A Systematic Review of the Efficacy of Animal-Assisted Interventions for Neurological Disorders in Adults
DOI:
https://doi.org/10.61704/pr.614Keywords:
Animal-Assisted Therapy, Hippotherapy, Equine-Assisted Therapy, Neurological Rehabilitation, Occupational TherapyAbstract
Animal-assisted therapy (AAT) has gained increasing attention due to its potential to enhance physical, psychological, and social well-being. In recent years, its application has expanded within clinical rehabilitation settings, including neurological care. This systematic review aims to critically evaluate the effectiveness of animal-assisted interventions in adults with neurological disorders. A comprehensive literature search was conducted across PubMed, Scielo, Embase, and PEDro databases to identify clinical studies examining the impact of AAT on neurological conditions. Studies were selected based on predefined inclusion and exclusion criteria focusing on adult populations, clinical trial designs, and clearly reported outcome measures. From the initially identified studies, seventeen clinical trials met the eligibility criteria and were included in the final analysis. Overall findings indicate that animal-assisted therapy contributes positively to multiple outcome domains, including motor performance, physical functioning, psychological health, and behavioral outcomes across various neurological disorders. The evidence synthesized in this review suggests that animal-assisted therapy represents a promising complementary approach in neurological rehabilitation. These findings provide occupational therapists and rehabilitation professionals with supportive evidence to integrate AAT alongside conventional therapeutic strategies to improve patient outcomes.
References
Beck, Lisa, and Elizabeth A. Madresh. "Romantic partners and four-legged friends: An extension of attachment theory to relationships with pets." Anthrozoös 21.1 (2008): 43-56. https://doi.org/10.2752/089279308X274056
Beinotti, F., Christofoletti, G., Correia, N., & Borges, G. (2013). Effects of horseback riding therapy on quality of life in patients post stroke. Topics in stroke rehabilitation, 20(3), 226-232. https://doi.org/10.1310/tsr2003-226
Berry, A., Borgi, M., Terranova, L., Chiarotti, F., Alleva, E., & Cirulli, F. (2012). Developing effective animal‐assisted intervention programs involving visiting dogs for institutionalized geriatric patients: a pilot study. Psychogeriatrics, 12(3), 143-150. https://doi.org/10.1111/j.1479-8301.2011.00393.x
Bunketorp Käll, L., Lundgren-Nilsson, Å., Blomstrand, C., Pekna, M., Pekny, M., & Nilsson, M. (2012). The effects of a rhythm and music-based therapy program and therapeutic riding in late recovery phase following stroke: a study protocol for a three-armed randomized controlled trial. BMC neurology, 12(1), 141. https://doi.org/10.1186/1471-2377-12-141
Bunketorp-Käll, L., Lundgren-Nilsson, Å., Samuelsson, H., Pekny, T., Blomvé, K., Pekna, M., ... & Nilsson, M. (2017). Long-term improvements after multimodal rehabilitation in late phase after stroke: a randomized controlled trial. Stroke, 48(7), 1916-1924. https://doi.org/10.1161/STROKEAHA.116.016433
Bunketorp-Käll, L., Lundgren-Nilsson, Å., Nilsson, M., & Blomstrand, C. (2018). Multimodal rehabilitation in the late phase after stroke enhances the life situation of informal caregivers. Topics in sTroke rehabiliTaTion, 25(3), 161-167. https://doi.org/10.1080/10749357.2017.1413761
Bunketorp-Käll, L., Pekna, M., Pekny, M., Blomstrand, C., & Nilsson, M. (2019). Effects of horse-riding therapy and rhythm and music-based therapy on functional mobility in late phase after stroke. NeuroRehabilitation, 45(4), 483-492. https://doi.org/10.3233/NRE-192905
Dell, C., Chalmers, D., Stobbe, M., Rohr, B., & Husband, A. (2019). Animal-assisted therapy in a Canadian psychiatric prison. International journal of prisoner health, 15(3), 209-231. https://doi.org/10.1108/IJPH-04-2018-0020
della Salute, M. (2015). Interventi Assistiti con gli Animali (IAA). Linee guida nazionali.
Dorothea L., & N. Maello. (2003). Hippotherapy aids children with sensory and motor issues. Nurs. Health Source, 33, 55–61.
Filan, S. L., & Llewellyn-Jones, R. H. (2006). Animal-assisted therapy for dementia: a review of the literature. International psychogeriatrics, 18(4), 597-611. https://doi.org/10.1017/S1041610206003322
Fine, A. H. (Ed.). (2019). Handbook on animal-assisted therapy: Foundations and guidelines for animal-assisted interventions. Academic press. https://doi.org/10.1016/C2017-0-03315-3
Friedmann, E., Galik, E., Thomas, S. A., Hall, P. S., Chung, S. Y., & McCune, S. (2015). Evaluation of a pet-assisted living intervention for improving functional status in assisted living residents with mild to moderate cognitive impairment: a pilot study. American Journal of Alzheimer's Disease & Other Dementias®, 30(3), 276-289. https://doi.org/10.1177/1533317514545477
G. Gutiérrez, D. R. Granados, & N. Piar. (2007). Interacciones humano-animal: Características e implicaciones para el bienestar de los humanos. Revista Colombiana de Psicología, 16(1), 163–184. https://dialnet.unirioja.es/servlet/articulo?codigo=3245451
Hediger, K., Meisser, A., & Zinsstag, J. (2019). A one health research framework for animal-assisted interventions. International journal of environmental research and public health, 16(4), 640. https://doi.org/10.3390/ijerph16040640
Iannuzzi, D., & Rowan, A. N. (1991). Ethical issues in animal-assisted therapy programs. Anthrozoös, 4(3), 154-163. https://doi.org/10.2752/089279391787057116
J. Dotti. (2005). Terapia e animais. PC Editorial.
Óscar Iván Gómez Rincón. (2006). Breve esquema del pensamiento de Winnicott sobre los fenómenos transicionales. Pensamiento Psicológico, 2(2). Universidad Cooperativa de Colombia. https://repository.ucc.edu.co/server/api/core/bitstreams/ad342246-4a70-4e78-8c8d-a064503a7388/content
Kang, K. D., Jung, T. W., Park, I. H., & Han, D. H. (2018). Effects of equine-assisted activities and therapies on the affective network of adolescents with internet gaming disorder. The Journal of Alternative and Complementary Medicine: Paradigm, Practice, and Policy Advancing Integrative Health, 24(8), 841-849. https://doi.org/10.1089/acm.2017.0416
Lechner, H. E., Kakebeeke, T. H., Hegemann, D., & Baumberger, M. (2007). The effect of hippotherapy on spasticity and on mental well-being of persons with spinal cord injury. Archives of physical medicine and rehabilitation, 88(10), 1241-1248. https://doi.org/10.1016/j.apmr.2007.07.015
Levine, M. A. (1999). Investigating the origins of horse domestication. Equine Veterinary Journal, 31(S28), 6-14. https://doi.org/10.1111/j.2042-3306.1999.tb05149.x
Majić, T., Gutzmann, H., Heinz, A., Lang, U. E., & Rapp, M. A. (2013). Animal-assisted therapy and agitation and depression in nursing home residents with dementia: a matched case–control trial. The American journal of geriatric psychiatry, 21(11), 1052-1059. https://doi.org/10.1016/j.jagp.2013.03.004
Marcus, D. A., Bernstein, C. D., Constantin, J. M., Kunkel, F. A., Breuer, P., & Hanlon, R. B. (2012). Animal-assisted therapy at an outpatient pain management clinic. Pain Medicine, 13(1), 45-57. https://doi.org/10.1111/j.1526-4637.2011.01294.x
Marks, G., & McVilly, K. (2020). Trained assistance dogs for people with dementia: A systematic review. Psychogeriatrics, 20(4), 510-521. https://doi.org/10.1111/psyg.12529
Martin-Lemoyne, V., Gagnon, D. H., Routhier, F., Poissant, L., Tousignant, M., Corriveau, H., & Vincent, C. (2016). To what extent can the use of a mobility assistance dog reduce upper limb efforts when manual wheelchair users ascend a ramp?. Journal of applied biomechanics, 32(2), 186-195. https://doi.org/10.1123/jab.2014-0292
Menna, L. F., Santaniello, A., Gerardi, F., Sansone, M., Di Maggio, A., Di Palma, A., ... & Formisano, P. (2019). Efficacy of animal‐assisted therapy adapted to reality orientation therapy: measurement of salivary cortisol. Psychogeriatrics, 19(5). https://doi.org/10.1111/psyg.12418
Moretti, Francesca, Diana De Ronchi, Virginia Bernabei, Lucia Marchetti, Barbara Ferrari, Claudia Forlani, Francesca Negretti, Cleta Sacchetti, and Anna Rita Atti. "Pet therapy in elderly patients with mental illness." Psychogeriatrics 11, no. 2 (2011): 125-129. https://doi.org/10.1111/j.1479-8301.2010.00329.x
Moriello, G., Terpstra, M. E., & Earl, J. (2020). Outcomes following physical therapy incorporating hippotherapy on neuromotor function and bladder control in children with Down syndrome: A case series. Physical & occupational therapy in pediatrics, 40(3), 247-260. https://doi.org/10.1080/01942638.2019.1615601
Mossello, E., Ridolfi, A., Mello, A. M., Lorenzini, G., Mugnai, F., Piccini, C., ... & Marchionni, N. (2011). Animal-assisted activity and emotional status of patients with Alzheimer's disease in day care. International psychogeriatrics, 23(6), 899-905. https://doi.org/10.1017/S1041610211000226
Muñoz-Lasa, S., de Silanes, C. L., Atín-Arratibel, M. Á., Bravo-Llatas, C., Pastor-Jimeno, S., & Máximo-Bocanegra, N. (2019). Effects of hippotherapy in multiple sclerosis: pilot study on quality of life, spasticity, gait, pelvic floor, depression and fatigue. Medicina Clínica (English Edition), 152(2), 55-58. https://doi.org/10.1016/j.medcle.2018.11.012
Murthy, R., Bearman, G., Brown, S., Bryant, K., Chinn, R., Hewlett, A., ... & Weber, D. J. (2015). Animals in healthcare facilities: recommendations to minimize potential risks. infection control & hospital epidemiology, 36(5), 495-516. https://doi.org/10.1017/ice.2015.15
Nagasawa, M., Kikusui, T., Onaka, T., & Ohta, M. (2009). Dog's gaze at its owner increases owner's urinary oxytocin during social interaction. Hormones and behavior, 55(3), 434-441. https://doi.org/10.1016/j.yhbeh.2008.12.002
Olsen, C., Pedersen, I., Bergland, A., Enders-Slegers, M. J., & Ihlebæk, C. (2016). Effect of animal-assisted activity on balance and quality of life in home-dwelling persons with dementia. Geriatric nursing, 37(4), 284-291. https://doi.org/10.1016/j.gerinurse.2016.04.002
Olsen, C., Pedersen, I., Bergland, A., Enders‐Slegers, M. J., Patil, G., & Ihlebæk, C. (2016). Effect of animal‐assisted interventions on depression, agitation and quality of life in nursing home residents suffering from cognitive impairment or dementia: A cluster randomized controlled trial. International journal of geriatric psychiatry, 31(12), 1312-1321. https://doi.org/10.1002/gps.4436
Pereira, M. J. F., Pereira, L., & Ferreira, M. L. (2007). Os benefícios da Terapia Assistida por Animais: uma revisão bibliográfica. Saúde coletiva, 4(14), 62-66. https://www.redalyc.org/pdf/842/84201407.pdf
Pruskowski, K. A., Gurney, J. M., & Cancio, L. C. (2020). Impact of the implementation of a therapy dog program on burn center patients and staff. Burns, 46(2), 293-297. https://doi.org/10.1016/j.burns.2019.11.024
Rollin, B. E. (2010). Animal rights & human morality. Prometheus Books.
Rodríguez-Martínez, M. D. C., De la Plana Maestre, A., Armenta-Peinado, J. A., Barbancho, M. Á., & García-Casares, N. (2021). Evidence of animal-assisted therapy in neurological diseases in adults: a systematic review. International Journal of Environmental Research and Public Health, 18(24), 12882. https://doi.org/10.3390/ijerph182412882
Santaniello, A., Sansone, M., Fioretti, A., & Menna, L. F. (2020). Systematic review and meta-analysis of the occurrence of ESKAPE bacteria group in dogs, and the related zoonotic risk in animal-assisted therapy, and in animal-assisted activity in the health context. International journal of environmental research and public health, 17(9), 3278. https://doi.org/10.3390/ijerph17093278
Santaniello, A., Garzillo, S., Cristiano, S., Fioretti, A., & Menna, L. F. (2021). The research of standardized protocols for dog involvement in animal-assisted therapy: A systematic review. Animals, 11(9), 2576. https://doi.org/10.3390/ani11092576
S. T. Hansen, et al. (2022). Effectiveness of therapeutic horseback riding in children with disabilities: A systematic review and meta-analysis. Disability and Rehabilitation.
Schroeder, K., Van Allen, J., Dhurandhar, E., Lancaster, B., Heidari, Z., Cazenave, K., ... & Erdman, P. (2019). Riding into health: A case study on an Equine-assisted childhood obesity intervention. International journal of environmental research and public health, 16(23), 4835. https://doi.org/10.3390/ijerph16234835
Slim, M., Lebib, S., Dziri, C., Salah, F. B., & Hammadi, M. (2007). La thérapie par le cheval dans la réadaptation des enfants handicapés mentaux Expérience Tunisienne. Journal de Réadaptation Médicale: Pratique et Formation en Médecine Physique et de Réadaptation, 27(4), 115-127. https://doi.org/10.1016/S0242-648X(07)79731-1
Snipelisky, D., Smidt, J., Gallup, S., Myrick, J., Bauer, B., & Burton, M. C. (2019). Canine-Assisted Therapy in Hospitalized Patients Awaiting Heart Transplantation. Southern medical journal, 112(6), 344-348. https://doi.org/10.14423/smj.0000000000000980
Solomon, J., Beetz, A., Schöberl, I., Gee, N., & Kotrschal, K. (2019). Attachment security in companion dogs: Adaptation of Ainsworth’s strange situation and classification procedures to dogs and their human caregivers. Attachment & human development, 21(4), 389-417. https://doi.org/10.1080/14616734.2018.1517812
UCLA Health. (n.d.). Animal-assisted therapy research findings. https://www.uclahealth.org/pac/animal-assisted-therapy
Vallejo Ruilova, J. (2006). Introducción a la psicopatología ya la psiquiatría. In Introducción a la psicopatología ya la psiquiatría (pp. 912-p).
Vermöhlen, V., Schiller, P., Schickendantz, S., Drache, M., Hussack, S., Gerber-Grote, A., & Pöhlau, D. (2018). Hippotherapy for patients with multiple sclerosis: A multicenter randomized controlled trial (MS-HIPPO). Multiple Sclerosis Journal, 24(10), 1375-1382. https://doi.org/10.1177/1352458517721354
White-Lewis, S., Johnson, R., Ye, S., & Russell, C. (2019). An equine-assisted therapy intervention to improve pain, range of motion, and quality of life in adults and older adults with arthritis: A randomized controlled trial. Applied nursing research, 49, 5-12. https://doi.org/10.1016/j.apnr.2019.07.002
Wijker, C., Leontjevas, R., Spek, A., & Enders-Slegers, M. J. (2019). Process evaluation of animal-assisted therapy: Feasibility and relevance of a dog-assisted therapy program in adults with autism spectrum disorder. Animals, 9(12), 1103. https://doi.org/10.3390/ani9121103
Wollenweber, V., Drache, M., Schickendantz, S., Gerber-Grote, A., Schiller, P., & Pöhlau, D. (2016). Study of the effectiveness of hippotherapy on the symptoms of multiple sclerosis–Outline of a randomised controlled multicentre study (MS-HIPPO). Contemporary clinical trials communications, 3, 6-11. https://doi.org/10.1016/j.conctc.2016.02.001
Yamamoto, K. C. M., Silva, E. Y. T., Costa, K. N., Souza, M. S., Silva, M. L. M., Albuquerque, V. B., ... & Oliva, V. N. L. D. S. (2012). Avaliação fisiológica e comportamental de cães utilizados em terapia assistida por animais (TAA). Arquivo Brasileiro de Medicina Veterinária e Zootecnia, 64, 568-576. https://doi.org/10.1590/S0102-09352012000300007
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Abeer M. Alsheikly, Hadeel E. Hassan, Marwah A. Alfahad, shahad F. Abass
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright © 2025 by the authors. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). You may not alter or transform this work in any way without permission from the authors. Non-commercial use, distribution, and copying are permitted, provided that appropriate credit is given to the authors and Al-Hadba University.
