The specific effect of underwater exercise in a 61-year old woman with cerebellar ataxia induced by spinocerebellar degeneration was observed. She was treated through home visit rehabilitation. She was admitted to this hospital in 2004 and started underwater exercise. She received 40 minutes of physical therapy three times a week as well as 40 minutes of occupational therapy and 30 minutes of underwater exercise three times a week. After that training, her cerebellar ataxia was relieved, and she could walk indoors with good stability using a T cane. During 5 hospitalizations in 3.5 years, her cerebellar ataxia improved and her walking was stabilized.
Some differences in her rehabilitation during hospitalization compared to when she was at home was that occupational therapy was added and that the training frequency was increased five times by physical therapy and occupational therapy for one week in total, and that underwater exercise was added. In regards to the improvement of her dysfunction in terms of daily living, a trunk and an inferior limb were important factors. Therefore, we think that intervention through physical therapy and underwater exercise was significant. Also, the difference between her physical therapy during hospitalization and when at-home was three times a week during hospitalization and twice a week when at home. Therefore, we determined there was a large difference of her rehabilitation effected by the underwater exercise. There is a possibility the underwater exercise improved her intension tremor and dysmetria, stabilized her indoor walking, and extended the distance she walked outdoors.
Underwater exercise is a plural classical training method that is reasonably safe while at the same time providing rehabilitation for cerebellar ataxia, and this exercise is expected to provide addition due to the warm temperature of the water.
The authors propose that new rehabilitation using underwater exercise for cerebellar ataxia be considered.

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Objective
The purpose of this trial was to compare the cumulative and sustained effect of repeated acupuncture treatment and repeated local injection of anesthesia for localized low back pain.
Methods
A computer program was used to randomly allocate 26 patients with low back pain to either an acupuncture group (n=13) or a local injection group (n=13). Patients in both groups received treatment at the most painful points (from 2 to 5 points) once a week for a total of 4 weeks. For the acupuncture treatment, a 0.18mm diameter stainless steel needle was inserted to a depth of 10 to 20mm and then manual stimulation using the sparrow pecking method (1Hz) was given. For the local injection, injection needle (25G, 0.5mm in diameter) was inserted to a depth of 10 to 20mm before injection of the anesthetic (a mixture of local anesthetic and neurotropin). The visual analog scale (VAS: 100mm) was used to measure subjective pain intensity before and directly after the first treatment, before subsequent treatments, and at two and four weeks after completion of the treatment. The Roland-Morris Disability Questionnaire (RDQ) and Pain Disability Assessment Scale (PDAS) were also used to evaluate Quality of Life (QOL) of the subject at before the first treatment, at the time of completion of treatment, and at two and four weeks after the completion of treatment.
Results
There was a significant difference (p=0.0016) in changes in the VAS scores between two groups, with more favorable results in the acupuncture group than in the local injection group. Calculation of the degree of change from the initial scores indicated that acupuncture group showed significantly better results than those in the local injection group at directly after the first treatment (p=0.0348), and there was a significant cumulative effect (at the end of treatment: p=0.0076) and sustained effect (two weeks after treatment: p=0.0096, four weeks after treatment: p=0.0128). Similarly, RDQ and PDAS were also better in the acupuncture group compared to the local injection group.
Discussion
Both local injection and acupuncture reduced low back pain. The superior effect of acupuncture directly after treatment and its superior cumulative and sustained effect, indicate that it could be an effective treatment for low back pain. The reason for the disparity between the effects could be due to differences in the mechanisms of pain suppression.

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A case report
A 70-year-old male with small bowel adenocarcinoma involving retroperitoneal invasion had undergone chemotherapy after non-curative operation. However, this patient had to discontinue the first and second lines of chemotherapies within one month due to serious side effects of anti-cancer agents. Subsequently, the patient complained of severe low-back pain and there was evidence of local recurrence around the resected small intestine. Therefore, phototherapy was applied three times a week to relieve the low-back pain while the patient underwent the third line of chemotherapy. It was interesting to note that these combination therapies coincidentally ameliorated the various side effects caused by anti-cancer drugs. For one year during the third line of chemotherapy, the patient had to temporarily discontinue chemotherapy only two times when phototherapy was not available for one week due to consecutive national holidays in May and November. The quality of life of this patient was well maintained, and he only needed to be hospitalized for the last two months before he died.
Epidemiological studies have shown a high incidence of cancer in people less exposed to solar rays. The sunshine “vitamin” 1 alpha, 25-dihydroxy vitamin D₃ (1, 25(OH)₂D₃) is involved in these epidemiological studies based on the evidence that 1, 25(OH)₂D₃ is an antiproliferative agent that may inhibit proliferation of cancer cells in vitro and development in animals. To elucidate the synergetic effect of phototherapy in combination with chemotherapy, we assayed serum levels of 1, 25(OH)₂D₃ in this patient compared with those of end-stage cancer patients undergoing chemotherapy alone. Serum levels of 1, 25(OH)₂D₃ in this patient after receiving the combination therapies were higher than those in other cancer patients treated with chemotherapy alone.
Our results indicate that phototherapy may be a good complementary therapy with chemotherapy for cancer patients.

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Ginseng powder was dissolved in the warm water to develop bath salt that contained Ginseng powder (250mg: 1% Ginseng powder, 500mg: 2% Ginseng powder) and it made comparative study of the effects with the tap warm water for seven healthy adults (male 3, female 4, 20.7±0.8 years old). The Ginseng powder of 250mg and 500mg was made so that the bath salt of 25g may become 1% and 2%. The whole body immersion of 15 minutes was done to all subjects under the condition that 1% or 2% cannot be distinguished without tap water bathing.
As a result, the warm water with Ginseng powder increased in the changes of the deep thermometer in front of chest between immersion and after bathing, compared with the tap warm water. But there were not significant change of the surface skin temperature on the arm and the tissue blood flow on thigh skin.
Therefore, the warm water with Ginseng powder was suspected that the thermo effects and the retaining warmth were good compared with the tap warm water.
It seemed that it was possible to use it safely as bath salt for it did not change of the blood pressure, the heart rate, and abnormality of the skin without the case to whom the skin had temporarily flushed, was not additionally recognized.

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緒言: 慢性心不全患者において以前より運動耐容能の低下が指摘されており、それは、心機能の低下のみならず、慢性血管反応 (拡張性) の低下、骨格筋の変化等、全身疾患として近年考えられるようになった。慢性心不全に対する非薬物治療の一つとして運動療法は以前から知られているが、近年では温熱療法が慢性心不全の自他覚症状の改善、予後の改善等に有効であることが示唆されている。今回我々は当病院で行っている慢性心不全患者に対する温泉浴効果について報告する。
方法: 2週間毎日 (週5回) 40度の温泉に10分程度温泉浴をしてもらい、自覚的症状 (NYHA分類)、及び他覚的所見として、心胸比: CTR、左室駆出率: EF、脈波伝達速度: PWV、血液検査 (心室性利尿ペプチド: BNP、内因性一酸化窒素合成酵素阻害物質: ADMA) についての変化を検討した。(n=13)。なお対照群として、シャワー浴のみのグループと比較した (n=13)
結果: 慢性効果として、温泉入浴2週間後には、心拍数、心胸比等に変化はなかったが、自覚的症状、平均血圧、左室駆出率の改善、脈波伝達速度の低下、ADMAの低下が認められた。さらに、BNPの低下を認める等、血管拡張反応の改善、及び心機能改善を示唆する結果が認められた。
考察: 温泉浴療法は、末梢血管反応を改善し、血管抵抗を低下させる事により、心負荷を軽減し、最終的に自覚的症状の改善を呈する可能性が示唆された。

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我々は温泉療法が慢性閉塞性肺疾患患者に対して、自覚症状軽減及び呼吸機能改善効果を有することを報告してきた。今回我々は慢性閉塞性肺疾患患者を対象に温泉療法の6分間歩行試験に対する効果について検討した。当院に呼吸リハビリテーション目的で入院中の慢性閉塞性肺疾患患者25例 (男性22例、女性3例) を対象とした。対象患者の病期分類は慢性閉塞性肺疾患の診断、治療、予防に関するグローバルストラテジーに従い、軽症2例、中等症9例、重症14例であった。温泉プール水中運動、鉱泥湿布療法、ヨードゾル吸入療法等による複合温泉療法を4週間施行し、その間の呼吸機能、6分間歩行試験における歩行距離、動脈血酸素飽和度、修正 Borg スケールの変化を比較検討した。VCは有意に増加した。FVC、FEV_1.0、FEF₇₅、FEF₅₀、FEF₂₅、FEF_25-75、RV、FRC、PEF及びDLcoは増加傾向にあった。6分間歩行距離は温泉療法前288±106mから温泉療法後323±114mと有意に上昇した。修正Borgスケールは有意に低下した。動脈血酸素飽和度 (SpO₂) は上昇傾向にあった。6分間歩行距離の上昇は、VC、FVC、FEV_1.0、FEF₅₀、SpO₂の改善と有意に相関した。温泉療法により呼吸機能の改善が得られ、これにより6分間歩行距離が上昇したと考えられた。温泉療法が慢性閉塞性肺疾患の治療に有用で、運動耐容能を改善することが示唆された。

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