Effectiveness of animal-assisted therapy on pain in children:A systematic review and meta-analysis

Aims:Animal-assisted therapy(AAT)relieves pain by creating a relaxed and comfortable environment to reduce anxiety in children.Yet little is known about its effects on pain in children.This study aims to systematically evaluate the effects of AAT on pain in children.Methods:Eight databases including PubMed,Cochrane Library,Web of Science,CINAHL Complete,Chinese Biomedical Database(CBM),Weipu Database(VIP),China Knowledge Resource Integrated Database(CNKI)and Wanfang Database were retrieved,and all randomized controlled trials or controlled clinical trial using AAT on children’s pain were recruited from inception to October 2019.Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies.RevMan 5.3 software was employed for meta-analysis.Results:Seven published studies containing 4 RCTs and 3 CCTs were included for the systematic review.The results of meta-analysis showed that AAT could reduce children’s pain when compared with the control group[MD=-0.53,95%CI(-0.77,-0.30),P<0.00001].Conclusion:Current evidence shows that AAT can relieve pain in children to some extent.Considering the limited quality and quantity of the available studies,more high quality studies should be performed to verify the above conclusion.

Feasibility,efficacy,and safety of animal-assisted activities with visiting dogs in inpatient pediatric oncology

Background Childhood cancer entails a heavy burden for patients and their families.Recent advances in overall survival rates have increasingly brought long-term quality of life into focus.Animal-assisted activities(AAAs)have long been hypothesized to alleviate the burden on pediatric patients and their peers in the hospital setting.However,their use in inpatient pediatric oncology has been a sensitive issue mainly due to the fear of infections,resulting in a lack of studies.This study presents data on the feasibility,safety,and efficacy of AAAs from a single German center.Methods Between 2018 and 2022,60 patients(median age=10.3 years)diagnosed with malignancy and undergoing treatment were visited by an intervention dog(total visits=100).Patients were screened for infections as per hospital policy,with additional microbiological testing performed based on symptoms.The dog was screened for human pathogens and zoonoses.Microbial data and hospitalizations were analyzed from two months prior to the first visit until two months after the last visit.Acceptance of being in the hospital,both with and without planned animal-assisted interventions and pre-and post-intervention state stress,were measured using a validated visual analogue scale(0-10).Results Patients benefited from AAAs,showing increased acceptance of being in the hospital(median:7.25 vs.4.50,P<0.001)and decreased median state stress ratings one hour after the visit compared to one hour before the visit(1.00 vs.4.25,P<0.001).The intervention did not result in an increased number of infections or unplanned hospitalizations,and no zoonoses were detected.All microbial screening tests of the dog were negative.Conclusions AAAs with visiting dogs in inpatient pediatric oncology are feasible and safe.Although they hold promise for enhancing patients’well-being,further prospective studies are needed.

Effects of therapeutic horseback riding on post-traumatic stress disorder in military veterans

Background:Large numbers of post-deployment U.S.veterans are diagnosed with post-traumatic stress disorder(PTSD)and/or traumatic brain injury(TBI),leading to an urgent need for effective interventions to reduce symptoms and increase veterans’coping.PTSD includes anxiety,flashbacks,and emotional numbing.The symptoms increase health care costs for stress-related illnesses and can make veterans’civilian life difficult.Methods:We used a randomized wait-list controlled design with repeated measures of U.S.military veterans to address our specific aim to test the efficacy of a 6-week therapeutic horseback riding(THR)program for decreasing PTSD symptoms and increasing coping self-efficacy,emotion regulation,social and emotional loneliness.Fiftyseven participants were recruited and 29 enrolled in the randomized trial.They were randomly assigned to either the horse riding group(n=15)or a wait-list control group(n=14).The wait-list control group experienced a 6-week waiting period,while the horse riding group began THR.The wait-list control group began riding after 6 weeks of participating in the control group.Demographic and health history information was obtained from all the participants.PTSD symptoms were measured using the standardized PTSD Checklist-Military Version(PCL-M).The PCL-M as well as other instruments including,The Coping Self Efficacy Scale(CSES),The Difficulties in Emotion Regulation Scale(DERS)and The Social and Emotional Loneliness Scale for Adults-short version(SELSA)were used to access different aspects of individual well-being and the PTSD symptoms.Results:Participants had a statistically significant decrease in PTSD scores after 3 weeks of THR(P≤0.01)as well as a statistically and clinically significant decrease after 6 weeks of THR(P≤0.01).Logistic regression showed that participants had a 66.7%likelihood of having lower PTSD scores at 3 weeks and 87.5%likelihood at 6 weeks.Under the generalized linear model(GLM),our ANOVA findings for the coping self-efficacy,emotion regulation,and social and emotional loneliness did not reach statistical significance.The results for coping self-efficacy and emotion regulation trended in the predicted direction.Results for emotional loneliness were opposite the predicted direction.Logistic regression provided validation that outcome effects were caused by riding longer.Conclusion:The findings suggest that THR may be a clinically effective intervention for alleviating PTSD symptoms in military veterans.

The Effects of Therapeutic Horseback Riding Program on Motor Skills inChildren with Autism Spectrum Disorder

Therapeutic horseback riding(THR)as an animal-assisted intervention is one of the innovative approaches emer-ging in the treatment for children with autism spectrum disorder(ASD).The current study was designed to inves-tigate the effects of a 12-week,twice a week THR program on motor skills in sixty-eight children with ASD aged 5–10 years old.All participants selected met the DSM-V criteria for ASD,and a total offifty-three participants completed the study.A randomized controlled trial design was utilized for the study.Data was collected via a pre-THR test,interim-THR test,and post-THR test to investigate the possible changes in motor skills throughout the 12-week THR program.Results showed that the THR program significantly improved overall motor skills across time points(p<0.05)and sub-skills of run,gallop and two-hand catch(as compared to the control group,p<0.05).In conclusion,the THR program may be an effective option for improving motor skills in children with ASD and further investigation with a longer period of intervention is warranted.