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: 10652438
• 负责人: Megan Narad
• 金额: $ 29.75万
• 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/10652438
• 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; Length of Stay; Life; Link; Literature; Measures; Mediating; Mediator; 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; Qualifying; Randomized; Rehabilitation therapy; Reporting; Research; Risk; Safety; 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 status; improved; improved outcome; innovation; innovative technologies; insight; multidisciplinary; novel; patient engagement; physical therapist; pilot trial; positive mood; psychosocial; recruit; 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 获得性脑损伤（ABI）的儿童在住院康复单位治疗的显着风险， 长期功能障碍，强调最大限度地提高有效性和利用的重要性， 住院康复治疗。拟议的交叉试验旨在确定动物辅助 在儿科获得性脑损伤后住院康复期间使用AAT治疗。为了实现这一 目的，我们将采用受试者内交叉试验。将在四次治疗期间收集数据 在两周内（入院第1周2例，入院第2周2例）。AAT，通过将狗整合到 病人的物理治疗（PT）和职业治疗（OT）会议，将发生在其中一个两个 在第一周和两个会议之一的第二周。非AAT条件将是 患者治疗团队定义的常规治疗（TAU），导致2次AAT治疗和2次TAU治疗 会议总。每周将单独随机分配条件顺序。我们将招募90名患者 年龄4-21岁，在CCHMC的住院康复病房接受ABI治疗。我们聘请了一位 合格的多学科团队，以确保方法的安全性，可行性和有效性。我们将 完成以下目标：1）确定AAT对住院康复患者参与的影响 治疗，2）检查AAT相关改善患者参与的潜在作用机制 (mood和生理痛苦），以及3）确定缓和AAT对患者影响的因素 参与度（患者拟人化、患者-动物亲密度、入院时程，以及 人口统计学和损伤特征）。我们假设，更高水平的患者参与将是 与常规治疗（TAU）阶段相比，在AAT阶段观察到。此外，AAT将 与更积极的情绪和更低的痛苦水平相关，这反过来又与更大的耐心有关。 订婚最后，在患者入院期间，AAT的作用更大， 拟人化和病人与动物的亲密关系将与更高水平的病人 在AAT会议期间参与。我们建议使用新的方法和创新技术， 数据收集旨在解决与AAT中主观结果的偏倚和依赖相关的问题 证据基础这一创新定位的项目，以填补现有的AAT文献中的一个重要空白。 研究结果将提供关键的新见解，为什么儿科住院患者受益于AAT，谁最有可能 从中获益我们将转化我们的发现，以最终改善儿科脑部手术后的功能结果 受伤是导致残疾的主要原因。

项目成果

The feasibility and acceptability of integrating dogs into inpatient rehabilitation therapy with children with acquired brain injury.

将狗纳入患有后天性脑损伤的儿童住院康复治疗的可行性和可接受性。

• DOI: 10.1002/pmrj.13176
• 发表时间: 2024
• 期刊: PM & R : the journal of injury, function, and rehabilitation
• 作者: Narad,MeganE;Knestrick,Kaelynn;Wade,ShariL;Kurowski,BradG;McConnell,AllenR;Quatman-Yates,CatherineC
• 通讯作者: Quatman-Yates,CatherineC