Transfer effects of animal-assisted therapy on socioemotional skills in adult inpatient rehabilitation after acquired brain injury: a randomized controlled trial.
Elena Pauli, Sophie Dubach, Carmina Haase and 4 others
PMID 42757242WHAT IT FOUND
After six weeks, adults with brain injury who received animal-assisted occupational, speech, or physiotherapy showed more social behavior in a standardized outside-therapy task than usual therapy.
Mood, thinking, motivation, quality of life and attendance did not differ. High dropouts mean this is not firm evidence.
Key findings
01At post-assessment, the animal-assisted therapy group showed significantly more social behavior than the usual therapy group (difference 3.24; 95% CI 0.87 to 5.62; p = .009).
02At post-assessment, there were no significant differences between groups in positive emotions, negative emotions, depressive symptoms, social cognition, therapy motivation, quality of life, or therapy adherence.
03The preregistered 18-week primary endpoint could not be meaningfully analyzed because of substantial attrition, so the post-assessment findings are exploratory.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The preregistered 18-week primary endpoint could not be meaningfully analyzed because of substantial attrition, so the reported post-assessment results are exploratory. Seventy patients were randomized, but the post-assessment analysis included 44 patients. Drop-out rates by the end of the study were 55.81% in the animal-assisted therapy group and 74.07% in the usual therapy group. Blinding was not possible, so patients and video coders could know group allocation after the first session. Randomization produced imbalanced groups, with 43 patients assigned to animal-assisted therapy and 27 to usual therapy. Therapy modality counts differed between groups, with the animal-assisted therapy group attending fewer occupational therapy sessions and more speech therapy sessions than the usual therapy group. Participants were mostly post-acute, high functioning, and had low depressive symptoms at baseline, so the findings may not apply to more impaired patients. The standardized social task and composite social behavior score were not validated for acquired brain injury. Many assessments occurred during the COVID-19 pandemic, with masks or face shields possibly affecting social behavior coding. The study was single-center, which limits generalizability across different clinics and cultures.
Declared interests
Financial support was received from the foundation pro REHAB Basel and the Swiss National Science Foundation under an Ambizione grant awarded to KH. No other author conflict statement is provided.
The easy way to misread this
Do not conclude that animal-assisted therapy improves socioemotional recovery after brain injury. Only social behavior differed at the six-week post-assessment, and that analysis was exploratory because the preregistered 18-week endpoint could not be analyzed. Mood, thinking, motivation, quality of life and attendance showed no significant difference. The animal component cannot be separated from therapist attention, social interaction, novelty, and treatment expectancy.