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Changes in Physical Activity and Sleep Among Veterans Using a Service Dog as a Rehabilitation Modality for Post-traumatic Stress Disorder: An Open-Label Single-Arm Exploratory Trial Using Actigraphy-Based Measures

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Abstract

Little is known about the changes occurring after acquiring a service dog (SDPTSD) trained for the management of post-traumatic stress disorder (PTSD) symptoms on physical activity and sleep among veterans. To quantify, using actigraphy measures, changes in physical activity and sleep before and after acquiring a SDPTSD. A total of 18 veterans with chronic PTSD wore an actigraph wGT3X-BT during 7 days, 3 months before (T−3) and 9 months after (T+9) acquiring their SDPTSD. They also completed online questionnaires at both measuring times: Life Space Assessment, Pittsburgh Sleep Quality Index, Post-traumatic Stress Disorder Checklist-Military version and Beck Depression Inventory II. Non-parametric statistics compared results between T−3 and T+9 and Cohen’s d effect sizes (E.S.) determined the magnitude of changes. Veterans remained sedentary during most of their awake time at T+9 (p = 0.173; E.S. = 0.249), whereas the percentage of time dedicated to moderate physical activity (p = 0.038, E.S. = 0.38) and the number of steps/day (p = 0.008; E.S. = 0.49) increased. These changes were accompanied by expanded mobility patterns into their neighborhood (p = 0.002; E.S. = 0.52) and outside of town (p = 0.03, E.S. = 0.36). Actigraphy measures showed no change in sleep parameters despite reported improvements in sleep efficiency (p = 0.006; E.S. = 0.45), quality (p = 0.04, E.S. = 0.35), and disturbances (p = 0.001; E.S. = 0.55). Decreased PTSD (p ≤ 0.001; E.S. = 0.60) and depressive (p ≤ 0.001; E.S. = 0.60) symptoms were reported. Acquiring a SDPTSD represents a promising rehabilitation intervention for veterans with PTSD that improves moderate physical activity and the number of steps/day while reportedly triggering positive changes on mobility patterns, sleep quality, and psychiatric symptoms. The present exploratory trial provides the rationale for studying larger groups of participants in controlled studies over longer periods of time.

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Acknowledgements

The authors would like to acknowledge the input of all members of the PTSD/service dog Research Team: Frédéric Dumont PhD, Geneviève Belleville PhD, Édouard Auger MD, Vicky Lavoie PhD, Markus Besemann MD, and Noël Champagne MA, express their gratitude to the veterans and their family who participated in this research project, and acknowledge the contribution of Professor Scott E. Crouter PhD and his team at the University of Tennessee, Knoxville, USA, for sharing their R analysis package and providing technical support.

Funding

This work was supported by the Canadian Institute for Military and Veteran Health Research [CIMVHR Grant# IE 112256]; the Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) (doctoral scholarship), and the School of Rehabilitation at the Université de Montréal (doctoral scholarship). The CIMVHR had no role in the study design, collection, analysis, or interpretation of data, writing of the article, or the decision to submit it for publication.

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Authors and Affiliations

  1. School of Rehabilitation, Faculty of Medicine, Université de Montréal, Succursale Centre-ville, C.P. 6128, Montréal, QC, H3C 3J7, Canada

    Geneviève Lessard & Dany H. Gagnon

  2. Centre for Interdisciplinary Research in Rehabilitation of the Greater Montreal (CRIR), Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal, 6363 Chemin Hudson, Montréal, QC, H3S 1M9, Canada

    Geneviève Lessard & Dany H. Gagnon

  3. Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), 525, Boul. Wilfrid-Hamel, Québec, QC, G1M 2S8, Canada

    Geneviève Lessard & Claude Vincent

  4. Department of Rehabilitation, Université Laval, Pavillon Ferdinand-Vandry, Québec, QC, G1V 0A6, Canada

    Claude Vincent

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  1. Geneviève Lessard
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  2. Dany H. Gagnon
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  3. Claude Vincent
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Members of the PTSD-Service Dog Research Team

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DHG and CV conceived and planned the research protocol and obtained funding; GL, DHG, and CV participated actively to data collection, treatment, and validation; statistical analyses and interpretation of the results; drafted, wrote and revised the manuscript.

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Correspondence to Dany H. Gagnon.

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Lessard, G., Gagnon, D.H., Vincent, C. et al. Changes in Physical Activity and Sleep Among Veterans Using a Service Dog as a Rehabilitation Modality for Post-traumatic Stress Disorder: An Open-Label Single-Arm Exploratory Trial Using Actigraphy-Based Measures. J. Psychosoc. Rehabil. Ment. Health 7, 243–262 (2020). https://doi.org/10.1007/s40737-020-00187-4

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