Improved Functional Independence Associated with Canine Assisted Intervention During Inpatient Rehabilitation: A Real-World Observational Study Using Inverse Probability Weighting.

Abstract

Objective To evaluate the association between canine-assisted intervention (CAI) and functional independence among patients receiving inpatient rehabilitation. Design Retrospective cohort study SETTING: Inpatient Rehabilitation Facility (IRF) PARTICIPANTS: Adults (n= 1,619) discharged from an IRF on or after August 2024, when the facility-dog program was initiated. Interventions Exposure to CAI, defined as participation in at least one therapy session involving a trained facility dog during inpatient rehabilitation. Main outcome measures The primary outcome was functional independence, measured by change in a composite GG Self-care and Mobility score from admission to discharge. Change in Self-Care and change in Mobility were analyzed separately as key secondary outcomes. The association between CAI exposure and improvement in composite functional independence was assessed using Inverse probability of treatment weighting. Among CAI-exposed patients, exploratory dose-response analyses examined associations between cumulative CAI exposure and improvement in composite functional independence score. Results Among 1,619 patients, 269 (16.6%) received CAI. Exposure to CAI was associated with greater improvement in composite functional independence score (average treatment effect among the treated [ATET]: 2.4 points; 95% Confidence Interval [CI], 0.01 to 4.76; p=0.049). The associations of CAI with Self-Care and Mobility domain estimates were directionally consistent but did not independently reach significance (p=0.060 and p=0.210). Among CAI recipients, higher cumulative exposure was associated with progressively greater improvement in composite functional independence, with a significant dose-response trend (p=0.048). Conclusions In this IRF cohort, CAI exposure was associated with greater improvements in composite functional independence, suggesting that CAI may be a meaningful addition to rehabilitation care. Prospective studies are needed to confirm these findings and to define optimal patient selection and dosing.