“Commonly, barriers such as fear, anxiety, low motivation, fatigue and pain impede progress,” Dr. Tropiano said. “I jumped at the opportunity to apply for a facility dog, because I saw the potential for creatively navigating barriers to help patients reach their goals.”
Dr. Tropiano became a facility dog handler in 2020. She was matched with Peru – a Labrador-Golden Retriever mix – who was trained by Canine Companions, a national service dog organization. She affectionately jokes that patients now also know her as “Peru’s mom.”
Almost immediately after integrating Peru into treatment sessions with physical therapists, occupational therapists and speech language pathologists, Dr. Tropiano noticed significant changes.
It quickly became clear that patients would do much more with Peru than without her, and suddenly those barriers to progress did not seem as big,” she said. Julie Robertson, a physical therapist who works closely with Dr. Tropiano, also noticed the positive changes right away.
“Adding Peru to our team brought a different type of fun and joyfulness into sessions. When patients find a task not quite as difficult, they spend more time doing it,” she said. “And when patients do more in physical therapy, they get better faster.”
Dr. Tropiano and Julie were asked to quantify their clinical observations. Over three months, they evaluated 69 patients participating in physical therapy tasks like kicking balls, tapping balloons and playing ring toss games. They compared how patients did while working with Peru versus without the dog.
Last July, they published their findings in Anthrozoös, a journal focusing on human-animal interactions. The study marked the first published research of its kind measuring the effect of integrating a facility dog into inpatient rehabilitation sessions.
In addition to finding that all participants could do the same tasks longer with Peru than without her, Dr. Tropiano and Julie discovered heart rate and self-reported pain was lower when the facility dog was introduced to the patient on the first task of an activity. When they were introduced to the facility dog on the second task, patients overall reported higher pain and had increased heartrate, but persisted longer in completing the task with the dog.
“If patients start doing more and realizing they can push through some of the pain that is related to their injury or illness, we can improve their independence and get them home safely,” Julie said. “That was our goal – to show these dogs can have a powerful impact in rehabilitation, leading to better patient outcomes.”
Bringing in Marcy
The published study is just the beginning. This past February, occupational therapist Colette Calomeris at Adventist HealthCare Rehabilitation Rockville matched with facility dog Marcy.
“We have expanded the clinical reach of the program with two facility dogs – one at each rehabilitation hospital,” Dr. Tropiano said.
Within her work as an occupational therapist and as Marcy’s handler, Colette has already seen Marcy’s impact. She recalls a patient who was unable to use his hand post-stroke.
“Fine motor coordination tasks were frustrating, and he often gave up, until Marcy assisted us in sessions. Marcy brought him clothespins, which he took from her mouth and pinched open to place on her working vest,” Colette explained. “He engaged in this task with Marcy for the whole session, without frustration, and this helped him relearn dressing skills. It was a turning point in his recovery.”
Plans for Growth
The team plans to expand upon their research by studying how and why facility dogs help patients achieve their rehabilitation goals.
Dr. Tropiano also hopes to extend the facility dog program to additional Adventist HealthCare sites, starting with outpatient rehabilitation. “It would be a natural growth path for us,” she said, adding that she is also working toward a successor dog for inpatient rehabilitation when Peru retires.
Julie hopes a recent grant application will allow her to expand on a case study performed years ago. The study looked at whether patients who had a stroke resulting in paralysis on one half of the body achieved greater improvements when walking with a dog than using a device like a cane.
“We hope to find that patients walk with a more normalized gait pattern with the dog versus when they are using a cane or other device,” she said. “This would mean collaborating with a facility dog could be a unique and effective method to improve patients’ mobility.”
A Research Hub
Dr. Tropiano explained the program aims to grow its reach and its research efforts. “We hope to establish Adventist HealthCare as the authority at the intersection of human-animal interactions” within the field of rehabilitation.
“I think there is tremendous potential,” said Nicole Fromm, PsychD, director of Neuropsychology and Rehabilitation Psychology Services and director of Research for Adventist HealthCare Post-Acute Care Services. “Within the next decade we can position ourselves as emerging leaders in research in rehabilitation for the first time.”
As Julie said: “There is no limit to what we can do with these dogs on our team. Our only limits are our own creativity.”
To learn more about how facility dogs make an impact send an email at Adventist HealthCare Rehabilitation.
