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.

抽象的 在住院康复单位治疗的患有脑损伤的儿童（ABI）有很大的风险 长期功能障碍，强调了最大化有效性和利用的重要性 住院康复疗法。拟议的跨界试验旨在确定动物辅助的影响 小儿脑损伤后住院康复期间的治疗（AAT）。实现这一目标 目的，我们将在受试者的交叉试验中采用一个。数据将在四个疗法课程中收集 在两个星期（入学的第1周中有2个，在入学的第2周中有2个）。通过将狗整合到 患者的物理治疗（PT）和职业治疗（OT）会议将在两者之一中发生 第一周的会议和第二周的两个会议之一。非AAT条件将是 如往常 总共会议。条件顺序每周将分别随机分别分组。我们将招募90名患者 在CCHMC的住院康复单元上接受了4-21岁的ABI治疗。我们参与了高度 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 完成以下目的：1）确定AAT对患者参与住院康复的影响 疗法，2）检查与AAT相关改善患者参与的潜在作用机制 （情绪和生理困扰），以及3）确定适度AAT对患者影响的因素 参与度（患者拟人化，患者 - 动物的亲密关系，入学时课程和 人口和伤害特征）。我们假设将有更高水平的患者参与度 与往常一样（TAU）会话相比，在AAT会议期间观察到。另外，AAT将是 与更积极的情绪和较低的困扰相关，这反过来将与更大的患者有关 订婚。最后，在患者入院期间将提前注意AAT的更大效果，并且水平更高 拟人化和患者的亲密关系将与更高的患者有关 在AAT会议期间参与。我们建议在新方法和创新技术中使用 数据收集旨在解决与AAT中主观结果的偏见和依赖有关的问题 证据基础。这项创新定位了该项目，以填补现有AAT文献中的重要空白。 调查结果将提供关键的新见解，说明为什么儿科住院病人从AAT中受益以及最有可能是谁 受益。我们将翻译我们的发现，以最终改善小儿大脑的功能结果 受伤，是残疾的主要原因。