Authors: Lis Eversden,^#1 Fiona Maggs,² Peter Nightingale,³ and Paresh Jobanputra^#2

Men and women aged 18 years or older with Rheumatoid Arthritis (meeting American College of Rheumatology criteria), who were attending rheumatology clinics at Selly Oak Hospital in Birmingham, were invited to participate in a scientific study of the effects of hydrotherapy versus land exercises in the treatment of their arthritis.

Scientists concluded that the patients with Rheumatoid Arthritis (RA), who are treated with hydrotherapy, are more likely to report feeling much better or very much better than those treated with land exercises.

Authors: N. Gusi ^{1 *}, P. Tomas-Carus ¹, A. Häkkinen ², K. Häkkinen ³, A. Ortega-Alonso ⁴

¹Fitness and Lifequality Laboratory, University of Extremadura, Cáceres, Spain
²Jyväskylä Central Hospital, Jyväskylä, Finland
³University of Jyväskylä, Jyväskylä, Finland
⁴Fitness and Lifequality Laboratory, University of Extremadura, Cáceres, Spain, and University of Jyväskylä, Jyväskylä, Finland

Thirty-four women were randomly assigned to either an exercise group to perform 3 weekly sessions of training (in waist-high warm water) including aerobic, proprioceptive, and strengthening exercises during 12 weeks, or to a control group (which did not participate in these hydrotherapy exercises). Maximal unilateral isokinetic strength was measured in the knee extensor and flexor muscles.

The strength of the knee extensors in concentric actions increased by 20% in both limbs after the training period, and these improvements were maintained after the de-training period in the exercise group. Health-Related Quality of Life (HRQOL) improved by 93%, and pain was reduced by 29% in the exercise group during the training.

Hydrotherapy relieved pain and improved HRQOL and muscle strength in the lower limbs at low velocity in patients with initial low muscle strength and high number of tender points. Most of these improvements were maintained long term.

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Authors: HU Pei-cheng 胡佩诚 Department of Medical Psychology, Peking University Health Science Centre, Beijing 100083, China; SU Ying 苏 英 College of Psychology, Beijing Normal University, Beijing 100875, China

Flotation Therapy

The purpose of this research study conducted in China was to find out the effect of flotation therapy on the basic psychological and physiological function of ordinary people, focusing especially on the effectiveness of promoting relaxation and improving emotion states.

Flotation therapy is one of the models of Restricted Environmental Stimulation Therapy (REST). It has been studied and used in clinics in western countries for many years. According to the research results, flotation therapy can be used effectively in many ways. Some of the research done in China showed that flotation therapy could be helpful in the treatment of hypertension as well as cerebral paraplegia. It has also been observed in clinics that flotation therapy can induce deep relaxation, improve emotional states and have beneficial effects on some kinds of neurosis and psychosomatic diseases. But the effect of flotation therapy on the basic psychological and physiological function of ordinary Chinese has not been studied systemically. And there is no objective research result that has demonstrated the benefits of flotation therapy in Chinese clinics.

Deepening relaxation and reducing stress level

Inducing deep relaxation is the basic function of flotation therapy. Heart rate and EMG are common relaxation indexes used in REST studies. The changes of these two objective indices in this study suggest the subject's body is relaxed deeply during flotation. Previous studies have shown that when relaxed, the arousal level of cerebral cortex is lowered, the activity of the sympathetic nervous system is also lowered whereas the activity of the parasympathetic nervous system is heightened. Through the changes of neural system, endocrine system and autonomic nervous system, the functioning of the human body becomes modified. Therefore, it was suggested that flotation therapy could promote the healthy functioning of the human body.We believe that because flotation therapy eliminates most external stimuli, the stimulating events the individual needs to deal with during the process are few. Thus, one would expect the stress level of the subjects to go down during flotation therapy. Combined with the effects of inducing deep relaxation and lowering the functions of the thalamus-pituitary-adrenal gland axis, it can be suggested that flotation therapy reduces stress level.

 
Emotional state improved

It has been reported that flotation therapy can improve the subject's emotion state. The results of this study show flotation could improve mood state and reduce anxiety and depression level significantly.

The mechanisms may be as follows:

① Some psychologists have proposed that along with cognitive activities and emotions, every individual has their own ideal level of stimulation and arousal. Researchers studying flotation therapy believe that the usual level of stimulation encountered in modern society is too much for some individuals to handle. An environment of overwhelming stimulation leads to too much stimulation and information flooding the cognitive system of the individual. The individual cannot deal with all this information and stimulation effectively. So maladaptive reactions to the situation occur. If the individual is taken out of that environment and put into a less demanding one, these reactions could be avoided, reduced or eliminated. The person's whole mood status could be improved as well.

② According to the cognitive theory of emotion, emotion is affected by three factors: environmental, physiological and cognitive.［10］ During flotation therapy, external stimuli are extremely reduced so the stimulating events are few. So the mood is improved.

③ Some preliminary studies have suggested that flotation therapy may facilitate the release of endogenous beta-endorphin in the brain: beta-endorphin is a peptide that can induce euphoria state in human beings.

④ Flotation can induce deep relaxation. An individual feels comfortable, amused and pleasing when he or she is relaxed.

⑤ The effect of improving mood state may come from the collaborative operation of all the mechanisms.

Considering the results of this study and other studies, it can be suggested that flotation therapy may be helpful in the treatment of many psychological disorders and psychosomatic diseases. In hypertensive patients we have obtained good results through flotation therapy, but in patients with other psychological disorders or psychosomatic diseases must be tested in further studies and clinic works.

A previous study has shown that gender has no influence on the effects of REST. The results of this study shows that gender may influence the mood improving effect of flotation therapy. The improvement for women is better than that for men. This show that the flotation therapy may be better suited for females, but it needs further study and clinical work.

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