The "Dog-tor" is In
In a recent, very formal poll of all my patients, nine out of 10 said physical therapy could be “not fun.” Let’s be honest: the 10th patient was kind of an anomaly. Who actually likes their “pain and torture” sessions? So what if we provided an option that just about guaranteed you’d enjoy your therapy session? Introducing... therapy dogs! I bet if we re-polled patients after introducing therapy dogs, we’d budge their fun meter at least a little bit.
The use of dogs as service animals began during World War I for individuals with visual impairments. In 1919 in the U.S., animals began assisting medical professionals with psychiatric patients. The use of therapy animals has expanded in the 100-plus years since. Service dogs assist people with disabilities with tasks of daily living, including retrieving items, pulling a wheelchair, calming individuals during an anxiety attack or guiding the visually impaired.
An emotional support animal, according to the ADA National Network, does not have special training to do the same tasks a service animal performs, but provides support of a more emotional nature, such as providing companionship or reducing depression and anxiety. A therapy animal falls somewhere in the middle of this spectrum. Therapy pets usually, though not always, have formal training in tasks they may encounter in their interactions with patients in therapy settings, including physical therapy and occupational therapy. They can even assist in helping patients reach therapy goals, such as improving balance by playing a game of tug of war, improving strength by throwing a ball for the dog or improving trunk rotation by reaching across the body to deliver treats.
A variety of research studies have proven what animal lovers everywhere know intuitively; there are many benefits of animal-assisted therapy. With animal-assisted therapy, patients experience a reduction in anxiety, as measured by both self-report and biomarkers (blood pressure, heart rate, neurochemicals and hormones). When kids read to therapy dogs, learning, cognition, motor skills and reading skills all improve. When typically developing kids and kids with special needs spent 20 minutes with dogs twice a week for four weeks, they showed a greater drop in cortisol levels than kids participating in yoga for the same amount of time. Could you imagine the potential effects of puppy yoga?
Animal-assisted therapy has also been shown to reduce fatigue, fear, feelings of isolation, depression, boredom, perception of pain and risk of cardiovascular disease and stroke. In addition to patient benefits, staff stress has documented reductions after interactions with therapy animals. Patient satisfaction, energy levels, self-esteem, mood, motor skills, social skills, communication, affect and playfulness all improved as well with therapy pet interventions. There are various theories as to the mechanisms of all these improvements. The animals may provide a non-judgmental social support, a calming presence, and/or a tactile comfort that helps distract patients from the pain of therapy. The animals may increase a patient’s sense of safety and improve a positive attitude during therapy.
There were a couple of interesting studies on the use of therapy dogs in outpatient clinic settings. One study, in an outpatient pain management clinic, found that a 10-minute interaction in the waiting room before treatment reduced pain by 0.7 points in the 0-10 scale with concurrent improvements in energy levels, anxiety, depression, anger, self-perceptions of calm and pleasantness. There were even effects noted after less than five minutes of exposure to the therapy dog. In this study, patients, clinic staff and patient support persons all noted benefits. The vast majority of patients had positive responses and only 1.3 percent of patients did not want to see the therapy dog again.
The experiment was an overwhelming positive for staff, an important outcome given the burnout rates in the medical profession and the high levels of stress associated with managing patients with high levels of pain. A second study on the use of therapy dogs following joint arthroplasty found a 2-point improvement in pain (0-10 scale) and improved patient satisfaction scores following therapy dog interventions compared to a control group.
Laura Crower, D.P.T., C.S.C.S., is a physical therapist and certified strength and conditioning specialist at MyMichigan Health.
