O2094: Animal Assisted Intervention During Cast Removal in Children: A Pilot Study

Background: Animal assisted intervention (AAI) is a broad term encompassing strategies for using human-animal interaction to achieve a beneficial outcome. The positive benefit of AAI for children undergoing stressful procedures has been demonstrated in other disciplines. Cast removals for children can be stressful for a variety of reasons including the loud noise and vibrations associated with cast saws. Multiple distractions have been studied to help alleviate cast room anxiety; however, the benefits of AAI during cast removal have not been studied.

Methods: Patients between the ages of 4-18, undergoing cast removal, were enrolled. exclusion criteria included prior behavioral conditions or cast removal. The AAI consisted of a certified facility dog present for cast removal. The dog sat with the participant on the table, and participants could pet or hold on to the dog throughout the procedure. Participants were divided into the AAI and control group based on the availability of the handler for the facility dog. Patient anxiety was assessed using the Short State-Trait Anxiety Inventory (STAI-S) before and after cast removal as well as the STAI-parent form (STAI-P), Children’s fear scale (CFS), and pre-, intra-, and post- procedural heart rate measurements. Statistical analysis of STAI-S pre/post, STAI-P, CFS, and heart rate between groups was performed using two-tailed t-tests and Mann–Whitney U test as appropriate. Linear regression was performed to evaluate trend by age for STAI-S and STAI-P.

Results: A total of 89 patients (27 AAI, 62 control) were enrolled. The mean age was 9.4 ± 2.8. There was no difference in the mean pre-cast removal STAI-S scores (p = 0.55), nor post-cast removal STAI-S scores between groups (p = 0.47). Similarly, there was no difference in the mean CFS between groups (p = 0.75). Patient caregivers demonstrated similar results with no difference in the mean STAI-P scores between groups (p = 0.91). The mean heart rate pre-, intra-, and post- measurements were 86.4, 87.5, and 84.7 in the control group and 91.0, 90.3, and 88.2 in the dog group (p = 0.28, 0.60, and 0.37 respectively). There was also no difference in the change in heartrate from pre-cast removal to post cast removal (p= 0.79). Linear regression demonstrated no correlation between STAI-S post-cast removal and age (p = 0.79), nor between STAI-P and age (p = 0.50). The dog behaved appropriately during all cast removals with no harm to participant or dog during the study.

Conclusion: We found that AAI did not impact stress during cast removal in our pilot sample of children without behavioral and mental health conditions. We now plan to evaluate how AAI can benefit children with additional diagnoses who are more sensitive to the frightening environment in the cast room.