Various approaches to stroke rehabilitation, such as facilitation techniques including proprioceptive neuromuscural facilitation techniques (PNF), Brunnstrom's approach, and Bobath's approach, have been studied to improve the functional recovery of hemiplegia due to brain damage. However, there is some controversy surrounding these facilitation techniques with regard to their efficacy in stroke rehabilitation. Specifically, there is insufficient evidence that these techniques are superior to conventional exercise therapies.
Recent studies have shown that brain plasticity results in functional recovery in humans. Recovery depends on the plasticity of the synapse, and changes in the strength of a synapse are controlled by a basic mechanism:An increase in synaptic efficacy arises from the repeated stimulation of the postsynaptic cell by the presynaptic cell. The basic theory of repetitive facilitation exercises (RFE) using novel facilitation methods for the hemiplegic limb mainly aim to strengthen the neuronal circuits through the injured descending motor tracts by repetition of the movements that are to be recovered. The patient's intentions to move the hemiplegic limb are realized by using multiple sensory stimulations to target the neural circuits related to each movement. The effects of RFE on the functional recovery of hemiplegic limbs have been confirmed by scientific studies.
Combined therapy using vibratory or electrical stimulation might promote efficacy of RFEs for patients with hemiplegia.

Dry skin causes many skin disorders such as dry dermatitis. It requires a lot of time and medication to treat patients with skin disorder that cover a vast skin area. Although glycerin is a component of many skin care creams and cosmetics, there is no report regarding the effects of glycerin alone as a bathwater additive. We investigated the effects of bathing in warm water with added glycerin on skin conditions and the prevention of skin disorders in patients with severe motor and intellectual disabilities.
Two studies were conducted to analyze the effects of a glycerin+warm water bath (GWWB). In study 1, the skin conditions in a total of 18 subjects were compared between the glycerin group (G) and nonglycerin group (NG). In the G group, skin moisture, skin pH, and skin sebum were measured with a skin analyzer noninvasively at the forehead and precordial and lateral forearm after GWWB for approximately 6 months. Subjects in the 2 groups had bathed 2 times per week and were immersed in warm water at 40 to 41°C for 2 to 3min. In the G group, 250ml glycerin was added in a 14001 bathtub. In study 2, a total of 78 subjects were examined retrospectively; their medical records after GWWB for approximately 6 months were investigated to gain information regarding cutaneous diseases (number of diagnosis, drugs, areas affected with cutaneous diseases, and days of treatment) in order to compare the G and NG groups.
Skin moisture levels at forearm improved significantly (p<0.05) in the G group. The average skin moisture level in other areas was higher in the G group than in the NG group but without sig nificance. Skin sebum levels at the forehead improved significantly (p<0.05) in the G group. The number of diagnosis, drugs, and areas with cutaneous disease were significantly lower in the G group than in the NG group. Further, the average number of treatment days was lower in case of the G group than in case of the NG group but without significance.
The moisturizing effects are produced due to a thin film formed by glycerin after GWWB, especially in an area where there is friction between the skin and clothes. Skin sebum is also maintained due to glycerin-film formation.
It is possible that maintenance of skin moisture protects the skin from cutaneous diseases due to xerosis. In conclusion, these results indicate that GWWB maintains skin moisture and sebum and prevents skin disorders.

The effects of the bathing on renal function were studied in 12 healthy men (32.3±7.7y. o.). The subjects took 41°C, 10min bathing and kept warm by a blanket for 30min, and then a mixture of 10% para-aminohippurate (PAH, 0.3ml/kg) and 10% sodium thiosulfate (NTS, 80ml) was infused intravenously. Clearance of PAH and NTS was calculated as the index of renal plasma flow (RPF) and glomerular filtration rate (GFR). PAH and NTS clearance test was also done at rest without bathing in another day. Blood Pressure (BP), Heart rate (HR), cardiac output (CO), sublingual temperature by electric thermista as deep body temperature were measured during the experiment. 30min after bathing, sublingual temperature was significantly increased by 0.9°C, and CO by +40%. After bathing, renal plasma flow (PAH clearance) significantly increased from 388.5±158.9ml/min to 572±170.7ml/min. Glomerular filtration rate (NTS clearance) was, however, unchanged from 115.6±37.3ml/min to 119.3±51.3ml/min. Filtration fraction (GFR/RPF) was significantly decreased. These results indicated that GFR was not improved by bathing although CO and RPF was increased by thermal vasodilation effect. The mechanism of unchanged GFR, despite of increased RPF, is probably that glomerular filtration pressure unchanged by thermal vasodilation of glomerular efferent and afferent arterioles.

Objective: Warm water immeresion (WWI) has been customary in Japan as useful thermal therapy. However, a comprehensive investigation of the effects of WWI on internal organs has never been undertaken. The purpose of this study was to examine the effects of single WWI on indocyanine green (ICG) excretion in healthy humans. Subjects: 23 healthy males. (32.6±1.9 [mean±SEM] years) Methods: 1CG was administered intravenously (0.5mg/kg) to calculate excretion rate (ER). ICG injection was given before and after WWI (10min at 41°C). Sublingual temperature (ST), blood pressure (BP), heart rate (HR), and cardiac output (CO) were simultaneously measured by noninvasive methods. Results: Significant changes were observed after WWI. These included an increase in ST, HR, and CO and a decrease in systolic BP (p<0.01). ER significantly decreased from 0.210±0.015 to 0.168±0.009 (p<0.01). Front-back ratio of ICG-ER which was calculated in order to evaluate the effect of aging increased significantly with age (R=0.582, p<0.0001). Conclusion: These results indicate that although CO increased due to the vasodilating effects of WWI, hepatic blood flow decreased after WWI and its response reduced with age even in before middle age.