Theuer, Amanda

Therapy dogs have been increasingly incorporated into a variety of medical treatment programs to improve patients’ treatment outcomes and wellbeing. However, research investigating the stress level of therapy dogs in this setting is limited. This is the first randomized–controlled and prospective study that investigated the wellbeing of therapy dogs in an inpatient stroke rehabilitation program. In this study, 14 therapy dog–handler pairs were embedded in an inpatient stroke rehabilitation program to provide animal-assisted treatment (AAT). These therapy dog–handler pairs actively participated in stroke rehabilitation by walking with the patient, playing fetch with the patient, and being petted/brushed by the patient, amongst various other AAT activities. To measure canine stress responses during the rehabilitation sessions, salivary cortisol and oxytocin concentrations, heart rate and heart rate variability, tympanic membrane temperature, and a behavioral evaluation were recorded before and after interactions with the patient. The results demonstrated that therapy dogs had significantly decreased heart rate and increased heart rate variability after the AAT session. Right tympanic temperature significantly increased after the session, but there was no significant difference in terms of salivary cortisol or oxytocin levels, nor in stress-related behavioral evaluations after the AAT session. Taken together, the results suggest that incorporating AAT into an inpatient stroke rehabilitation program did not induce stress in the therapy dogs, and that the therapy dogs may have been more relaxed after the session.

ImportanceThis is the first population-based study quantifying the incidence of nonsynostotic positional plagiocephaly and/or brachycephaly (PPB) in infancy and its association with developmental disorders.ObjectiveTo report the incidence of PPB before age 1 year, the incidence of craniosynostosis, and the percentage of children with PPB diagnosed with a developmental disorder by age 7 years.Design, Setting, and ParticipantsThis was a retrospective, population-based cohort study of children in the Rochester Epidemiology Project (REP) born in Olmsted County, Minnesota, from January 1, 2008, through December 31, 2012, with follow-up through age 7 years. Data were analyzed from March 2021 to April 2024.ExposurePhysical examination detecting cranial deformity.Main Outcomes and MeasuresThe primary outcome was the incidence of PPB. Secondary outcomes were the incidence of craniosynostosis and the percentage of children with PPB diagnosed with a developmental disorder by age 7 years.ResultsOf 9909 infants (5084 [51.3%] male; 9205 [92.9%] born at term and 704 [7.1%] born preterm) included in the study, 575 had PPB, for a PPB incidence of 5.8% (95% CI, 5.3%-6.3%). The incidence of PPB was 5.3% (95% CI, 4.8%-5.8%) in term infants vs 11.8% (95% CI, 9.4%-14.6%) in preterm infants. The incidence of craniosynostosis was 0.16% (95% CI, 0.09%-0.26%). A developmental disorder was known or suspected in 4.2% (95% CI, 2.7%-6.2%) of infants at the time of PPB diagnosis; among 402 infants with PPB and follow-up through age 7 years, 30 (7.5%; 95% CI, 5.0%-10.7%) had a confirmed developmental disorder by 7 years of age. The prevalence of autism spectrum disorder (ASD) in children with a history of PPB who were followed up to age 7 years was 2.2% (9 of 402 children).Conclusions and RelevanceThis study found that only a small percentage of the infants had positional head deformity significant enough to be documented and/or referred for subspecialty evaluation, and only a small subset of these children went on to have a developmental disorder in childhood. This information is helpful for counseling families about their child’s developmental risk at time of PPB diagnosis.

Background: Innovation in prosthetic devices for adults with upper limb loss is necessary to meet the demand for effective devices to optimize participation in daily activity. We evaluate the SoftHand Pro (SHP) as a terminal device to determine the application of this biologically-inspired prosthetic hand for use for a person with transradial limb deficiency. Method: This case study describes and measures the first use of the SHP by an individual with transradial limb deficiency in their home environment. This paper reports the features and functionality of the SHP prototype and provides recommendations for changes to further optimize function. Results: The participant found the simple mechanics, durability, and ease of use of the SHP to be beneficial. She praised the SHP’s positive impact on quality of life and suggested areas for optimization. Objective assessments of dexterity and function showed improvements. Conclusion: Using a biologically-inspired myoelectric hand provides an opportunity for intuitively controlled grasp of common large and small objects. The simplicity of use and the lightweight, durable design of the SHP has the potential to provide a positive impact on quality of life, and this case study has provided valuable feedback to further improve the hand and enable larger at-home trials.

Background: Behavioral Shaping Therapy (BeST) is a program that uses a multidisciplinary approach to treat patients diagnosed with functional movement disorder (FMD). While this diagnosis is classified as a psychological disorder by the Diagnostic and Statistical Manual of Mental Disorders, the BeST program focuses on treating the physical manifestations of FMD. Occupational therapists are an integral part of the multidisciplinary team, employing a variety of cognitive behavioral and motor reprogramming techniques to normalize movement patterns. Method: Patients 18 years of age or older with a confirmed diagnosis of FMD participated in this study. This retrospective chart review used the Canadian Occupation Performance Measure to examine the patients’ satisfaction and perceived change in task performance on discharge from the program. Results: Results from the dependent t-test indicated a positive outcome after participating in the BeST program, with a mean change in performance of 3.4 and a mean change in satisfaction of 4.7. Discussion: This study shows that occupational therapy can have a positive effect on patients diagnosed with FMD.