Purpose
 Forearm bathing is considered beneficial for the hands of patients with spastic hemiplegia, but the effect has not been investigated comprehensively. This study investigated the effectiveness of forearm bathing for patients with hemiplegic hands.
Subjects and Methods
 In total, nine hemiplegic patients participated in the study (mean±standard deviation age=56.9±16.6 years; mean±standard deviation period from onset=21.1±21.2 months). Participants sat in a relaxed position on a chair, and dipped the affected forearms into 40°C warm water for 15 mins. The Simple Test for Evaluating Hand Function (STEF) score was evaluated before and after forearm bathing as an indicator of hemiplegic hand function. The Modified Ashworth Scale (MAS) score for the biceps brachii muscle, and both the resistance power of elbow extension and the F/M ratio (F-wave amplitudes/ M wave amplitudes) for the abductor pollicis brevis muscle, were evaluated as indicators of hemiplegic hand spasticity. The device used to measure the resistance power of elbow extension comprised a motor, cuffs to fix the hemiplegic arm and forearm in place, and a control system. The axis of rotation of the device was positioned over the axis of rotation of the elbow joint. The device induced passive elbow flexion and extension movements at an angular velocity of 60°/sec or 90°/sec.
Results
 After forearm bathing, the STEF score increased significantly (p<0.05) from 42.9±28.0 to 47.8±28.4 (n=9), the resistance power of elbow extension at 90°/min decreased significantly (p<0.01) from 4.0±1.8 N to 3.0±1.9 N, and the MAS score and F/M ratio were unchanged (n=6).
Conclusions
 Forearm bathing appeared to improve function and decrease spasticity in hemiplegic hands. This treatment might facilitate hand rehabilitation.

The effect of spa-drink (Misasa hot spring) on exocrine pancreatic function was studied in controls and drink therapy group. To examine exocrine pancreatic function, two different methods were used for determination of pancreatic chymotrypsin activity. One was a colorimetric method for the determination of fecal chymotrypsin activity and the other was PFD fest. Following conclusions were obtained.
1) With spa-drink therapy, fecal chymotrypsin activity was raised in 2 weeks in 40% of patients, while it remained unchanged in the next 2 weeks.
2) With spa-drink therapy, PFD value was raised in 2 weeks in 50% of patients, while it returned to the pre-treatment value in the next 2 weeks.
3) Spa-drink therapy for 2 weeks was effective for improving exocrine pancreatic function.

Objective: Exercise baths are generally considered to be one of the most appropriate and advantageous rehabilitative therapies, yet their effects have not been comprehensively investigated. The aim of this study is to assess the efficacy of exercise baths on quality of life (QOL).
Methods: The 49 subjects consisted of 20 patients with brain disease, 21 patients with orthopaedic disease, and 8 patients with other diseases (i.e., 7 life-style related diseases and one heat burn). In the present study, all patients were first treated by conventional rehabilitation comprising physical therapy and occupational therapy for 4.2±1.4 weeks. Exercise baths were then added to the rehabilitation program for a further 4.4±1.2 weeks. The subjects were immersed in water at 38°C for 30-60min, twice a week. QOL was evaluated by alterations in the MOS Short-Form 36-item Health Survey (SF-36). We defined the period from admission to exercise bath start as Treatment I, and the period from exercise bath start to discharge (exercise bath finish) as Treatment II. On admission, before and after exercise bath, QOL was evaluated using the SF-36 scores.
Results: We found that the increase of all eight subscales of the SF-36 was smaller in Treatment I period than in Treatment II period. Increases in SF-36 scores were observed in all patients, in all eight domains. Specifically, after exercise baths, increased scores of Physical functioning (PF), Role physical (RP), General health (GH), Vitality (VT), Role emotional (RE) and Mental health (MH) subscales of the SF-36 were observed in the patients with brain disease. Further, after exercise baths, increased scores of PF, RP, Bodily pain (BP), GH, VT, RE and MH subscales of the SF-36 were observed in the patients with orthopedic disease.
Conclusions: It was concluded that exercise baths are an effective non-pharmacological treatment that might facilitate rehabilitation programs.

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.