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Background: The goal of hypertension management is to keep blood pressure within normal bounds while also enhancing elderly patients’ quality of life and health. Warm foot baths are a straightforward, affordable, and effective therapy method that can be used in naturopathy to alleviate hypertension. Materials and Methods: This study used a quasi-experimental design that included two groups, the hypertensive intervention group and hypertensive control group, which was studied over 3 months between March 2020 and May 2020. The necessary ethical committee permissions with reference number VMRF/2020/037 and informed consent from all the patients included have been obtained properly before proceeding with the study. Results: Among the 100 individuals involved in the study, 53% were males and 47% were females. The mean age among the intervention group was 53.62 ± 7.26, and 52.84 ± 6.47 among the control group. The majority of the males included in the study were nonsmokers (69.8%). The mean ± standard deviation of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the intervention group during the pretest phase was 157.3 ± 13.4 and 88.1 ± 9.4, whereas, after the intervention of foot bath therapy, the measurements of SBP and DBP were reduced significantly to 133.8 ± 9.7 and 76.9 ± 7.2, which was statistically significant with a P value < 0.001. Conclusion: Warm foot bath soak therapy is anticipated to be used as a nonpharmacological treatment for hypertension in older patients.
ABSTRACT
Sleep disturbance is one among the biggest worldwide health threats. Regardless of the age groups, people are affected with symptoms ofinsomnia one or the other way. To mention, the geriatrics. The objectives of the study are to assess the effectiveness of warm foot bath onquality of sleep among experimental group. Evaluative approach and quasi-experimental, non-randomized control group design wereadopted for the study. A total of 60 subjects were selected by non-probability purposive sampling technique. The subjects were assignedto experimental and control group so as to include 30 subjects in each group. The quality of sleep was assessed by Pittsburgh SleepQuality Index. Independent sample t-test was used to compare the quality of sleep between experimental and control groups. In theexperimental group, the mean post-test score of the quality of sleep among the elderly (11.73 ± 3.9) was much less than of control group(15.16 ± 4.24). In the experimental group the mean difference was 4.16 and it was more than the difference of control group (?2.26).Furthermore, in the experimental group, the calculated “t” value (t(29) = 18.08) was found to be greater than the table value (t(29) =2.09) at <0.05 level of significance, indicating that warm foot bath is effective in improving the quality of sleep among elderly people. Thelikelihood ratio and Chi-square test were used to find the association between pre-test scores of the quality of sleep and selecteddemographic variables. There was no association between pre-test sleep quality scores and selected demographic variables.
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Foot baths reportedly reduce pain and improve sleeplessness. In addition, foot baths may induce vasodilation, and thereby improve blood flow, reduce swelling, induce relaxation, and increase deep body temperature. However, the influence of foot baths on energy metabolism and physiological indices are unclear. Therefore, the present study aimed to clarify the effects of foot baths on energy consumption and physiological indices (e.g., heart rate, tympanic temperature, and blood pressure). Nine healthy males were included in this study (age, 23.0±1.0 years; body weight, 66.5±5.6 kg; body fat percentage, 15.1±4.3%). Expired gas composition (i.e., oxygen and carbon dioxide consumption) was analyzed using the Food method in an environmentally-controlled room (room temperature 25°Cand humidity 40%). Subjects were rested in the hood during the measurement. After 30 min rest in the sitting position, a 30 min foot bath was performed, after which the subjects sat for 60 min. Expired gas composition and heart rate were measured over time, and tympanic temperature and blood pressure were measured every 15 min. The foot bath involved immersion of the knees, and the temperature of the water was maintained at 41°C. There were no significant changes in energy consumption after the foot bath, and no significant changes in heart rate, tympanic temperature, and blood pressure. Therefore, our results suggested that there were no significant energy metabolism changes after 30 min of foot bathing at 41°C.
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Objective To observe the clinical efficacy of TCM foot bath in adjuvant treatment for early diabetic lower-extremity peripheral arterial disease (LEPAD). Methods Totally 90 cases with early diabetic LEPAD were divided into treatment group and control group by random number table method, with 45 cases in each group. Control group was given routine treatment, including health education, diet control, proper exercise, control of blood sugar, blood pressure and blood lipids, nutritional nerves, dilation of blood vessels. On the basis of control group, the treatment group was given TCM foot bath, soaking the lower limbs for 30 minutes each time, once a day, for 12 weeks. The clinical efficacy of the two groups was evaluated. The TCM syndrome score, maximum painless walking distance, temperature of the toe skin, diameter of the lower extremity arterial blood vessels, lower extremity arterial blood flow, ankle brachial index (ABI), blood pressure (BP), FBG, HbA1c, serum adiponectin, IL-6 and TNF-α were detected. The blood routine, liver and kidney function were detected and adverse reactions were recorded. Results The total effective rate was 82.22% (37/45) in the treatment group and 68.89% (31/45) in the control group. The treatment group was significantly better than the control group (Z=-2.099, P=0.036). Compared with before treatment, the levels of TCM syndromes, BP, FBG, HbA1c, serum IL-6 and TNF-α were significantly lower in both groups after treatment (P<0.05); serum adiponectin level increased after treatment (P<0.05); the maximum painless walking distance, the temperature of the toe skin, the diameter of the lower extremity arterial blood vessels, the lower extremity arterial blood flow and ABI were significantly improved. Compared with the control group, the scores of TCM syndromes in the treatment group were significantly lower (P<0.05); the levels of IL-6 and TNF-α in the treatment group were significantly lower than those in the control group (P<0.05); the maximum painless walking distance, the temperature of the toe skin, the diameter of the lower extremity arterial vessels, the lower extremity arterial blood flow and ABI, serum adiponectin level in the treatment group were significantly higher than those of the control group (P<0.05). Conclusion TCM foot bath in adjuvant treatment for early diabetic LEPAD is with obvious efficacy, and the mechanism may be related to improving the level of serum inflammatory cytokines to inhibit the inflammatory injury of blood vessels.
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Objective To observe the therapeutic effect of DENG Tie-tao's Foot-bath Recipe (mainly composed of Radix Achyranthis Bidentatae,Rhizoma Chuanxiong,Spica Prunellae,Fructus Evodiae,Ramulus Uncariae Cum Uncis,etc.)for the treatment of essential hypertension with hyperactivity of liver Yang syndrome. Methods Eighty essential hypertension patients with hyperactivity of liver Yang syndrome were randomly divided into treatment group and control group,40 cases in each group. Both groups were given basic antihypertensive western medicine treatment, and additionally the treatment group was given external application of DENG Tie-Tao's Foot-bath Recipe and the control group was given foot-bath with warm water. Seven days constituted one treatment course. Before and after treatment , the scores of traditional Chinese medicine(TCM)symptoms and Athens Insomnia Scale were observed , blood pressure variability (BPV)was detected with ambulatory blood pressure monitoring instrument , and plasma norepinephrine(NE) and epinephrine(E) levels were examined by enzyme-linked immunosorbent assay (ELISA). Results (1)The total effective rate for improving TCM symptom scores of the treatment group was 87.5%, and that of the control group was 75.0% , the difference being significant (P < 0.05). (2)The total effective rate for lowering blood pressure of the treatment group was 85.0%, and that of the control group was 72.5% , the difference being significant (P < 0.05). (3)After treatment,scores of Athens Insomnia Scale in the two groups were obviously decreased(P<0.01 compared with those before treatment),and the decrease in the treatment group was superior to that in the control group (P <0.01). (4)After treatment,24h BPV,daytime BPV and night BPV in the two groups were decreased to certain degrees (P < 0.05 compared with those before treatment),and the decrease of 24h BPV and night BPV in the treatment group was superior to that in the control group(P<0.05).(5)After treatment,plasma NE and E levels in the two groups were decreased to certain degree (P < 0 . 05 compared with those before treatment), and the decrease in the treatment group was superior to that in the control group (P < 0.05). Conclusion DENG Tie-Tao's Foot-bath Recipe exerts synergistic action on lowering blood pressure steadily by relieving TCM symptoms, improving the quality of sleep, decreasing 24hBPV of essential hypertension with hyperactivity of liver yang syndrome. And the regulation of plasma NE and E levels may be one of its therapeutic mechanisms.
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Objective To observe the clinical efficacy of traditional Chinese medicine foot bath combined with Xueshuantong injection in the treatment of diabetic peripheral neuropathy.Methods Sixty patients with diabetic peripheral neuropathy(DPN)were randomly divided into two groups.According to the patients' condition,oral hypoglycemic drugs or insulin were used to control blood glucose.The control group was treated with Xueshuantong injection on routine nutrition nerve program.In the conventional nutrition nerve program based on the use of traditional Chinese medicine foot bath combined with Xueshuantong injection treatment,2 groups were treated after 10 days to evaluate the efficacy.Results The total effective rate of the observation group and the control group was 90％and 66.7％respectively.The sensory and motor function of the observation group were significantly improved after the treatment group,and the blood rheology and serum endothelin level were significantly decreased.Conclusion Chinese medicine foot bath combined with Xueshuantong injection for the treatment of diabetic peripheral neuropathy.
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PURPOSE: The purpose of this study was to identify the effects of hand and foot baths on sleep and body temperature of the elderly. METHODS: The research was designed for a nonequivalent control group before and after the test design. The subjects of this study totaled 43, aged 65 and over (23 people in hand bath group and 20 people in a foot bath group), who received a written voluntary consent to participate in experimental treatment and are in the W care center, S Nursing Home, and H care center in Seoul. Data were collected with questionnaires and observations, and were analyzed on the basis of frequency, percentage, mean, standard deviation, χχ2-test, Fisher exact test, t-test and paired t-test. RESULTS: There are no significant differences in homogeneity test of a dependent variable between groups (hand bath, foot bath). The differences between 2 groups on the sleep quality score and systolic blood pressure, diastolic blood pressure temperature were not significant statistically except on the pulse. CONCLUSION: Based on the results of this study, hand bath is as efficient as foot bath. Therefore, a hand bath can be a nursing intervention in order to enrich sleep quality for the elderly because a hand bath is more convenient than foot bath.
Subject(s)
Aged , Humans , Baths , Blood Pressure , Body Temperature , Foot , Hand , Nursing , Nursing Homes , Seoul , Vital SignsABSTRACT
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.
ABSTRACT
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.
ABSTRACT
A foot bath is one of the partial baths which soaks a foot in hot water. The effect makes the blood circulation of the part of the warmed foot better, and is effective for fatigue, edema, poor circulation, and sleep. The purpose in this study is to examine how aging influences the change of the autonomic nerve during a foot bath. The subjects were nine elderly individuals (four men, five women, average age of 73.5 ± 8.4 years old), eight young individuals (all men, average age of 25.5 ± 3.4 years old), and for a 20-minute foot bath, when I touched the lower thigh to the 41°C bath in a seated position for rest ten minutes, performed rest after a foot bath for five minutes. Tympanic temperature with a thermistor, skin blood flow with a laser Doppler flowmeter, and blood pressure and heart rate with an automatic sphygmomanometer were measured. In the younger subjects, tympanic temperature was significantly increased compared to the elderly subjects, and skin blood flow was significantly increased during the foot bath in the lower thigh with both subjects, and the younger subjects were significantly increased compared to the elderly subjects. The femor-skin blood flow significantly increased only in the young subjects. The blood pressure did not change in the young subjects during the foot bath, but the elderly subjects’ pressure dropped. The heart rate increase was shown in the young subjects; however, it was not shown in the elderly subjects. It is thought that an increase of the quantity of fat and decrease of the muscle volume due to aging, a decline in the flexibility of the blood vessel, and attenuation of the sensitivity of the receptor affect the change of these autonomic nerve functions.
ABSTRACT
A foot bath is one of the partial baths which soaks a foot in hot water. The effect makes the blood circulation of the part of the warmed foot better, and is effective for fatigue, edema, poor circulation, and sleep. The purpose in this study is to examine how aging influences the change of the autonomic nerve during a foot bath. The subjects were nine elderly individuals (four men, five women, average age of 73.5 ± 8.4 years old), eight young individuals (all men, average age of 25.5 ± 3.4 years old), and for a 20-minute foot bath, when I touched the lower thigh to the 41°C bath in a seated position for rest ten minutes, performed rest after a foot bath for five minutes. Tympanic temperature with a thermistor, skin blood flow with a laser Doppler flowmeter, and blood pressure and heart rate with an automatic sphygmomanometer were measured. In the younger subjects, tympanic temperature was significantly increased compared to the elderly subjects, and skin blood flow was significantly increased during the foot bath in the lower thigh with both subjects, and the younger subjects were significantly increased compared to the elderly subjects. The femor-skin blood flow significantly increased only in the young subjects. The blood pressure did not change in the young subjects during the foot bath, but the elderly subjects’ pressure dropped. The heart rate increase was shown in the young subjects; however, it was not shown in the elderly subjects. It is thought that an increase of the quantity of fat and decrease of the muscle volume due to aging, a decline in the flexibility of the blood vessel, and attenuation of the sensitivity of the receptor affect the change of these autonomic nerve functions.
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Objectives: Recently, it has been reported that the effects of artificial high concentration carbon-dioxide (CO2) on core temperature, cutaneous blood flow, thermal sensation. However, the effect of artificial high concentration CO2 water foot baths for spasticity, lower extremity motor function and walking ability was not identified. The purpose of this study was to investigate whether the newly artificial high concentration CO2 water foot bath inhibits spasticity and improves lower extremity motor function and gait speed in spastic paraplegia patient. Case Presentation: The patient was a 37 years old man with spastic paraplegia of human immunodeficiency virus encephalopathy, without signs of cognitive impairment. The patient was able to walk without assistance using a T-cane or an ankle-foot orthosis. He had no medical condition that limited footbath usage (such as uncontrolled cardiopulmonary disease, severe joint disability and severe sensory disturbance), severe aphasia that made it impossible to follow verbal instructions, and cognitive dysfunction that interfered with outcome assessments. Informed consent was obtained from him according to the ethical guidelines of the hospital, after he fully understood the purpose and methodology of the study. This work was carried out with permission from the Ethical Committee of Kagoshima University. Methods: This case study was before and after intervention trial. Six outcome instruments were used at baseline and after the artificial high concentration CO2 water foot bath: the modified Ashworth scale (MAS) score for the gastrocnemius muscles as a measure of spasticity, ankle clonus, muscle stiffness at triceps muscle of calf, deep body and surface skin temperature as a monitor for physical condition, the active range of motion as an assessment tool for motor function, and the 10-m walk test as a measure of walking ability. Lower-extremity movement acceleration was also measured using an accelerometer. The subject rested in a chair for 10 min and the above-noted physiological reactions during the last 5 min of the resting period were recorded as baseline values. Next, the subject received a 20-min foot bath in water at 38 °C, with a 10-min recovery period. The artificial high concentration CO2 water foot bath improved the acceleration of the spastic lower extremities and this improvement in acceleration lasted for 10 min after the footbath usage. Results: The subject experienced no discomfort before, during or after the intervention, and all assessments were completed safely. The deep body temperature and skin temperature increased immediately after and 10 minutes after the artificial high concentration CO2 water foot baths. The MAS score, ankle clonus and the muscle stiffness for the triceps muscle of calf were decreased. The active range of motion for ankle dorsiflexion and gait speed improved after the 20-min intervention. Conclusion: These findings suggest that artificial high concentration CO2 water foot bath is an effective method for controlling spasticity, and improves motor function and walking ability in spastic paraplegia patients.
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Objectives: The warm-water foot bathing is widely used as a clinical method for hemiplegic limb. Recent research have reported that the artificial high concentration carbon-dioxide (CO2) water foot bathing have a potent vasodilative action. However, the definite effects of the artificial high concentration CO2 water foot bath for hemiplegic limbs remain uncertain. We examined that the effects of the artificial high concentration CO2 water foot bath for patients after stroke. Patients: Three inpatients after stroke were recruited for this study. The age and duration after onset were 58.3 ± 21.4 years and 63.0 ± 38.9 months, respectively. Of the three patients (two males and one female), two were diagnosed with cerebral hemorrhage, one with cerebral infarction. Methods: The artificial high concentration CO2 water foot bath and tap water foot bath were prepared. The concentration of CO2 water foot bath was approximately 1000-1,200 ppm, and both lower limbs (under the knee joint) were immersed in 38 °C water for 20 minutes. Foot bathing in tap water was also carried out under the same conditions in the another day. The following physiological data were measured before foot bathing and after the end of foot bathing. Not only the deep body temperature at axillary, the surface skin temperature at the front of femur, the calf of the leg and the dorsal foot, but also the muscle stiffness at triceps muscle of calf were evaluated. Results: None of the subjects experienced discomfort before and after both the high concentration CO2 water and the tap water foot bath. The physiological examination was completed safely in all subjects. The results were as follows: The deep body temperature and the surface skin temperature had increased, and the muscle stiffness had been relieved in the high concentration CO2 water foot bath compared with the tap water bathing. The deep body temperature of the high concentration CO2 water foot bath have risen from 36.4 °C to 36.9 °C, the surface-skin temperature of the front of femur (from 26.7 °C to 28.1 °C), the calf of the leg (from 29.5 °C to 31.9 °C) and the dorsal foot (from 29.9 °C to 32.3 °C) have risen, respectively. The muscle stiffness have been relieved from 55.3 to 51.8 before and after. There was no change that the tap water had increased in the deep body temperature and the surface-skin temperature, and the muscle stiffness had been relieved before and after. Conclusion: These results suggested that the use of the high concentration CO2 water foot bath was more effective in hyperthermia compared with the tap water. Furthermore, we considered that carbon dioxide had promoted to increase the skin and the muscle blood flow by vasodilative action to the arteriole, and use of the high concentration CO2 water foot bath contribute to improve the circulatory dynamics for the hemiplegic limb. These findings may suggest that the use of the high concentration CO2 water foot bath is an effective physiotherapy for circulatory dynamics treatment that might facilitate stroke rehabilitation
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The impairment of vasodilatory function is common symptom in elderly especially among those who have arteriosclerosis and diabetic merits. In the 19th-century Europe, CO2-enriched water had been used as naturopathy for hypertensions, exclusively. In 1997 Japan, the CO2-enriched water could be adopted as a clinical application, since the device was developed to produce artificial CO2-water easier. Thereafter, artificial CO2-water had been comparable effect of natural CO2-hot spring water in experimental animal models (Hashimoto, 1999), and the efficacy has been studied in various disease states of human. In the therapy of peripheral arterial disease (PAD), several reports demonstrated the effects for intermittent claudication including the improved hemodynamic status of immersion part (Hartmann et al, 1997). Based on these findings, we focused on microcirculatory effects of topical application of artificial CO2-enriched water, and studied clinical efficacy in patients with PAD especially critical limb ischemia (CLI). Initially, we showed that immersion of feet in artificial CO2-water (CO2 immersion) increased the blood flow of feet much higher than the plain water even in the patients with CLI, and it improved the limb preservation rate in patients without indication of revascularization (Toriyama et al, 2002). Furthermore, we clarified that CO2 immersion accelerated wound healing after lower extremities bypass surgery in CLI patients with ulcer/gangrene as an adjuvant therapy (Hayashi et al, 2008). We summarize the clinical studies for artificial CO2-water foot bathing in PAD, and clarify the therapeutic usefulness of CO2 immersion in CLI patients.
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Objectives: Spasticity is defined as a pathological increase in muscle tonus, and increased muscle tonus of lower limbs is a major obstacle to the stroke rehabilitation. Foot baths are considered to provide beneficial thermal therapy for post-stroke patients with spasticity, but their anti-spastic effects have not been investigated comprehensively. The present study aimed to evaluate alterations in spasticity and motor function using foot baths in post-stroke patients with spastic hemiplegia. Methods: We underwent two separate experiments each consisting of immersion in warm water up to the knee joint level, and measuring spasticity, physiological examination and motor function. Experiment 1; Fourteen post-stroke patients with lower limb spasticity were enrolled in this study (nine males and five females; mean age 50.4±12.9 years; range, 28-65 years). The subjects’ legs from below the knee joint were immersed in water at 41°C for 15 min. Measurements of F-waves and a physiological examination were carried out immediately (within 5 min) after the foot-bath session, and again 30 min later, while the subject remained wrapped in blankets on the lift-bath stretcher. Experiment 2; Six post-stroke patients with lower limb spasticity were enrolled in this study (five males and one female; mean age 55.2±14.6 years; range, 39-68 years). The subjects’ legs from below the knee joint were immersed in the artificial high concentration carbon-dioxide (CO2) water or tap water foot bath at 38°C for 30 min. Measurements of muscle stiffness, motor function (active range of motion: A-ROM) and a physiological examination were carried out immediately (within 5 min) after the foot-bath session, and again 10 min later, while the subject remained wrapped in blankets. Results: None of the subjects experienced discomfort before, during or after the foot-bath treatment. The physiological examination was completed safely in all subjects. Experiment 1; The mean values of F-wave parameters were significantly reduced after foot-bath treatment (P<0.01). The anti-spastic effects of foot-bath treatment were indicated by decreased F-wave parameters, in parallel with decreases in modified Ashworth scale (MAS) score. The body temperature was significantly increased both immediately after, and 30 min following foot-bath treatment. Experiment 2; The changes both in the body and surface skin temperature were higher in the artificial high concentration CO2 water foot bath compared with the tap water foot bath. The changes in the MAS score, muscle stiffness and A-ROM were also higher in the high concentration CO2 water foot bath than in the tap water foot bath. Conclusion: These findings demonstrate that the use of foot baths is an effective non-pharmacological anti-spastic treatment that might facilitate stroke rehabilitation. In addition, the high concentration CO2 water foot baths appeared to play an important role in decreased spasticity.
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<b>Objectives: </b>Recently, it has been reported that the effects of artificial high concentration carbon-dioxide (CO<sub>2</sub>) on core temperature, cutaneous blood flow, thermal sensation. However, the effect of artificial high concentration CO<sub>2</sub> water foot baths for spasticity, lower extremity motor function and walking ability was not identified. The purpose of this study was to investigate whether the newly artificial high concentration CO<sub>2</sub> water foot bath inhibits spasticity and improves lower extremity motor function and gait speed in spastic paraplegia patient.<BR><b>Case Presentation: </b>The patient was a 37 years old man with spastic paraplegia of human immunodeficiency virus encephalopathy, without signs of cognitive impairment. The patient was able to walk without assistance using a T-cane or an ankle-foot orthosis. He had no medical condition that limited footbath usage (such as uncontrolled cardiopulmonary disease, severe joint disability and severe sensory disturbance), severe aphasia that made it impossible to follow verbal instructions, and cognitive dysfunction that interfered with outcome assessments. Informed consent was obtained from him according to the ethical guidelines of the hospital, after he fully understood the purpose and methodology of the study. This work was carried out with permission from the Ethical Committee of Kagoshima University.<BR><b>Methods: </b>This case study was before and after intervention trial. Six outcome instruments were used at baseline and after the artificial high concentration CO<sub>2</sub> water foot bath: the modified Ashworth scale (MAS) score for the gastrocnemius muscles as a measure of spasticity, ankle clonus, muscle stiffness at triceps muscle of calf, deep body and surface skin temperature as a monitor for physical condition, the active range of motion as an assessment tool for motor function, and the 10-m walk test as a measure of walking ability. Lower-extremity movement acceleration was also measured using an accelerometer. The subject rested in a chair for 10 min and the above-noted physiological reactions during the last 5 min of the resting period were recorded as baseline values. Next, the subject received a 20-min foot bath in water at 38 °C, with a 10-min recovery period. The artificial high concentration CO<sub>2</sub> water foot bath improved the acceleration of the spastic lower extremities and this improvement in acceleration lasted for 10 min after the footbath usage.<BR><b>Results: </b>The subject experienced no discomfort before, during or after the intervention, and all assessments were completed safely. The deep body temperature and skin temperature increased immediately after and 10 minutes after the artificial high concentration CO<sub>2</sub> water foot baths. The MAS score, ankle clonus and the muscle stiffness for the triceps muscle of calf were decreased. The active range of motion for ankle dorsiflexion and gait speed improved after the 20-min intervention.<BR><b>Conclusion: </b>These findings suggest that artificial high concentration CO<sub>2</sub> water foot bath is an effective method for controlling spasticity, and improves motor function and walking ability in spastic paraplegia patients.
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<b>Objectives:</b> The warm-water foot bathing is widely used as a clinical method for hemiplegic limb. Recent research have reported that the artificial high concentration carbon-dioxide (CO<sub>2</sub>) water foot bathing have a potent vasodilative action. However, the definite effects of the artificial high concentration CO<sub>2</sub> water foot bath for hemiplegic limbs remain uncertain. We examined that the effects of the artificial high concentration CO<sub>2</sub> water foot bath for patients after stroke. <BR><b>Patients: </b>Three inpatients after stroke were recruited for this study. The age and duration after onset were 58.3 ± 21.4 years and 63.0 ± 38.9 months, respectively. Of the three patients (two males and one female), two were diagnosed with cerebral hemorrhage, one with cerebral infarction. <BR><b>Methods: </b>The artificial high concentration CO<sub>2</sub> water foot bath and tap water foot bath were prepared. The concentration of CO<sub>2</sub> water foot bath was approximately 1000-1,200 ppm, and both lower limbs (under the knee joint) were immersed in 38 °C water for 20 minutes. Foot bathing in tap water was also carried out under the same conditions in the another day. The following physiological data were measured before foot bathing and after the end of foot bathing. Not only the deep body temperature at axillary, the surface skin temperature at the front of femur, the calf of the leg and the dorsal foot, but also the muscle stiffness at triceps muscle of calf were evaluated. <BR><b>Results: </b>None of the subjects experienced discomfort before and after both the high concentration CO<sub>2</sub> water and the tap water foot bath. The physiological examination was completed safely in all subjects. The results were as follows: The deep body temperature and the surface skin temperature had increased, and the muscle stiffness had been relieved in the high concentration CO<sub>2</sub> water foot bath compared with the tap water bathing. The deep body temperature of the high concentration CO<sub>2</sub> water foot bath have risen from 36.4 °C to 36.9 °C, the surface-skin temperature of the front of femur (from 26.7 °C to 28.1 °C), the calf of the leg (from 29.5 °C to 31.9 °C) and the dorsal foot (from 29.9 °C to 32.3 °C) have risen, respectively. The muscle stiffness have been relieved from 55.3 to 51.8 before and after. There was no change that the tap water had increased in the deep body temperature and the surface-skin temperature, and the muscle stiffness had been relieved before and after. <BR><b>Conclusion:</b> These results suggested that the use of the high concentration CO<sub>2</sub> water foot bath was more effective in hyperthermia compared with the tap water. Furthermore, we considered that carbon dioxide had promoted to increase the skin and the muscle blood flow by vasodilative action to the arteriole, and use of the high concentration CO<sub>2</sub> water foot bath contribute to improve the circulatory dynamics for the hemiplegic limb. These findings may suggest that the use of the high concentration CO<sub>2</sub> water foot bath is an effective physiotherapy for circulatory dynamics treatment that might facilitate stroke rehabilitation
ABSTRACT
The impairment of vasodilatory function is common symptom in elderly especially among those who have arteriosclerosis and diabetic merits. In the 19th-century Europe, CO<sub>2</sub>-enriched water had been used as naturopathy for hypertensions, exclusively. In 1997 Japan, the CO<sub>2</sub>-enriched water could be adopted as a clinical application, since the device was developed to produce artificial CO<sub>2</sub>-water easier. <BR> Thereafter, artificial CO<sub>2</sub>-water had been comparable effect of natural CO<sub>2</sub>-hot spring water in experimental animal models (Hashimoto, 1999), and the efficacy has been studied in various disease states of human. In the therapy of peripheral arterial disease (PAD), several reports demonstrated the effects for intermittent claudication including the improved hemodynamic status of immersion part (Hartmann et al, 1997).<BR> Based on these findings, we focused on microcirculatory effects of topical application of artificial CO<sub>2</sub>-enriched water, and studied clinical efficacy in patients with PAD especially critical limb ischemia (CLI). Initially, we showed that immersion of feet in artificial CO<sub>2</sub>-water (CO<sub>2</sub> immersion) increased the blood flow of feet much higher than the plain water even in the patients with CLI, and it improved the limb preservation rate in patients without indication of revascularization (Toriyama et al, 2002). Furthermore, we clarified that CO<sub>2</sub> immersion accelerated wound healing after lower extremities bypass surgery in CLI patients with ulcer/gangrene as an adjuvant therapy (Hayashi et al, 2008). <BR> We summarize the clinical studies for artificial CO<sub>2</sub>-water foot bathing in PAD, and clarify the therapeutic usefulness of CO<sub>2</sub> immersion in CLI patients.
ABSTRACT
<b>Objectives:</b> Spasticity is defined as a pathological increase in muscle tonus, and increased muscle tonus of lower limbs is a major obstacle to the stroke rehabilitation. Foot baths are considered to provide beneficial thermal therapy for post-stroke patients with spasticity, but their anti-spastic effects have not been investigated comprehensively. The present study aimed to evaluate alterations in spasticity and motor function using foot baths in post-stroke patients with spastic hemiplegia. <BR><b>Methods:</b> We underwent two separate experiments each consisting of immersion in warm water up to the knee joint level, and measuring spasticity, physiological examination and motor function. <BR><b>Experiment 1;</b> Fourteen post-stroke patients with lower limb spasticity were enrolled in this study (nine males and five females; mean age 50.4±12.9 years; range, 28-65 years). The subjects’ legs from below the knee joint were immersed in water at 41°C for 15 min. Measurements of F-waves and a physiological examination were carried out immediately (within 5 min) after the foot-bath session, and again 30 min later, while the subject remained wrapped in blankets on the lift-bath stretcher. <BR><b>Experiment 2;</b> Six post-stroke patients with lower limb spasticity were enrolled in this study (five males and one female; mean age 55.2±14.6 years; range, 39-68 years). The subjects’ legs from below the knee joint were immersed in the artificial high concentration carbon-dioxide (CO<sub>2</sub>) water or tap water foot bath at 38°C for 30 min. Measurements of muscle stiffness, motor function (active range of motion: A-ROM) and a physiological examination were carried out immediately (within 5 min) after the foot-bath session, and again 10 min later, while the subject remained wrapped in blankets. <BR><b>Results: </b>None of the subjects experienced discomfort before, during or after the foot-bath treatment. The physiological examination was completed safely in all subjects. <BR><b>Experiment 1; </b>The mean values of F-wave parameters were significantly reduced after foot-bath treatment (P<0.01). The anti-spastic effects of foot-bath treatment were indicated by decreased F-wave parameters, in parallel with decreases in modified Ashworth scale (MAS) score. The body temperature was significantly increased both immediately after, and 30 min following foot-bath treatment. <BR><b>Experiment 2;</b> The changes both in the body and surface skin temperature were higher in the artificial high concentration CO<sub>2</sub> water foot bath compared with the tap water foot bath. The changes in the MAS score, muscle stiffness and A-ROM were also higher in the high concentration CO<sub>2</sub> water foot bath than in the tap water foot bath. <BR><b>Conclusion:</b> These findings demonstrate that the use of foot baths is an effective non-pharmacological anti-spastic treatment that might facilitate stroke rehabilitation. In addition, the high concentration CO<sub>2</sub> water foot baths appeared to play an important role in decreased spasticity.
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ObjectiveTo investigate the influence of foot bath with traditional Chinese medicine on physical recovery of patients after cesarean section,in order to prevent postoperative complications. Methods180 cases of parturients after cesarean section were divided into the control group and the experimental group with 90 cases in each group according to ward number and bed number.The experimental group began foot bath 6 hours postoperation,and in the next 3 to 5 days,took foot bath at 7:00 to 8:00 and 21:00 to 22:00 every day,20 minutes per time.The control group only received routine nursing.The anus exhaust time and independent ambulation time were observed. ResultsThe anal exhaust time for the first time,independent ambulation time of the experimental group was earlier than the control group. ConclusionsFoot bath with traditional Chinese medicine can promote gastrointestinal function recovery and early ambulation,improve appetite and sleep quality,reduce postoperative complication and promote physical recovery after surgery.