Association between habitual hot spring bathing and depression in Japanese older adults: A retrospective study in Beppu.

OBJECTIVES: Thermal therapy is used to manage various psychological diseases, such as depression. We investigated the relationship between hot spring bathing and depression in older adults using questionnaire responses. DESIGN AND SETTING: We comprehensively evaluated the preventive effects of long-term hot spring bathing in 10429 adults aged ≥ 65 years in Beppu, Japan, by conducting a questionnaire study on the prevalence of depression (n = 219). MAIN OUTCOME MEASURES: Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a multivariable logistic regression model for history of depression. RESULTS: A separate multivariable logistic regression model for inference showed that female sex (OR, 1.56; 95 % CI, 1.17-2.08; p = 0.002), arrhythmia (OR, 1.73; 95 % CI, 1.18-2.52; p = 0.004), hyperlipidemia (OR, 1.63; 95 % CI, 1.14-2.32; p = 0.006), renal disease (OR, 2.26; 95 % CI, 1.36-3.75; p = 0.001), collagen disease (OR, 2.72; 95 % CI, 1.48-5.02; p = 0.001), allergy (OR, 1.97; 95 % CI, 1.27-3.04; p = 0.002), and habitual daily hot spring bathing (OR, 0.63; 95 % CI, 0.41-0.94; p = 0.027) were independently significantly associated with a history of depression. CONCLUSIONS: We found an inverse relationship between habitual daily hot spring bathing and history of depression. Prospective randomized controlled trials on habitual daily hot spring bathing as a treatment for depression are warranted to investigate whether the use of hot springs can provide relief to those with psychiatric and mental health disorders.

Night-Time Hot Spring Bathing Is Associated with a Lower Systolic Blood Pressure among Japanese Older Adults: A Single-Institution Retrospective Cohort Study.

Hot spring bathing is practiced to help manage hypertension. We retrospectively investigated the effects of hot spring bathing on hypertension with the aim of identifying a novel approach to prevent and manage hypertension. The study cohort comprised 99 patients aged ≥65 years admitted to Kyushu University Beppu Hospital between 1 December 2021 and 30 November 2022 who could walk by themselves and who used hot springs for ≥3 days during their hospital stay. The changes in both systolic and diastolic blood pressure were significantly decreased in the night-time bathing group (n = 21) compared with the noontime (n = 26) and afternoon (n = 52) groups. Night-time hot spring bathing was significantly associated with reduced systolic blood pressure the next morning in older adults. Although prospective randomized controlled trials on night-time hot spring bathing as a hypertension treatment are warranted to investigate whether the practice can prevent hypertension among adults aged ≥65 years, we have initiated a single-center, phase II study on the relationship between sleep quality and quality of life in hypertensive patients after night-time hot spring bathing.

Hot spring bathing accelerates wound healing and enhances heat retention effect in guinea pigs.

This study aimed to demonstrate the effects of hot springs on wound healing and heat retention by performing comparative experiments with tap water. The hot spring water used in this study was from an alkaline hot spring that was rich in sodium and chloride ions and exhibited high reducibility. Guinea pigs were divided into a hot spring bathing group and a tap water bathing group, and a bathing test was conducted for eight consecutive days. A comparison of the plasma amino acid composition between the two groups after the bathing test revealed differences in the concentrations of several amino acids associated with wound healing. Image analysis demonstrated that wounds made on the abdominal skin of guinea pigs were significantly contracted by hot spring bathing compared to that by tap water bathing, and histopathological findings showed that wound healing was accelerated. In the thermography test, changes in body surface temperature after bathing were investigated in both groups. The heat retention effect was not observed in the tap water bathing group after bathing, whereas it was enhanced in the hot spring bathing group until 30 min after bathing. In conclusion, this study demonstrated that hot spring bathing accelerates wound healing and has a more significant heat retention effect than tap water bathing.

Prevalence of osteoarthrosis and its association with hot spring bathing among local adults in typical hot spring areas of Guizhou Province / 上海预防医学

Objective To investigate the prevalence of osteoarthrosis and the association between hot spring bathing and osteoarthrosis among local adults in typical hot spring areas of Guizhou Province. Methods A face-to-face questionnaire survey was conducted among residents aged from 30 to 65 in five typical hot spring areas, including Xifeng(Xifeng County, Guiyang), Jianhe(Jianhe County, Qiandongnan), Fodingshan(Shiqian County, Tongren), Guiyu(Wudang District, Guiyang)and Huishangu(Suiyang County, Zunyi). Residents' basic information, bone and joint diseases prevalence, hot spring bathing, and other health-related behaviors were investigated in this study. The prevalence of local bone and joint diseases was analyzed, and binary logistic regression was used to calculate OR(95%CI)to analyze the association between hot spring bathing and bone and joint diseases. Results A total of 3 708 adults(1 648 males and 2 060 females)were included as the statistical analysis survey subjects, and 794 people reported bone and joint diseases, accounting for a prevalence rate of 21.41%, 95% CI: 0.201-0.227. The prevalence of females(24.56%)was higher than that of males(17.48%)(P < 0.001). The prevalence rates of diseases increased with age(χtrend2=130.265, P < 0.001). There were also statistically significant differences in the prevalence rate of bone and joint diseases among different genders, age groups, occupations, education levels, and smoking behaviors(P < 0.05). After gender, age, occupation, education and smoking were adjusted for, compared with the group who never took hot spring baths, participants who took hot spring baths occasionally(OR=0.793, 95%CI: 0.631-0.996)and frequently(OR=0.713, 95%CI: 0.536-0.948)were associated with a lower risk of bone and joint diseases. Conclusion The prevalence of osteoarthrosis is 21.41% in the typical hot spring areas of Guizhou Province. Older or females have a higher risk of prevalence of bone and joint diseases. Hot spring bathing may be associated with a lower risk of bone and joint diseases.

Association between hot spring bathing behavior and hypertension and the mediating effect of sleep quality problems in typical hot spring areas of Guizhou Province / 上海预防医学

Objective To investigate the association between hot spring bathing behavior and hypertension and understand the mediation effect of sleep quality problems on the association. Methods A cross-sectional survey was conducted among adults aged 30 to 65 living and working around five hot springs in Guizhou Province, employing a self-designed questionnaire on the health status and hot spring bathing, and 3 708 qualified questionnaires were collected. Participants were divided into three groups according to their frequency of hot spring bathing: never, occasionally, and frequently. Stratified via sex and sleep quality, the binary logistic regression model was used to analyze the association between different hot spring bathing frequencies and self-reported hypertension. Results Significant difference was detected in the self-reported hypertension between groups who never bathe(13.7%), who occasional bathe(9.4%)and who frequently bathe(8.5%)among female participants(χ2=10.460, P=0.005). However, no significant difference was found among different bathing groups in males. Furthermore, multivariate analysis showed that compared with no bathing, occasional(OR=0.692)and frequent (OR=0.594)hot spring bathing were associated with lower hypertension prevalence among female population, and female groups of occasional and frequent bathing with sleep quality problems had smaller OR(OR=0.571 and 0.406, respectively). After sleep quality problems were included, hot spring bathing was still associated with lower hypertension risk, and the OR values of occasional bathing and frequent bathing groups were 0.723 and 0.611, respectively. The sleep quality problems of female population played a partial mediating role in the association between hot spring bathing and hypertension, and the relative mediating effects of occasional bathing and frequent bathing with hypertension were both statistically significant(Zm=-2.022 and -1.995, P < 0.05), which accounted for 34.34% and 30.15% of the total effects, respectively. Conclusion Regular hot spring bathing may play an auxiliary role in the prevention of hypertension, and it may provide a stronger protection for women, and especially those with sleep quality problems. Sleep quality problems may explain part of the association between hot spring bathing and hypertension in female population.

Intervention effects of hot spring bathing on blood pressure, resting heart rate, cardiovascular function indicators and physical signs in population with high-normal blood pressure / 上海预防医学

Objective To investigate the effects of hot spring baths on blood pressure, resting heart rate, cardiovascular function related indicators and physical signs in population with high-normal blood pressure. Methods Residents of typical hot spring areas in Guizhou Province were included as the subjects. According to the epidemiological survey of the research group and the physical examination results before the intervention, combined with the inclusion and exclusion criteria, a total of 217 people with high normal blood pressure were selected as the observation subjects. The intervention of hot spring baths was carried out for four weeks, once time per day, 5 times per week, for 40-50 minutes each time. After the intervention, the blood pressure, resting heart rate and serum levels of creatine kinase(CK), lactate dehydrogenase(LDH), and α-hydroxybutyrate dehydrogenase(α-HBDH)were detected, and the improvement of cardiovascular related signs(palpitation, dizziness/headache, cough/sputum and night sweats)were clinically examined. SPSS 23.0 software was used for statistical analysis. Results Paired t-test results showed that the systolic blood pressure, diastolic blood pressure and resting heart rate of 217 high normal blood pressure subjects were significantly lower after hot spring baths(P < 0.01). Further analysis revealed that the number of people with high normal blood pressure dropped from 217 to 128 after the hot spring baths. Before the intervention, 95 of the 217 people with high-normal blood pressure had resting heart rates between 80 and 90 beats/min, and 35 of them above 90 beats/min. After the intervention, the resting heart rates of those above people decreased to 68 and 14, respectively. Serum levels of cardiovascular related indicators showed that CK, LDH, and α-HBDH levels in people with high-normal blood pressure decreased to some extent after the intervention, and CK level was significantly lower than that before the intervention(P < 0.05). The results of clinical examination showed that hot spring baths had a significant improvement effect on palpitation, dizziness/headache, cough/expectoration, and night sweats in people with high-normal blood pressure. Conclusion The typical hot spring baths in Guizhou Province can reduce the blood pressure and resting heart rate in population with high-normal blood pressure, and improve the cardiovascular function related indicators and physical signs to a certain extent.

Study of hot spring bathing and chronic disease prevalence among residents between 30 and 65 in typical hot spring areas of Guizhou Province / 上海预防医学

Objective To investigate hot spring bathing behavior and chronic disease prevalence of residents aged 30 to 65 in typical hot spring areas of Guizhou Province. Methods Totally 3 708 individuals between 30 and 65 in five typical hot spring areas of Guizhou Province were included in this study. Their hot spring bathing behavior and chronic disease prevalence were recorded. Unconditional logistic regression was used to analyze the association between hot spring bathing and the incidence of chronic diseases. Results 71.3% of the residents in the hot spring areas had bathed in hot springs, with the proportion higher in males than females(χ2=92.856, P < 0.001). 76.3% of people took hot spring baths fewer than or equal to 6 times per year, 30.8% of residents often chose to take hot spring baths in the evening, and 37.6% of the residents took hot spring baths for 21-40 minutes. Bathing was more common in winter. 11.5% and 17.9% of the residents added other substances and used hot spring facilities, and most of them added traditional Chinese medicine and used the sauna. 46.6% and 41.6 % of the residents took hot spring baths to relax and relieve fatigue. The self-reported prevalence rate of chronic diseases was 522.1‰, and the top five single diseases were lumbar intervertebral disc disease(119.7‰), hypertension(118.1‰), urinary calculus(77.7‰), cervical intervertebral disc disease(53.7‰)and osteogenesis(44.5‰). Compared with those who never bathed in hot springs, taking hot spring baths 7-11 times a year was negatively correlated with chronic diseases.(OR=0.551, 95%CI: 0.345-0.879). Conclusion Hot spring bathing is popular in typical hot spring areas of Guizhou Province, but its frequency is not high. The overall prevalence of chronic diseases is relatively high, and the order of most prevalent chronic diseases is different from that in other areas. Proper hot spring bathing is negatively correlated with chronic diseases.

My Research on Balneology, Sauna, Exercise and Rehabilitation Medicine / 日本温泉気候物理医学会雑誌

  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.<BR>  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.<BR>  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-autonomicmechanism. Scarlet coloring of venous blood due to increased pO₂ and decreased pCO₂ highly suggested improved tissue oxygenation as the basic bathing effects.<BR>  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.<BR>  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.<BR>  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.<BR>  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.

My Research on Balneology, Sauna, Exercise and Rehabilitation Medicine / 日本温泉気候物理医学会雑誌

  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.

13-3The questionnaire about the hot spring use and the anamnesis for Beppu residents aged 65 and over / 日本温泉気候物理医学会雑誌

<b>Objective: </b>It has been believed that hot spring bathing has therapeutic effect for certain life style-associated diseases. In addition, medical preventive effect of hot spring bathing to diseases has not been well known. In order to investigate preventive effect for life style associated diseases, we performed an epidemiological study about the relationship between personal habits of hot spring bathing and past history of diseases of aged population over 64 years old in Beppu city, which has the most hot spring fountainheads in the world. Beppu city also bear 10 kinds of spa of all except radioactivity hot spring. <BR><b>Materials and Methods: </b>There are about 35,000 Beppu citizens over 64 years old. We sent the questionnaires to randomly chosen 20,000 people among them, asking the personal history of hot-spring-bathing and disease-history in Nov 2012. We received 11,146 replies filled in Jan 2013. <BR><b>Results: </b>We received filled-out questionnaires from 4,706 men and 6,352 women. Forty-eight percent of the replying participants take a hot spring bath daily. The age distribution of the respondents was comparable admittably to that of all Beppu citizens registered over 64 years old. Age adjusted, hot spring user showed less rate of some diseases. The results showed that daily hot spring bathing was associated with past history of less diseases of some, such as ischemic heart disease, apoplexy, hypertension, bronchial asthma, diabetes mellitus, chronic renal disease, and depression. As for this tendency, the difference was seen among men and women (Figure 1). Moreover, the medical effect of the hot spring had the higher one where a hot spring use period is longer.<BR><b>Conclusion:</b> This observation suggests that daily hot spring bathing contributes to lessen the susceptibility of some of life style associated diseases.

13-5Balneotherapy and rehabilitation: differences, similarities and synergies / 日本温泉気候物理医学会雑誌

  Balneotherapy is defined as a group of treatment modalities using natural remedies. The term also is used to describe complex multimodal interventions for the prevention, treatment and rehabilitation of (chronic) health conditions. The use of the term rehabilitation also is dual: on one hand it is used for a health strategy to overcome disability and to improve functioning. On the other hand it is defined as a set of measures used in multidisciplinary teams. Thus, the definitions of balneotherapy and rehabilitation are different but have some overlap too. It needs to be discussed, how balneotherpy can be used for rehabilitation of chronic health conditions and what the evidence of the added value is. Secondly, the tradition of comprehensive treatments in health resorts should be analysed using the criteria of rehabilitation measures and also here the added value must be demonstrated.

13-5 Balneotherapy and rehabilitation: differences, similarities and synergies / 日本温泉気候物理医学会雑誌

  Balneotherapy is defined as a group of treatment modalities using natural remedies. The term also is used to describe complex multimodal interventions for the prevention, treatment and rehabilitation of (chronic) health conditions. The use of the term rehabilitation also is dual: on one hand it is used for a health strategy to overcome disability and to improve functioning. On the other hand it is defined as a set of measures used in multidisciplinary teams. Thus, the definitions of balneotherapy and rehabilitation are different but have some overlap too. It needs to be discussed, how balneotherpy can be used for rehabilitation of chronic health conditions and what the evidence of the added value is. Secondly, the tradition of comprehensive treatments in health resorts should be analysed using the criteria of rehabilitation measures and also here the added value must be demonstrated.

13-3 The questionnaire about the hot spring use and the anamnesis for Beppu residents aged 65 and over / 日本温泉気候物理医学会雑誌

Objective: It has been believed that hot spring bathing has therapeutic effect for certain life style-associated diseases. In addition, medical preventive effect of hot spring bathing to diseases has not been well known. In order to investigate preventive effect for life style associated diseases, we performed an epidemiological study about the relationship between personal habits of hot spring bathing and past history of diseases of aged population over 64 years old in Beppu city, which has the most hot spring fountainheads in the world. Beppu city also bear 10 kinds of spa of all except radioactivity hot spring. Materials and Methods: There are about 35,000 Beppu citizens over 64 years old. We sent the questionnaires to randomly chosen 20,000 people among them, asking the personal history of hot-spring-bathing and disease-history in Nov 2012. We received 11,146 replies filled in Jan 2013. Results: We received filled-out questionnaires from 4,706 men and 6,352 women. Forty-eight percent of the replying participants take a hot spring bath daily. The age distribution of the respondents was comparable admittably to that of all Beppu citizens registered over 64 years old. Age adjusted, hot spring user showed less rate of some diseases. The results showed that daily hot spring bathing was associated with past history of less diseases of some, such as ischemic heart disease, apoplexy, hypertension, bronchial asthma, diabetes mellitus, chronic renal disease, and depression. As for this tendency, the difference was seen among men and women (Figure 1). Moreover, the medical effect of the hot spring had the higher one where a hot spring use period is longer. Conclusion: This observation suggests that daily hot spring bathing contributes to lessen the susceptibility of some of life style associated diseases.

Effects of Hot Spring Bathing on Nasal Obstruction —Investigation using rhinomanometry— / 日本温泉気候物理医学会雑誌

<B>Background:</B> Nasal obstruction is an annoying condition. In this study, we evaluated the effects of hot spring bathing at 41 to 42°C using a rhinomanometer.<br><B>Methods:</B> Ten healthy adult volunteers (10 men, mean age of 27.8±4.4 years) were asked to bathe in a hot spring for 10 minutes. Using a rhinomanometer (HI-801), nasal resistance was measured before and after bathing by active anterior rhinomanometry. Total nasal resistance was calculated using Ohm’s law formula with right and left nasal resistance values (1/T=1/R+1/L, T: bilateral resistance, R: right resistance, L: left resistance). Resistance at ΔP=100 Pa was used for evaluation.<br><B>Results:</B> Right and left nasal resistance values were significantly decreased after bathing in subjects with a pre-bathing nasal resistance of greater than 0.75 Pa/cm<SUP>3</SUP>/s (inspiratory, <I>P</I>=0.0117; expiratory, <I>P</I>=0.0277; Wilcoxon <I>t</I>-test). No significant change was observed in subjects with a pre-bathing nasal resistance of below 0.75 Pa/cm<SUP>3</SUP>/s.Post-bathing total nasal resistance was significantly decreased in subjects with a pre-bathing nasal resistance of greater than 0.5 Pa/cm<SUP>3</SUP>/s (<I>P</I>=0.0115; Wilcoxon <I>t</I>-test).<br><B>Conclusion:</B> This study showed that nasal obstruction can be improved by hot spring bathing, which may contribute to the reasons why cold symptoms are relieved by hot spring bathing.

Effects of Hot Spring Bathing on Nasal Obstruction —Investigation using rhinomanometry— / 日本温泉気候物理医学会雑誌

Background: Nasal obstruction is an annoying condition. In this study, we evaluated the effects of hot spring bathing at 41 to 42°C using a rhinomanometer. Methods: Ten healthy adult volunteers (10 men, mean age of 27.8±4.4 years) were asked to bathe in a hot spring for 10 minutes. Using a rhinomanometer (HI-801), nasal resistance was measured before and after bathing by active anterior rhinomanometry. Total nasal resistance was calculated using Ohm’s law formula with right and left nasal resistance values (1/T=1/R+1/L, T: bilateral resistance, R: right resistance, L: left resistance). Resistance at ΔP=100 Pa was used for evaluation. Results: Right and left nasal resistance values were significantly decreased after bathing in subjects with a pre-bathing nasal resistance of greater than 0.75 Pa/cm3/s (inspiratory, P=0.0117; expiratory, P=0.0277; Wilcoxon t-test). No significant change was observed in subjects with a pre-bathing nasal resistance of below 0.75 Pa/cm3/s.Post-bathing total nasal resistance was significantly decreased in subjects with a pre-bathing nasal resistance of greater than 0.5 Pa/cm3/s (P=0.0115; Wilcoxon t-test). Conclusion: This study showed that nasal obstruction can be improved by hot spring bathing, which may contribute to the reasons why cold symptoms are relieved by hot spring bathing.

Effects of Hot Spring Bathing on Salivary Secretion and Secretory IgA secretion in Healthy Volunteers / 日本温泉気候物理医学会雑誌

This study examined the effect of hot-spring bathing (40 to 41°C) on salivary secretion and salivary secretory IgA (sIgA) in healthy volunteers. Ten volunteers (10 men, average 33.6±9.3 years old) bathed in a hot-spring for 10 minutes.<br>Saliva samples were collected before bathing, during bathing (from 5 to 7 min), and after bathing using the Saxon test. The saliva flow rates and sIgA concentration were determined and then the sIgA secretion rates were calculated.<br>The saliva flow rates increased significantly during the bathing (p<0.02) and decreased after bathing. The sIgA secretion rates during bathing were significantly higher than those before and after bathing (p<0.02).<br>The increases in saliva flow rates and sIgA secretion rates during bathing were considered to indicate the improvement of local immunity in the oral cavity and thus considered to be useful for preventing upper respiratory tract infections.

Effects of Underwater Exercise with Balneotherapy on Middle Aged People / 日本温泉気候物理医学会雑誌

We investigated the effects of underwater exercise plus hot-spring bathing on middle aged people.<br>Twenty-five subjects (mean age: 59.6±8.9 years) were divided into three groups (A, B, and C) and examined. Group A (three males, seven females) was subjected to underwater exercise and hot-spring bathing. Group B (eight females) was subjected to underwater exercise and fresh water bathing. Group C (seven females) was a control group (no exercise and no bathing).<br>Group A and B performed underwater exercise consisting of underwater walking, basic exercise, and swimming for 70 minutes. Group A was then subjected to hot-spring bathing (sodium bicarbonate spring, PH 8.0, 39°C) for 20min, and while Group B was subjected to fresh-water bathing (30°C).<br>Blood pressure was measured and blood tests were conducted early in the morning on the day of exercise plus bathing and on the following day. Further, Profile of Mood Status (POMS) tests were also conducted on the day following the exercise with bathing and data were compared.<br>The findings were as follows.<br>1) On the day following the exercise plus bathing, group A (underwater exercise plus hot-spring bathing) had significantly lower diastolic blood pressure, total cholesterol, CD4, red blood cells, hematocrit and total protein when compared with values before treatment (p<0.05).<br>2) After the exercise plus bathing, group A (underwater exercise plus hot-spring bathing) had significantly lower levels of depression-dejection, anger-hostility and confusion in POMS tests when compared with those of Group C (control group, no exercise and no bathing) (p<0.05).<br>We concluded that underwater exercise plus hot-spring bathing has good effects on the health of middle aged people.

Clinical Analysis of Platelet Shape Change and Coagulation-Fibrinolytic Markers in Patients with Cerebral Infarction in a Spa Resort / 日本温泉気候物理医学会雑誌

This study investigated the existence of platelet activation before the onset of cerebral infarction, and analyzed the association between the platelet activation and the degree of atherosclerosis. Furthermore, prediction of the risk of cerebral infarction by assessing platelet activation was attempted. Thirteen patients with cerebral infarction, 7 patients with atherosclerosis and 8 healthy subjects were enrolled in this study. Ultrastructural shape change, peroxidase reaction, and fibrinogen content in the platelets were observed and plasma levels of thrombin antithrombin complex, α₂-plasmin inhibitor plasmin complex, β-thromboglobulin and platelet factor-4 were measured in patients with atherosclerosis and cerebral infarction at the acute, subacute and chronic phases. The ultrastructural shape change, peroxidase reaction, and fibrinogen content did not differ among acute, subacute and chronic phases of cerebral infarction. The frequency of platelet shape changes were also increased in patients with atherosclerosis, compared with healthy subjects. Plasma levels of β-thromboglobulin, platelet factor-4, and thrombin antithrombin complex increased only during the acute phase of cerebral infarction. It is suggested that platelet activation occurs before the onset of cerebral infarction and that platelet shape change is associated with the degree of atherosclerosis, or plaque stability. Platelet activation would be derived not from thrombotic event itself but from endothelial damage or pre-existing atherosclerosis. Platelet shape change, therefore, could predict the risk of cerebral infarction. Taken together with our previous reports demonstrating increased blood viscosity, noctural hypotension, increased human atrial natriuretic peptide, decreased fibrinolytic activity, and platelet shape change were observed after very hot hot-spring bathing, cerebral infarction in spa-resort could be caused partly by very hot hot-spring bathing after traveling on a tight schedule and alcohol drinking by elderly patients with atherosclerosis.

Effect of Hot-spring Bathing on the Control Factors of Coagulation / 日本温泉気候物理医学会雑誌

We have investigated change in platelets and the blood coagulation and fibrinolytic systems as a mechanism of the onset of thrombotic diseases during and after hot-spring bathing. In this study, We examined effect of 10min 42°C and 37°C hot-spring bathing on protein C, protein S and antithrombin III in seven healthy male subjects. The mean values of protein C antigen, protein C activity, total and fee protein S antigens, protein S activity and antithrombin III activity were slightly increased by both methods, while these changes were not statistically significant. Taken together with our previous reports, 10min 42°C hot-spring bathing gives no effect on the blood coagulation system.