This study aimed at explaining the influence of foot care before bed as an aid to natural sleep in elderly people who often suffer from sleeping disorders. 22 subjects living in welfare facilities for the aged whose average age was 80.2 ± 6.4 years old were examined. During the five-day experiment period an actigraph was attached to each of the subjects and a comparison was made between nights when foot care was given and the nights it was not. Differences in sleep minutes, wake episodes, sleep latency and sleep efficiency were noted. An OSA questionnaire was also carried out. Though no conclusive difference was noted between nights when foot care was and was not given. In an investigation of individual subjects, no difference was found in the ratio between those whose sleeping conditions improved and those whose sleeping conditions deteriorated. According to the OSA questionnaire we conducted, in the factors 1(sleepiness) and 2(sleep continuity), those who improved were seen to greatly outnumber those who deteriorated. As a result it became clear that there are elderly people who made improvement in the feeling of sleep through foot care.

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　The purpose of this study was to clarify the clinical effect of cryotherapy using a cold pack after total knee arthroplasty (TKA). Forty-eight knees of 48 patients were randomized into two groups : Those receiving cryotherapy and those receiving no treatment. Subjects were assessed for skin surface temperature, post-operative blood loss, swelling of the bilateral lower limbs, pain, blood parameters (International Normalized Ratio of Prothrombin Time : INR). Skin surface temperature and pain score was recorded just after the operation and at 4, 10, 24, 48 and 72 hours post-surgery. Post-operative blood loss and lower limb swelling was recorded 24, 48 and 72 hours after surgery. Blood was collected on the day prior to surgery and postoperative day 4 to determine INR. Skin surface temperature of cryotherapy group was significantly lower than the temperature of control group. There was no significant difference between two groups in post-operative blood loss and INR. There were no significant differences between the two groups regarding swelling of the lower limbs, measured as the circumference at thigh, mid patella and maximum swelling crus. There was no significant difference between two groups in pain score that measured by using the Visual Analog Scale. It was suggested that there was no beneficial effect for skin surface temperature of knee, post-operative blood loss, swelling of the lower limbs, INR, pain in cryotherapy using a cold pack in 72 hours after total knee arthroplasty.

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[in Japanese]

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　Hot footbaths were introduced into Japan from the UK and the USA as a nursing technique for the relief of severe headaches and to increase perspiration in the late 19th century. This study sought to determine how the application of hot footbaths developed into a treatment method for the promotion of sleep solely in Japan, and what underlying factors were responsible for this development. The authors examined the descriptions of footbaths and other interventions for facilitating sleep in 25 nursing textbooks published from 1877 through 2004. We also sourced information on nurse working patterns, nursing education, and general knowledge on sleep in the field of basic medicine in successive eras.
　The authors found that the domestic development of footbath techniques and related factors evolved over time : (1) Sleep promotion effects were observed after bedside bathing of feet with a hot wet towel since the time when nurses were held responsible for the daily physical care requirements of their clients. (2) Like bedside bathing with a hot wet towel and/or bathing, the application of hot water on the feet or parts of body associated with hot foot bathing was similarly expected to induce sleep. (3) Conditions associated with hot foot bathing were found to be effective for intentionally affecting the increase or decrease of core body temperature. These findings were made based on experiments of the relationship between the time of administering foot bathing and the change in core temperature that follows the footbath. (4) Nurses reviewed the application of hot footbaths for promoting onset of sleep when the physiological relationship between sleep and core body temperature was elucidated, changing the conditions under which foot bathing was administeredbased on these findings.

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