Clinical implications of thermal therapy in lifestyle-related diseases

Changes of blood flow volume in the superior mesenteric artery and brachial artery with abdominal thermal stimulation

In traditional Chinese medicine, moxibustion is a local thermal therapy that is used for several conditions. Quantifying the effects of moxibustion therapy has been difficult because the treatment temperature depends on the physician's experience, and the temperature distribution in the target area is not uniform. This prospective observational study aims to quantify the effect of local thermal stimulation to the abdomen. We developed a heat transfer control device (HTCD) for local thermal stimulation. Twenty-four healthy subjects were enrolled and they underwent abdominal thermal stimulation to the para-umbilical region with the device for 20 min. Blood flow volume in the superior mesenteric artery (SMA) and brachial artery (BA), the heart rate and the blood pressure were measured at rest, 15 min after starting thermal stimulation and 10, 20, 30 and 40 min after completing thermal stimulation. Blood flow parameters were measured by high-resolution ultrasound. In the SMA, blood flow volume was significantly increased during thermal stimulation (P < .01), as well as at 10 min (P < .01) and 20 min (P < .05) after stimulation. In the BA, blood flow volume decreased at 40 min after stimulation (P < .01). In conclusion we could quantify the effect of local thermal stimulation with an HTCD and high-resolution ultrasound. Thermal stimulation of the para-umbilical region increased blood flow in the SMA 20 min after stimulation in healthy subjects.

The effects of repeated thermal therapy on quality of life in patients with type II diabetes mellitus

OBJECTIVES

Decreased quality of life in diabetes is associated with poor health outcomes. Far-infrared sauna treatments improve the quality of life for those with chronic pain, chronic fatigue syndrome, depression, and congestive heart failure. The objective of this study is to determine whether far-infrared saunas have a beneficial effect on quality of life in those with type II diabetes.

DESIGN

This was a sequential, longitudinal, interrupted time series design study.

SETTING/LOCATION

The setting was Fraser Lake BC, a rural village in central British Columbia, Canada.

SUBJECTS

All patients of the Fraser Lake Community Health Center with type II diabetes were invited to participate in this study.

INTERVENTIONS

The study consisted of 20-minute, 3 times weekly infrared sauna sessions, over a period of 3 months.

OUTCOME MEASURES

To assess quality of life, subjects completed the 36-item Short-form Health Survey Version 2 (SF-36v2) questionnaire as well as "Zero-to-Ten" Visual Analogue Scales. Baseline study parameters were measured within 1 week prior to commencing sauna sessions. Postintervention measurements were collected between 1 and 3 days after the last sauna session.

RESULTS

Physical health, general health, and social functioning indices of the SF-36v2 improved. Visual Analogue Scales for stress and fatigue improved.

CONCLUSIONS

Far-infrared sauna use maybe associated with improved quality of life in people with type II diabetes mellitus. Uptake of infrared saunas use is greater than the uptake of other lifestyle interventions.

Changes in the lipid profile of blood serum in women taking sauna baths of various duration

OBJECTIVES

There is little information on lipid metabolism after sauna treatment in the literature. The present research is aimed to determine the influence of sauna baths on fat metabolism in young women.

MATERIALS AND METHODS

Twenty healthy, eumenhorreic, female volunteers (19-21 yr old) were exposed to Finnish sauna bath seven times every second day. In group I (n = 10) each time the sauna treatment lasted 30 min, whereas in group II (n = 10) 40 min with 5-minute break to cool down. Body mass, heart rate and blood pressure were measured before and after sauna bath. Rectal temperature was monitored during stay in sauna room. Prior to the sauna bath and during its last two minutes the minute oxygen uptake and the level of CO2 exhalation were analyzed in the exhaled air, and the respiratory quotient RQ was calculated. In the blood samples collected before the sauna bath and immediately afterwards hematocrit, hemoglobin, and lipid profile--total lipids, free fatty acids, total free fatty acids, triacylglycerols, total cholesterol (TC), high density lipids (HDL), low density lipids (LDL) were analyzed.

RESULTS

Rectal temperature was lower in the last sauna bath than in the first one. Losses of plasma were greater during the seventh bath than during the first one. Acceleration of the metabolism of lipids occurs after every sauna bath. A reduced level of TC and LDLC and a raised level of HDL was observed after repeated sauna baths.

CONCLUSION

After 2 weeks of repeated sauna session some changes in total cholesterol and concentration of LDLC were observed, while concentration of HDLC increased after 7th sauna bath in group I. Those kinds of changes may be good prognoses of ischemic heart disease prevention, but further research on the influence of sauna on fat metabolism is needed.

It is time to thoroughly study the effects of mild stress in rodents, but also in human beings

Many experiments on the effect of mild stress on aging have been done in invertebrates, but not in mammals. Using mild stress to improve healthspan seems to be possible, because the few studies on humans which have been published appear to be promising. Particularly, one may wonder whether heat shocks could be of some use in therapy or as an integrated part of daily life of elderly people. However, the top priority is probably to study more thoroughly the effects of mild stress in rodents, and not only in invertebrates.

Do sauna therapy and exercise act by raising the availability of tetrahydrobiopterin?

Sauna therapy has been used to treat a number of different diseases known or thought to have a tetrahydrobiopterin (BH4) deficiency. It has been interpreted to act in multiple chemical sensitivity by increasing chemical detoxification and excretion but there is no evidence that this is its main mode of action. Sauna therapy may act to increase BH4 availability via two distinct pathways. Increased blood flow in heated surface tissues leads to increased vascular shear stress, inducing increased activity of GTP cyclohydrolase I (GTPCH-I) in those vascular tissues which will lead to increasing BH4 synthesis. A second mechanism involves the heat shock protein Hsp90, which is induced by even modest heating of mammalian tissues. Sauna heating of these surface tissues may act via Hsp90, which interacts with the GTPCH-I complex and is reported to produce increased GTPCH-I activity by lowering its degradation. The increased consequent availability of BH4 may lead to lowered nitric oxide synthase uncoupling, such as has been reported for the eNOS enzyme. Increased BH4 synthesis in surface tissues of the body will produce increased circulating BH4 which will feed BH4 to other body tissues that may have been BH4 deficient. Similar mechanisms may act in vigorous exercise due to the increased blood shear stresses and possibly also heating of the exercising tissues and heart. There is a large and rapidly increasing number of diseases that are associated with BH4 depletion and these may be candidates for sauna therapy. Such diseases as hypertension, vascular endothelial dysfunction, multiple chemical sensitivity and heart failure are thought to be helped by sauna therapy and chronic fatigue syndrome and fibromyalgia may also be helped and there are others that may be good candidates for sauna therapy.

Regular thermal therapy may promote insulin sensitivity while boosting expression of endothelial nitric oxide synthase--effects comparable to those of exercise training

Regular thermal therapy, using saunas or hot baths, has the potential to improve impaired insulin sensitivity and boost endothelial expression of the "constitutive" isoform of nitric oxide synthase--effects, analogous to those of aerobic training that should promote vascular health. Previous clinical reports suggest that hot tubs may be beneficial for diabetic control, and that sauna therapy can decrease blood pressure in essential hypertension and provide symptomatic benefit in congestive heart failure. For those who lack ready access to a sauna or communal hot tub, regular hot baths at home may suffice as practical thermal therapy. Thermal therapy might be viewed as an alternative to exercise training in patients too physically impaired for significant aerobic activity.

Waon therapy improves the prognosis of patients with chronic heart failure

BACKGROUND

We developed a Waon therapy (soothing warm therapy) and have previously reported that repeated Waon therapy improves hemodynamics, peripheral vascular function, arrhythmias, and clinical symptoms in patients with chronic heart failure (CHF). The aim of this study was to investigate the effect of Waon therapy on the prognosis of CHF patients.

PATIENTS AND METHODS

We studied 129 patients with CHF in NYHA functional class III or IV who were admitted to our hospital between January 1999 and March 2001. In the Waon therapy group, 64 patients were treated with a far infrared-ray dry sauna at 60 degrees C for 15 min and then kept on bed rest with a blanket for 30 min. The patients were treated daily for 5 days during admission, and then at least twice a week after discharge. In the control group, 65 patients, matched for age, gender, and NYHA functional class, were treated with traditional CHF therapy. The follow-up time was scheduled for 5 years.

RESULTS

Recent, complete follow-up data on each patient were obtained. The overall survival rate was 84.5% (Kaplan-Meier estimate). Twelve patients died in the control group and 8 patients died in the Waon therapy group at 60 months of follow-up. Cardiac events due to heart failure or cardiac death occurred in 68.7% of the control group but only 31.3% of the Waon therapy group (P<0.01) at 60 months of follow-up.

CONCLUSION

Waon therapy reduced cardiac events in patients with CHF. This therapy is a promising non-pharmacological treatment for CHF.

Thermal balneotherapy induces changes of the platelet serotonin transporter in healthy subjects

Although the beneficial effects of balneotherapy have been recognized since a long time, a few information is available on the biological mechanisms underlying them and the subjective feelings of increased well-being and mood. The links between the serotonin (5-HT) system and mood prompted us to investigate the 5-HT platelet transporter (SERT), which is considered a reliable, peripheral marker of the same structure present in presynaptic neurons, in 20 healthy volunteers before (t0) and 30 min after (t1) thermal balneotherapy with ozonized water of Montecatini spa, as compared with a similar group who underwent a bath in non-mineral water. The SERT was evaluated by means of the specific binding of (3)H-paroxetine ((3)H-Par) to platelet membranes. Equilibrium-saturation binding data, the maximal binding capacity (Bmax) and the dissociation constant (Kd), were obtained by means of the Scatchard analysis. The results showed that, while Bmax values did not change in both groups, the Kd values decreased significantly at t1 only in those subjects who bathed in ozonized water. The results of this study, while showing a decrease of the dissociation constant (Kd) which is the inverse of affinity constant, of (3)H-Par binding to SERT in all subjects after balneotherapy and not in those bathing in normal water, suggest that SERT modifications may be related to a specific effect of ozonized water and, perhaps, also to the increased sense of well-being.

Bakera, a herbal steam bath for postnatal care in Minahasa (Indonesia): documentation of the plants used and assessment of the method

Bakera, a steam bath prepared with various plants, is a traditional method used in Minahasa (North Sulawesi, Indonesia) for recuperation after childbirth. Semi-structured interviews were conducted with 14 midwives and 166 mothers in different villages of Minahasa, in order to document the preparation and plants used for the bakera. Overall, the use of 60 different plant species for the bakera was recorded. Among the 10 most frequently cited bakera plants, eight are essential oil plants, which are usually cultivated in the kitchen gardens and often used as spices. The therapeutic effects of thermotherapy and aromatherapy contribute to the effectiveness of the bakera. Thermotherapy soothes symptoms such as muscular strain, heaviness in the limbs, edema, loss of appetite, and constipation, whereas the essential oils of the plants used have an immuno-stimulant, antiseptic, and antiphlogistic effect. If applied under the guidance of an experienced person, during the late childbed, the bakera can be regarded as an effective and safe method for recuperation after child birth.

Health effects and risks of sauna bathing

OBJECTIVES

To study physiological, therapeutic and adverse effects of sauna bathing with special reference to chronic diseases, medication and special situations (pregnancy, children).

STUDY DESIGN

A literature review.

METHODS

Experiments of sauna bathing were accepted if they were conducted in a heated room with sufficient heat (80 to 90 degrees C), comfortable air humidity and adequate ventilation. The sauna exposure for five to 20 minutes was usually repeated one to three times. The experiments were either acute (one day), or conducted over a longer period (several months).

RESULTS

The research data retrieved were most often based on uncontrolled research designs with subjects accustomed to bathing since childhood. Sauna was well tolerated and posed no health risks to healthy people from childhood to old age. Baths did not appear to be particularly risky to patients with hypertension, coronary heart disease and congestive heart failure, when they were medicated and in a stable condition. Excepting toxemia cases, no adverse effects of bathing during pregnancy were found, and baths were not teratogenic. In musculoskeletal disorders, baths may relieve pain. Medication in general was of no concern during a bath, apart from antihypertensive medication, which may predispose to orthostatic hypotension after bathing.

CONCLUSIONS

Further research is needed with sound experimental design, and with subjects not accustomed to sauna, before sauna bathing can routinely be used as a non-pharmacological treatment regimen in certain medical disorders to relieve symptoms and improve wellness.

Efeitos da sauna sobre doenças cardiovasculares e doenças relacionadas com o estilo de vida

Freqüentar a sauna é uma prática popular de jovens, adultos e idosos saudáveis. Os médicos do esporte são, com freqüência, solicitados a opinar sobre o impacto da sauna nas doenças e na saúde de modo geral. A sauna pode ser benéfica ou maléfica, dependendo do uso que fazemos dela. Nos últimos anos, a sauna está sendo considerada benéfica para os portadores de doenças cardiovasculares como a insuficiência cardíaca e doenças relacionadas com o estilo de vida, principalmente por melhorar a função endotelial periférica, via aumento do débito cardíaco e vasodilatação periférica. A disfunção endotelial está presente em quase todas as doenças cardiovasculares. O presente artigo pretende fazer uma revisão sobre os efeitos da sauna sobre o sistema cardiovascular em indivíduos saudáveis e em determinadas doenças cardiovasculares.

Rhabdomyolysis caused by hot air sauna burn

Sauna-related burns are rare, even in Finland where sauna bathing is a popular leisure pastime. Burns induced by hot air are even more rare and constitute a very small subgroup of all sauna burns. Hot air burns are characterised by a combination of full thickness skin damage with deep tissue destruction. We report here on six consecutive patients suffering from hot air sauna burns with rhabdomyolysis. All six patients were middle-aged, the majority of them men. Acute excessive consumption of alcohol exacerbated by a hot environment resulted in dehydration and loss of consciousness. Immobility and prolonged exposure to hot, dry air resulted in third degree regional burns with 5-32% TBSA. Rhabdomyolysis was evident on admission. The laboratory values of plasma creatine kinase (P-CK), plasma myoglobin (PM), blood pH, and serum potassium (S-K) during the first five days were evaluated. Aggressive fluid management and correction of acidosis and myoglobinuria were started on admission. Surgical management consisted of early, aggressive excision at fascial level, in some patients involving sacrifice of the upper layers of muscle. Even so, mortality in this small series was 50%. The best indicator of poor prognosis was a highly elevated CK value on the second post-injury day.

Repeated thermal therapy diminishes appetite loss and subjective complaints in mildly depressed patients

OBJECTIVE

We observed that repeated thermal therapy improved appetite loss and general well-being in patients with chronic heart failure. The purpose of this study is to clarify the effects of repeated thermal therapy in mildly depressed patients with appetite loss and subjective complaints.

METHODS

Twenty-eight mildly depressed inpatients with general fatigue, appetite loss, and somatic and mental complaints were randomly assigned to thermal therapy group (n = 14) or nonthermal therapy group (n = 14). Patients in the thermal therapy group were treated with 60 degrees C far-infrared ray dry sauna for 15 minutes and were then kept at bed rest with a blanket for 30 minutes once a day, 5 days a week for a total of 20 sessions in 4 weeks.

RESULTS

Four weeks after admission, somatic complaints, hunger, and relaxation scores significantly improved (p < .001, p < .0001, p < .0001, respectively) and mental complaints slightly improved (p = .054) in the thermal therapy group compared with the nonthermal therapy group. Furthermore, the plasma ghrelin concentrations and daily caloric intake in the thermal therapy group significantly increased compared with the nonthermal therapy group (p < .05).

CONCLUSIONS

These findings suggest that repeated thermal therapy may be useful for mildly depressed patients with appetite loss and subjective complaints.