In the United States alone, 15,590 children and adolescents will be diagnosed with cancer this year. Cancer is the leading cause of death in children and the oncological treatments are brutal physically, psychologically, and financially on both the child and their family leading to a reduced quality of life. Children undergoing treatment often have signs and symptoms related to treatment such as nausea, vomiting, pain, decreased appetite, distress, anxiety, depression, decrease in social interactions, and fatigue. According to Rodger’s systematic review, most children experience these symptoms in clusters, so finding strategies to address multiple symptoms at the same time is crucial.
As clinicians we should use validated self-report measures to determine the symptoms children undergoing treatment are experiencing, so we can tailor their treatment to address as many symptoms as possible.
As physical therapists (PTs), our scope of practice’s focus surrounds physical activity. Children undergoing cancer treatments often are fatigued, socially isolated, losing weight, reducing bone density, and stressed. All of which we have the ability to treat.
In fact, Dimeo studied physical activity impacts on fatigue and psychological status in cancer patients. He discovered that aerobic physical activity during oncological treatments actually reduced the amount of distress, depression, anxiety, and fatigue in patients compared to the control group.
When children experience these symptom clusters1 inhibiting them from typical childhood activities, how do we as PTs encourage them to participate in therapy?
Animal Assisted Therapy (AAT) is “‘a goal oriented, planned and structured therapeutic intervention directed and/or delivered by health, education and human service professionals.
(…) AAT is delivered and/or directed by a formally trained (with active licensure, degree or equivalent) professional with expertise within the scope of the professionals’ practice. AAT focuses on enhancing physical, cognitive, behavioral and/or socio-emotional functioning of the particular human recipient.’”
Many studies have discovered that AAT is an effective and safe way to provide therapy in a multitude of settings: hospitals, pediatrics, oncology, and outpatient rehabilitation. Although a lack of high quality evidence and for pediatric AAT research results such as decreased pain, pain killers consumed, depression, and anxiety have been found. A longitudinal, quasi-experimental study focusing on AAT for an outpatient pediatric oncology facility in Brazil aimed to expand our knowledge on this topic by conducting the first quantitative AAT in a pediatric oncology facility. They focused their research on symptoms effecting quality of life, physiological, and psychological aspects of children receiving oncological treatments while receiving PT. The study performed AAT 3x/week for 30 minute sessions in groups containing children to provide social interaction. The therapist planned their interventions around upper extremity stimulation, sensory stimulation, activities of daily living, gait, agility, recreation, and socialization. Examples include: playing fetch, brushing dog, feeding dog, walking dog, obstacle courses, and performing dog shows. From the outcome measure data analysis, the researchers found that the patient’s pain level, stress, and irritation were significantly reduced. The researchers also found that caregivers had significantly reduced anxiety, stress, and mental confusion. Both caregivers and patients had a reduction of depressive symptoms.
Combining PT treatments with AAT is a potential technique therapists can use to address these symptom clusters1 as well as tackle physical impairments, activity limitations, and participation restrictions that develop throughout treatment. Dogs truly are a kid’s best friend.