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Gait retraining approaches and walking aids currently used for patients with recent stoke present limitations regarding their utilization in clinical and real life settings. A rehabilitation facility implemented an innovative approach using a rehabilitation dog for gait retraining and as a walking aid.
To explore the effectiveness of rehabilitation...
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... 35.html for a full descrip- tion).These dogs were selected and trained to respond to the demands and expectations of a rehabilitation dog. The therapists were coached by the trainers to work with the qualified dog. The dog wore a leather harness mounted with metal bars attached to a handle and pa- tients used it as a walking aid (see Fig. 2). The rehabili- tation dog was also used in some parts of the training to practice transfer from a sitting to a standing position or from chair to bed, and for re-education of the affected upper ...
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Background:
The robotic Hybrid Assistive Limb (HAL) provides motion according to the wearer's voluntary activity. HAL training effects on walking speed and capacity have not been clarified in subacute stroke.
Objectives:
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Objectives:
The aim of this study was to evaluate the effect of a powered gait orthosis (PGO) on the temporal-spatial parameters and kinematics of walking in both healthy participants and persons with spinal cord injury (SCI) using three-dimensional motion analysis to facilitate further development of such devices.
Methods:
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Citations
... A Canadian research team investigated the effects of dog therapy on stroke patients. At the end of the dog therapy participants showed improvement in their gait pattern and were able to move faster with the dog in comparison to walking with a cane [9]. A US study examined patients with nonfluent aphasia who had suffered a left hemisphere cerebral infarction years earlier. ...
Background
Any illness places a significant burden on patients, including deterioration in quality of life. Animal assisted therapy may be helpful in the rehabilitation process and in the treatment of patients to alleviate this phenomenon.
Methods
A randomized, controlled research was conducted in 2019 and 2020 in a rehabilitation center in Budapest. In our study, the control and experimental groups received the same therapy, but the rehabilitation treatment of the intervention group was complemented by dog therapy. Patients were evaluated by means of the short form Beck Depression Inventory, State-Trait Anxiety Inventory, Illness Intrusiveness Ratings Scale, Visual Analog Scale for pain and the WHO-5 Well-being Index. For statistical analysis paired T-test and ANCOVA was performed.
Results
58 participants in both groups took part in the research. Results confirm that both groups showed statistically significant improvement in all outcome measures, except for depression symptoms in dog therapy group. Quality of life of the participants improved significantly, their pain and anxiety levels were significantly reduced, they felt significantly less burdened by the disease in their daily lives. Therapeutic-dog sessions had a large effect on patients’ quality of life and anxiety.
Conclusions
There is a strong case for animal assisted therapy as a complementary therapy in the rehabilitation program, and it is proposed that consideration should be given to the application of this method on a larger scale within health care. The study was retrospectively registered at ISRCTN Registry (registration number: ISRCTN10208787) on 15/03/2022.
... In the presence of a therapy dog, gait speed and gait pattern improved significantly in all cases. According to their results, practicing with a therapy dog improves these scores of patients significantly more than using other aids [22]. ...
Background
In our experience, working with a therapy animal strengthens endurance, maintains motivation, provides a sense of achievement, and boosts overall mental resilience. The aims of this work were to summarize the results of quantitative research on the possibilities of animal-assisted intervention (AAI) among people with neurodegenerative and cerebrovascular diseases and to attempt to assess the effects of animal-assisted interventions in an objective manner and to find supporting evidence based on published literature.
Methods
Our target groups are people diagnosed with Parkinson’s disease, multiple sclerosis, or stroke. A systematic search of relevant articles was conducted by two independent researchers in April 2021 and August 2023. The search for studies was conducted using PubMed, Google Scholar, Web of Science, Scopus, and Ovid databases, specifying keywords and search criteria. The qualitative evaluation of the research reports was conducted by four independent researchers, using the Newcastle–Ottawa Quality Assessment Form.
Results
According to the scientific criteria and based on the Newcastle–Ottawa Quality Assessment Form, thirteen publications met the search criteria, out of which 9 publications were rated good and 4 publications were rated poor. Evaluating the publications we found evidence that AAI had a measurable impact on participants, as their physical and mental health status significantly improved; however, mental health improvement was more prominent.
Conclusions
By developing evidence-based research methodology and standardized research settings, AAI could be measured effectively as part of health care practice. This would bring significant benefits to the rehabilitation of patients in need.
Systematic review registration
PROSPERO CRD42021255776.
... In a study of occupational therapy after spinal cord injury, Thompkins et al. (2019) found lower negative affect when a dog was integrated into the therapy than in a control group without a dog. Dogs may also be able to assist gait training, as suggested by two small case studies, which found faster improvement when the person trained with a dog than with the traditional stick (Abbud et al., 2014;Rondeau et al., 2010). A dog-handler team may also be integrated into the health professional's approach for retraining clients' hand and speech functions after a paresis. ...
Rehabilitation psychology is based on the biopsychosocial model of health and thus includes attention to psychosocial support needs after loss of somatic functions. Human–animal interaction may augment several kinds of treatment and support. Both fields are relatively new, and their intersection has been sparsely explored. This article introduces the fields, elaborates on three intersections between them, and discusses psychologists’ roles in these. The elaborations are based on reviews and exemplars of contributions in human-animal interaction research, and we advocate and apply the IAHAIO standards for terminology and human and animal welfare that have become the consensus view for about 100 organizations across the globe.
... In a case study by Abbud et al. involving two individuals with ataxia, mobility dog partnership was shown to improve walking patterns and promote safer, more independent mobility [14]. Research by Rondeau et al. examining the results of an intervention involving a trained "rehabilitation dog" concluded that all four study participants (stroke survivors) demonstrated improved walking speed and gait patterns when ambulating with the rehabilitation dog versus with a cane [15]. Noguchi et al. explored the kinematics of sit to stand transfers by persons with rheumatoid arthritis. ...
... It is possible that this is due to the modulating effect of the dog's speed on the participants' pace and stride length (and therefore joint angle). This is in contrast to prior findings supporting the positive impacts of mobility dog partnership on walking speed and gait patterns in persons with disabilities [13,15]. In the present study, the dog's trainer/owner walked with the dog to ensure dog and participant safety and proper positioning. ...
While prior research has explored various physiological consequences associated with assistive device use for ambulation, limited research has specifically explored the impact of mobility dog partnership on human kinematics. This descriptive study examined the impact of mobility dog partnership on kinematics of individuals in the normal young adult population. Sixteen participants were video recorded while walking in a straight line for 3.7 m (12 feet) under three different conditions (ambulating with no device, ambulating with a standard cane on the left side, and ambulating with a mobility dog on the left side). Differences between joint angles under each of the conditions were analyzed. Statistically significant differences were found in left elbow flexion when comparing ambulating with a cane versus ambulating with no device; left shoulder abduction when comparing ambulating with a cane versus ambulating with a mobility dog, ambulating with a mobility dog versus no device, and ambulating with a cane versus no device; and left hip extension when comparing ambulating with a mobility dog versus no device, and when ambulating with a mobility dog versus a cane. These findings suggest that providers should evaluate and monitor potential negative impacts of assistive devices such as mobility dogs on human kinematics.
... Another form of stationary haptic stimuli used with chronic stroke are instrumented handrails, which can improve balance and gait economy [22]. There have also been more dynamic forms of haptic input, such as the instrumented cane [23,24] and the rehabilitation dog [25], the latter providing some ecological context to the mechanical leash [26] proposed in the current study. When walking overground with a rehabilitation dog, chronic stroke individuals have improved gait speed and reduced gait deviations related to lower limb coordination, even with respect to a cane, over the course of a training protocol [25]. ...
... There have also been more dynamic forms of haptic input, such as the instrumented cane [23,24] and the rehabilitation dog [25], the latter providing some ecological context to the mechanical leash [26] proposed in the current study. When walking overground with a rehabilitation dog, chronic stroke individuals have improved gait speed and reduced gait deviations related to lower limb coordination, even with respect to a cane, over the course of a training protocol [25]. ...
... As previously seen, all three groups increased gait speed during the force and post-force epoch with CG and HF groups walking as fast or faster with the leash compared to the cane [27]. These results corroborate with previous findings where a rehabilitation dog was compared to the cane overground [25] and overground walking with haptic cues [28,43]. Both CG and HF groups increased gait speed by 0.11-0.13 ...
Background
Walking with a haptic tensile force applied to the hand in a virtual environment (VE) can induce adaptation effects in both chronic stroke and non-stroke individuals. These effects are reflected in spatiotemporal outcomes such as gait speed. However, the concurrent kinematic changes occurring in bilateral lower limb coordination have yet to be explored.
Methods
Chronic stroke participants were stratified based on overground gait speed into lower functioning (LF < 0.8 m/s, N = 7) and higher functioning (HF ≥ 0.8 m/s, N = 7) subgroups. These subgroups and an age-matched control group (N = 14, CG) walked on a self-paced treadmill in a VE with either robot-generated haptic leash forces delivered to the hand and then released or with an instrumented cane. Walking in both leash (10 and 15 N) and cane conditions were compared to pre-force baseline values to evaluate changes in lower limb coordination outcomes.
Results
All groups showed some kinematic changes in thigh, leg and foot segments when gait speed increased during force and post-force leash as well as cane walking. These changes were also reflected in intersegmental coordination and 3D phase diagrams, which illustrated increased intersegmental trajectory areas (p < 0.05) and angular velocity. These increases could also be observed when the paretic leg transitions from stance to swing phases while walking with the haptic leash. The Sobolev norm values accounted for both angular position and angular velocity, providing a single value for potentially quantifying bilateral (i.e. non-paretic vs paretic) coordination during walking. These values tended to increase (p < 0.05) proportionally for both limbs during force and post-force epochs as gait speed tended to increase.
Conclusions
Individuals with chronic stroke who increased their gait speed when walking with tensile haptic forces and immediately after force removal, also displayed moderate concurrent changes in lower limb intersegmental coordination patterns in terms of angular displacement and velocity. Similar results were also seen with cane walking. Although symmetry was less affected, these findings appear favourable to the functional recovery of gait. Both the use of 3D phase diagrams and assigning Sobolev norm values are potentially effective for detecting and quantifying these coordination changes.
... AAT refers to the presentation of an animal to patients for the purpose of helping them recover, both psychologically and physically, as part of neurorehabilitation [14][15][16][17]. To this day, dogs are the primary animals utilized in AAT to improve independent activities of daily living and gait performance of patients post-stroke [18,19]. AAT with dogs can be combined with the training received in both physical and occupational therapy, which has been found to increase patient participation [20]. ...
... (1) sadness, (2) pessimism, (3) past failure, (4) loss of pleasure, (5) guilty feelings, (6) punishment feelings, (7) self-dislike, (8) self-criticalness, (9) suicidal thoughts, (10) crying, (11) agitation, (12) loss of interest, (13) indecisiveness, (14) worthlessness, (15) loss of energy, (16) changes in sleeping patterns, (17) irritability, (18) changes in appetite, (19) concentration difficulty, (20) tiredness or fatigue, and (21) loss of interest in sex. The original version items 10,16,17,18, and 21 were removed, following which the scale was considered more appropriate for the depression assessment of post-stroke patients and can also reduce their burden [32]. ...
... The strength of this study is that it is the first RCT study that confirms the effects of AAT on post-stroke patients. The effect of AAT with dogs is in line with previous cases, and pilot studies that found it to be effective in improving gait performance, gait speed, and rehabilitation participation [18,19]. ...
Background:
Animal-assisted therapy using dogs is being administered to patients post-stroke for the purpose of recovering psychological and physical activity.
Objective:
This study was conducted to confirm the effect of animal-assisted therapy using dogs on gait performance, pulmonary function, and psychological variables in patients post-stroke. All outcomes were analyzed using two-way repeated-measure analysis.
Methods:
In total, 30 post-stroke patients were divided into an experimental group (gait training by animal-assisted activity, n = 15) and a control group (gait training, n = 15). Gait performance (cadence, gait speed, stride length, symmetric index), respiratory pulmonary function (forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP)), and psychological variables (rehabilitation motivation and depression assessment) were measured before and after eight weeks of intervention.
Results:
Gait performance, respiratory pulmonary function, and psychological variables significantly increased in the experimental group compared to the control group.
Conclusion:
Based on this study, it was found that animal-assisted therapy using dogs is an effective intervention for recovery of psychological and physical activity in patients post-stroke.
... For example, dog-assisted speech-language therapy led to more motivation and joy as well as less stress in patients with aphasia compared with traditional speech-language therapy while both were effective therapeutically (Macauley, 2006). In another study, the gait pattern and walking speed of patients with hemiparesis after a stroke improved during dog walking compared with walking with a cane (Rondeau et al., 2010). In a first randomized controlled trial, patients with acquired brain injury displayed significantly increased social behaviour and positive emotions when they interacted with an animal during therapy compared with standard therapy sessions (Hediger et al., 2019a). ...
The second edition of this book contains 32 chapters divided into 4 main sections that discuss the theoretical foundations of One Health; methods, skills and perspectives for the practice of One Health; the application of One Health in infectious and non-infectious diseases and governance and capacity building, all of which are related to the global issues of the prevention and control of animal, plant and human diseases in the wake of drug resistance by pathogens, biodiversity loss, natural disasters, climate change and the recent COVID-19 novel coronavirus pandemic.
... Es wurde darüber hinaus auch untersucht und beschrieben, wie tiergestützte Therapie generell in der Neurorehabilitation bei Patienten mit erworbenen Hirnschädigungen umgesetzt werden kann (8). So fand eine Pilotstudie, dass sich der Gang bei 4 Patienten mit Hemiparese nach einem Schlaganfall durch hundegestützte Therapie verbesserte (9). Eine andere Pilotstudie zeigte, dass tiergestützte Logopädie gleich effektiv war wie konventionelle Logopädie, die Patienten jedoch motivierter waren und die Atmosphäre als weniger stressig empfanden, wenn ein Hund anwesend war (10). ...
... Regarding mobility, there is some emerging evidence that AAT may benefit patients with hemiparesis due to stroke [18][19][20], with aphasia [21], and with traumatic brain injury [22]. Walking with a dog can stimulate correct posture, regain momentum, and promote proper movement [23], as well as improve balance and gait function [22]. In addition, the interaction between the patient, the therapy animal, and the therapist has been shown to create a context that improves communication and confidence [24]. ...
Disorders of communication, social relationships, and psychomotricity are often characterized by cognitive impairment, which hinders daily activities and increases the risk of falls. This study aimed to evaluate the efficacy of an animal-assisted therapy (AAT) program in an institutionalized geriatric population with cognitive impairment. The variables evaluated included level of communication and changes in gait and/or balance. We performed a two-arm, parallel controlled, open-label, nonrandomized cluster clinical trial in two nursing home centers from an urban area. Patients in the two centers received 12 weekly sessions of physiotherapy, but the experimental group included AAT with a therapy dog. The study included a total of 46 patients (23 Control Group [CG], 23 Experimental Group [EG]) with a median age of 85.0 years. Of these, 32.6% had mild–moderate cognitive decline (Global Deterioration Scale of Reisberg [GDS] 2–4) and 67.4% severe cognitive decline (GDS 5–6). After the intervention, patients in the CG and EG showed a statistically significant improvement in all the response variables. When comparing both groups, no statistically significant differences were found in any of the Tinetti scale results (measuring gait and balance). However, the communication of patients in the EG, measured on the Holden scale, showed a statistically significant greater improvement postintervention than that of patients in the CG. AAT can be useful as a complementary, effective treatment for patients with different degrees of cognitive decline.
... These interventions provide joy to patients, increase their motivation, and allow them to rest [17], and patients are able to resolve their unmet physical and emotional needs by being involved in activities related to patients therapeutic goals [18]. In particular, walking a living animal is not only beneficial to dementia patients but also facilitates the rehabilitation of adults who have undergone surgery or have an illness by reacquainting them with ambulation and recovering ambulation speed [19][20][21]. The first AAI to be developed were found to reduce depression [22], and the ability of AAI to reduce depression and improve QOL in older people with dementia is currently being investigated [11,[23][24][25]. ...
Patients with dementia suffer from psychological symptoms such as depression, agitation, and aggression. One purpose of dementia intervention is to manage patients’ inappropriate behaviors and psychological symptoms while taking into consideration their quality of life (QOL). Animal-assisted intervention (AAI) and pet-robot intervention (PRI) are effective intervention strategies for older people with cognitive impairment and dementia. In addition, AAI and PRI have been shown to have positive effects on behavioral and psychological symptoms of dementia (BPSD). However, studies into the association between AAI/PRI and BPSD have elicited inconsistent results. Thus, we performed a meta-analysis to investigate this association. We analyzed nine randomized controlled trials on AAI and PRI for dementia patients published between January 2000 and August 2019 and evaluated the impact of AAI/PRI on agitation, depression, and QOL. We found that AAI and PRI significantly reduce depression in patients with dementia. Subsequent studies should investigate the impact of AAI and PRI on the physical ability and cognitive function of dementia patients and conduct a follow-up to investigate their effects on the rate of progression and reduction of symptoms of dementia. Our research will help with neuropsychological and environmental intervention to delay or improve the development and progression of BPSD.
