Use of a Robotic Seal as a Therapeutic Tool to Improve Dementia Symptoms: A Cluster-Randomized Controlled Trial

Wendy Moyle; Cindy J Jones; Jenny E Murfield; Lukman Thalib; Elizabeth R A Beattie; David K H Shum; Siobhan T O'Dwyer; M Cindy Mervin; Brian M Draper

doi:10.1016/j.jamda.2017.03.018

Use of a Robotic Seal as a Therapeutic Tool to Improve Dementia Symptoms: A Cluster-Randomized Controlled Trial

J Am Med Dir Assoc. 2017 Sep 1;18(9):766-773. doi: 10.1016/j.jamda.2017.03.018. Epub 2017 Aug 2.

Authors

Wendy Moyle¹, Cindy J Jones², Jenny E Murfield², Lukman Thalib³, Elizabeth R A Beattie⁴, David K H Shum⁵, Siobhan T O'Dwyer⁶, M Cindy Mervin⁷, Brian M Draper⁸

Affiliations

¹ Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia. Electronic address: w.moyle@griffith.edu.au.
² Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia.
³ Department of Public Health, College of Health Sciences, Qatar University, Qatar.
⁴ School of Nursing, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia.
⁵ Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Applied Psychology, Mt Gravatt Campus, Griffith University, Brisbane, Queensland, Australia.
⁶ Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; Medical School, University of Exeter, Exeter, United Kingdom.
⁷ Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; Center for Applied Health Economics, School of Medicine, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia.
⁸ School of Psychiatry, University of New South Wales, Sydney, Australia.

PMID: 28780395
DOI: 10.1016/j.jamda.2017.03.018

Abstract

Objectives: To test the effects of individual, nonfacilitated sessions with PARO (version 9), when compared against a look-alike plush toy and usual care, on the emotional and behavioral symptoms of dementia for people living in long-term care facilities.

Design: Parallel, 3-group, cluster-randomized controlled trial conducted between June 14, 2014, and May 16, 2015.

Setting: Twenty-eight long-term care facilities operated by 20 care organizations located in South-East Queensland, Australia.

Participants: Four hundred fifteen participants aged ≥60 years, with a documented diagnosis of dementia.

Intervention: Stratified by private/not-for-profit status and randomized using a computer-generated sequence, 9 facilities were randomized to the PARO group (individual, nonfacilitated, 15-minute sessions 3 times per week for 10 weeks); 10 to plush toy (same, but given PARO with robotic features disabled); and 9 to usual care. Treatment allocation was masked to assessors.

Measurements: Primary outcomes were changes in levels of engagement, mood states, and agitation after a 10-week intervention, assessed by coded video observations (baseline, weeks 1, 5, 10, and 15) and Cohen-Mansfield Agitation Inventory-Short Form (baseline, weeks 10 and 15). Analyses followed intention-to-treat, using repeated measures mixed effects models. Australian New Zealand Clinical Trials Registry (ACTRN12614000508673).

Results: Video data showed that participants in the PARO group were more verbally [3.61, 95% confidence interval (CI): 6.40-0.81, P = .011] and visually engaged (13.06, 95% CI: 17.05-9.06, P < .0001) than participants in plush toy. Both PARO (-3.09, 95% CI: -0.45 to -5.72, P = .022) and plush toy (-3.58, 95% CI: -1.26 to -5.91, P = .002) had significantly greater reduced neutral affect compared with usual care, whilst PARO was more effective than usual care in improving pleasure (1.12, 95% CI: 1.94-0.29, P = .008). Videos showed that PARO was more effective than usual care in improving agitation (3.33, 95% CI: 5.79-0.86, P = .008). When measured using the CMAI-SF, there was no difference between groups.

Conclusions: Although more effective than usual care in improving mood states and agitation, PARO was only more effective than a plush toy in encouraging engagement.

Keywords: Agitation; BPSD; PARO; engagement; mood state; older people.

Publication types

Randomized Controlled Trial

MeSH terms

Aged
Aged, 80 and over
Australia
Cluster Analysis
Dementia / physiopathology*
Dementia / therapy*
Female
Humans
Male
Play and Playthings / psychology*
Queensland
Robotics*