Using Dogs to Promote Therapeutic Engagement During Inpatient Rehabilitation Following Pediatric Acquired Brain Injury: Understanding Mechanisms and Moderators of Treatment Response

在儿科获得性脑损伤后住院康复期间使用狗促进治疗参与：了解治疗反应的机制和调节因素

• 批准号: 10308160
• 负责人: Megan Narad
• 金额: $ 37.39万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-09 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10308160
• 关键词: Address; Admission activity; Adolescent; Affect; Age; Aggressive behavior; Animals; Auditory; Behavior; Behavioral; Brain Injuries; Canis familiaris; Characteristics; Child; Child Care; Childhood; Clinical; Clinical Trials; Code; Cognitive; Cross-Over Trials; Crossover Design; Data; Data Collection; Distress; Effectiveness; Emotional; Ensure; Family; Fatigue; Feedback; Fright; Goals; Health; Human; Impaired cognition; Infection; Injury; Inpatients; Intervention; Lead; Length of Stay; Life; Link; Literature; Measures; Mediating; Mediator of activation protein; Medical; Methodology; Methods; Moods; Motivation; Occupational Therapist; Occupational Therapy; Outcome; Oxytocin; Pain; Parents; Participant; Patient Admission; Patient Self-Report; Patients; Pediatric Brain Injury; Pediatric Hospitals; Personal Satisfaction; Physical Medicine; Physical therapy; Physicians; Physiological; Population; Positioning Attribute; Psychologist; Randomized; Rehabilitation therapy; Reporting; Research; Risk; Salivary; Sampling; Severities; Social Interaction; Specialist; Technology; Testing; Therapeutic; Time; Translating; Trauma; Videotape; Visual impairment; Work; animal-assisted therapy; clinical care; design; disability; efficacy evaluation; emotional adjustment; evidence base; facial recognition software; functional disability; functional improvement; functional outcomes; functional status; improved; improved outcome; innovation; innovative technologies; insight; multidisciplinary; novel; patient engagement; physical therapist; pilot trial; positive mood; psychosocial; recruit; safety and feasibility; social; success; treatment as usual; treatment response; tumor; volunteer

Abstract Children with acquired brain injuries (ABI) treated on an inpatient rehabilitation unit are at significant risk for long term functional impairment, highlighting the importance of maximizing the effectiveness and utilization of inpatient rehabilitation therapies. The proposed crossover trial seeks to determine the effect of animal-assisted therapy (AAT) during inpatient rehabilitation following pediatric acquired brain injury. To accomplish this objective, we will employ a within subjects cross-over trial. Data will be collected during four therapy sessions across two weeks (2 in week 1 of admission and 2 in week 2 of admission). AAT, via integration of dogs into patient's physical therapy (PT) and occupational therapy (OT) session, will occur during one of the two sessions in the first week and one of the two sessions the second week. The non-AAT condition will be treatment as usual (TAU) as defined by the patient's treatment team, resulting in 2 AAT sessions and 2 TAU sessions total. The order of condition will be randomized separately for each week. We will recruit 90 patients ages 4-21 being treated for ABI on the inpatient rehabilitation unit at CCHMC. We have engaged a highly qualified multidisciplinary team to ensure the safety, feasibility, and effectiveness of the methods. We will accomplish the following aims: 1) determine the effect of AAT on patient engagement in inpatient rehabilitation therapies, 2) examine potential mechanisms of action for AAT-associated improvement in patient engagement (mood and physiological distress), and 3) determine factors that moderate the effect of AAT on patient engagement (patient anthropomorphism, patient-animal closeness, time course in admission, and demographic and injury characteristics). We hypothesize that a greater level of patient engagement will be observed during AAT sessions compared to treatment as usual (TAU) sessions. Additionally, AAT will be associated with more positive mood and lower levels of distress, which in turn will be related to greater patient engagement. Finally, a greater effect of AAT will be noted earlier during patient admissions, and greater levels of anthropomorphism and patient-animal closeness will be associated with greater levels of patient engagement during AAT sessions. We propose the use of novel methodology and innovative technology in data collection designed to address concerns related to bias and reliance of subjective outcomes in the AAT evidence base. This innovation positions the project to fill an important gap in the existing AAT literature. Findings will provide critical new insights into why pediatric inpatients benefit from AAT and who is most likely to benefit. We will translate our findings to ultimately improve functional outcomes following pediatric brain injury, a leading cause of disability.

摘要