- 第二部 - 「動物介在療法（AAT）に関する発表」“Presentation on AAT (Animal Assisted Therapy)”
福田 美穂氏（社会福祉法人 信愛報恩会 信愛病院）

Miho FUKUDA, Shinai Hospital, Social Welfare Corporation Shin-ai Hoon Kai

Hello everybody. My name is Miho Fukuda and I work

medical therapist provide information about theas an occupational therapist at Shinai Hospital.

patients who will be coming to the session, the handlers
explain what the activity dogs can and cannot do, andLocated in Kiyose City in Tokyo Prefecture, Shinai

then the medical therapist decides which of the activity

Hospital is a 199-bed hospital with general wards,dogs will be suitable for each individual program.

recovery rehabilitation wards, palliative care wards andsanatorium-style wards that include specialist dementia

Next, before moving onto the individual programs,

care wards. With the cooperation of the Japan Animal

the dogs and the patients enjoy some time interacting

Hospital Association, animal-assisted activities (AAA)

together. Two or three programs are then conductedstarted up at the hospital in 1997, and animal-assistedwith each patient. After the programs are completed,therapy (AAT) was introduced in 2000.

the dogs and the patients share another short period
of interaction time and then the patients return to

AAT is a form of adjuvant therapy involving the use

their own wards. Finally, the staff members hold anof animals as intermediaries that is carried out asevaluation meeting in which they exchange opinions

a specialized treatment procedure in the context

about the day’s sessions.

of human medical treatment. Led by medical staff,
the treatment consists of setting out one or more

Let me explain the flow of the AAT for the patients fromtherapeutic goals tailored to the needs of individual

start to finish.

patients, such as improved psychological, physiologicalor social functioning, selecting appropriate animals,

First of all, a rehabilitation staff meeting is held tovolunteers and handlers, and also evaluating theconsider which patients we would like to introduce totherapeutic effects.

AAT, to judge whether each of these patients is suitable
for the therapy or not, and to draw up a program

At this hospital, AAT sessions take place three times

plan. Then, in consultation with the patient’s primaryeach month on the first, third and fourth Tuesdays,

physician and the chief nurse of the ward, we makerunning for one hour from 3:30 pm. The sessions

sure that the plan is suitable for the patient concerned.

take place in the occupational therapy rooms andAfter that, the patient observes an AAT session. Lastly,

are carried out by a staff team that includes three

we obtain a consent form signed by the patient and/or

occupational therapists, one medical therapist, twoa family member agreeing to the patient’s participation

handlers and two activity dogs from the Japan Animalin the therapy and to video recordings of the sessions,

Hospital Association. Usually two or three patientsand then the AAT itself can begin.

participate in each session. In principle, the therapy isoffered to patients who are fond of animals, those who

In principle, individual AAT programs are carried out

have experienced keeping animals at home, and thoseover a six-month period. A video recording is made of

who the medical staff judge are likely to improve their

the first session and the last session at the end of themotivation as a result of being in contact with animals.

six-month period. Evaluations of physical function andmovement ability are also carried out at these times.

The AAT day begins with a staff meeting to discuss

During the AAT period, the patient’s condition during

the day’s programs. The occupational therapists andeach session and the result of the program are also

2nd Live Love Animals International Conference on Animal Care in Kobe 2012117

recorded. In the case of patients whose conditions weAfter that, the same patient strokes the dog in aexpect to continue to improve, AAT may be continued

standing position. The patient puts their weight on theirfor longer than six months.

paralyzed right leg and strokes the dog with their righthand. This exercise combines balanced standing with

From the introduction of AAT in July 2000 up to themoving and controlling the right hand as an approachpresent time, a total of 37 patients—13 male and 24

to dealing with the sensory paralysis of the right hand.

female—have participated in the program. The majorityof these patients have been in their eighties and their

Next comes walking using a walking aid. The patient

most common major medical condition has beenwalks together with a member of the rehabilitation

cerebrovascular disease, also known as stroke.

staff. The handler controls the dog by adjusting its
lead and walking diagonally a little way in front of theNow I would like to give you a partial introduction topatient. In this way, the patient can enjoy walking while

the AAT program that we carry out at our hospital.

calling to the dog.

First, let’s look at ball throwing. This patient has

This next pract ice is walking the dog using alight movement paralysis on the right side of thewheelchair. Due to a subarachnoid hemorrhage, thisbody caused by a cerebral infarction. The patient haspatient has paralysis along the left side of the bodydifficulty maintaining their balance while standing soin addition to an attention deficiency on the left side

they are standing using a walking aid. As they continue

due to a higher cerebral dysfunction that was an after-to throw the ball (by taking one hand off the walking

effect of the hemorrhage. The patient moves their ownaid) they are simultaneously practicing maintaining

wheelchair while paying careful attention not to hit thetheir balance and using their right hand. Also, by seeing

dog that is walking slightly in front on the patient’s left

the dog fetch the ball happily, the patient is motivatedside.

to throw the ball repeatedly many times.
Now, let me introduce you to this patient’s case.
The next practice I’d like to show you is scarf tying.
This is the same patient we saw in the previous photo.

The patient is a 40-year-old woman who I will call

The intention behind scarf tying is to practice making

A-san. Three years earlier she had experienced adelicate movements of the right hand and to promote

subarachnoid hemorrhage. Among the aftereffects

the simultaneous use of both hands. The patient can

she was left with motor paralysis on the left side

exercise their own initiative and the practice can alsoof her body, sensory paralysis and higher cerebral

become a cue toward increasing communication with

dysfunction. Please refer to the slides for information

other people. For instance, the patient can chooseon the course of the disease and the rehabilitationa scarf that suits the dog, which invites positive

objectives. Since this patient loves animals, we expected

comments from surrounding people who tell the patient

AAT to have a greater than usual rehabilitation effectthat the dog looks cute wearing that particular scarf.

on her. She had been participating in AAT for twoyears prior to this time point. The AAT targets were118

In this next practice, the dog jumps through a hula-based on the rehabilitation targets, which included

hoop. This patient also has moderate paralysis on theseated posture improvement, right hand and feetright side of the body due to a stroke. The patient keeps

muscle strengthening, and higher cerebral dysfunction

hold of the hula-hoop in a fixed position and fixed angle

improvement. In the AAT program, our planned

using their paralyzed right hand so that it is easier for

approach called for stroking a dog in a seated position,

the dog to jump. This practice is used as a means ofball throwing, wheelchair walking, and tackling therehabilitating the right hand.

patient’s memory impairment.

りぶ・らぶ・あにまるず 神戸アニマルケア国際会議 2012

This was a therapeutic process. The photograph on

given movement is performed or in the duration of thethe left shows the patient stroking the dog in a seatedexercise. For this reason, AAT is considered useful as anposition at the time when the AAT program began. The

adjuvant therapy for rehabilitation. For information on

patient was afraid to lean her upper body forward or

reference books on this subject, please look at the slide.

to the left side because it was easy for her to fall overdue to the movement and sensory paralysis on theLet me close by saying that I obtained prior agreement

left side of her body, so the range of her right-handfrom the patients concerned to show the pictures usedreach was limited. The photograph on the right showsin this presentation. Thank you very much for listening.

her appearance two years later. In this photograph,
her fear of reaching the right hand forward is lesspronounced and she can stroke the dog while keeping
herself balanced. We can’t see much improvement in
the sensory paralysis of the left hand and foot, but herability to balance her right hand and foot has improved.
With the improvement in her seated postural balance,
the patient has become able to keep stroking the dog
without falling down even when seated in a place
without back support.
In addition, there has been an improvement in herendurance. She is able to move the wheelchair a greater
distance by herself and at present she can move aroundalmost anywhere inside the ward by herself. She
takes part in rehabilitation sessions five or six times
each week apart from AAT, so we can’t judge that herimprovement is due to AAT alone, but certainly AAT,
which she undertakes three times a week, has madea contribution to her improvement as an adjuvant
therapy.
In summary, in AAT, an occupational therapist or aphysiotherapist chooses an animal that best meets theobjectives of the individual patient, plans a programthat includes the movements they wish the patient topractice intentionally, and then carries out the program.
Also, a handler controls the dog in accordance withthe program while paying attention to the behavior ofthe dog. Meanwhile, the patient relaxes in a pleasantatmosphere while interacting with the dog, and isconsequently more able to move in order to engage
with the animal on their own initiative. The patient’s
movements as a result of this process are more naturalthan would be the case if they were not interacting withthe animal, and this also motivates the patient to move
more as witnessed by increases in number of times a

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りぶ・らぶ・あにまるず 神戸アニマルケア国際会議 2012

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りぶ・らぶ・あにまるず 神戸アニマルケア国際会議 2012