Background: The traditional Japanese style of soaking in a hot bath is a lifestyle custom for many citizens, no study had ever investigated the association between bathing as a lifestyle practice and the onset of long-term depression. Through a large-scale six-year longitudinal study, we aimed to determine whether tub bathing as a lifestyle custom plays a role in preventing the onset of long-term depression.

  Methods: Of 11,882 individuals who responded to surveys conducted in 2010 and 2016 as part of the Japan Gerontological Evaluation Study (the JAGES) project, we analyzed 6,452 and 6,465 individuals for whom information was available regarding summer bathing frequency and winter bathing frequency, respectively; all of these individuals were independent, had a Geriatric Depression Scale (hereafter, “GDS”) score of ≤4, and did not suffer from depression. The cohort study involved dividing participants into a group of those who bathed 0-6 times a week and a group of those who bathed ≥7 times a week and determining the percentages of individuals who developed depression based on their GDS scores six years later. Multiple logistic regression analysis was performed to determine odds ratios for the association between depression onset and tub bathing.

  Results: For individuals who tub bathed ≥7 times a week, the odds ratios for depression onset versus individuals who bathed 0-6 times a week in summer and winter were 0.84 (95% confidence interval, 0.64-1.10) and 0.76 (95% confidence interval, 0.59-0.98), respectively. Tub bathing ≥7 times a week in winter significantly reduced the risk of depression onset.

  Conclusions: New-onset depression was shown to be infrequent in older adults who bathe in a tub frequently. Tub bathing was suggested to potentially contribute to the prevention of depression in the elderly.

  Background: The STarT (Subgrouping for Targeted Treatment) Back Screening Tool (SBST) is an established clinical evaluation tool that easily assesses the risk of chronic or refractory low back pain. This study aimed to examine the usefulness of acupuncture in patients with low back pain.

  Methods: A total of 71 outpatients with low back pain who underwent acupuncture and moxibustion at the Center for Integrative Medicine, Tsukuba University of Technology, between 2019 and 2022 were included in this study, regardless of the specific medical condition causing the pain. Survey items included the SBST and lumbar pain intensity visual analog scale (VAS). Demographic factors and contents of acupuncture treatment were collected from the medical charts. The VAS score 4 weeks after the start of treatment was used as an index of clinical outcome and was analyzed using repeated measures analysis of variance (ANOVA) and hierarchical multiple regression analysis.

  Results: Classification using the SBST at the first visit resulted in 36, 30, and 15 patients in the low-, medium-, and high-risk groups, respectively. Repeated-measures ANOVA showed statistically significant differences in the mean VAS values with respect to differences in time point (P < 0.01), group (P < 0.01), and interaction (P < 0.05). The VAS values after 4 weeks in the high-risk group were significantly higher than those in the other two groups (both P < 0.01). In the hierarchical multiple regression analysis, with VAS as the dependent variable, the relationship between SBST classification and VAS maintained a significant positive relationship in all models, including adjustments for interaction terms and patients’ background items. A simple slope analysis indicated that this relationship was more evident in patients with lower limb symptoms than in those without symptoms.

  Conclusion: The SBST could be a simple and useful tool for predicting the clinical outcomes of acupuncture.

  Purpose: This study aimed to investigate the effects of underwater walking for 6 weeks at 60% of the predicted maximum heart rate on respiratory muscle strength of elderly people as well as its sustained effects on respiratory muscle strength.

  Methods: The participants were 43 healthy elderly men, who were randomly divided into the continuous group (n=21) and the non-continuous group (n=22). Initially, both groups performed 30 min of underwater walking four times a week for 6 weeks, after which the continuous group continued the same for another 6 weeks, whereas the non-continuous group was prohibited from performing any exercise, except for daily activities. The walking speed during underwater walking was adjusted such that the exercise intensity was 60% of the predicted maximum heart rate, with the water depth up to the fourth intercostal space or higher.

  Outcome Measures: The maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), and vital capacity (VC) were measured before exercise and 6, 8, 10, and 12 weeks after exercise.

  Results: The PImax and PEmax were significantly higher after 6 weeks of exercise than those before exercise. In the continuation group, PEmax increased significantly at 12 weeks of exercise compared to that at 6 weeks, whereas PImax did not show a significant increase. In the non-continuous group, PEmax decreased significantly from the 10th week onwards as compared to that at 6 weeks and showed a significantly lower value than that of the continuous group. The PImax of the non-continuous group decreased significantly at 12 weeks compared to that at 6 weeks. The VC after the 6-week underwater walking program did not differ from the pre-exercise value, with no significant difference observed between the two groups. Moreover, the VC in both groups showed no significant changes after 12 weeks of underwater walking compared to that after 6 weeks.

  Conclusions: Because underwater walking involves moving forward while resisting water pressure, it is necessary to activate the expiratory abdominal muscles to stabilize the trunk. Notably, the respiratory muscle strength in the non-continuous group decreased 4-6 weeks after the underwater walking program was terminated.