Human-animal interaction to promote recovery following pediatric brain injury

人与动物的互动促进小儿脑损伤后的康复

• 批准号: 9764403
• 负责人: Megan Narad
• 金额: $ 24.19万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9764403
• 关键词: Address; Admission activity; Adolescent; Affect; Age; Animals; Area; Arousal; Behavioral; Brain; Brain Injuries; Canis familiaris; Child; Child Care; Childhood; Clinical; Complex; Cross-Over Trials; Crossover Design; Data; Distress; Effectiveness; Ensure; Family; Fatigue; Feedback; Foundations; Goals; Health Benefit; Hospital Volunteers; Human; Impaired cognition; Impairment; Infection; Injury; Inpatients; Intervention; Lead; Length of Stay; Life; Mediator of activation protein; Medical; Methods; Moods; Nature; Occupational Therapist; Occupational Therapy; Participant; Patient Care; Patient Participation; Patients; Pediatric Brain Injury; Physical therapy; Physiological; Populations at Risk; Psychologist; Randomized; Randomized Clinical Trials; Recovery; Rehabilitation therapy; Reporting; Research; Risk; Sampling Studies; Severities; Specialist; Therapeutic; Time; Trauma; Videotape; animal efficacy; animal-assisted therapy; biological sex; care providers; clinical care; cohort; comparison group; design; evidence base; experience; functional disability; functional outcomes; improved; improved outcome; member; multidisciplinary; physical therapist; pilot trial; programs; recruit; safety and feasibility; satisfaction; sex; social; success; treatment as usual; 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 pilot trial seeks to explore the value 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; all participants will have a volunteer dog involved in 50% of their physical therapy (PT) and occupational therapy (OT) sessions over a 2-week study period. We will recruit 40 patients between the ages of 6-17 being treated for ABI on the inpatient rehabilitation unit at CCHMC. AAT will consist of integration of a dog from the hospital volunteer dog program in PT and OT sessions, while the non- AAT condition will be treatment as usual (TAU) as identified by the patients' treatment team. 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) Examine the effect of AAT on level of patient participation, patient affect, and physiological distress during PT and OT sessions, and 2) Explore the effect of AAT on functional outcomes using a historic cohort comparison group. As an exploratory aim, we will examine a number of variables (injury type/severity, child sex and anthropomorphism, therapist factors, and dog handler factors) to begin to determine which patients are most likely to benefit from AAT during inpatient rehabilitation for ABI, and potential mechanisms of action. Qualitative feedback from patients, families, and care providers (therapists, medical team, and dog handlers) will be collected at the completion of their engagement in the trial to determine feasibility and satisfaction with the intervention as well as potential barriers and areas for improvement. We hypothesize that the utilization of ATT in PT and OT sessions will be associated with increased patient participation, greater positive affect, and lower levels of physiological distress compared to TAU. Additionally, it is expected that the study sample will demonstrate greater improvement in functional outcomes than a historical cohort comparison group. Findings will provide evidence regarding the utility of AAT for inpatient rehabilitation of ABI and have the potential to inform and improve clinical care. If successful, this pilot will lay the foundation for transforming rehabilitation interventions for a difficult-to-engage population at risk for significant long-term functional deficits.

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。拟议的试点试验旨在探索动物辅助治疗的价值 （AAT）在儿科后住院期间康复。为了实现这一目标，我们 将在受试者的跨界试验中雇用；所有参与者都将有一只志愿狗参与其50％ 在2周的研究期间，物理治疗（PT）和职业治疗（OT）会议。我们将招募40 在CCHMC的住院康复单元上接受ABI治疗的6-17岁年龄段的患者。 AAT会 包括在PT和OT课程中从医院志愿狗计划中整合狗，而非 - AAT状况将像往常一样治疗（TAU），如患者的治疗团队所确定的。我们订婚了 一个高素质的多学科团队，可确保方法的安全性，可行性和有效性。我们 将完成以下目的1）检查AAT对患者参与水平，患者影响， PT和OT会议期间的生理困扰，以及2）探索AAT对功能的影响 使用历史群体比较组的结果。作为探索目的，我们将研究许多 变量（伤害类型/严重程度，儿童性别和拟人化，治疗师因素和狗处理者因素） 开始确定哪些患者在ABI的住院康复期间最有可能受益于AAT， 潜在的作用机理。来自患者，家庭和护理提供者的定性反馈（治疗师， 医疗团队和狗的处理者）将在他们参与审判时收集 确定对干预措施的可行性和满意度以及潜在的障碍和区域 改进。我们假设PT和OT会议中ATT的利用将与 与患者的参与增加，更大的积极影响以及生理困扰水平较低相比 tau。此外，预计研究样本将显示出更大的功能改善 结果比历史人群比较组。调查结果将提供有关AAT效用的证据 用于ABI的住院康复，并有可能为临床护理提供信息和改善。如果成功，这 飞行员将为在难以参与的人群中转变康复干预措施奠定基础 大量长期功能缺陷的风险。