My research started in 1973 at Kagoshima University Hospital Kirishima Branch founded at 1937. The hospital was reorganized as the Department of Rehabilitation Medicine and Kirishima Rehabilitation Center in 1988. I established a new pharmacological method to measure integrated cardiovascular autonomic nervous functions, and essential hypertension was classified into two types, Type I with low sympathetic, low renin, Na-retention type and Type II with high sympathetic, high rennin, non-Na-retention type. By bathing at 41°C for 10 min, an increase in HR and CO and decrease in TPRi was shown. Using autonomic blockers, tachycardia was shown to be derived by vagal inhibition and vasodilation by a non-autonomic mechanism. Scarlet coloring of venous blood due to increased pO2 and decreased pCO2 highly suggested improved tissue oxygenation as the basic bathing effects. Tachycardia during exercise was derived firstly by increased sinus automaticity, and secondly vagal inhibition and sympathetic activation. Athletic bradycardia was induced firstly by decreased sinus automaticity, and secondly by vagal activation and sympathetic suppression. Hemodynamic studies of Ibusuki sandbath showed a remarkable increase in CO and decrease in TPRi, and an increase in RAP and PAP due to heavy sand. Increased venous pO2 and decreased pCO2 and lactate-pyruvate level indicate highly accelelated tissue oxygenation and clearance of wasted material by increased peripheral circulation. Although ICG clearance rate was reduced, increased acetoaminophen absorption indicated an increased intestinal blood flow. Increased RPF and unchanged GFR suggested suppressed intra-glomerular pressure from bathing. Urodynamic study after bathing, showed reduced intravesical pressure and increased bladder volume indicating the effects of bathing on pollakiuria in winter due to the relaxation of detrusor muscle. Against the usual concept that bathing is harmful for CHF, we showed bathing at 40°C for 10 min was a very useful tool as a new vasodilation therapy for CHF. Sauna bathing at 60°C for 15 min was more convenient and Dr. Tei named it Waon therapy. He achieved remarkable improvements in NYHA class symptoms and circulatory parameters in severe CHF, i.e., CO, EF, intra cardiac pressure and BNP. Waon therapy was also shown to be very useful in peripheral arterial disease, post-operative paretic ileus and fibromyalgia.
Foot and hand baths are used well in partial baths. It is thought that a warm temperature effect varies according to the size of warmed part in a partial bath, but it is not clear. The purpose of this study is to examine the thermal response on the size of warming area and position during foot and hand baths. The subjects were ten young individuals (all men, average age 23.2 ± 1.3 years), and these individuals partook in a 15-min foot and hand bath. Subjects submerged themselves up to the lower thigh and forearm in a bath at 42°C, in a seated position, rested in the position for five min, and then rested for an additional five min after bathing. There are five styles for baths (single thigh, both thighs, single forearm, both forearms, and no bath). Tympanic temperature was taken with a thermistor, skin blood flow with a laser Doppler flowmeter, and sweat rate with capsule method on the right side. We measured whether the subjects felt warm and comfortable. Tympanic temperature was significantly increased in both the foot and hand baths. Skin blood flow and sweat rate showed no change under any condition. Warm temperature and subjects’ feelings of comfort varied for all bathing conditions, in comparison with no bath. Warm temperature feeling was significant for both the foot and hand baths, in comparison with single baths. The change in these temperatures depended on the surface area warmth in the bath, and the response of the warming at different parts of body was suggested by various factors.
Background and objectives: Bathing services are available under long-term care insurance for the elderly. However, care workers have difficulty assessing safety for bathing in the absence of concrete criteria and guidelines. Currently, the pre-bathing health condition of care receivers is assessed mainly by blood pressure and body temperature measurements. This study aimed to identify the relationship of pre-bathing health condition assessed by blood pressure and body temperature measurements with illness and incidents related to bathing care. Methods: 1. Design: A case-control study (prospective registry study). 2. Subjects: All registered service providers of long-term care (2,330 in total) offering at-home bathing support. 3. Methods: Cases were defined as community-dwelling residents who had a bathing care-related illness or incident. As controls, two care receivers for each service provider were randomly extracted from the collected data. The study period was 1 year, from June 2012 to May 2013. A simple comparative analysis between the two groups was conducted for age, sex, degree of independence in daily life of disabled elderly individuals (degree to which they were bedbound), degree of long-term care needed, modified Rankin Scale score, level of alertness, degree of independence in daily life of patients with dementia, blood pressure before bathing, and body temperature before bathing. Univariate and multivariate logistic regression analyses were performed, with illness and all incidents or illness and incidents excluding elevated body temperature and elevated or reduced blood pressure as objective variables, and other factors as explanatory variables. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Results: A total of 596 cases and 1,511 controls were analyzed. Simple comparative analysis revealed more care receivers had elevated body temperature before bathing in the case group than in the control group. Multivariate analysis with illness and incidents excluding elevated body temperature and blood pressure changes as objective variables showed significant relationships when systolic blood pressure was 160-179 mmHg (OR, 3.63; 95%CI, 1.39-9.50), diastolic blood pressure was 100-109 mmHg (OR, 14.71; 95%CI, 1.31-165.77), body temperature was 37.5-37.9°C(OR, 16.47; 95%CI, 3.30-82.40), and body temperature was ≥38.0°C (OR, 6.57; 95%CI, 1.40-30.81) before bathing. Conclusion: High blood pressure (≥160/100 mmHg) and elevated body temperature (≥37.5°C) before bathing are possible risk factors of bathing-care-related illness and incidents.
Objective: Neck pain is a very common complaint in the general population. However, little is known about the characteristics of this complaint. The aim of this study was to clarify the psychological and physical characteristics of neck pain. Method: The subjects were 13 adult men with complaints of neck pain (NP group, mean age 20.2±0.7 years) and 10 healthy volunteers (CON group, mean age 21.2±1.5 years). This study used findings of neck tenderness and muscle stiffness for evaluation of neck pain, and employed the visual analog scale (VAS) to record the subjects’ assessment of their pain. State-Trait Anxiety Inventory (STAI), MOS 36-Item Short-Form Health Survey (SF-36), VAS for evaluation of perceived stress, and measurements of salivary cortisol density levels were utilized to measure stress. The salivary cortisol density was measured by the enzyme immunity method of measurement (the ELISA method). In addition, saliva samples were collected between 9 AM to 10 AM. Results: The mean VAS score for neck pain in the NP group was 56.9±17.3. There was no significant difference in muscle stiffness between the groups. Tenderness of the upper trapezius fibers and right splenius capitis muscle were significantly higher in the NP group (p<0.05). The VAS score of perceived stress and the state anxiety of STAI were significantly higher in the NP group (p<0.05). The SF-36 score was significantly lower in the CON group (p<0.05). The trait anxiety of STAI and the salivary cortisol density were not significantly different. Conclusion: There was no significant difference in the salivary cortisol density levels between the two groups. The degrees of perceived stress and uneasiness were reported as higher in the NP group, while the degrees of psychological and physical health were lower. These findings suggest the role of psychosociological factors in neck pain.
Japan has been speculated to have more than 10,000 bathing accidents per year, and the number increases annually. In particular, the number of bathing accidents in the elderly is increasing. I investigated the bathing accidents that occurred in Noboribetsu City between April of 2014 and March of 2015 with the full cooperation of the Noboribetsu ambulance service. There were 52 accidents in total; 25 occurred in women with an average age of 64.4±20.5 years, and 27 occurred in men with an average age of 70.7±18.2 years. In 11 cases, patients were transported via ambulance because of cardiopulmonary arrest (CPA). Eight of these patients were men, and three were women; 10 of the 11 CPA patients were brought to the hospital during the winter. Although I was unable to clearly determine whether alcohol consumption influenced the increase in the number and seriousness of bathing accidents, I do not recommend heavy alcohol consumption because of the additional risk of consciousness disturbance and drowning. The number of bathing accidents at the patient’s own home in Noboribetsu City increased significantly (P<0.05) in the winter, and I found no correlation between the season of the year and the number of accidents in public baths in Noboribetsu City and the number of accidents in hotels and inns in Noboribetsu hot springs.