Use of Lower-Leg Bathing to Facilitate Exercise Therapy in a Patient With Severe Pulmonary Arterial Hypertension: A Case Report.

Waon therapy (WT), which in Japanese means soothing warmth, is a repeated sauna therapy that improves cardiac and vascular endothelial function in patients with chronic heart failure (CHF). However, lower-leg baths can be easily performed anywhere. Here, we report a case in which leg baths were used to alleviate the symptoms of heart failure and enable the introduction of exercise therapy. A woman in her 70s with collagenous pulmonary arterial hypertension (class Ⅲ) associated with scleroderma was on home oxygen therapy; however, she experienced difficulty in performing active exercise therapy owing to shortness of breath on exertion and hypotension. As an alternative to WT, three sessions of lower-leg bathing at 42°C were performed weekly for three weeks. After lower-leg bathing, the patient's peripheral blood flow improved, and her clinical symptoms were alleviated; as such, exercise therapy could be introduced. However, tricuspid regurgitation pressure gradient and N-terminal pro-B-type natriuretic peptide returned to pre-intervention levels nine months after discharge. Although lower-leg bathing can temporarily alleviate the patient's symptoms, its effect is not long-lasting. Although lower-leg bathing has no long-term effects, it may be a treatment option for severe pulmonary hypertension (PH) when exercise therapy is difficult to introduce.