Spa therapy which has been performed for patients with respiratory disease, particularly for those with asthma and pulmonary emphysema for last 22 years, demonstrates that spa therapy is effective for asthma and pulmonary emphysema. The characteristics of patients with respiratory disease has been changing during last 22 years. The frequency and number of elderly patients with asthma, and the number of those with pulmonary emphysema has been increasing in recent years. Elderly patients with asthma and COPD including pulmonary emphysema show the narrowing of airways by mucus, and hyperinflation of the lungs as results of aging. At present time any physicians have no medication improving hyperinflation of the lungs. In the present study, evaluation of hyperinflation of the lungs by a band display procedure on HRCT and the effects of spa therapy on the hyperinflation were discussed in patients with asthma and COPD. The results show that spa therapy is important for the treatment of elderly patients with asthma and COPD, because the therapy can improve hyperinflation of the lungs without adverse side effects.
The purpose of this study was to clarify effects of foot bathing at 44°C for the patients with hemiplegia. The subjects of this study were six patients with hemiplegia (average 71.6 years old) and six healthy volunteers (average 74.3 years old). Blood pressure and heart rate were measured using an autonomic spygmomanometer, tympanic temperature using a thermistor, and sweat rate using the ventrilated capsule method during the control period of 10 minutes before foot bathing, for 20 minutes during foot bathing, and for 10 minutes after foot bathing. Subjects wore a plain clothes while taking a footbath and the ambient temperature was set to 20°C. During foot bathing, heart rate was significantly increased, but blood pressure and pressure-rate product did not changed. Tympanic temperature was no significant changed in both subjects during foot bathing. But a significant increase of sweat rate was observed in patients. In healthy volunteers, in contrast, skin blood flow on the bottom of the foot was significant increased. These findings suggest that regulation system of cardiovascular is slightly declined in the patient, and patient's thermoregulatory system was difficult in healthy humans.
In recent times, an ingestible capsule sensor for the measurement of core body temperature has become available. This equipment was used to measure the relationship between core body temperature and daily living activities such as eating, exercise and bathing etc. The main findings were as followings: 1. With respect to daily living activities, the core body temperature during bathing showed higher values in comparison with eating and light-grade exercise etc. 2. For the same-grade of exercise (HRmax60%) either in an environmentally controlled room at either constant temperature (25°C) and humidity (50%) or in water (36°C; 50%humidity), the core body temperature showed almost identical changes for peak value and the rise and fall ever time. 3. Atypical work at midnight was associated with a continuous decrease in core body temperature. 4. Atypical sleep in the daytime was associated with a continuous decrease in core body temperature. 5. For daily living activities inducing an increase in core body temperature, the correlation coefficient between core body temperature and heart beats/min was 0.87 (p<0.01).
Objective Seventeen patients with FMS were treated with balneo-Morita therapy, which combines the balneotherapy with Morita therapy. After one year of treatment, patients with favorable outcome were compared with those with poor outcome. Subjects and methods The mean treatment period was 4.3 weeks. The outcome after one year of treatment was assessed. Patients who were able to return to work without a relapse of FMS were classified into the responsive group (13 cases, 74.6% in all), and those who showed a relapse or were not able to return to work were classified into the unresponsive group (4 cases, 23.5%). The cases of these two groups were compared in terms of biological (physical), psychological, social and existential status induvidually. Results There was no significant difference in sex or age distribution between the two groups. In terms of disease entity, FMS can be classified into psychosomatic type (hyperadaptation type) and neurotic type (possible presence of psychosocial-existential problems which are difficult to resolve such as great trauma, or the conditions ranging from neurosis to psychosis). Cases of neurotic type were prevailing in the unresponsive group. Patients were assessed to find out in which of the particular features of biological, psychological, social and existential aspects the notable problems proper to each patient lie. The number of patients having psychological problems was higher in the unresponsive group, with a significant difference. In one case of the unresponsive group, the condition changed into ME/CFS (myalgic encephalopathy/chronic fatigue syndrome). Discussion In the treatment of these patients, the somatic approaches or physical therapy such as pharmacological therapy or simple balneotherapy, should be given more importance for cases of the psychosomatic type. However, psychological therapy should be added to this treatment for cases of neurotic type. The efficacy of the balneo-Morita therapy was compared between the groups as classified by the type of the disease. The therapy was effective in 91.6% of the cases of psychosomatic type, while the efficacy rate was 40.0% for cases of neurotic type. During the period of the balneo-Morita therapy, a tendency of dependency on therapists may appear in patients. Although involution may be allowed transiently for the purpose of introducing catharsis, autonomy should be enhanced eventually. Yuatari (balneo-phenomenon, or balneo-intoxication) is a phenomenon, that develops in psychosomatic confusion resulting from sudden release from tension after the start of balneotherapy. This phenomenon is regarded as catharsis, from which patients are encouraged to establish a new self. Through this therapeutic experience, the therapists lead the patients from involution to autonomy without being so instructed, finally to cause a change in the way of living. In cases of psychosomatic type, this conversion was relatively easily achieved, but in cases of neurotic type such conversion was difficult. It is considered that difficulty in such conversion is attributable to psychological factors of patients (strength of self, severity of trauma, presence or absence of meaning, autonomy).