Basic Research on the Safe Way of Bathing Care and Water Exercise in the Elderly

我们首先研究了热浴盆沐浴温度对老年人心肺和代谢功能的影响。其次，我们比较了老年人和年轻人洗澡时的生理反应。第三，我们调查了社区老年人的实际沐浴状况。最后，比较了水上运动与体操运动的效果。在第一个项目中，12名健康的老年志愿者在27℃的室温下进行不同水温（41℃、38℃）的沐浴。我们评估了整个实验过程中收缩压和舒张压（SBP， DBP）、心率（HR）、压率产物（PRP）、氧饱和度（Spo2）、鼓室温度（Ttymp）、动态心电图和耗氧量（VO2）的变化。38℃浸泡时，心肺指标无明显变化，41℃浸泡时SBR、PRP和Ttymp显著升高。在41℃时，VO2比38℃时增加。血浆儿茶酚胺…更多的血液在沐浴后略有下降。这些结果表明，41℃的沐浴比38℃的沐浴给心肺系统带来更大的压力。在第二个项目中，受试者是12名老年健康志愿者和12名青年志愿者。他们分别在27℃和20℃的室温下进行41℃的浴。我们评估的指标与前一次实验相同。27℃时，老年人洗澡时收缩压几乎没有下降，但洗澡后明显下降。然而，即使在洗澡时，年轻志愿者的收缩压也有所下降。两组患者在沐浴期间和沐浴后舒张压均下降。老年人沐浴时PRP变化不大，沐浴后PRP下降，而年轻人沐浴后PRP立即上升，然后迅速下降。在老年人中，Spo2在洗澡后逐渐下降，而在年轻志愿者中则没有。两组人在洗澡后Ttymp都有所增加。在20℃的室温下，老年人的收缩压和舒张压的降低都有所减少，而年轻人则没有。HR和PRP的变化与27℃时相似。在20℃的室温下，老年人洗澡时的交感神经张力反应明显强于年轻人，而在27℃的室温下则没有。在27℃时，两组沐浴后血管舒张作用均显著。在27℃的环境温度下洗澡对老年人的血液动力学有良好的影响。少

We firstly investigated the effects of temperature of hot tub bathing on the elderly regarding cardiopulmonary and metabolic functions. Secondly, we compared the physiological responses to bathing between the elderly and the youth. Thirdly, we surveyed the actual bathing status of the elderly in communities. Lastly, the effects of water exercise were compared to those of gymnastic one. In the first project, 12 elder healthy volunteers took baths of different water temperature (41℃,38℃) at 27℃ room temperature. We assessed changes in systolic and diastolic blood pressures (SBP, DBP), heart rates (HR), pressure-rate products (PRP), oxygen saturations (Spo2), tympanic temperatures (Ttymp), Holter ECGs, and oxygen consumption (VO2) throughout the experiment. In 38℃-bath immersions, none of the cardiopulmonary indices significantly changed but 41℃-bath immersions significantly increased SBR, PRP, and Ttymp during bathing. VO2 increased during bathing at 41℃ more than 38℃. Plasma catecholami … More nes slightly decreased after bathing. These results suggested that 41℃- bathing give more stress to the cardiopulmonary system than 38℃-bathing. In the second project, subjects were 12 elderly healthy volunteers and 12 young volunteers. They took 41℃-baths at 27℃ and at 20℃ room temperature. We assessed the same indices as the former experiment. At 27℃, SBP in the elderly hardly decreased during bathing but significantly decreased after bathing. The young volunteers, however, showed a decrease in SBP even during bathing. DBP decreased during and after bathing in both groups. PRP in the elderly hardly changed during bathing and decreased after bathing, but in the young it increased immediately following bathing and then quickly decreased. In the elderly Spo2 decreased gradually after bathing but not in the young volunteers. Ttymp increased after bathing in both groups. At 20℃ room temperature, reduction of both SBP and DBP was diminished in the elderly but not in the young. Changes in HR and PRP were similar to those under 27℃. Elderly subjects showed more sympathicotonic response than did young subjects during bathing at 20℃ but not at 27℃ room temperature. Vasodilating effects after bathing were prominent at 27℃ in both groups. Bathing at 27℃ ambient temperature affords favorable hemodynamic effects in the elderly. Less