Rôles du chien de service, l’activité physique et le sommeil chez des vétérans avec un trouble de stress post-traumatique

The psychiatric service dog (SDPTSD) is emerging as an assistive modality for the management of symptoms associated with post-traumatic stress disorder (PTSD) among veterans. The scientific evidence pertaining to the tasks the SDPTSD accomplishes and the changes brought about its acquiring on physical activity and sleep, two of the life habits perturbed by PTSD, remain limited. The specific objectives of this thesis were thus to: 1) specify the roles and tasks accomplished by the SDPTSD, the advantages and obstacles associated to its use, and recommendations to increase its efficacy, 2) describe sedentariness, physical activity, and sleep before and after the acquiring of a SDPTSD using actigraphy and standardized questionnaires and examining if the changes reported following its acquiring were accompanied by an expansion of mobility areas and a diminution of the intensity of PTSD-related and depressive symptoms, and 3) explore the associations between 1) sedentariness, physical activity, and the intensity of PTSD-related and depressive symptoms, and 2) sedentariness, physical activity, and sleep three months before and nine months after the acquiring of a SDPTSD among veterans living with chronic PTSD. These specific objectives were carried out with an exploratory cross-sectional case study realized among 10 expert veterans who had been using their SDPTSD for two to four years (objective/study 1), a prepost intervention exploratory study without a control group realized among 18 veterans living with chronic PTSD (objective/study 2), and a correlational study realized among 27 veterans living with chronic PTSD (objective/study 3). In brief, the results of study 1 showed that the SDPTSD accomplishes several roles (e.g., detecting intrusive symptoms), and tasks (e.g., awakening the veteran during a nightmare), and that it brings several advantages (e.g., facilitating symptom management), despite obstacles (e.g., cost related to its use). Observations gathered in this study support issuance of recommendations (e.g., creating a national SDPTSD program) to improve its use. The results of study 2 suggest that the acquiring of a SDPTSD improves the percentage of daily awake time dedicated to practising physical activity of moderate intensity, the number of steps per day, mobility areas (neighborhood and outside of town), and the intensity of PTSD-related and depressive symptoms. No significative improvements emerged when considering actigraphic sleep results, although results at the Pittsburgh Sleep Quality Index revealed an improved sleep quality and efficiency and a diminution of sleep perturbations. The results of study 3 uncovered weak and moderate correlations suggesting the presence of synergic effects between physical activity, sleep and the intensity of PTSD-related and depressive symptoms. In conclusion, these encouraging results confirm that the SDPTSD is a promising assistive aid in the management of PTSD-related symptoms.

Keyphrases: Activity monitors, Combat veteran, Dog-assisted intervention, Mental health rehabilitation, Operational-stress-related disorders, Physical exercise, Sleep perturbations