This bibliometric study analyzes the evolving field of thermotherapy, a medical treatment that utilizes heat to treat various conditions, including cancer, by applying controlled temperatures to targeted tissues. Utilizing bibliographic data from the core collection of Web of Science and analysis software Biblioshiny and VOSviewer, we analyzed several key metrics to gain insights into the development and trends in thermotherapy research. The annual scientific production revealed a significant increase in publications over the past two decades, reflecting growing interest in this field. Analysis of the most relevant authors and sources highlighted key contributors and influential journals. Trend topics demonstrated a shift from early focus areas like hyperthermia and laser-induced thermotherapy to recent advancements involving nanoparticles and combination therapies. The thematic map provided insights into core, emerging, and niche areas within the research landscape. A historiograph traced the chronological development of significant publications, while the co-occurrence of keywords and bibliographic coupling of documents identified major themes and interconnections in the literature. International collaborations were mapped, showing the global nature of thermotherapy research. The study identified several research gaps, including the need for large-scale clinical trials, interdisciplinary approaches, and standardized treatment protocols. Practical implications suggest focusing on targeted delivery systems, expanding cancer research, and fostering collaborative projects to advance the field.

UNASSIGNED: The pulmonary endothelium is the primary target of lung ischemia-reperfusion injury leading to primary graft dysfunction after lung transplantation. We hypothesized that treating damaged rat lungs by a transient heat stress during ex-vivo lung perfusion (EVLP) to elicit a pulmonary heat shock response could protect the endothelium from severe reperfusion injury.
UNASSIGNED: Rat lungs damaged by 1h warm ischemia were reperfused on an EVLP platform for up to 6h at a constant temperature (T°) of 37°C (EVLP37°C group), or following a transient heat stress (HS) at 41.5°C from 1 to 1.5h of EVLP (EVLPHS group). A group of lungs exposed to 1h EVLP only (pre-heating conditions) was added as control (Baseline group). In a first protocol, we measured lung heat sock protein expression (HSP70, HSP27 and Hsc70) at selected time-points (n=5/group at each time). In a second protocol, we determined (n=5/group) lung weight gain (edema), pulmonary compliance, oxygenation capacity, pulmonary artery pressure (PAP) and vascular resistance (PVR), the expression of PECAM-1 (CD31) and phosphorylation status of Src-kinase and VE-cadherin in lung tissue, as well as the release in perfusate of cytokines (TNFα, IL-1β) and endothelial biomarkers (sPECAM, von Willebrand Factor -vWF-, sE-selectin and sICAM-1). Histological and immunofluorescent studies assessed perivascular edema and formation of 3-nitrotyrosine (a marker of peroxinitrite) in CD31 lung endothelium.
UNASSIGNED: HS induced an early (3h) and persisting expression of HSP70 and HSP27, without influencing Hsc70. Lungs from the EVLP37°C group developed massive edema, low compliance and oxygenation, elevated PAP and PVR, substantial release of TNFα, IL-1β, s-PECAM, vWF, E-selectin and s-ICAM, as well as significant Src-kinase activation, VE-cadherin phosphorylation, endothelial 3-NT formation and reduced CD31 expression. In marked contrast, all these alterations were either abrogated or significantly attenuated by HS treatment.
UNASSIGNED: The therapeutic application of a transient heat stress during EVLP of damaged rat lungs reduces endothelial permeability, attenuates pulmonary vasoconstriction, prevents src-kinase activation and VE-cadherin phosphorylation, while reducing endothelial peroxinitrite generation and the release of cytokines and endothelial biomarkers. Collectively, these data demonstrate that therapeutic heat stress may represent a promising strategy to protect the lung endothelium from severe reperfusion injury.

BACKGROUND: Musculoskeletal (MSK) pain includes a wide variety of causes and conditions. Despite the heterogeneity of MSK pain, it is possible to identify some common clinical features and treatments. Heat therapy (HT) is one of the most common and could be a suitable non-pharmacological approach.
OBJECTIVE: To obtain a European overview on the use of non-pharmacological approaches and the role of heat therapy in the treatment of MSK pain.
METHODS: Through a two-cycle Delphi-like method, an international board of experts reached a consensus on 13 questions for a survey to healthcare professionals who provide direct patient care. Between November 2021 and January 2022, the resulting web survey was distributed to professionals with the collaboration of ten European scientific societies and associations. Univariate and bivariate analyses were performed on collected data.
RESULTS: Two hundred eighty-two answers were validated. Most of the respondents had extensive professional experience. Participants were widely distributed throughout Europe. HT is administered to about 50% of patients, with a higher percentage administered to those affected by low back pain (92%) and neck pain (84%). The choice of exogenous HT is based on both personal clinical experience and scientific evidence. HT is primarily chosen due to its relaxation effect, high safety profile and enhancement of tissue perfusion. The use of HT is recommended by 86.5% of respondents.
CONCLUSIONS: Experts indicate that exogenous HT represents a valid therapeutic choice and is widely used in Europe. Patients should be informed about the use of heat therapy as a valuable self-management therapy option.

BACKGROUND: Knee osteoarthritis (KOA) is one of most prevalent and fastest-growing causes of pain, impaired mobility, and poor quality of life in the rapidly aging population worldwide. There is a lack of high-quality evidence on the efficacy of traditional Chinese medicine (TCM), particularly acupuncture, and a lack of KOA practice guidelines that are tailored to unique population demographics and tropical climates.
OBJECTIVE: Our HARMOKnee (Heat and Acupuncture to Manage Osteoarthritis of the Knee) trial aims to address these gaps by evaluating the short- and medium-term clinical and cost-effectiveness of acupuncture with heat therapy in addition to standard care, compared to standard care alone. Through a robust process and economic evaluation, we aim to inform evidence-based practice for patients with KOA to facilitate the large-scale implementation of a comprehensive and holistic model of care that harmonizes elements of Western medicine and TCM. We hypothesize that acupuncture with heat therapy as an adjunct to standard care is clinically more effective than standard care alone.
METHODS: A multicenter, pragmatic, parallel-arm, single-blinded, effectiveness-implementation hybrid randomized controlled trial will be conducted. We intend to recruit 100 patients with KOA randomized to either the control arm (standard care only) or intervention arm (acupuncture with heat therapy, in addition to standard care). The inclusion criteria are being a community ambulator and having primary KOA, excluding patients with secondary arthritis or previous knee replacements. The primary outcome measure is the Knee Osteoarthritis Outcome Score at 6 weeks. Secondary outcome measures include psychological, physical, quality of life, satisfaction, and global outcome measures at 6, 12, and 26 weeks. A mixed method approach through an embedded process evaluation will facilitate large-scale implementation. An economic evaluation will be performed to assess financial sustainability.
RESULTS: Patient enrollment has been ongoing since August 2022. The recruitment process is anticipated to conclude by July 2024, and the findings will be analyzed and publicized as they are obtained. As of November 6, 2023, our patient enrollment stands at 65 individuals.
CONCLUSIONS: The findings of our HARMOKnee study will contribute substantial evidence to the current body of literature regarding the effectiveness of acupuncture treatment for KOA. Additionally, we aim to facilitate the creation of standardized national guidelines for evidence-based practice that are specifically tailored to our unique population demographics. Furthermore, we seek to promote the adoption and integration of acupuncture and heat therapy into existing treatment models.
BACKGROUND: ClinicalTrials.gov NCT05507619; https://clinicaltrials.gov/study/NCT05507619.
UNASSIGNED: DERR1-10.2196/54352.

Rheumatic and musculoskeletal diseases (RMDs) usually lead to morphological and functional deficits of various extend, increased morbidity and a considerable loss of quality of life. Modern pharmacological treatment has become effective and can stop disease progression. Nonetheless, disease progression is often only slowed down. Moreover, pharmacological treatment does not improve functionality per se. Therefore, multimodal treatment of rheumatic disorders with physical therapy being a key element is of central importance for best outcomes. In recent years, research into physical medicine shifted from a sole investigation of its clinical effects to a combined investigation of clinical effects and potential changes in the molecular level (e.g., inflammatory cytokines and the cellular autoimmune system), thus offering new explanations of clinical effects of physical therapy. In this review we provide an overview of studies investigating different heat applications in RMDs, their effect on disease activity, pain and their influence on the molecular level.

BACKGROUND: Passive heating is receiving increasing attention within human performance and health contexts. A low-cost, portable steam sauna pod may offer an additional tool for those seeking to manipulate physiological (cardiovascular, thermoregulatory and sudomotor) and perceptual responses for improving sporting or health profiles. This study aimed to 1) report the different levels of heat stress and determine the pods\' inter-unit reliability, and 2) quantify the reliability of physiological and perceptual responses to passive heating.
METHODS: In part 1, five pods were assessed for temperature and relative humidity (RH) every 5 min across 70 min of heating for each of the 9 settings. In part 2, twelve males (age: 24 ± 4 years) completed two 60 min trials of passive heating (3 × 20 min at 44 °C/99% RH, separated by 1 week). Heart rate (HR), rectal (Trectal) and tympanic temperature (Ttympanic) were recorded every 5 min, thermal comfort (Tcomfort) and sensation (Tsensation) every 10 min, mean arterial pressure (MAP) at each break period and sweat rate (SR) after exiting the pod.
RESULTS: In part 1, setting 9 provided the highest temperature (44.3 ± 0.2 °C) and longest time RH remained stable at 99% (51±7 min). Inter-unit reliability data demonstrated agreement between pods for settings 5-9 (intra-class correlation [ICC] >0.9), but not for settings 1-4 (ICC <0.9). In part 2, between-visits, high correlations, and low typical error of measurement (TEM) and coefficient of variation (CV) were found for Trectal, HR, MAP, SR, and Tcomfort, but not for Ttympanic or Tsensation. A peak Trectal of 38.09 ± 0.30 °C, HR of 124 ± 15 b min-1 and a sweat loss of 0.73 ± 0.33 L were reported. No between-visit differences (p > 0.05) were observed for Trectal, Ttympanic, Tsensation or Tcomfort, however HR (+3 b.min-1) and MAP (+4 mmHg) were greater in visit 1 vs. 2 (p < 0.05).
CONCLUSIONS: Portable steam sauna pods generate reliable heat stress between-units. The highest setting (44 °C/99% RH) also provides reliable but modest adjustments in physiological and perceptual responses.

暂无摘要。

Purpose: Hot water immersion (HWI) is a strategy theorised to enhance exercise recovery. However, the acute physiological responses to HWI following resistance exercise are yet to be determined. Methods: The effect of HWI on intramuscular temperature (IMT), muscle function, muscle soreness and blood markers of muscle cell disruption and inflammatory processes after resistance exercise was assessed. Sixteen resistance trained males performed resistance exercise, followed by either 10 min HWI at 40°C or 10 min passive recovery (PAS). Results: Post-intervention, the increase in IMT at all depths was greater for HWI compared to PAS, however this difference had disappeared by 1 h post at depths of 1 and 2 cm, and by 2 h post at a depth of 3 cm. There were no differences between groups for muscle function, muscle soreness or any blood markers. Conclusion: These results suggest that HWI is a viable means of heat therapy to support a greater IMT following resistance exercise. Recovery of muscle function and muscle soreness is independent of acute changes in IMT associated with HWI.

UNASSIGNED: The aim of this review is to assess the efficacy and safety of using heat and cold therapy for adults with lymphoedema.
UNASSIGNED: A multi-database search was undertaken. Only studies which included adults with lymphoedema who were treated with heat or cold therapy reporting any outcome were included. Screening, data extraction, and assessment of bias were undertaken by a single reviewer and verified by a second. Due to the substantial heterogeneity, a descriptive synthesis was undertaken.
UNASSIGNED: Eighteen studies were included. All nine studies which assessed the effects of heat-therapy on changes in limb circumference reported a point estimate indicating some reduction from baseline to end of study. Similarly, the five studies evaluating the use of heat-therapy on limb volume demonstrated a reduction in limb volume from baseline to end-of-study. Only four studies reported adverse events of which all were deemed to be minor. Only two studies explored the effects of cold therapy on lymphoedema.
UNASSIGNED: Tentative evidence suggests heat-therapy may have some benefit in treating lymphoedema with minimal side effects. However, further high-quality randomised controlled trials are required, with a particular focus on moderating factors and assessment of adverse events.Implications for rehabilitationThis review highlights the potential benefit that heat therapy may have on reducing limb circumference and volume for adults with lymphoedema.There was no evidence that controlled localised heat therapy was unsafe.The current evidence-base is at a point where no specific clinical recommendations can be made.The use of heat therapy should only be applied as part of a methodologically robust study to treat lymphoedema.

BACKGROUND: Chronic heat therapy may have beneficial effects on cardiovascular function. These effects may be more pronounced in older adults. We performed a pilot feasibility study of repeated heat therapy sessions in a hot tub (40.5 °C) in older adults while wearing a noninvasive hemodynamic monitor. As part of the protocol, the volunteers underwent cardiovascular performance testing pre- and post-intervention.
METHODS: Fifteen volunteers > 50 years old underwent 8-10 separate 45-min hot tub session over 14 days in this exploratory and mixed methods trial. The participants had maximal oxygen consumption (VO2 max) and other cardiovascular data measured via exercise treadmill testing prior to and after all hot tub sessions. The participants also wore noninvasive fingertip volume clamp monitors while immerged in hot water that calculated systemic vascular resistance, heart rate, blood pressure, and cardiac output in order to ascertain the feasibility and utility of this data. Other laboratory studies were obtained pre- and post-intervention. The protocol was determined feasible if the heat therapy and cardiovascular testing was completed by at least 90% (14/15 subjects). Feasibility of the noninvasive monitor was determined by the fidelity of the results. Secondary exploratory outcomes were analyzed for differences to identify if they are acceptable to include in an efficacy trial.
RESULTS: All participants completed the study protocol identifying the feasibility of the protocol. The noninvasive hemodynamic monitors successfully recorded cardiac output, systemic vascular resistance, heart rate, and blood pressure with fidelity based on the analysis of recordings. In the secondary analyses, we found no difference in the pre- to post-intervention measurement of VO2 max but did find increased exercise duration following hot tub therapy compared with prior to the therapy (571 s versus 551 s).
CONCLUSIONS: The current pilot study protocol is feasible for the purpose of analyzing the effects of heat therapy and cardiovascular performance in older adults while wearing a noninvasive hemodynamic monitor and undergoing treadmill stress testing. Secondary analyses found increased exercise tolerance but no differences in VO2 max following heat sessions.