Repeated sauna therapy reduces urinary 8-epi-prostaglandin F(2alpha)

The multifaceted benefits of passive heat therapies for extending the healthspan: A comprehensive review with a focus on Finnish sauna

Passive heat therapy is characterized by exposure to a high environmental temperature for a brief period. There are several types of passive heat therapy which include hot tubs, Waon therapy, hydrotherapy, sanarium, steam baths, infrared saunas and Finnish saunas. The most commonly used and widely studied till date are the Finnish saunas, which are characterized by high temperatures (ranging from 80-100°C) and dry air with relative humidity varying from 10-20%. The goal of this review is to provide a summary of the current evidence on the impact of passive heat therapies particularly Finnish saunas on various health outcomes, while acknowledging the potential of these therapies to contribute to the extension of healthspan, based on their demonstrated health benefits and disease prevention capabilities. The Finnish saunas have the most consistent and robust evidence regarding health benefits and they have been shown to decrease the risk of health outcomes such as hypertension, cardiovascular disease, thromboembolism, dementia, and respiratory conditions; may improve the severity of musculoskeletal disorders, COVID-19, headache and flu, while also improving mental well-being, sleep, and longevity. Finnish saunas may also augment the beneficial effects of other protective lifestyle factors such as physical activity. The beneficial effects of passive heat therapies may be linked to their anti-inflammatory, cytoprotective and anti-oxidant properties and synergistic effects on neuroendocrine, circulatory, cardiovascular and immune function. Passive heat therapies, notably Finnish saunas, are emerging as potentially powerful and holistic strategies to promoting health and extending the healthspan in all populations.

A Phase 1 randomized, open-label clinical trial to evaluate the effect of a far-infrared emitting patch on local skin perfusion, microcirculation and oxygenation

Far-infrared radiation (FIR) has been investigated for reduction of pain and improvement of dermal blood flow. The FIRTECH patch is a medical device designed to re-emit FIR radiated by the body. This phase 1 study was conducted to evaluate the local effects of the FIRTECH patch on local skin perfusion, microcirculation and oxygenation. This prospective, randomized, open-label, parallel designed study admitted 20 healthy participants to a medical research facility for treatment for 31 h on three anatomical locations. During treatment, imaging assessments consisting of laser speckle contrast imaging, near-infrared spectroscopy, side-stream dark-field microscopy, multispectral imaging and thermography were conducted regularly on patch-treated skin and contralateral non-treated skin. The primary endpoint was baseline perfusion increase during treatment on the upper back. Secondary endpoints included change in baseline perfusion, oxygen consumption and temperature of treated versus untreated areas. The primary endpoint was not statistically significantly different between treated and non-treated areas. The secondary endpoints baseline perfusion on the forearm (least square means [LSMs] difference 2.63 PU, 95% CI: 0.97, 4.28), oxygen consumption (LSMs difference: 0.42 arbitrary units [AUs], 95% CI: 0.04, 0.81) and skin temperature (LSMs difference 0.35°C, 95% CI: 0.16, 0.6) were statistically significantly higher in treated areas. Adverse events observed during the study were mild and transient. The vascular response to the FIRTECH patch was short-lived suggesting a non-thermal vasodilatory effect of the patch. The FIRTECH patch was well tolerated, with mild and transient adverse events observed during the study. These results support the therapeutic potential of FIR in future investigations.

Far-Infrared Irradiation Decreases Proliferation in Basal and PDGF-Stimulated VSMCs Through AMPK-Mediated Inhibition of mTOR/p70S6K Signaling Axis

BACKGROUND

Far-infrared (FIR) irradiation has been reported to improve diverse cardiovascular diseases, including heart failure, hypertension, and atherosclerosis. The dysregulated proliferation of vascular smooth muscle cells (VSMCs) is well established to contribute to developing occlusive vascular diseases such as atherosclerosis and in-stent restenosis. However, the effects of FIR irradiation on VSMC proliferation and the underlying mechanism are unclear. This study investigated the molecular mechanism through which FIR irradiation inhibited VSMC proliferation.

METHODS

We performed cell proliferation and cell death assay, adenosine 5'-triphosphate (ATP) assay, inhibitor studies, transfection of dominant negative (dn)-AMP-activated protein kinase (AMPK) α1 gene, and western blot analyses. We also conducted confocal microscopic image analyses and ex vivo studies using isolated rat aortas.

RESULTS

FIR irradiation for 30 minutes decreased VSMC proliferation without altering the cell death. Furthermore, FIR irradiation accompanied decreases in phosphorylation of the mammalian target of rapamycin (mTOR) at Ser2448 (p-mTOR-Ser2448) and p70 S6 kinase (p70S6K) at Thr389 (p-p70S6K-Thr389). The phosphorylation of AMPK at Thr172 (p-AMPK-Thr172) was increased in FIR-irradiated VSMCs, which was accompanied by a decreased cellular ATP level. Similar to in vitro results, FIR irradiation increased p-AMPK-Thr172 and decreased p-mTOR-Ser2448 and p-p70S6K-Thr389 in isolated rat aortas. Pre-treatment with compound C, a specific AMPK inhibitor, or ectopic expression of dn-AMPKα1 gene, significantly reversed FIR irradiation-decreased VSMC proliferation, p-mTOR-Ser2448, and p-p70S6K-Thr389. On the other hand, hyperthermal stimulus (39°C) did not alter VSMC proliferation, cellular ATP level, and AMPK/mTOR/p70S6K phosphorylation. Finally, FIR irradiation attenuated platelet-derived growth factor (PDGF)-stimulated VSMC proliferation by increasing p-AMPK-Thr172, and decreasing p-mTOR-Ser2448 and p-p70S6K-Thr389 in PDGF-induced in vitro atherosclerosis model.

CONCLUSION

These results show that FIR irradiation decreases the basal and PDGF-stimulated VSMC proliferation, at least in part, by the AMPK-mediated inhibition of mTOR/p70S6K signaling axis irrespective of its hyperthermal effect. These observations suggest that FIR therapy can be used to treat arterial narrowing diseases, including atherosclerosis and in-stent restenosis.

The acute effect of whole-body heat therapy on peripheral and cerebral vascular reactivity in Black and White females

Among females in the U.S., Black females suffer the most from cardiovascular disease and stroke. While the reasons for this disparity are multifactorial, vascular dysfunction likely contributes. Chronic whole-body heat therapy (WBHT) improves vascular function, but few studies have examined its acute effect on peripheral or cerebral vascular function, which may help elucidate chronic adaptative mechanisms. Furthermore, no studies have investigated this effect in Black females. We hypothesized that Black females would have lower peripheral and cerebral vascular function relative to White females and that one session of WBHT would mitigate these differences. Eighteen young, healthy Black (n = 9; 21 ± 3 yr; BMI: 24.7 ± 4.5 kg/m2) and White (n = 9; 27 ± 3 yr; BMI: 24.8 ± 4.1 kg/m2) females underwent one 60 min session of WBHT (49 °C water via a tube-lined suit). Pre- and 45 min post-testing measures included post-occlusive forearm reactive hyperemia (peripheral microvascular function, RH), brachial artery flow-mediated dilation (peripheral macrovascular function, FMD), and cerebrovascular reactivity (CVR) to hypercapnia. Prior to WBHT, there were no differences in RH, FMD, or CVR (p > 0.05 for all). WBHT improved peak RH in both groups (main effect of WBHT: 79.6 ± 20.1 cm/s to 95.9 ± 30.0 cm/s; p = 0.004, g = 0.787) but not Δ blood velocity (p > 0.05 for both groups). WBHT improved FMD in both groups (6.2 ± 3.4 % to 8.8 ± 3.7 %; p = 0.016, g = 0.618) but had no effect on CVR in either group (p = 0.077). These data indicate that one session of WBHT acutely improves peripheral micro- and macrovascular but not cerebral vascular function in Black and White females.

Does the Combination of Finnish Sauna Bathing and Other Lifestyle Factors Confer Additional Health Benefits? A Review of the Evidence

Sauna bathing, a tradition deeply rooted in the Finnish culture, has been used for thousands of years for leisure, relaxation, and wellness. Sauna bathing is linked with substantial health benefits beyond its use for leisure and relaxation. Several observational and interventional studies suggest that regular or frequent sauna bathing reduces the incidence of vascular and nonvascular diseases, such as hypertension, cardiovascular disease, dementia, and respiratory conditions; may improve the severity of conditions such as musculoskeletal disorders, COVID-19, headache, and influenza; and increases the life span. The beneficial effects of sauna bathing on adverse outcomes have been linked to its blood pressure-reducing, anti-inflammatory, antioxidant, cytoprotective, and stress-reducing properties and its synergistic effect on neuroendocrine, circulatory, cardiovascular, and immune function. Evidence suggests that frequent sauna bathing is an emerging protective risk factor that may augment the beneficial effects of other protective risk or lifestyle factors, such as physical activity and cardiorespiratory fitness, or attenuate or offset the adverse effects of other risk factors, such as high blood pressure, systemic inflammation, and low socioeconomic status. This review summarizes the available epidemiologic and interventional evidence linking the combined effects of Finnish sauna bathing and other risk factors on vascular outcomes including cardiovascular disease and intermediate cardiovascular phenotypes, nonvascular outcomes, and mortality. We also discuss the mechanistic pathways underlying the joint contributions of Finnish sauna bathing and other risk factors on health outcomes, the public health and clinical implications of the findings, gaps in the existing evidence base, and future directions.

Acute and adaptive cardiovascular and metabolic effects of passive heat therapy or high-intensity interval training in patients with severe lower-limb osteoarthritis

Exercise is painful and difficult to perform for patients with severe lower-limb osteoarthritis; consequently, reduced physical activity contributes to increased cardiometabolic disease risk. The aim of this study was to characterize the acute and adaptive cardiovascular and metabolic effects of two low or no impact therapies in patients with severe lower-limb osteoarthritis: passive heat therapy (Heat) and high-intensity interval training (HIIT) utilizing primarily the unaffected limbs, compared to a control intervention of home-based exercise (Home). Participants completed up to 12 weeks of either Heat (20-30 min immersed in 40°C water followed by ~15-min light resistance exercise), HIIT (6-8 × 60-s intervals on a cross-trainer or arm ergometer at ~90-100% peak V ̇ $$ \dot{V} $$ O₂ ) or Home (~15-min light resistance exercise); all 3 sessions/week. Reductions in systolic (12 & 10 mm Hg), diastolic (7 & 4 mm Hg), and mean arterial (8 & 6 mm Hg) blood pressure (BP) were observed following one bout of Heat or HIIT exposure, lasting for the duration of the 20-min monitoring period. Across the interventions (i.e., 12 weeks), resting systolic BP and diastolic BP decreased with Heat (-9 & -4 mm Hg; p < 0.001) and HIIT (-7 & -3 mm Hg; p ≤ 0.011), but not Home (0 & 0 mm Hg; p ≥ 0.785). The systolic and diastolic BP responses to an acute exposure of Heat or HIIT in the first intervention session were moderately correlated with adaptive responses across the intervention (r ≥ 0.54, p ≤ 0.005). Neither intervention improved indices of glycemic control (p = 0.310). In summary, both Heat and HIIT induced potent immediate and adaptive hypotensive effects, and the acute response was moderately predictive of the long-term response.

Effect of water filtration infrared-A (wIRA) sauna on inorganic ions excreted through sweat from the human body

Sweat discharged as a result of exposure to sauna plays an important role in removing inorganic ions accumulated in the body, including heavy metals. In this study, inorganic ions (toxic and nutrient elements) excreted in the form of sweat from the body using a water-filtered infrared-A (wIRA) sauna were determined using inductively coupled plasma sector field mass spectrometry. The analyzed elements included eight toxic elements (Al, As, Be, Cd, Ni, Pb, Ti, and Hg) and 10 nutrient elements (Ca, Co, Cr, Cu, Fe, Mg, Mn, Se, V, and Zn), and their correlations were determined. Analysis of the sweat obtained from 22 people using the wIRA sauna showed a higher inorganic ion concentration than that obtained from conventional activities, such as exercise or the use of wet sauna, and the concentration of toxic elements in sweat was higher in females than in males. Correlation analysis of the ions revealed a correlation between the discharge of toxic elements, such as As, Be, Cd, and Ni, and discharge of Se and V, and Ni was only correlated with Mn. This study provides fundamental information on nutritional element supplementation when using wIRA sauna for detoxification.

Physical properties and biological effects of ceramic materials emitting infrared radiation for pain, muscular activity, and musculoskeletal conditions

BACKGROUND

Up to 33% of the general population worldwide suffer musculoskeletal conditions, with low back pain being the single leading cause of disability globally. Multimodal therapeutic options are available to relieve the pain associated with muscular disorders, including physical, complementary, and pharmacological therapies. However, existing interventions are not disease modifying and have several limitations.

METHOD

Literature review.

RESULTS

In this context, the use of nonthermal infrared light delivered via patches, fabrics, and garments containing infrared-emitting bioceramic minerals have been investigated. Positive effects on muscular cells, muscular recovery, and reduced inflammation and pain have been reported both in preclinical and clinical studies. There are several hypotheses on how infrared may contribute to musculoskeletal pain relief, however, the full mechanism of action remains unclear. This article provides an overview of the physical characteristics of infrared radiation and its biological effects, focusing on those that could potentially explain the mechanism of action responsible for the relief of musculoskeletal pain.

CONCLUSIONS

Based on the current evidence, the following pathways have been considered: upregulation of endothelial nitric oxide synthase, increase in nitric oxide bioavailability, anti-inflammatory effects, and reduction in oxidative stress.

Frequent sauna bathing offsets the increased risk of death due to low socioeconomic status: A prospective cohort study of middle-aged and older men

BACKGROUND AND AIM

Low socioeconomic status (SES) and frequent sauna bathing are associated with increased and decreased risk of all-cause mortality, respectively. Whether there is an interplay among SES, sauna bathing and all-cause mortality risk is not known. We aimed to evaluate the separate and joint associations of SES and frequency of sauna bathing (FSB) with all-cause mortality risk in a prospective cohort study.

METHODS

We employed the Kuopio Ischaemic Heart Disease Study cohort comprising of 2575 men aged 42-61 years at study entry. Self-reported SES and sauna bathing habits were assessed at baseline. Socioeconomic status was categorized as low and high (median cutoff) and FSB as low and high (defined as ≤2 and 3-7 sessions/week, respectively).

RESULTS

During a median follow-up of 27.8 years, 1618 deaths occurred. Comparing low vs high SES, the multivariable-adjusted HR (95 % CI) for all-cause mortality was 1.31 (1.18-1.45). Comparing high vs low FSB, the multivariable-adjusted HR (95 % CI) for all-cause mortality was 0.86 (0.76-0.97). Compared with high SES-low FSB, low SES-low FSB was associated with an increased risk of all-cause mortality 1.35 (1.20-1.51), without significant evidence of an association for low SES-high FSB and all-cause mortality risk 1.07 (0.89-1.29). Positive additive and multiplicative interactions were found between SES and FSB.

CONCLUSIONS

There exists an interplay among SES, sauna bathing and all-cause mortality risk in a general Finnish male population. Frequent sauna baths may offset the increased overall mortality risk due to low SES.

Far-Infrared Therapy Improves Arteriovenous Fistula Patency and Decreases Plasma Asymmetric Dimethylarginine in Patients with Advanced Diabetic Kidney Disease: A Prospective Randomized Controlled Trial

Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase and plays a significant role in the pathogenesis of arteriovenous fistula (AVF) dysfunction. The aim of this study is to evaluate the effect of far-infrared (FIR) therapy on the maturation and patency of newly-created AVFs in patients with advanced diabetic kidney disease (DKD) as well as the concurrent change in plasma ADMA. The study enrolled 144 participants with advanced DKD where 101 patients were randomly allocated to the FIR therapy group (N = 50) and control group (N = 51). Patients receiving FIR therapy had a decreased AVF failure rate within 12 months (16% versus 35.3%; p = 0.027); decreased incremental change of ADMA concentration at the 3rd and 12th month; increased AVF blood flow at the 1st, 3rd, and 12th month; increased 3-month physiologic maturation rate (88% versus 68.6%; p = 0.034); increased 1-year unassisted AVF patency rate (84% versus 64.7%; p = 0.017); and increased clinical AVF maturation rate within 12 months (84% versus 62.7%; p = 0.029) compared to the control group. The study demonstrates that FIR therapy can reduce the incremental changes in plasma ADMA concentration, which may be associated with the improvement of AVF prognosis in patients with advanced DKD.

Infrared sauna as exercise-mimetic? Physiological responses to infrared sauna vs exercise in healthy women: A randomized controlled crossover trial

BACKGROUND

Passive heat therapies have been reported to have similar effects on the cardiovascular system as exercise. Studies supporting these findings in healthy populations have predominantly been done with men using warm water immersions or traditional saunas, rather than newer infrared-based saunas.

OBJECTIVE

To explore short-term thermal and cardiovascular responses in women using an infrared sauna as compared to moderate-intensity exercise.

STUDY DESIGN

Randomized controlled crossover trial with balanced allocations.

SETTING

Brisbane, Australia (August 2019 - March 2020) PARTICIPANTS: Ten healthy women (36 ± 9 years) INTERVENTIONS: 45 min of resting, infrared sauna or indoor bicycling PRIMARY OUTCOME MEASURES: tympanic/skin temperatures; respiratory rate; blood pressure; arterial stiffness; heart rate variability RESULTS: Tympanic temperatures were elevated during infrared sauna as compared to both control (mean diff = +1.05 ^oC ± SEM 0.12 ^oC, 95% C.I.: 0.73 - 1.36, p < 0.0005) and exercise (mean diff = +0.79 ^oC ± SEM 0.12 ^oC, 95% C.I.: 0.49 - 1.08, p < 0.0005). Respiratory rates were higher during exercise as compared to both control (mean diff = +7.66 ± SEM 1.37, 95% C.I.: 4.09 - 11.23, p < 0.0005) and infrared sauna (mean diff = +6.66 ± SEM 1.33, 95% C.I.: 3.20 - 10.11, p < 0.0005). No significant differences in non-invasive measures of blood pressure, arterial stiffness or heart rate variability were detected between any of the interventions.

CONCLUSIONS

These findings suggest the physiological effects of infrared sauna bathing are underpinned by thermoregulatory-induced responses, more so than exercise-mimetic cardiorespiratory or cardiovascular activations.

The Effect of Far-Infrared Therapy on the Peritoneal Membrane Transport Characteristics of Uremic Patients Undergoing Peritoneal Dialysis: An Open-Prospective Proof-of-Concept Study

Long-term peritoneal dialysis (PD) can lead to detrimental changes in peritoneal membrane function, which may be related to the accumulation of glucose degradation products. A previous study demonstrated that 6 months of far-infrared (FIR) therapy may decrease glucose degradation products in PD dialysate. Due to limited literature on this matter, this study aims to investigate the effect of FIR therapy on the peritoneal membrane transport characteristics of PD patients. Patients were grouped according to baseline peritoneal transport status: lower transporters (low and low-average) and higher transporters (high-average and high). Both groups underwent 40 min of FIR therapy twice daily for 1 year. In lower transporters, FIR therapy increased weekly dialysate creatinine clearance (6.91 L/wk/1.73 m²; p = 0.04) and D/P creatinine (0.05; p = 0.01). In higher transporters, FIR therapy decreased D/P creatinine (−0.05; p = 0.01) and increased D/D0 glucose (0.05; p = 0.006). Fifty percent of high transporter patients shifted to high-average status after FIR therapy. FIR therapy may decrease D/P creatinine for patients in the higher transporter group and cause high transporters to shift to high-average status, which suggests the potential of FIR therapy in improving peritoneal membrane function in PD patients.

Effects of far infrared light on Alzheimer's disease-transgenic mice

Far infrared light has been used in many medical procedures. However, the detailed biological mechanisms of infrared light’s effects have not yet been elucidated. Many researchers have pointed out the thermal effects of treatments such as infrared saunas, which are known to increase blood flow. Alzheimer’s disease (AD) is associated with gradual decreases in brain blood flow and resulting dementia. In this study, we attempted to clarify the beneficial effects of far infrared light using the 5xFAD mouse, a transgenic model of AD. We exposed 5xFAD mice to far infrared light for 5 months. Among the far infrared-exposed AD mice, body weights were significantly decreased, and the levels of nerve growth factor and brain-derived neurotrophic factor protein were significantly increased in selected brain areas (compared to those in non-irradiated AD mice). However, cognition and motor function (as assessed by Morris water maze and Rota Rod tests, respectively) did not differ significantly between the irradiated and non-irradiated AD mouse groups. These results indicated that exposure to far infrared light may have beneficial biological effects in AD mice. However, the experimental schedule and methods may need to be modified to obtain clearer results.

The effect of heat therapy on blood pressure and peripheral vascular function: A systematic review and meta-analysis

NEW FINDINGS

What is the topic of this review? We have conducted a systematic review and meta-analysis on the current evidence for the effect of heat therapy on blood pressure and vascular function. What advances does it highlight? We found that heat therapy reduced mean arterial, systolic and diastolic blood pressure. We also observed that heat therapy improved vascular function, as assessed via brachial artery flow-mediated dilatation. Our results suggest that heat therapy is a promising therapeutic tool that should be optimized further, via mode and dose, for the prevention and treatment of cardiovascular disease risk factors.

ABSTRACT

Lifelong sauna exposure is associated with reduced cardiovascular disease risk. Recent studies have investigated the effect of heat therapy on markers of cardiovascular health. We aimed to conduct a systematic review with meta-analysis to determine the effects of heat therapy on blood pressure and indices of vascular function in healthy and clinical populations. Four databases were searched up to September 2020 for studies investigating heat therapy on outcomes including blood pressure and vascular function. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to assess the certainty of evidence. A total of 4522 titles were screened, and 15 studies were included. Healthy and clinical populations were included. Heat exposure was for 30-90 min, over 10-36 sessions. Compared with control conditions, heat therapy reduced mean arterial pressure [n = 4 studies; mean difference (MD): -5.86 mmHg, 95% confidence interval (CI): -8.63, -3.10; P < 0.0001], systolic blood pressure (n = 10; MD: -3.94 mmHg, 95% CI: -7.22, -0.67; P = 0.02) and diastolic blood pressure (n = 9; MD: -3.88 mmHg, 95% CI: -6.13, -1.63; P = 0.0007) and improved flow-mediated dilatation (n = 5; MD: 1.95%, 95% CI: 0.14, 3.76; P = 0.03). Resting heart rate was unchanged (n = 10; MD: -1.25 beats/min; 95% CI: -3.20, 0.70; P = 0.21). Early evidence also suggests benefits for arterial stiffness and cutaneous microvascular function. The certainty of evidence was moderate for the effect of heat therapy on systolic and diastolic blood pressure and heart rate and low for the effect of heat therapy on mean arterial pressure and flow-mediated dilatation. Heat therapy is an effective therapeutic tool to reduce blood pressure and improve macrovascular function. Future research should aim to optimize heat therapy, including the mode and dose, for the prevention and management of cardiovascular disease.

The effectiveness of far-infrared irradiation on foot skin surface temperature and heart rate variability in healthy adults over 50 years of age: A randomized study

BACKGROUND

Far-infrared irradiation (FIR) is used in the medical field to improve wound healing, hemodialysis with peripheral artery occlusive disease, and osteoarthritis but seldom used in ameliorating poor lower extremity circulation. The purpose of this study was to evaluate the effect of FIR on changes in foot skin surface temperature (FSST) and autonomic nerve system (ANS) activity to evaluate its effectiveness in improving lower limb circulation.

METHODS

A randomized controlled study was conducted. Subjects (n = 44), all over the age of 50 years and satisfying the inclusion criteria, were randomly allocated into 2 groups. The intervention group received FIR on a lower limb for 40 minutes and the control group received no intervention. Left big toe (LBT), right big toe (RBT), left foot dorsal (LFD), right foot dorsal (RFD) surface skin temperature, autonomic nervous activity, and blood pressure were assessed.

RESULTS

The main results were skin surface temperature at the LBT increased from 30.8 ± 0.4°C to 34.8 ± 0.4°C, at RBT increased from 29.6 ± 0.4°C to 35.3 ± 0.4°C and LFD increased from 31.9 ± 0.3°C to 36.4 ± 0.4°C, RFD increased from 30.7 ± 0.3°C to 37.7 ± 0.2°C. FIR caused a significant increase of the FSST ranging in a 4°C to 7°C increase after 40 minutes irradiation (P < .001). The ANS low-frequency (LF) and high-frequency (HF) activity showed a statistically significant increase in the FIR group (P < .05) but not the LF/HF ratio.

CONCLUSION

FIR significantly increased the FSST from between 4°C and 7°C after 40 minutes irradiation, which might improve lower extremity circulation and regulation of ANS activity.

A cartography of energy medicine: From subtle anatomy to energy physiology

The field of energy medicine (EM) is perhaps the most controversial branch of integrative medicine. Its core concept - the existence of an invisible healing energy - has not yet been validated by Western medicine, and the mechanism(s) of action of its techniques have not been fully elucidated. This paper addresses these problems by marshalling several types of evidence: basic science research into electromagnetic fields (EMF), subjective sensations experienced when receiving EM treatments, and clairvoyant perceptions of EM in action. The latter two sources of information, while not solid enough to meet current standards of scientific rigor, can nonetheless generate important new information. A hypothesis is then developed to explain these findings. First, the main components of the human subtle energy system are presented: the "subtle anatomy" of the meridians, of the energy centers and of the biofield. Several representative EM techniques are then analyzed to determine which specific components of that energy structure they impact. Next, EM's mechanisms of action are explored by describing how these altered energy dynamics can affect biologic processes. This subject is termed "energy physiology", in parallel with conventional medicine's foundation in anatomy and physiology. Finally, potential research into energy physiology is outlined that focuses on several common but distinctive experiences which are not fully explained by the current mechanistic biomedical model. Plausible and testable energy-based explanations are proposed for phantom limb pain, emotional entrainment in groups, unusually rapid symptom response to EM, and the invisible templates that guide cell growth and differentiation. This analysis is intended to serve as a guide to future clinical and research explorations into the multidimensional nature of human beings. As Western medicine develops technologies that can generate objective empiric evidence in these subtle domains, we will be able to more fully understand the energetic components of health and illness.

Hand heating lowers postprandial blood glucose concentrations: A double-blind randomized controlled crossover trial

OBJECTIVES

Examine effect of single hand heating with and without negative pressure on fasting blood glucose (FBG) and postprandial blood glucose (PBG).

DESIGN

Double-blind randomized controlled trial with crossover design.

SUBJECTS

FBG experiment: 17 healthy subjects (4 males). PBG experiment: 13 healthy subjects (1 males).

INTERVENTIONS

Devices included one providing heat only, one heat and negative pressure, and one acting as a sham. For the FBG experiment the devices were used for 30 min. For the PBG experiment the devices were used for one hour during an oral glucose tolerance test (OGTT).

OUTCOME MEASURES

Blood glucose measurements were used to determine change in FBG, peak PBG, area under the curve (AUC), and incremental AUC (iAUC).

RESULTS

Temperature: Change in tympanic temperature was ≤ 0.15 °C for all trials. FBG: There was no effect on FBG. PBG: Compared to the sham device the heat plus vacuum and heat only device lowered peak blood glucose by 16(31)mg/dL, p = 0.092 and 18(28)mg/dL, p = 0.039, respectively. AUC and iAUC: Compared to the sham device, the heat plus vacuum device and heat only device lowered the AUC by 5.1(15.0)%, p = 0.234 and 7.9(11.1)%, p = 0.024 respectively and iAUC by 17.2(43.4)%, p = 0.178 and 20.5(34.5)%, p = 0.054, respectively.

CONCLUSIONS

Heating a single hand lowers postprandial blood glucose in healthy subjects.

Far-infrared Ray-mediated Antioxidant Potentials are Important for Attenuating Psychotoxic Disorders

Far-infrared ray (FIR) is an electromagnetic wave that produces various health benefits against pathophysiological conditions, such as diabetes mellitus, renocardiovascular disorders, stress, and depression etc. However, the therapeutic ap-plication on the FIR-mediated protective potentials remains to be further extended. To achieve better understanding on FIR-mediated therapeutic potentials, we summarized additional findings in the present study that exposure to FIR ameliorates stressful condition, memory impairments, drug dependence, and mitochondrial dysfunction in the central nervous system. In this review, we underlined that FIR requires modulations of janus kinase 2 / signal transducer and activator of transcription 3 (JAK2/STAT3), nuclear factor E2-related factor 2 (Nrf-2), muscarinic M1 acetylcholine receptor (M1 mAChR), dopamine D1 receptor, protein kinase C δ gene, and glutathione peroxidase-1 gene for exerting the protective potentials in response to neuropsychotoxic conditions

Is sauna bathing protective of sudden cardiac death? A review of the evidence

Sudden cardiac death (SCD) is a global public health burden accounting for 15-20% of all deaths. Though established atherosclerotic risk factors explain a large proportion of the risk of SCD, these factors are often absent in a large proportion of SCD victims and the pathogenesis of SCD is still not fully established. It therefore appears that additional factors may be involved. Sauna bathing is a traditional Finnish activity that is mainly used for the purposes of relaxation and pleasure. Beyond its use for these purposes, sauna bathing has been linked with several health benefits. Emerging evidence suggests that sauna bathing is associated with reduced risk of adverse cardiovascular (CV) disease (CVD) and non-CVD outcomes as well as mortality. A number of reports have linked sauna bathing with reduced or increased risk of SCD, but the evidence is uncertain. This review summarizes available studies linking sauna bathing with SCD, the postulated mechanistic pathways underlying these associations, outlines areas of outstanding uncertainty, and the implications for prevention. We employed a comprehensive search for observational studies, randomized controlled trials (RCTs), and non-RCTs from MEDLINE and Embase since their inception until March 2019. Observational data suggest that regular sauna bathing is associated with a substantial risk reduction in SCD. Furthermore, the data suggest that a combination of regular physical activity and sauna baths confers substantial risk reduction for SCD compared with either modality alone. Few reports have linked sauna baths with SCDs, but these single case incidents have been attributed to the effects of dehydration, hypotension, and cardiac arrhythmias due to a combination of sauna exposure and alcohol consumption. Sauna bathing is generally safe for most healthy people and even among patients with stable CVD, if used sensibly and with caution. Plausible pathways underlying the protective effect of sauna bathing on SCD may be linked to the impact on CV function via reduced arterial stiffness, decreases in inflammation and oxidative stress, stabilization of the autonomic nervous system, beneficial changes in circulating lipid profiles and other CVD risk markers, and lowering of systemic blood pressure. Sauna is a potential novel tool to promote SCD prevention in addition to other known means, being an enjoyable way to take care of general health and well-being.

Passive heating and glycaemic control in non-diabetic and diabetic individuals: A systematic review and meta-analysis

Objective

Passive heating (PH) has begun to gain research attention as an alternative therapy for cardio-metabolic diseases. Whether PH improves glycaemic control in diabetic and non-diabetic individuals is unknown. This study aims to review and conduct a meta-analysis of published literature relating to PH and glycaemic control.

Methods

Electronic data sources, PubMed, Embase and Web of Science from inception to July 2018 were searched for randomised controlled trials (RCT) studying the effect of PH on glycaemic control in diabetic or non-diabetic individuals. To measure the treatment effect, standardised mean differences (SMD) with 95% confidence intervals (CI) were calculated.

Results

Fourteen articles were included in the meta-analysis. Following a glucose load, glucose concentration was greater during PH in non-diabetic (SMD 0.75, 95% CI 1.02 to 0.48, P < 0.001) and diabetic individuals (SMD 0.27, 95% CI 0.52 to 0.02, P = 0.030). In non-diabetic individuals, glycaemic control did not differ between PH and control only (SMD 0.11, 95% CI 0.44 to -0.22, P > 0.050) and a glucose challenge given within 24 hours post-heating (SMD 0.30, 95% CI 0.62 to -0.02, P > 0.050).

Conclusion

PH preceded by a glucose load results in acute glucose intolerance in non-diabetic and diabetic individuals. However, heating a non-diabetic individual without a glucose load appears not to affect glycaemic control. Likewise, a glucose challenge given within 24 hours of a single-bout of heating does not affect glucose tolerance in non-diabetic individuals. Despite the promise PH may hold, no short-term benefit to glucose tolerance is observed in non-diabetic individuals. More research is needed to elucidate whether this alternative therapy benefits diabetic individuals.

Effect of heat stress on vascular outcomes in humans

In addition to its role as an environmental stressor, scientists have recently demonstrated the potential for heat to be a therapy for improving or mitigating declines in arterial health. Many studies at both ends of the scientific controls spectrum (tightly controlled, experimental vs. practical) have demonstrated the beneficial effects of heating on microvascular function (e.g., reactive hyperemia, cutaneous vascular conductance); endothelial function (e.g., flow-mediated dilation); and arterial stiffness (e.g., pulse-wave velocity, compliance, β-stiffness index). It is important to note that findings of beneficial effects are not unanimous, likely owing to the varied methodology in both heating protocols and assessments of outcome measures. Mechanisms of action for the effects of both acute and chronic heating are also understudied. Heat science is a very promising area of human physiology research, as it has the potential to contribute to approaches addressing the global cardiovascular disease burden, particularly in aging and at risk populations, and those for whom exercise is not feasible or recommended.

Potential mechanisms for the effects of far-infrared on the cardiovascular system - a review

Far-infrared (FIR) is a form of thermal radiation, which may have beneficial effects on cardiovascular health. Clinical studies suggest that FIR irradiation may have therapeutic effects in heart failure, myocardial ischaemia and may improve flow and survival of arteriovenous fistula. Animal studies have suggested a wide range of potential mechanisms involving endothelial nitric oxide synthase and nitric oxide bioavailability, oxidative stress, heat shock proteins and endothelial precursor cells. However, the exact cellular and molecular mechanism of FIR on the cardiovascular system remains elusive. The purpose of this review is to discuss the current literature, focusing on mechanistic studies involving the cardiovascular system, and with a view to highlighting areas for future investigation.

Far-infrared therapy improves ankle brachial index in hemodialysis patients with peripheral artery disease

Ankle brachial index (ABI) is a diagnostic tool for peripheral artery disease (PAD), which is an important issue in hemodialysis (HD) patients. We enrolled 198 maintenance HD patients in this study. PAD is defined as ABI ≤ 0.90. Only PAD patients received far-infrared (FIR) therapy using the WS TY101 FIR emitter for 40 min during each HD session, three times weekly for 6 months. The ABI was measured at the bilateral lower extremities for 4 times [pre-dialytic timing (0 min) and 40 min after the initiation of HD session at both day 0 and 6 months after the FIR therapy]. The primary outcome is the change in ABI. There were 51 out of 198 patients with PAD. In comparison with the period without FIR therapy in the 51 PAD patients, 6 months of FIR therapy significantly improved the ABI of the right/left side for 0 min (from 0.77 ± 0.19 to 0.81 ± 0.20, p = 0.027/0.79 ± 0.20 to 0.81 ± 0.17, p = 0.049), 40 min during HD (from 0.73 ± 0.23 to 0.83 ± 0.19, p < 0.001/from 0.77 ± 0.21 to 0.83 ± 0.18, p < 0.001), and the incremental change between 0 and 40 min (from - 0.04 ± 0.14 to 0.05 ± 0.13, p = 0.007/from - 0.05 ± 0.13 to 0.03 ± 0.11, p = 0.012), respectively. In conclusion, the application of FIR therapy for 40 min, three times weekly for 6 months, has improved the ABI of both lower extremities, thus providing a new strategy of PAD treatment in HD patients.

Cardiovascular and Other Health Benefits of Sauna Bathing: A Review of the Evidence

Sauna bathing, an activity that has been a tradition in Finland for thousands of years and mainly used for the purposes of pleasure and relaxation, is becoming increasingly popular in many other populations. Emerging evidence suggests that beyond its use for pleasure, sauna bathing may be linked to several health benefits, which include reduction in the risk of vascular diseases such as high blood pressure, cardiovascular disease, and neurocognitive diseases; nonvascular conditions such as pulmonary diseases; mortality; as well as amelioration of conditions such as arthritis, headache, and flu. The beneficial effects of sauna bathing on these outcomes have been linked to its effect on circulatory, cardiovascular, and immune functions. It has been postulated that regular sauna bathing may improve cardiovascular function via improved endothelium-dependent dilatation, reduced arterial stiffness, modulation of the autonomic nervous system, beneficial changes in circulating lipid profiles, and lowering of systemic blood pressure. This review summarizes the available epidemiological, experimental, and interventional evidence linking Finnish sauna bathing and its effects on cardiovascular outcomes and other disease conditions on the basis of a comprehensive search for observational studies, randomized controlled trials, and non-randomized controlled trials from MEDLINE and EMBASE from their inception until February 24, 2018. An overview of the postulated biological mechanisms underlying the associations between sauna bathing and its health benefits, areas of outstanding uncertainty, and implications for clinical practice is also provided.

Longitudinal associations of sauna bathing with inflammation and oxidative stress: the KIHD prospective cohort study

PURPOSE

We sought to determine cross-sectional and longitudinal associations of frequency of sauna bathing with high sensitivity C-reactive protein (hsCRP), fibrinogen, leucocyte count and gamma-glutamyltransferase (GGT).

DESIGN

Baseline sauna bathing habits were assessed in 2269 men aged 42-61 years. Concentrations of hsCRP, fibrinogen, leucocyte count, and GGT were determined at baseline and 11 years later. The associations of sauna bathing frequency with baseline and 11-year hsCRP, fibrinogen, leucocyte count, and GGT levels were examined using robust multivariate regression analyses.

RESULTS

In baseline analysis, 4-7 sauna sessions/week (compared with 1 sauna session/week) was associated with -0.84 mg/l (95% CI, -1.55, -0.14; p = .019) lower hsCRP; -0.07 g/l (95% CI, -0.15, 0.02; p = .112) lower fibrinogen; and -0.28 × 10⁹/l (95% CI, -0.51, -0.06; p = .015) lower leucocyte count, after multivariable adjustment. In longitudinal analysis, the corresponding estimates were -1.66 mg/l (95% CI, -3.13, -0.19; p = .027); -0.16 g/l (95% CI, -0.31, -0.02; p = .031); and -0.49 × 10⁹/l (95% CI, -0.85, -0.14; p = .007) respectively. Sauna bathing frequency was not associated with GGT at baseline and 11 years.

CONCLUSION

Observational evidence supports the hypothesis that reduction in inflammation may be one of the pathways linking frequent sauna bathing with decreased risk of acute and chronic disease conditions. KEY MESSAGES Cross-sectional evidence or short-term studies suggest Finnish sauna bathing may exert its beneficial health effects via reduction in inflammation and oxidative stress; however, the long-term effects of sauna bathing on these outcomes are uncertain. In this population-based prospective cohort study, frequent sauna sessions significantly decreased levels of inflammatory markers at baseline and 11-year follow-up; but had no effect on oxidative stress. The health benefits of sauna bathing may in part be mediated via reduced systemic inflammation.

Short-term effects of Finnish sauna bathing on blood-based markers of cardiovascular function in non-naive sauna users

Emerging evidence suggests that sauna bathing is associated with reduced risk of cardiovascular and all-cause mortality events. However, the biochemical pathways by which sauna bathing might confer its effects on cardiovascular function are not certain. We aimed to study the acute effects of Finnish sauna bathing on various blood-based cardiovascular biomarkers. The study included 102 non-naive sauna users (54% male) with mean age of 51.9 years, who had at least one cardiovascular risk factor. Participants underwent a 30-min single sauna session (mean temperature, 73 °C). Biochemical profiling was conducted before, immediately after sauna and 30-min post-sauna. Overall median N-terminal pro-B-type natriuretic peptide (NT-proBNP) level (n = 20 participants) was 46.0 ng/L before sauna exposure, which increased to 50.5 ng/l immediately after sauna (median change, + 12.00%; p < 0.001) and remained persistent at 30-min post-sauna (median change from pre-sauna to post-30-min sauna, + 13.93%; p < 0.001). The changes were more evident in males compared with females. There were no significant changes in overall levels of high sensitivity C-reactive protein, creatine kinase, high sensitivity troponin I, and creatine kinase-MBm. However, levels of creatine kinase increased in males (median change immediately after sauna, + 2.99%; p = 0.024). Levels of NT-proBNP increased after sauna exposure. The increase in levels of creatine kinase was more evident in males. Long-term interventional studies are warranted to evaluate if these biomarkers are involved in pathways underlying the associations of sauna bathing with cardiovascular outcomes.

Clinical Effects of Regular Dry Sauna Bathing: A Systematic Review

Introduction

Many health benefits are claimed by individuals and facilities promoting sauna bathing; however the medical evidence to support these claims is not well established. This paper aims to systematically review recent research on the effects of repeated dry sauna interventions on human health.

Methods

A systematic search was made of medical databases for studies reporting on the health effects of regular dry sauna bathing on humans from 2000 onwards. Risk of bias was assessed according to the Cochrane Collaboration guidelines.

Results

Forty clinical studies involving a total of 3855 participants met the inclusion criteria. Only 13 studies were randomized controlled trials and most studies were small (n < 40). Reported outcome measures were heterogeneous with most studies reporting beneficial health effects. Only one small study (n = 10) reported an adverse health outcome of disrupted male spermatogenesis, demonstrated to be reversible when ceasing sauna activity.

Conclusions

Regular dry sauna bathing has potential health benefits. More data of higher quality is needed on the frequency and extent of adverse side effects. Further study is also needed to determine the optimal frequency and duration of distinct types of sauna bathing for targeted health effects and the specific clinical populations who are most likely to benefit.

Joint associations of sauna bathing and cardiorespiratory fitness on cardiovascular and all-cause mortality risk: a long-term prospective cohort study

PURPOSE

We aimed to evaluate the joint impact of cardiorespiratory fitness (CRF) and frequency of sauna bathing (FSB) on the risk of cardiovascular and all-cause mortality.

DESIGN

CRF measured by respiratory gas analyses and sauna exposure were assessed at baseline in a prospective study of 2277 men. CRF was categorized as low and high (median cut-offs) and FSB as low and high (≤2 and 3-7 sessions/week, respectively).

RESULTS

During a median follow-up of 26.1 years, 520 cardiovascular and 1124 all-cause deaths occurred. Comparing high versus low CRF, the multivariate-adjusted hazard ratios (HRs) 95% CIs for cardiovascular and all-cause mortality were 0.51 (0.41-0.63) and 0.65 (0.57-0.75), respectively. Comparing high versus low FSB, the corresponding HRs were 0.74 (0.59-0.94) and 0.84 (0.72-0.97), respectively. Compared to low CRF & low FSB, the HRs of CVD mortality for high CRF & high FSB; high CRF & low FSB; and low CRF & high FSB were 0.42 (0.28-0.62), 0.50 (0.39-0.63) and 0.72 (0.54-0.97), respectively. For all-cause mortality, the corresponding HRs were 0.60 (0.48-0.76), 0.63 (0.54-0.74) and 0.78 (0.64-0.96), respectively.

CONCLUSIONS

A combination of high CRF and frequent sauna bathing confers stronger long-term protection on mortality outcomes compared with high CRF or high FSB alone. KEY MESSAGES Cardiorespiratory fitness (CRF) and frequency of sauna bathing are independently associated with reduced mortality risk; a combination of good CRF and frequent sauna bathing may confer additional survival benefits. In a population-based prospective cohort study, a combination of high CRF levels and frequent sauna bathing (3-7 sessions per week) was associated with a substantial risk reduction in fatal cardiovascular and all-cause mortality events compared with good CRF or frequent sauna bathing alone. A combination of good fitness levels produced by aerobic exercises and frequent sauna bathing may have added health benefits and confer more protection on the risk of mortality.

Sauna Bathing and Risk of Psychotic Disorders: A Prospective Cohort Study

OBJECTIVE

Sauna bathing has been suggested to promote mental well-being and relaxation, but the evidence is uncertain with respect to mental disorders. We aimed to assess the association of frequency of sauna bathing with risk of psychosis in the Kuopio Ischemic Heart Disease prospective population-based study.

SUBJECTS AND METHODS

Baseline sauna bathing habits were assessed in 2,138 men aged 42-61 years who had no history of psychotic disorders. Participants were classified into three groups based on the frequency of sauna bathing (once, 2-3, and 4-7 times per week).

RESULTS

During a median follow-up of 24.9 years, 203 psychotic disorders were recorded. A total of 537, 1,417, and 184 participants reported having a sauna bath once a week, 2-3 times, and 4-7 times per week, respectively. In Cox regression analysis adjusted for age, compared to men who had 1 sauna session per week, the hazard ratio (95% confidence intervals) of psychosis for 4-7 sauna sessions per week was 0.23 (0.09-0.58). In a multivariable model adjusted for several risk factors and other potential confounders, the corresponding hazard ratio was 0.21 (0.08-0.52). The association was similar after further adjustment for total energy intake, socioeconomic status, physical activity, and C-reactive protein (0.22 [0.09-0.54]) and was unchanged on additional adjustment for duration of a sauna session and temperature of the sauna bath (0.23 [0.09-0.57]).

CONCLUSION

Our study suggests a strong inverse and independent association between frequent sauna bathing and the future risk of psychotic disorders in a general male population.

Statins and secondary prevention of venous thromboembolism: pooled analysis of published observational cohort studies

AIMS

There have been suggestions that statins may have a potential role in secondary prevention of venous thromboembolism (VTE) [which includes deep vein thrombosis (DVT) and pulmonary embolism (PE)], but the evidence is inconsistent. We aimed to evaluate the association between statin use and risk of recurrent VTE.

METHODS AND RESULTS

We conducted a systematic review and meta-analysis of observational cohort studies. All relevant studies which reported associations between statin use and recurrent VTE outcomes were identified from MEDLINE, EMBASE, Web of Science, and manual search of bibliographies from inception to January 2017. Study specific relative risks (RRs) with 95% confidence intervals were aggregated using random effects models. Eight eligible studies comprising of 103 576 participants and 13 168 recurrent VTE outcomes were included in the pooled analysis. In pooled analysis of 7 studies, the RR for recurrent VTE was 0.73 (0.68-0.79) when comparing statin use with no use. There was no evidence of heterogeneity between contributing studies (I2=0%, 0-71%; P = 0.93). The RRs for recurrent PE (three studies) and DVT (two studies) comparing statin use with no statin use were 0.75 (95% CI: 0.58-0.96) and 0.66 (95% CI: 0.60-0.71) respectively.

CONCLUSION

Available evidence from observational cohort studies suggests a beneficial effect of statin use on VTE recurrence. Well-designed intervention studies are needed to corroborate these findings.

An update of the effect of far infrared therapy on arteriovenous access in end-stage renal disease patients

The life qualities of end-stage renal disease (ESRD) patients rely largely on adequate dialysis, and a well-functioning vascular access is indispensable for high quality hemodialysis. Despite the advancement of surgical skills and the optimal maintenance of arteriovenous fistula (AVF), malfunction of AVF is still frequently encountered and has great impact on the life of ESRD patients. Several medical, mechanical and genetic prognostic factors are documented to affect the patency of AVF and arteriovenous graft (AVG). Heme oxygenase-1 (HO-1) is one of the genetic factors reported to play a role in cardiovascular disease and the patency of vascular access. Far infrared (FIR), a novel therapeutic modality, can not only conduct heat energy to AVF but also stimulate the non-thermal reactions mediated by HO-1. The use of FIR therapy significantly enhances the primary patency rate and maturation of AVF with fewer unfavorable adverse effects, and also achieves higher post-angioplasty patency rate for AVG. The only limitation in proving the effectiveness of FIR therapy in enhancing patency of AVF is that all the studies were conducted in Chinese people in Taiwan and thus, there is a lack of evidence and experience in people of other ethnicities.

Thermotherapy reduces blood pressure and circulating endothelin-1 concentration and enhances leg blood flow in patients with symptomatic peripheral artery disease

Leg thermotherapy (TT) application reduces blood pressure (BP) and increases both limb blood flow and circulating levels of anti-inflammatory mediators in healthy, young humans and animals. The purpose of the present study was to determine the impact of TT application using a water-circulating garment on leg and systemic hemodynamics and on the concentrations of circulating cytokines and vasoactive mediators in patients with symptomatic peripheral artery disease (PAD). Sixteen patients with PAD and intermittent claudication (age: 63 ± 9 yr) completed three experimental sessions in a randomized order: TT, control intervention, and one exercise testing session. The garment was perfused with 48°C water for 90 min in the TT session and with 33°C water in the control intervention. A subset of 10 patients also underwent a protocol for the measurement of blood flow in the popliteal artery during 90 min of TT using phase-contrast MRI. Compared with the control intervention, TT promoted a significant reduction in systolic (∼11 mmHg) and diastolic (∼6 mmHg) BP (P < 0.05) that persisted for nearly 2 h after the end of the treatment. The serum concentration of endothelin-1 (ET-1) was significantly lower 30 min after exposure to TT (Control: 2.3 ± 0.1 vs. TT: 1.9 ± 0.09 pg/ml, P = 0.026). In addition, TT induced a marked increase in peak blood flow velocity (∼68%), average velocity (∼76%), and average blood flow (∼102%) in the popliteal artery (P < 0.01). These findings indicate that TT is a practical and effective strategy to reduce BP and circulating ET-1 concentration and enhance leg blood flow in patients with PAD.

Clinical utility of far-infrared therapy for improvement of vascular access blood flow and pain control in hemodialysis patients

Background

Maintenance of a well-functioning vascular access and minimal needling pain are important goals for achieving adequate dialysis and improving the quality of life in hemodialysis (HD) patients. Far-infrared (FIR) therapy may improve endothelial function and increase access blood flow (Qa) and patency in HD patients. The aim of this study was to evaluate effects of FIR therapy on Qa and patency, and needling pain in HD patients.

Methods

This prospective clinical trial enrolled 25 outpatients who maintained HD with arteriovenous fistula. The other 25 patients were matched as control with age, sex, and diabetes. FIR therapy was administered for 40 minutes during HD 3 times/wk and continued for 12 months. The Qa was measured by the ultrasound dilution method, whereas pain was measured by a numeric rating scale at baseline, then once per month.

Results

One patient was transferred to another facility, and 7 patients stopped FIR therapy because of an increased body temperature and discomfort. FIR therapy improved the needling pain score from 4 to 2 after 1 year. FIR therapy increased the Qa by 3 months and maintained this change until 1 year, whereas control patients showed the decrease in Qa. The 1-year unassisted patency with FIR therapy was not significantly different from control.

Conclusion

FIR therapy improved needling pain. Although FIR therapy improved Qa, the unassisted patency was not different compared with the control. A larger and multicenter study is needed to evaluate the effect of FIR therapy.

Far-infrared therapy for cardiovascular, autoimmune, and other chronic health problems: A systematic review

Physical therapy (physiotherapy), a complementary and alternative medicine therapy, has been widely applied in diagnosing and treating various diseases and defects. Increasing evidence suggests that convenient and non-invasive far-infrared (FIR) rays, a vital type of physiotherapy, improve the health of patients with cardiovascular disease, diabetes mellitus, and chronic kidney disease. Nevertheless, the molecular mechanisms by which FIR functions remain elusive. Hence, the purpose of this study was to review and summarize the results of previous investigations and to elaborate on the molecular mechanisms of FIR therapy in various types of disease. In conclusion, FIR therapy may be closely related to the increased expression of endothelial nitric oxide synthase as well as nitric oxide production and may modulate the profiles of some circulating miRNAs; thus, it may be a beneficial complement to treatments for some chronic diseases that yields no adverse effects.

Effects of Waon therapy on chronic fatigue syndrome: a pilot study

OBJECTIVE

Chronic fatigue syndrome (CFS) is a disabling condition of unknown etiology, and no definitive therapy has been identified to date. We developed Waon therapy, a form of thermal therapy using a far-infrared dry sauna, and in this study herein examined its feasibility and safety in patients with CFS.

METHODS

Ten consecutive inpatients with CFS stayed in a 60°C sauna for 15 minutes and then rested on a bed under a blanket for an additional 30 minutes outside the sauna room. The treatments were performed once a day, five days a week for four weeks. Perceived fatigue, the primary outcome measure, was evaluated using a numerical rating scale before, during (two weeks after the commencement of therapy) and after therapy. The pain level, evaluated using a numerical rating scale, mood, assessed using the Profile of Mood States questionnaire, and performance status, assessed using a scale developed for CFS patients were also examined before and after therapy.

RESULTS

Perceived fatigue significantly decreased after therapy, although no significant reductions were observed during therapy. In addition, a negative mood, including anxiety, depression and fatigue, and the performance status significantly improved after therapy. However, the levels of pain and vigor did not change significantly. No patients reported any adverse effects during the therapy.

CONCLUSION

These findings suggest that Waon therapy may be a useful and safe treatment for CFS.

The effect of a single Finnish sauna bath after aerobic exercise on the oxidative status in healthy men

BACKGROUND

The aim of this study was to determine the effect of Finnish sauna as a regeneration method post-exercise on the oxidant-antioxidant balance in healthy men.

MATERIAL

43 men aged 24.0 ± 4.3 years performed a 30-min aerobic exercise on a cycle ergometer and rested for 39 min at a room temperature (Day 1; 20°C) or in a sauna for post-workout recovery (Day 2; 90°C, air humidity 10%). Blood was taken 3 times during both study days: Before the exercise (baseline), 20 and 40 min after the recovery. Methods. The activity of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) was determined in the subjects' erythrocytes. The concentration of thiobarbituric acid reactive substances (TBARS) was measured both in plasma (TBARSpl) and in the erythrocytes (TBARSer).

RESULTS

A 12.7% increase in the TBARSpl concentration versus the baseline was observed 40 min after the Finnish sauna (p < 0.01). The CAT activity observed 20 and 40 min after the sauna was also found higher by 8.1% and 8.9%, respectively, in comparison with the baseline (p < 0.05). In turn, the TBARSer concentration was lower by 17.5% 40 min after the recovery in the sauna, as compared with the TBARSer concentration 40 min after the recovery at the room temperature (p < 0.05).

CONCLUSIONS

A single Finnish sauna bath as a source of free radicals per se is able to reduce oxidative stress induced by a 30-min aerobic exercise in healthy men.

Novel therapies for hemodialysis vascular access dysfunction: myth or reality?

Hemodialysis vascular access dysfunction is a major source of morbidity for patients with ESRD. Development of effective approaches to prevent and treat vascular access failure requires an understanding of the underlying mechanisms, suitable models for preclinical testing, systems for targeted delivery of interventions to maximize efficacy and minimize toxicity, and rigorous clinical trials that use appropriate outcome measures. This article reviews the substantial progress and ongoing challenges in developing novel treatments for arteriovenous vascular access failure and focuses on localized rather than systemic interventions.

The skin function: a factor of anti-metabolic syndrome

The body's total antioxidant capacity represents a sum of the antioxidant capacity of various tissues/organs. A decrease in the body's antioxidant capacity may induce oxidative stress and subsequent metabolic syndrome, a clustering of risk factors for type 2 diabetes and cardiovascular disease. The skin, the largest organ of the body, is one of the major components of the body's total antioxidant defense system, primarily through its xenobiotic/drug biotransformation system, reactive oxygen species-scavenging system, and sweat glands- and sebaceous glands-mediated excretion system. Notably, unlike other contributors, the skin contribution is variable, depending on lifestyles and ambient temperature or seasonal variations. Emerging evidence suggests that decreased skin's antioxidant and excretory functions (e.g., due to sedentary lifestyles and low ambient temperature) may increase the risk for metabolic syndrome. This review focuses on the relationship between the variability of skin-mediated detoxification and elimination of exogenous and endogenous toxic substances and the development of metabolic syndrome. The potential role of sebum secretion in lipid and cholesterol homeostasis and its impact on metabolic syndrome, and the association between skin disorders (acanthosis nigricans, acne, and burn) and metabolic syndrome are also discussed.

Leg heating using far infra-red radiation in patients with chronic heart failure acutely improves the hemodynamics, vascular endothelial function, and oxidative stress

BACKGROUND

Systemic thermal therapy (STT) has been associated with beneficial effects in patients with chronic heart failure (CHF). The fact, however, that it requires a dedicated as well as spacious facility and trained personnel makes it difficult to practice in the daily care of patients with CHF.

OBJECTIVE

The aim of this study was to determine whether the leg thermal therapy (LTT) has a positive impact similar to that of STT in patients with CHF. Methods and Results Twenty patients with CHF (57 ± 17 years old, left ventricular ejection fraction=30 ± 10%) received LTT (45°C) for 20 minutes. Immediately after the treatment, the core temperature had increased (+0.3 ± 0.3°C) (p<0.01). While the LTT had no significant effects on the heart rate, systolic arterial pressure, and diastolic blood pressure, it increased the cardiac output (mixed venous oxygen saturation; +2 ± 3%) and decrease the pulmonary capillary wedge pressure (-2 ± 2 mmHg). The LTT significantly improved the flow-mediated vasodilatation (FMD) from 4.8 ± 2.6 to 7.1 ± 3.6%, the antioxidative markers, thiol from 4.0 ± 0.7 to 4.5 ± 0.9 μmoL/g, and the marker of oxidative deoxyribonucleic acid (DNA) damage, urine 8-hydroxy-2'deoxyguanosine (8OHdG) from 100 to 82 ± 3%, respectively (p<0.05). No patient had any adverse effects associated with LTT. Conclusion LTT acutely improved FMD, and oxidative stress in patients with CHF. Although the long-term effect of LTT remains to be investigated, its practicality which is comparable to that of STT would make it an attractive therapeutic strategy for patients with CHF.

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.

Effect of Waon therapy on oxidative stress in chronic heart failure

BACKGROUND

A previous report by our team showed that Waon therapy, using a far infrared-ray dry sauna at 60°C, improves cardiac and vascular function in patients with chronic heart failure (CHF). The purpose of the present study was to clarify the effect of Waon therapy on oxidative stress in CHF patients and investigate its mechanism by animal experiments.

METHODS AND RESULTS

Forty patients with CHF were divided into control (n=20) and Waon therapy (n=20) groups. All patients received standard optimal medications for CHF. Waon therapy group was treated with Waon therapy daily for 4 weeks. After 4 weeks of Waon therapy, concentrations of hydroperoxide and brain natriuretic peptide (BNP) decreased significantly (hydroperoxide, 422±116 to 327±88U.CARR, P<0.001; BNP, 402±221 to 225±137pg/ml, P<0.001), and the nitric oxide metabolites increased (71.2±35.4 to 92.0±40.5mmol/L, P<0.05). In contrast, none of these variables changed over the 4-week interval in the control group. Furthermore, animal experiments were performed using TO-2 cardiomyopathic hamsters. On immunohistochemistry, cardiac expression of 4-hydroxy-2-nonenal, a marker of oxidative stress, was decreased in the 4-week Waon therapy compared to untreated hamsters. On Western blotting, cardiac expressions of heat shock protein (HSP) 27, manganese superoxide dismutase and HSP32, which reduce oxidative stress, were significantly upregulated in the 4-week Waon therapy compared to untreated hamsters.

CONCLUSIONS

Waon therapy decreases oxidative stress in patients and hamsters with heart failure.

Effects of thermal therapy combining sauna therapy and underwater exercise in patients with fibromyalgia

Fibromyalgia syndrome (FMS) is a chronic disorder that is characterized by widespread pain with localized tenderness. We aimed to investigate whether thermal therapy combining sauna therapy and underwater exercise improved pain, symptoms, and quality of life (QOL) in FMS patients. Forty-four female FMS patients who fulfilled the American College of Rheumatology (ACR) criteria received 12-week thermal therapy program comprising sauna therapy once daily for 3 days/week and underwater exercise once daily for 2 days/week. Pain, symptoms, and QOL were assessed using a pain visual analog scale (VAS), a fibromyalgia impact questionnaire (FIQ), and a short form 36-item questionnaire (SF-36), respectively. All of the patients reported significant reductions in pain and symptoms of 31-77% after the 12-week thermal therapy program, which remained relatively stable (28-68%) during the 6-month follow-up period (that is, the thermal therapy program improved both the short-term and the long-term VAS and FIQ scores). Improvements were also observed in the SF-36 score. Thermal therapy combining sauna therapy and underwater exercise improved the QOL as well as the pain and symptoms of FMS patients.