Introduction: There are few therapy methods for patients in a minimally conscious state (MCS) and it is therefore important to find new ways to facilitate their rehabilitation process. Experiences from practice and a first case study indicate that animal-assisted therapy (AAT) is a promising treatment (Bardl, Bardl, & Kornhuber, 2013). The presented study investigates whether animal-assisted occupational therapy leads to more vegetative, emotional and motoric reactions in patients in MCS than regular occupational therapy does.
Methodology: 10 patients in a minimally conscious state (mean age = 47.2, SD = 19.4) participated in this randomized, controlled within-subject study with repeated measurement. Each patient received 16 therapy sessions over a period of four weeks, while intervention or control sessions alternated. Therefore, each patient received eight intervention and eight control sessions. Each therapy session included a range of activities from occupational therapy. Intervention sessions included a trained therapy companion animal (dog, guinea pig or rabbit), while control therapy sessions were conducted without animals.
Behavioral reactions were assessed via behavioral coding of the videotaped sessions in Noldus Observer, the Basler Vegetative State Assessment (BAVESTA) and a therapist's assessment via visual analogue scale. Moreover, patients’ heart rate and heart rate variability were measured. Data were analyzed with SPSS statistics using linear mixed models.
Main Results: The BAVESTA shows that patients communicated more non-verbally in the presence of an animal (p=0.028). Behavioral analyses in Noldus Observer are not yet finished but will be presented at the congress. Heart rate did not differ between intervention and control sessions. However, patients showed more HF in the control conditions compared to the AAT sessions (p=0.045).
Principal Conclusions and Implications for Field: The results indicate that integrating animals into a therapeutic setting of patients in MCS leads to more non-verbal communication and seems to decrease parasympathetic activity. Therefore, we suggest that AAT might be a method to increase awareness. This leads to the conclusion that animal-assisted therapy is a promising method to facilitate neurorehabilitation of patients in a minimally conscious state.