23 people, 13 men and 10 women, mean age 76.3±3.8 years, who belonged to the senior club in their community. Data were collected using focus group interviews with about 6 people in each interview. Semi-structured interviews were conducted based on PRECEDE assessment stages of the PRECEDE-PROCEED model, and the content of the interviews was then analyzed qualitatively. Forty-one categories were identified as actual oral health behaviors or factors effecting behavior. Categories classified under “QOL” represented the desire of older people to maintain chewing function, speaking function, good teeth to enjoy food, and relationships with people around them. Categories under “Health” showed the health problems of older people, including oral pain, bleeding of the gums, bad breath, thirst caused by decreased saliva secretion, and choking caused by dysphagia. “Behavior and lifestyle” categories showed that the oral health behavior of older people included not only dental hygiene and dysphagia but also going to the dentist. Categories under “Predisposing factors”, “Reinforcing factors”, “Enabling factors”, and “Environment” showed specific factors that affect oral health behavior, such as family concern about the oral health and meals of older people, and oral health support and systems in their community.

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