Category: Stroke; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Neuroplasticity (includes neuroscience)
Objective : To investigate the effect of animal assisted therapy (AAT) on participation during occupational therapy (OT) sessions for a patient post-stroke
Design : Case study
Setting : Skilled nusing facility
Participants (or Animals, Specimens, Cadavers) :
The patient was an 88-year-old female that presented with acute right intraparenchymal hemorrhage with extension into the subarachnoid space and resulting left hemiparesis. Comorbidities included Alzheimer's disease, hypothyroidism, and osteoporosis. She was unmotivated and non-participatory in rehabilitation prior to AAT.
Interventions : Animal assisted therapy (AAT) is a task-specific therapy that utilizes animals as an integral part of the therapy sessions. Animal assisted therapy was introduced in random sessions targeting motivation and participation during the patient's OT sessions which were 60 minutes, 5 days a week, spanning 8 weeks.
Main Outcome Measure(s) : The primary outcome measure applied was the Pittsburgh Rehabilitation Participation Scale (PRPS). Subjective reports from practitioners and the patient's family were also collected.
In OT sessions without AAT, PRPS averaged 2.33 (95% CI .23); in OT sessions incorporating AAT, the PRPS averaged 3.25 (95% CI .83) (p< 0.016). Subjective report from the therapist indicated that the patient was more positively engaged when working with the dog. Family members, attending therapy sessions, expressed their satisfaction with the AAT.
Conclusions : Participation increased significanlty during AAT sessions. Research supports neuroplasticity that is driven by task-specific practice salient to the individual. This particular patient was drawn to the dog in AAT and demonstrated increased motivation and participation. The potential AAT benefits are that it may be less threatening to the patient, is functional task-specific training, and is more engaging than other typical clinical tasks. Previous studies have identified patient participation as a predictor of outcomes at discharge by mitigating the negative effects of depression and cognitive impairment.
David Levine– Professor, The University of Tennessee at Chattanooga, Signal Mtn, Tennessee
Chloe Cross– Undergraduate Student, University of Tennessee at Chattanooga, Benton, Tennessee
Jennifer Matthews– Occupational Therapist, LifeCare Centers of America, Inc., Chattanooga, Tennessee
Susan McDonald– Department Head & Associate Professor, The University of Tennessee at Chattanooga, Chattanooga, Tennessee
Nancy Fell– Professor, The University of Tennessee at Chattanooga, Chattanooga, Tennessee