Consensus building for the development of guidelines for recommending mobility service dogs for people with motor impairments

Abstract

BACKGROUND: According to recent research, mobility service dogs (MSD) improve grasping ability, autonomy in ADL, manual wheelchair propulsion, walking, transfers, psychosocial aspects, reintegration into normal life, and satisfaction with important occupations, and decrease pain in manual wheelchair users' shoulders/wrists. However, it remains a challenge for rehabilitation professionals to recommend MSD for different profiles of neurological disorders. OBJECTIVE: Formulate guidelines to support the decision-making process of rehabilitation professionals recommending MSD. METHODS: Focus groups with MSD experts (7 therapists, 4 trainers, 3 managers, 5 users) responded to four research questions. They had to formulate and prioritize criteria to inform the recommendation of MSD for three clinical cases: A-tetraplegia with powered wheelchair, B-paraplegia with manual wheelchair, and C-ambulatory (incomplete SCI or neurodegenerative disease). RESULTS: For the decision-making process of recommending MSD, six main variables were identified: scientific evidence cited (they are different among clinical cases), added value of MSD compared to other assistive devices (dissimilar among clinical cases), prioritization of personal (7), environmental (8) and canine (6) characteristics, and possible negative consequences in MSD user's life (stigmatization, resilience, care burden, authority or obedience). CONCLUSIONS: The results provide the basis for the development of clinical practice guidelines for occupational therapists and physiotherapists recommending MSD to individuals presenting various profiles of neurological disorders.