In fall 2012, we renovated the grounds surrounding our hospital and constructed a “rehabilitation promenade,” along which patients could stroll and be in touch with the natural environment. The course is 500m long and includes pathways through a wood and along a pond. Using the promenade, patients can go for a stroll, exercise, or interact with other people. In our ambulatory rehabilitation center, the promenade has been incorporated in one of the center’s programs since last year. This time, we herein report a survey on the changes in the mental and physical function over a 6-month period from May 2013 and their satisfaction level with the use of the promenade by a questionnaire in December 2013.   22 subjects with a mean age of 77.5 ± 6.8 years were included in the survey on the mental and physical functions. Also, in satisfaction survey, valid responses were received from 58 individuals (mean age, 78.2 ± 8.2 years; 25 men and 33 women).   As a result, in terms of the 6-month changes in mental and physical functions were generally maintained.   In the questionnaire, more than 90% of users were satisfied with their use of the promenade, and the statistical analysis revealed that the highest level of satisfaction concerned going outside (p<0.01). For example, “I could feel the fresh air and the seasons” and “I could see a range of scenery.”   In addition, compare the results for each category according to sex, the women chose significantly more answers that were related to interacting with other people, whereas the men chose significantly more answers that were related to exercise.   From this survey, utilizing the surrounding environment may enable the development of more varied and satisfying forms of rehabilitation. We will continue with initiatives that utilize the promenade to help improve the QOL of those who use it.

Introduction: Prevention of the onset of cardio/cerebrovascular diseases, which represent circulatory system diseases, is now emphasized. It requires ensuring good arterial distensibility, which has been demonstrated to be reduced by life environments such as the lack of exercise or overnutrition but improved by aerobic exercise. Even if implementation of such exercises is possible, it increases the risks of the frail elderly with declined cardiopulmonary function and those with other diseases. This study aimed to focus on plantar flexion and dorsiflexion exercises of the ankles as a type of effective, low-load exercise that can induce dynamic stimulation associated with increased blood flow, using muscle pumping of the triceps surae and footbath, which could potentially increase overall blood flow via hyperthermic action. We then investigate the benefits of the combined effects of these two exercises on arterial distensibility. Methods: We selected 25 physically and mentally healthy adult men and women (17 men and eight women; mean ± SD age, 25.7 ± 3.3 years) as study subjects.   All the 25 subjects performed each of three exercises, namely footbath, ankle exercise, and ankle exercise in footbath, in a sitting position for 15 minutes. Ankle-brachial index (ABI), brachial-ankle pulse wave velocity (PWV), systolic blood pressure, diastolic blood pressure, and heart rate were measured using form PWV/ABI before and after the exercise for the evaluation of arterial distensibility. Results: No significant differences were observed in the PWVs, ABIs, systolic/diastolic blood pressures, and heart rates before and after exercise in the footbath and exercise groups. However, for the footbath exercise group, a significant reduction in PWV was observed from before to after exercise. Discussion: In this study, we focused our attention on the ankle exercise in footbath as a low-load exercise that could improve arterial distensibility. The results indicated a significant reduction in PWV, an index used to show the level of arterial distensibility, only for the footbath exercise group, which performed the combination of ankle exercise and footbath. We can infer that the improvement of arterial distensibility is attributed to the synergistic effect of the muscle pump and hyperthermic actions, which result in further increases and facilitation of cardiac output. Conclusions: This study demonstrated that the ankle exercise in footbath was beneficial for the improvement of arterial distensibility.