Animal-assisted therapy for patients in a minimally conscious state: A randomized two treatment multi-period crossover trial

Karin Hediger; Milena Petignat; Rahel Marti; Margret Hund-Georgiadis

doi:10.1371/journal.pone.0222846

Animal-assisted therapy for patients in a minimally conscious state: A randomized two treatment multi-period crossover trial

PLoS One. 2019 Oct 1;14(10):e0222846. doi: 10.1371/journal.pone.0222846. eCollection 2019.

Authors

Karin Hediger^{1

2

3

4}, Milena Petignat^{1

2}, Rahel Marti^{1

2}, Margret Hund-Georgiadis²

Affiliations

¹ Department of Psychology, Division of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland.
² REHAB Basel, Clinic for neurorehabilitation and paraplegiology, Basel, Switzerland.
³ Department of Epidemiology and Public Health, Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.
⁴ Institute for Interdisciplinary Research on the Human-Animal Relationship Switzerland, Basel, Switzerland.

Abstract

Objective: To investigate if animal-assisted therapy (AAT) leads to higher consciousness in patients in a minimally conscious state during a therapy session, measured via behavioral reactions, heart rate and heart rate variability.

Methods: In a randomized two treatment multi-period crossover trial, 10 patients in a minimally conscious state participated in eight AAT sessions and eight paralleled conventional therapy sessions, leading to 78 AAT and 73 analyzed control sessions. Patients' responses during sessions were assessed via behavioral video coding and the Basler Vegetative State Assessment (BAVESTA), heart rate and heart rate variability (SDNN, RMSSD, HF and LF). Data were analyzed with generalized linear mixed models.

Results: Patients showed more eye movements (IRR = 1.31, 95% CI: 1.23 to 1.40, p < 0.001) and active movements per tactile input during AAT compared to control sessions (IRR = 1.13, 95% CI: 1.02 to 1.25, p = 0.018). No difference was found for positive emotions. With BAVESTA, patients' overall behavioral reactions were rated higher during AAT (b = 0.11, 95% CI: 0.01 to 0.22, p = 0.038). AAT led to significantly higher LF (b = 5.82, 95% CI: 0.55 to 11.08, p = 0.031) and lower HF (b = -5.80, 95% CI: -11.06 to -0.57, p = 0.030), while heart rate, SDNN, RMSSD did not differ.

Conclusions: Patients in a minimally conscious state showed more behavioral reactions and increased physiological arousal during AAT compared to control sessions. This might indicate increased consciousness during therapeutic sessions in the presence of an animal.

Trial registration: ClinicalTrials.gov NCT02629302.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Animal Assisted Therapy*
Animals
Consciousness / physiology*
Cross-Over Studies
Female
Heart Rate / physiology
Humans
Male
Middle Aged
Persistent Vegetative State / physiopathology
Persistent Vegetative State / therapy*

Associated data

ClinicalTrials.gov/NCT02629302

Grants and funding

Karin Hediger received support from an Ambizione grant from the Swiss National Science Foundation (grant PZ00P1_174082) and the Förderverein pro REHAB Basel. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.