Despite the broad rehabilitative potential of aquatic exercises, the relationship between aquatic exercise and the immune system has not been fully elucidated to date. In particular, there are few specific and delicate immunological approaches to the effect of water temperature on immunity. Thus, we examined the effect of water temperature on immunity during aquatic exercise. The animal tumor model was adopted to examine the impact of aquatic exercise at thermoneutral temperature (TT; 29°C) on immunity compared with aquatic exercise at body temperature (BT; 36°C). Tumor-bearing mice were made to swim in TT water or in BT water for 3 wk and immune cells and their functional activity were analyzed using FACS. Tumor growth was significantly suppressed in mice that exercised in TT than in BT water. The tumor control correlated with the increased number of NK (2-fold), γδT cells (2.5-fold), NKT (2.5-fold), and cytotoxic CD8⁺ T cells (1.6-fold), which play a critical role in anti-tumor immune responses. Furthermore, the functional activity was dramatically improved in the TT group, showing enhanced production of IFNγ in CD8⁺ T cells compared with the BT group. This study demonstrates that aquatic exercise in TT water may improve protective immune responses more effectively than in BT water. Although the effects of water temperature on immune function need further verification in humans, this study suggests that water temperature in human hydrotherapy may be important for improving immune function.
Animals ; Body Temperature ; Exercise ; Humans ; Hydrotherapy ; Immune System ; Interferons ; Mice ; T-Lymphocytes ; Water

OBJECTIVE: To investigate rehabilitation treatment cost of patients with cerebral palsy (CP) according to age. METHODS: We analyzed the cost of rehabilitation treatment from 2007 to 2013 for patients diagnosed with CP by sourcing data from the National Health Information Database. RESULTS: While the number of recently born children requiring rehabilitation treatment has decreased, the number of patients requiring this treatment in other age groups has gradually increased. In addition, annual physical therapy, occupational therapy, hydrotherapy, and botulinum toxin injection treatment costs per person have increased. On the other hand, the number of orthopedic surgeries and selective dorsal rhizotomy performed has decreased. CONCLUSION: This study investigated trends in the cost of treatment for patients with CP. This study can be used as a basis to provide treatment support for patients with CP.
Botulinum Toxins ; Cerebral Palsy* ; Child ; Hand ; Health Care Costs ; Humans ; Hydrotherapy ; Korea* ; Occupational Therapy ; Orthopedics ; Rehabilitation* ; Rhizotomy

This paper reviews the principle and clinical application of hydrosurgery system, including the burn debridement, diabetic foot wounds debridement and other trauma debridement. Meanwhile, this paper introduces the development direction of waterjet technology. Furthermore, the safety, effectiveness and suitability can be discussed.
Burns ; therapy ; Debridement ; methods ; Foot Ulcer ; therapy ; Humans ; Hydrotherapy ; Treatment Outcome ; Wound Healing

OBJECTIVE: To determine the efficacy of aquatic treadmill training (ATT) as a new modality for stroke rehabilitation, by assessing changes in gait symmetry, balance function, and subjective balance confidence for the paretic and non-paretic leg in stroke patients. METHODS: Twenty-one subacute stroke patients participated in 15 intervention sessions of aquatic treadmill training. The Comfortable 10-Meter Walk Test (CWT), spatiotemporal gait parameters, Berg Balance Scale (BBS), and Activities-specific Balance Confidence scale (ABC) were assessed pre- and post-interventions. RESULTS: From pre- to post-intervention, statistically significant improvements were observed in the CWT (0.471±0.21 to 0.558±0.23, p<0.001), BBS (39.66±8.63 to 43.80±5.21, p<0.001), and ABC (38.39±13.46 to 46.93±12.32, p<0.001). The step-length symmetry (1.017±0.25 to 0.990±0.19, p=0.720) and overall temporal symmetry (1.404±0.36 to 1.314±0.34, p=0.218) showed improvement without statistical significance. CONCLUSION: ATT improves the functional aspects of gait, including CWT, BBS and ABC, and spatiotemporal gait symmetry, though without statistical significance. Further studies are required to examine and compare the potential benefits of ATT as a new modality for stroke therapy, with other modalities.
Gait* ; Humans ; Hydrotherapy ; Leg ; Rehabilitation ; Stroke*

This study discusses the historical significance of the Natural Cure Movement of Germany, centering on the Kneipp Cure, a form of hydrotherapy practiced by Father Sebastian Kneipp (1821-1897). The Kneipp Cure rested on five main tenets: hydrotherapy, exercise, nutrition, herbalism, and the balance of mind and body. This study illuminates the reception of the Kneipp Cure in the context of the trilateral relationship among the Kneipp Cure, the Natural Cure Movement in general, and modern medicine. The Natural Cure Movement was ideologically based on naturalism, criticizing industrialization and urbanization. There existed various theories and methods in it, yet they shared holism and vitalism as common factors. The Natural Cure Movement of Germany began in the early 19th century. During the late 19th century and the early 20th century, it became merged in the Lebensreformbewegung (life reform movement) which campaigned for temperance, anti-tobacco, and anti-vaccination. The core of the Natural Cure Movement was to advocate the world view that nature should be respected and to recognize the natural healing powers of sunlight, air, water, etc. Among varied natural therapies, hydrotherapy spread out through the activities of some medical doctors and amateur healers such as Johann Siegmund Hahn and Vincenz Prieβnitz. Later, the supporters of hydrotherapy gathered together under the German Society of Naturopathy. Sebastian Kneipp, one of the forefathers of hydrotherapy, is distinguished from other proponents of natural therapies in two aspects. First, he did not refuse to employ vaccination and medication. Second, he sought to be recognized by the medical world through cooperating with medical doctors who supported his treatment. As a result, the Kneipp cure was able to be gradually accepted into the medical world despite the “quackery” controversy between modern medicine and the Natural Cure Movement. Nowadays, the name of Sebastian Kneipp remains deeply engraved on the memories of German people through various Kneipp spa products, as well as his books such as My Water Cure and Thus Shalt Thou Live! Wörishofen, where Kneipp had served as catholic priest as well as hydrotherapist for 42 years from 1855, changed its name to “Bad Wörishofen” (“Wörishofen Spa” in German). The Kneipp Cure and the Natural Cure Movement became a source of ecologica l thought which is currently gaining more and more sympathy from German people. It is regarded as a lieu de mémoire (site of memory) reflecting the collective identity of German people.
Clergy ; Fathers ; Germany* ; Herbal Medicine ; History, Modern 1601-* ; Humans ; Hydrotherapy ; Naturopathy ; Quackery ; Sunlight ; Temperance ; Urbanization ; Vaccination ; Vitalism ; Water

BACKGROUND: The aim of this study is to test if adjuvant hydrotherapy with viscosupplement is beneficial on management of pain, stiffness, function, and mental relaxation in knee osteoarthritis (OA). METHODS: Nineteen patients with OA were randomly assigned to hydrotherapy or control groups. All patients received viscosupplement injections once a week for 3 weeks. Hydrotherapy group (n=9) had a spa containing green tea, 3 days a week for 2 weeks. The control group (n=10) received only injections. All patients were assessed at baseline and after the third injection. All were assessed for pain (visual analog scale, VAS), pain severity, and functional status (Western Ontario and McMaster Universities osteoarthritis index, WOMAC), emotional status, quality of life (Euro quality of life health-related quality of life inventory five dimension, EQ-5D), and relative spectral power of alpha waves in electroencephalography (EEG). RESULTS: Both groups reported a statistically significant reduction of pain at the end of treatment and detailed assessment of pain, and function in WOMAC and the relative power of alpha in electroencephalogram showed statistical significant difference only in the hydrotherapy group. However, there were no significant intergroup differences, except for VAS score. CONCLUSION: Adjuvant 2-week hydrotherapy to viscosupplement might have a modest role in the management of pain and functional disability and the mental relaxation in patients with knee OA. Larger, randomized controlled trials with intervention of long term period to determine efficacy in treating knee OA are warranted.
Electroencephalography ; Humans ; Hydrotherapy* ; Knee ; Ontario ; Osteoarthritis ; Osteoarthritis, Knee* ; Quality of Life ; Relaxation* ; Tea ; Viscosupplements

BACKGROUNDAn increasingly aging population implies an increasing prevalence of osteoarthritis (OA) of hip or knee. It has been ascertained that unspecific hydrotherapy of OA according to Sebastian Kneipp not only improves the range of mobility but also reduces pain significantly and increases the quality of life of the patients affected.

OBJECTIVEThe main aim of this pilot study was to determine the effects of hydrotherapy in comparison to conventional physiotherapy, and to analyze the feasibility of the study design under clinical circumstances.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONSThe study design is a prospective randomized controlled three-arm clinical pilot trial, carried out at a specialist clinic for integrative medicine. Thirty patients diagnosed with symptomatic OA of hip or knee and radiologic findings were randomly assigned to one of two intervention groups and a control group: hydrotherapy (group 1), physiotherapy (group 2), and both physiotherapy and hydrotherapy (group 3, control group) of the affected joint.

MAIN OUTCOME MEASURES

PRIMARY OUTCOMEpain intensity of the affected joint in the course of inpatient treatment; secondary outcome: health-related quality of life, joint-specific pain and mobility in the course of the study.

RESULTSConcerning the main outcome, intervention group 1 showed most beneficial effects in the course of inpatient treatment, followed by groups 3 and 2, and also the indirect flexion ability of hip or knee together with the general patient mobility through the "timed up and go" test were mainly improved within group 1 followed by groups 3 and 2.

CONCLUSIONThe results of this pilot study demonstrate beneficial effects of hydrotherapy. The study design is feasible. For statistically significant evidence and a robust conclusion of efficacy of Kneipp's hydrotherapy, a larger sample size is necessary.

TRIAL REGISTRATION NUMBERNCT 00950326.

Aged ; Aged, 80 and over ; Female ; Humans ; Hydrotherapy ; Male ; Middle Aged ; Osteoarthritis, Hip ; physiopathology ; psychology ; therapy ; Osteoarthritis, Knee ; physiopathology ; psychology ; therapy ; Physical Therapy Modalities ; Pilot Projects ; Prospective Studies ; Quality of Life ; Range of Motion, Articular ; Treatment Outcome

OBJECTIVE: To evaluate the effect of the Whirlpool hydrotherapy on pain and anxiety in chronic myofascial pain syndrome (MPS) patients, compared to the conventional hydrocollator pack therapy. METHODS: Forty-one subjects who have MPS in the upper trapezius muscles without depression were recruited. The patients were randomly assigned into two groups: the whirlpool therapy group whose bodies were immersed in a whirlpool bath at 34degrees C-36degrees C for 30 minutes; the hydrocollator group who took a 30-minute application of a standard hot hydrocollator pack. Patients in both groups received therapy three days a week for 2 weeks and underwent several evaluations at baseline and after treatment. The variables we analyzed during evaluations were as follows: the primary outcome we considered was pain severity using a visual analogue scale. And the secondary outcomes examined included anxiety using the Korean version of the Beck Anxiety Inventory and quality of life (QoL) using the Korean version of the World Health Organization QoL Assessment, Brief Form. All follow-up values were compared with the baseline values. RESULTS: The baseline parameters did not show significant differences between two groups. And after 2-week treatment, both groups revealed significant improvement in anxiety levels and QoL, as well as in pain. However, the improvement on pain (p=0.002) and anxiety (p=0.010) was significantly greater in the whirlpool group, compared to the hydrocollator group. CONCLUSION: The whirlpool hydrotherapy can be used as a more effective therapeutic method to reduce pain and anxiety in chronic MPS patients without depression.
Anxiety ; Depression ; Follow-Up Studies ; Humans ; Hydrotherapy ; Muscles ; Myofascial Pain Syndromes ; Quality of Life ; World Health Organization

PURPOSE: Frostbite can affect people involved in winter sports, homeless and soldiers. It results in tissue necrosis from direct cellular damage and indirect damage secondary to vasospasm and the progressive microvascular thrombosis following reperfusion of the ischemic limb. However, the frostbite is under-estimated by the physicians. We describe the assessment and management of frostbite and identify the challenges of managing these complex tissue injuries. METHODS: A retrospective analysis of 62 injuries (61 men, average age; 20.5 yo) was conducted between August 2009 to April 2011 in the burn center of AFCH. We sought to determine the demographic characteristics, identification of soft tissue injury, treatment and complications. RESULTS: The 62 were treated as outpatients (n=23, 37.1%) or inpatients (n=39, 62.9%). The superficial degree was 38 (61.3%), while 24 (38.7) have deep degree. The 47.4% of superficial and 87.5% of deep frostbite were admitted. The sites most prone to frostbite were feet (95.2%), followed by hands (27.4%). The toes had the more deep injuries. The 6 cases (9.7%) occurred in wet circumstances. They had suffered more deep injuries than dry circumstances (66.6% vs 35.8%). Thirteen (33.3%) of inpatients were transferred to center 14 days after exposure. The increased levels of isoenzymes did not present the degree of injuries. The bone scan was performed in 22 (56.4%) of inpatients at average 11.3 PFD. We believe it showed an excellent correlation with clinical course, though not confirmed statistically. The patient was treated with rapid rewarming (7; 11.3%), hydrotherapy (11; 17.7%), STSG (3; 12.5 of deep frostbite), berasil (14; 22.6%) and ibuprofen (5; 8.1%). The PGE1 was administered to 34 (87.2%) of inpatients for 8.8 days. We believe the effect of PGE1 to prevent amputations, though not confirmed in evidence base. The sequelae of 9 (23.1%) inpatients included of paresthesia (10.3%), LOM (10.3%), Raynaud's syndrome (7.7%) and hyperhydrois (2.6%). CONCLUSION: In a military context, health education of troops is necessary to avoid moisture circumstances and to protect from cold injuries. We need new guideline to recommend early rewarming and evacuation to specialized units so that the degree of frostbite can be alleviated and rate of complication can be lowered. We need new principles to use NSAIDs, pentoxifylline, antiprostaglandin agents and thrombolytic therapy in amelioration of tissue damage. Together with initial aids, use of radiological assessment, triple phase bone scanning, Duplex studies, Plethysmograpy and future advancements should allow for a more aggressive and active approach to the management of tissue viability. This information is only a primer and requires continuous updating to improve patient outcomes.
Alprostadil ; Amputation ; Anti-Inflammatory Agents, Non-Steroidal ; Burn Units ; Cold Temperature ; Extremities ; Foot ; Frostbite ; Hand ; Health Education ; Humans ; Hydrotherapy ; Ibuprofen ; Inpatients ; Isoenzymes ; Male ; Military Personnel ; Necrosis ; Outpatients ; Paresthesia ; Pentoxifylline ; Reperfusion ; Retrospective Studies ; Rewarming ; Soft Tissue Injuries ; Sports ; Thrombolytic Therapy ; Thrombosis ; Tissue Survival ; Toes

PURPOSE: We aimed to evaluate the efficacy of warm water sitz baths in patients who have undergone transurethral resection of the prostate (TURP) owing to lower urinary tract symptoms secondary to benign prostatic hyperplasia. MATERIALS AND METHODS: We reviewed the records of 1,783 patients who had undergone TURP between 2001 and 2009. In the warm water sitz bath group, patients were instructed to sit in a tub containing lukewarm water at 40-45degrees C for 10 minutes each time. Patients were advised to perform the procedure for at least 5 days immediately after the removal of a Foley urethral catheter. The differences in post-TURP complications between the warm water sitz bath group and the no sitz bath group were compared. RESULTS: After TURP, 359 of the 1,561 patients performed a warm water sitz bath. Complications after TURP, such as hemorrhage, urinary tract infection, urethral stricture, and acute urinary retention were found in 19 (5.3%) and 75 (6.2%) patients in the sitz bath and no sitz bath groups, respectively (p=0.09). There was a significant difference in postoperative complications such as urethral stricture between the warm sitz bath group and the no sitz bath group (p=0.04). The group that did not undergo warm water sitz bath treatment showed a 1.13-fold increased risk of rehospitalization within 1 month after TURP due to postoperative complications compared with the warm water sitz bath group (odds ratio [OR]=1.134; 95% confidence interval [CI], 1.022 to 1.193; p=0.06). CONCLUSIONS: Warm water sitz bath treatment reduced postoperative complications such as urethral stricture. These results suggest that large-scale prospective studies are needed to establish an ideal method and optimal duration of sitz baths.
Baths ; Hemorrhage ; Humans ; Hydrotherapy ; Lower Urinary Tract Symptoms ; Postoperative Complications ; Prostate ; Prostatic Hyperplasia ; Transurethral Resection of Prostate ; Urethral Stricture ; Urinary Catheters ; Urinary Retention ; Urinary Tract Infections ; Water