Impact of dog-assisted therapy on biomechanical and functional parameters in adults with autism spectrum disorder: A non-randomized controlled trial

In the last 20 years, there has been a notable increase in the interest surrounding the incorporation of animal-assisted interventions in healthcare settings. A growing body of literature has shown the diverse advantages of human-animal interactions. Notably, dog-assisted therapy (DAT) programs have garnered attention for their potential to enhance both physical and psychological well-being (Grove et al., 2021; Parra et al., 2021). While the emotional and mental health benefits of these programs are well-established, there exists a notable gap in the scientific literature concerning the potential effects of DAT on physical and health effects.

Among these interventions, DAT programs have emerged as a relevant alternative for people with autism spectrum disorder (ASD) (Beavers et al., 2023; O’Haire et al., 2015). DAT appears to positively impact many social-emotional factors like social communication or social motivation (Ben-Itzchak & Zachor, 2021; Fung & Leung, 2014) as well as either patient-reported or caregiver-reported quality of life (Fung & Leung, 2014). Moreover, DAT seems to be effective in improving executive functioning, responsibility, and goal attainment of persons with ASD (Hill et al., 2020). Recent studies suggest that the positive effects of these therapies might be explained by the physiological impact of human-dog interaction, which has been associated with mood enhancement through increased oxytocin levels and decreased concentrations of stress-related hormones such as epinephrine, norepinephrine and cortisol (Menna et al., 2019; Wijker et al., 2021). However, most of the literature investigations have been performed with children or youths with ASD but there is very little evidence of its effectiveness in adults (Lei et al., 2024).

In this regard, adults with ASD often face challenges related to motor coordination, sensory integration, social communication, and mental health (Bell et al., 2019; Fusar-Poli et al., 2022; Hand et al., 2019). In this way, individuals with ASD commonly exhibit gait disturbances, including increased stride width, reduced gait speed, and lower capacity to attenuate trunk-to-head oscillations during locomotion (Lum et al., 2021). Consequently, these individuals with ASD often show greater postural sway during static posture, less coordination in dynamic actions, poorer balance and higher risk of falling compared to neurotypical individuals (Qu et al., 2025). The multifaceted nature of ASD needs comprehensive therapeutic approaches that extend beyond traditional methodologies (Howlin, 2021). In this way, DAT may be a feasible and relevant strategy for adults with ASD, reporting enhancements in self-awareness, happiness, a sense of calm, and increased physical interaction (Wijker et al., 2019). In addition, the investigation performed with youths and adults by Morales-Moreno et al. (Morales-Moreno et al., 2020) reported significant improvements in the establishment of behaviors, social relations, and expression of emotions, motivation, and concentration (Morales-Moreno et al., 2020). Another recent study focused on DAT in adults with ASD reached positive effects on the secure body, self-esteem and spontaneous dog-touching (Wijker et al., 2020a) together with significant cortisol level reductions that reflect acute stress decrease (Wijker et al., 2021).

DAT presents a promising strategy for addressing the unique needs of adults with ASD, as the presence of a therapy dog may serve as a facilitator for engagement, social interaction, and sensory integration (Wijker et al., 2019). Furthermore, although animal-assisted interventions are not typically designed as physical activity programs, they often require active engagement and movement from participants, which may result in physical health benefits (Sylvia et al., 2024). However, there is a notable gap in the scientific literature regarding the impact of a DAT on physical function variables like biomechanics, balance, and fall risk within this specific population. Therefore, based on the evidence presented, there is a clear need to implement and further investigate the effect of a DAT in people with autism on physical parameters, which are often severely impaired in this population (Fears et al., 2023; Memari et al., 2014). Thus, this study aimed to investigate the potential benefits of DAT on the motor challenges of adults with ASD and its impact on their functional independence. In this way, the investigation aimed to analyse the effects of DAT on the biomechanics, function and risk of falls of adults with ASD.