Effects of deep pressure stimulation on physiological arousal

Comfort evaluation and physiological effects/autonomic nervous system response of inflatable deep pressure vest in reducing anxiety

Background

Deep pressure therapy treats anxiety by triggering physiological responses and promoting calmness. Moreover, measuring user comfort can improve product quality.

Objective

To investigate the physiological effects and subjective comfort level of inflatable deep pressure vests to enhance their calming effect.

Methods

Experimental research was conducted with a one-group pretest-posttest design for physiological effects using pulse oximetry for peripheral pulse rate and a one-shot case study for three subscale parameters that help evaluate comfort (pressure, touch, and mobility) using the Numerical Rating Scale (NRS). Deep pressure intervention using the Inflatable Vest was performed for three sessions, each lasting 5 min.

Results

This study was conducted with 46 participants (24 males, 22 females) aged 17-20 (19.52 ± 0.78). Although pulse rate consistently decreased in all sessions, session 1 showed a significant decrease (p = 0.014*, d = 0.379), whereas sessions 2 (p = 0.274, d = 0.163) and 3 (p = 0.597, d = 0.078) demonstrated non-significant decreases with small effect sizes. The pressure comfort subscale showed that 87.0 %, 4.3 %, and 8.7 % of the participants, and the touch comfort subscale test revealed that 82.6 %, 8.7 %, and 73.9 % of the participants rated it as comfortable, very comfortable, and less comfortable, respectively. The mobility subscale test showed that 73.9 % of the participants rated no limitation, 17.4 % rated somewhat limited, and only 8.7 % rated limitation. Decreased pulse rate and pressure comfort were significantly positively correlated (r = 0.282**, p < 0.01), whereas touch pressure and mobility were not (r = 0.160, p > 0.05; and r = 0.121, p > 0.05, respectively). Decreased pulse rate was also positively correlated with the overall score for the three aspects (r = 0.201*, p < 0.05).

Conclusions

A comfortable inflatable deep pressure vest provides a physiologically calming effect for therapeutic modalities.

Effect of Weighted Blanket Versus Traditional Practices on Anxiety and Pain in Patients Undergoing Elective Surgery: A Multicenter Randomized Controlled Trial

Perioperative anxiety is common in surgical patients and linked to poor outcomes. This multicenter randomized controlled trial assessed the effect of the use of a warm weighted blanket on presurgical anxiety and pain, as well as postsurgical restlessness, nausea, and vomiting. Levels of anxiety and pain were measured in adult patients using a 100-point visual analog scale before elective surgery. Patients received either a warm weighted blanket (n = 74) or a traditional sheet or nonweighted blanket (n = 74). Patients in the intervention group had significantly lower preoperative anxiety scores (mean [SD] = 26.28 [25.75]) compared to the control group (mean [SD] = 38.73 [30.55], P = .008). However, the intervention had no significant effect on presurgical pain or postsurgical nausea, vomiting, or restlessness. These results suggest that weighted blankets reduce preoperative anxiety in adult patients.

The effect of weighted blankets on sleep and related disorders: a brief review

Background

Sleep disorders such as insomnia can lead to a range of health problems. The high risk of side effects and drug abuse of traditional pharmacotherapy calls for a safer non-pharmacotherapy.

Aims

To examine the use and efficacy of weighted blankets in improving sleep and related disorders in different populations and explore the possible mechanisms.

Methods

A literature search was conducted using PubMed, Embase, Web of Science, MEDLINE, Cochrane Library and CNKI databases. Eligible studies included an intervention with weighted blankets and outcomes covering sleep and/or related disorders (behavioral disturbance, negative emotions and daytime symptoms). Studies using other deep pressure, compression, or exercise-related interventions were excluded.

Conclusions

Most of the included studies showed that weighted blankets could effectively improve sleep quality and alleviate negative emotions and daytime symptoms in patients with sleep disorders, attention deficit hyperactivity disorder, autism spectrum disorder, and other related disorders, with a possible mechanism of deep pressure touch.

Recommendations

Weighted blankets might be a promising tool for sleep interventions among individuals with sleep disorders in clinical settings. More high-quality and large-scale randomized controlled trials are needed to further validate the safety and efficacy of weighted blankets and explore precise mechanisms.

Deep Pressure Therapy: A Promising Anxiety Treatment for Individuals With High Touch Comfort?

One method for managing anxiety, a highly prevalent modern mental health condition, is the calming touch sensations of deep pressure therapy (DPT). Solutions for administering DPT include the Automatic Inflatable DPT (AID) Vest, which we designed in past work. Although benefits of DPT are clear in a subset of the related literature, these benefits are not ubiquitous. There is limited understanding of what factors lead to DPT success for a given user. In this work, we present the findings of a user study ( N = 25) that evaluates the effects of the AID Vest on anxiety. We compared physiological and self-reported measures of anxiety across Active (inflating) and Control (inactive) states of the AID Vest. In addition, we considered the presence of placebo effects and assessed participant comfort with social touch as a potential moderator. The results support our ability to reliably induce anxiety, and show that the Active AID Vest tended to reduce biosignals related to anxiety. We also found a significant relationship between comfort with social touch and reductions in self-reported state anxiety for the Active condition. Those who seek to successfully deploy DPT can benefit from this work.

Weighted Blankets for Pain and Anxiety Relief in Acutely Injured Trauma Patients

To determine the impact of a weighted blanket on acute pain and anxiety in trauma patients, a preliminary prospective/retrospective study at a level-one trauma center (n = 24 patients) was conducted. In this study, 12 patients using weighted blankets for five consecutive days were compared to a matched retrospective cohort of 12 patients not using a blanket. The change in morphine milligram equivalents (MME) and alprazolam milligram equivalents (AME) over five days were compared. There was a significant difference of MME per day between the intervention group (mean MME change = -22.9) and matched controls (mean MME change = 6.2; p = 0.0072) by blanket use. Total MMEs in the intervention group decreased by 275.5 and in the control group increased by 75 between day 1 and day 5. There was no significant difference in AME change between groups (p = 0.3227). The majority of patients who took a post-intervention questionnaire reported less pain and less anxiety with blanket use compared to those without blanket use (78% and 56% of patients, respectively). To summarize, trauma patients in acute pain had less opioid use and reported less pain and anxiety when using a weighted blanket for five consecutive days compared to a control group who did not use a blanket.

Weighted blankets for sleep problems - prescription, use and cost analysis

BACKGROUND

Weighted blankets (WBs) have been suggested as a treatment option for insomnia and are commonly prescribed despite lack of evidence of efficacy.

AIM

To investigate prescription pattern, return rate and cost of WBs.

MATERIAL AND METHODS

This observational cohort register-based study in western Sweden included every individual who, in a 2.5-year period, was prescribed and received at least one WB (n = 4092). A cost evaluation was made by mapping prescription processes for WBs and sleep medication.

RESULTS

Individuals diagnosed with dementia, anxiety, autism or intellectual disability (ID) retained the WB longer than others. Individuals younger than six and older than 65 years had shorter use time. The cost evaluation showed that the prescription process for WBs was longer and resulted in a higher cost than for sleep medication.

CONCLUSIONS

Some individuals had longer use time, indicating a possible benefit from using a WB. Due to low risk of harm but high economic cost, a revision of the WBs prescription process could be recommended to identify those who might benefit from WB.

SIGNIFICANCE

Our result points towards a need for revision of the prescription process, to implement standardized sleep assessments, and create a more efficient prescription process to lower the cost.

“It’s possible”: reducing the coercion in care for adults living with neurodevelopmental disorders: a mixed-methods study

Introduction

Adults living with a neurodevelopmental disorder may present episodes of aggression, which may lead to the use of seclusion or restraint. The aim of the study was to assess the effect of an intervention aimed at reducing the use of coercive measures in a long-term care unit for adults suffering from a neurodevelopmental disorder with or without psychiatric co-morbidities.

Method

The single-center study used a sequential mixed-methods explanatory design. Retrospective data on periods of seclusion, with and without physical restraint, were collected for the ten-month pre-intervention and post-intervention periods. A qualitative survey was conducted at the end of the intervention period among the health professionals working in the unit to review the implementation and the efficiency of the approach.

Results

A significant decrease was observed between the pre- and post-intervention period in the number of seclusion and restraint sequences, the number of patients experiencing seclusion and restraint, and the duration of seclusion and restraint sequences. The efficiency of the approach was confirmed by the health care professionals and was attributed to leadership focused on limiting coercive measures, better adherence to legal obligations, team cohesion, and the implementation of alternative tools and methods.

Discussion

Reducing the use of coercive measures with adults with neurodevelopmental disorders is possible. Further studies are needed to confirm the effectiveness of alternative strategies to seclusion and restraint.

The brain-body disconnect: A somatic sensory basis for trauma-related disorders

Although the manifestation of trauma in the body is a phenomenon well-endorsed by clinicians and traumatized individuals, the neurobiological underpinnings of this manifestation remain unclear. The notion of somatic sensory processing, which encompasses vestibular and somatosensory processing and relates to the sensory systems concerned with how the physical body exists in and relates to physical space, is introduced as a major contributor to overall regulatory, social-emotional, and self-referential functioning. From a phylogenetically and ontogenetically informed perspective, trauma-related symptomology is conceptualized to be grounded in brainstem-level somatic sensory processing dysfunction and its cascading influences on physiological arousal modulation, affect regulation, and higher-order capacities. Lastly, we introduce a novel hierarchical model bridging somatic sensory processes with limbic and neocortical mechanisms regulating an individual's emotional experience and sense of a relational, agentive self. This model provides a working framework for the neurobiologically informed assessment and treatment of trauma-related conditions from a somatic sensory processing perspective.

Assessing the Impact of Weighted Blankets on Anxiety Among Patients With Anorexia Nervosa and Avoidant- Restrictive Food Intake Disorder: A Randomized Controlled Trial

IMPORTANCE

Interventions to reduce anxiety are needed for patients with anorexia nervosa (AN) and avoidant- restrictive food intake disorder (ARFID). Weighted blankets are one such intervention.

OBJECTIVE

To evaluate the impact of weighted blankets on anxiety for patients with AN and ARFID.

DESIGN

Randomized controlled trial conducted between November 2018 and March 2019. Patients were randomized into the control group or the intervention group.

SETTING

Inpatient setting; medical stabilization unit.

PARTICIPANTS

Patients (N = 23) diagnosed with AN or ARFID and experiencing moderate anxiety. The majority were female (91%), with a mean age of 26 yr (SD = 9.3), and the mean length of hospitalization was 22 days (SD = 17.3).

INTERVENTIONS

Control group participants received usual care, which included occupational therapy services. Intervention group participants received a weighted blanket along with usual care.

OUTCOMES AND MEASURES

Mixed-effects regression models were conducted. Primary outcomes included improvement in Beck Anxiety Inventory (BAI) scores by discharge.

RESULTS

Intervention group patients had a greater, non-statistically significant decrease in BAI score over time (B = 1.16, p = .83) than control group patients.

CONCLUSIONS AND RELEVANCE

Weighted blankets may be an effective tool for reducing anxiety among patients with AN or ARFID. What This Article Adds: The use of a weighted blanket, in conjunction with occupational therapy interventions, is potentially a beneficial non-pharmacological option for patients with anorexia nervosa (AN) and avoidant-restrictive food intake disorder (ARFID). The current study adds an additional modality to the multidisciplinary treatment approach for eating disorders.

Weighted Blankets' Effect on the Health of Older People Living in Nursing Homes

Background: An increasingly aging population is a global phenomenon. While considered a positive step forward, vulnerability to age-related health problems increases along with the ageing population. The aim of the study was to investigate weighted blankets’ effect on health regarding quality of life (QoL), sleep, nutrition, cognition, activities of daily living ADL and medication in older people living in nursing homes. Methods: In total, 110 older people were involved in an intervention with weighted blankets, and 68 older people completed the intervention. Measures before and after were performed regarding quality of life; QoL-AD, EQ-VAS, sleep; MISS, nutrition; MNA, cognition; S -MMSE (ADL) and medication. Comparative statistical analyses were applied. Results: After intervention with weighted blankets, health in general, such as QoL, improved. Sleep also improved significantly, especially with respect to waking up during the night. Nutrition was enhanced, health as a cognitive ability improved, and medication in the psychoanaleptic group decreased. The effect size varied between small and large. Conclusions: A weighted blanket seems to be an effective and safe intervention for older people in nursing homes, as several improvements were made regarding the health of older people.

Feasibility and Acceptability of a Remotely Delivered Weighted Blanket Intervention for People Living With Dementia and Their Family Caregivers

The COVID-19 pandemic amplified the need for interventions to support community-dwelling families living with dementia. This study examined the feasibility and acceptability of a remotely delivered weighted blanket intervention for people living with dementia, and the feasibility of collecting outcome measures specific to people with dementia and caregivers. A prospective, within subjects, pre-post design was used; 21 people with dementia and their caregivers participated. Measures of feasibility (days blanket was used for the recommended duration, injuries/adverse events, enrollment, and withdrawal rate, time to recruit sample) and acceptability (tolerability, satisfaction, and benefit perceived by participants with dementia and caregivers) were examined. Feasibility of collecting measures was examined through missing data. Results indicated high feasibility and acceptability. Collecting caregiver completed outcome measures was feasible, but measures completed by self-report by people with dementia was not. Weighted blankets are a promising tool for this population that warrant further examination to determine efficacy.

Physiological Effect of Deep Pressure in Reducing Anxiety of Children with ASD during Traveling: A Public Transportation Setting

Traveling with children with autism can be very challenging for parents due to their reactions to sensory stimuli resulting in behavioral problems, which lead to self-injury and danger for themselves and others. Deep pressure was reported to have a calming effect on people with autism. This study was designed to investigate the physiological effect of deep pressure, which is an autism hug machine portable seat (AHMPS) in children with autism spectrum disorders (ASD) in public transportation settings. The study was conducted with 20 children with ASD (16 boys and 4 girls) at the Semarang Public Special School with an age ranging from 4 to 13 years (mean 10.9 ± 2.26 years), who were randomly assigned into two groups. The experiment consisted of group I who used the AHMPS inflatable wraps model and group II who used the AHMPS manual pull model. Heart rate (HR) and skin conductance (SC) were analyzed to measure the physiological calming effect using pulse oximeter oximetry and a galvanic skin response (GSR) sensor. Heart rate was significantly decreased during the treatment compared to the baseline (pre-test) session in group I (inflating wrap model) with p = 0.019, while no change of heart rate variability (HRV) was found in group II (manual pull model) with p = 0.111. There was no remaining effect of deep pressure using the HRV indicator after the treatment in both groups (group I with p = 0.159 and group II with p = 0.566). GSR captured the significant decrease in skin conductance during the treatment with p < 0.0001 in group I, but no significant decrease was recorded in group II with p = 0.062. A skin conductance indicator captured the remaining effect of deep pressure (after the treatment); it was better in group I (p = 0.003) than in group II (p = 0.773). In conclusion, the deep pressure of the AHMPS inflating wrap decreases physiological arousal in children with ASD during traveling.

Effect of Short-Term Deep-Pressure Portable Seat on Behavioral and Biological Stress in Children with Autism Spectrum Disorders: A Pilot Study

Children with autism spectrum disorder (ASD) have challenging behaviors, which are associated with difficulties in parenting. Deep pressure is a therapeutic modality in occupational therapy, and it was reported to produce a calming effect. This study aimed to determine whether the short-term use of an autism hug machine portable seat (AHMPS) improves behavioral and neurobiological stress in children with ASD, and to determine whether AHMPS with an inflatable wrap or manual pull is more effective. This study enrolled children with ASD who were administered with the inflatable wrap (group I) and manual pull (group II) for 20 min twice a week for 3 weeks. Conners’ Parent Rating Scale-48 (CPRS-48) was used to rate behavioral improvements, and galvanic skin response (GSR) was used to measure sympathetic stress response. A total of 20 children with ASD (14 boys and 6 girls; aged 7–13 years) were included. CPRS-48 presented conduct problems: behavior was significantly decreased in the inflatable group (p = 0.007) compared to the manual pull group. The GSR captured a significant reduction in sympathetic response (p = 0.01) only in group I. Neurobiological stress was reduced in children who were wearing the AHMPS inflatable wrap; therefore, AHMPS inflatable wrap is an effective method to reduce emotional arousal.

Weighted blanket and sleep medication use among adults with psychiatric diagnosis - a population-based register study

OBJECTIVE

To measure rate of subscription of common sleep medication and diagnoses of substance use disorder (SUD) before and after receiving a prescribed weighted blanket (WB) among patients with psychiatric diagnoses.

MATERIALS AND METHODS

Using register-based data of health-related factors in a Swedish region, a total of 1785 adult individuals with a psychiatric diagnosis, received a WB and resided in the region during the study period were identified. Using each individual as their own control, the rate of one-year prior prescription of WB or diagnosed SUD was compared to rate after a half year wash-out after prescription of WB for a full year.

RESULTS

The number of patients without prescription of sleep medication increased by 3.3% (95% confidence interval (95%CI): 0.2-6.4, p=.04). Furthermore, the proportion without a prescription of benzodiazepine receptor agonist/antihistamines sleep medication increased by 5.5% (95%CI: 2.2-8.8, p=.001). Melatonin prescription increased after WB by 3.6% (95%CI: 1.1-6.2, p=.006). Younger age and unipolar-, anxiety-, attention-deficit/hyperactivity-, and post-traumatic stress disorder was associated with decreased use while psychotic-/bipolar- and personality disorder was not associated with a decrease in the use of sleep medication. The number of alcohol SUD diagnoses did not increase while sedative SUD rate increased statistically significantly by 0.7% (odds ratio = 1.63, p=.02). In a multivariate model, only younger age predicted discontinuation of sleep medication while psychotic-/bipolar- and personality disorder had statistically less decrease.

CONCLUSION

This observational register study found a statistically significant association between WB use and decreased use of common sleep medication except melatonin that increased slightly.

Feasibility trial of weighted blankets as an intervention for emergence delirium in postoperative pediatric patients

BACKGROUND

Emergence delirium (ED) is a significant problem in the post anesthesia care unit (PACU), resulting in dislodgement of medical devices, patient and staff injury, prolonged recovery, and parent dissatisfaction. Parental requests for the use of weighted blankets in the hospital setting have increased. However, while weighted blankets have shown potential as treatment for anxiety in adults and children, no studies have demonstrated their safe use with children in the hospital setting.

PURPOSE

To explore the safety of weighted blanket use with children in the PACU as an intervention for ED, a feasibility study was conducted.

DESIGN AND METHODOLOGY

A convenience sample of 93 participants, aged three to 10 years were recruited. Watcha scores, vital signs, length of wear time, and reason for blanket removal were recorded for all patients.

RESULTS

Eighty-five patients completed the study. Four participants experienced vital signs outside the defined safety parameters, with only one experiencing an adverse event (1.2%). This was consistent with the historic adverse event rate of 1% for the study site. Staff did not report issues with the use or cleaning of the blankets. Of interest, there was significant correlation between ED and suspected pain.

CONCLUSION

The study demonstrated weighted blanket use is safe and feasible with children in the hospital setting, Additional studies are needed to determine the effectiveness of weighted blankets as an intervention for ED and the impact pain may have on the severity and prevalence of ED.

Can Sensory- and Attachment-Informed Approaches Modify the Perception of Pain? An Experimental Study

Accumulating evidence linking pain with both attachment and sensory processing variables introduces the possibility that attachment- and sensory-informed strategies may modify pain experiences. The aim of this study was to investigate this proposition using an experimentally induced pain procedure. Pain perceptions of individuals using either a sensory-informed (weighted modality) or an attachment-informed (secure base priming) coping strategy were compared with those of individuals using no designated coping strategy. An independent measures experimental study design was used with a convenience sample of 272 pain-free adults. Experimental participants (n = 156) were randomly allocated to either an attachment (n = 75) or a sensory (n = 81) intervention group. Data from these participants were compared to those of 116 participants involved in an earlier cold pressor study in which no coping strategy was used. All participants completed the same sensory, attachment, and distress questionnaires and participated in the same cold pressor pain test. ANCOVAs revealed that participants in the sensory- and attachment-informed intervention groups reported significantly higher pain thresholds than the control group. Participants allocated to the sensory group also reported higher pain intensity scores than the control group. There were no significant differences in pain tolerance between the three groups after controlling for covariates. While further research is required, findings encourage further consideration of sensory- and attachment-informed strategies for people anticipating a painful experience.

A randomized controlled study of weighted chain blankets for insomnia in psychiatric disorders

STUDY OBJECTIVES

This study aimed to evaluate the effect of weighted chain blankets on insomnia and sleep-related daytime symptoms for patients with major depressive disorder, bipolar disorder, generalized anxiety disorder, and attention deficit hyperactivity disorder.

METHODS

One hundred twenty patients were randomized (1:1) to either a weighted metal chain blanket or a light plastic chain blanket for 4 weeks. The outcome was evaluated using the Insomnia Severity Index as primary outcome measure and day and night diaries, Fatigue Symptom Inventory, and Hospital Anxiety and Depression Scale as secondary outcome measures. Sleep and daytime activity levels were evaluated by wrist actigraphy.

RESULTS

At 4 weeks, there was a significant advantage in Insomnia Severity Index ratings of the weighted blanket intervention over the light blanket (P < .001) with a large effect size (Cohen's d 1.90). The intervention by the weighted blanket resulted in a significantly better sleep-maintenance, a higher daytime activity level, and reduced daytime symptoms of fatigue, depression, and anxiety. No serious adverse events occurred. During a 12-month open follow-up phase of the study, participants continuing to use weighted blankets maintained the effect on sleep, while patients switching from a light to a weighted blanket experienced an effect on Insomnia Severity Index ratings similar to that of participants using the weighted blanket from the beginning.

CONCLUSIONS

Weighted chain blankets are an effective and safe intervention for insomnia in patients with major depressive disorder, bipolar disorder, generalized anxiety disorder, or attention deficit hyperactivity disorder, also improving daytime symptoms and levels of activity.

CLINICAL TRIAL REGISTRATION

Registry: ClinicalTrials.gov; Name: Controlled Study of Chain Blanket for Insomnia; URL: https://clinicaltrials.gov/ct2/show/NCT03546036; Identifier: NCT03546036.

Impact of a sensory activity schedule intervention on cognitive strategy use in autistic students: A school-based pilot study

Introduction

Autistic students may experience difficulty performing classroom tasks due to atypical sensory processing and inefficient use of higher-order cognitive strategies. Limited research has investigated the influence of in-class sensory activities to enhance the thinking strategies required for task performance. This study evaluated a classroom-based sensory activity schedule and its impact on cognitive strategy use.

Methods

A quasi-experimental, non-equivalent groups design was used. Students ( n = 30, mean age 7.4 years) with atypical sensory processing negatively impacting classroom performance, and their teachers ( n = 23), from six autism-specific schools were grouped into intervention (Sensory Activity Schedule and usual teaching) and control (usual teaching only) groups. Students’ cognitive strategy use during the performance of classroom tasks was evaluated at baseline and post-intervention using Perceive, Recall, Plan, Perform Stage Two Cognitive Task Analysis.

Results

Statistical analysis (Mann–Whitney U test) indicated that students who received the Sensory Activity Schedule intervention improved significantly more than control group students in overall cognitive strategy use ( Z = –2.32, p = 0.02), and with strategy items involving attention and sensory perception (perceive, Z = –2.26, p = 0.02), and planning and organisation (Plan, Z = –.254, p = 0.01).

Conclusion

The Sensory Activity Schedule may enhance autistic students’ capacity to apply cognitive strategies more effectively during performance of classroom tasks.

Weighted Blankets and Sleep Quality in Children with Autism Spectrum Disorders: A Single-Subject Design

The purpose of the study was to explore the efficacy of weighted blanket applications and sleep quality in children with autism spectrum disorder and behavioral manifestations of sensory processing deficits. Two 4-year-old participants diagnosed with autism spectrum disorder who also experienced sleep disturbances took part in a single-subject design study. Objective sleep measures and caregiver surveys were tracked for a baseline period of eight days, followed by a 14-day weighted blanket intervention and a seven-day withdrawal phase. Caregiver reports and objective data were evaluated using visual analysis and the percentage of non-overlapping data methods. The results suggest minimal changes in sleep patterns as a result of the weighted blanket intervention. The findings based on using a weighted blanket intervention were enhanced morning mood after night use and a significantly decreased time to fall asleep for participants, though they were not strong enough to recommend for clinical use. Future directions include single-subject and cohort-designed studies exploring the efficacy of weighted blankets with increasing sleep quality among children with autism.

Effectiveness of anxiety reduction interventions on test anxiety: A comparison of four techniques incorporating sensory modulation

Introduction

Anxiety is one of the most commonly diagnosed mental health disorders on post-secondary campuses, often brought on by stressors unique to the college environment. Traditional psychological approaches to manage anxiety might focus on breathing techniques and progressive muscle relaxation. However, additional techniques that use specific sensory input to reduce anxiety have not received the same attention in the literature.

Method

This longitudinal study compared four interventions for state anxiety (deep breathing, progressive muscle relaxation, an adapted dive reflex, and use of a weighted lap object) in a cohort of professional occupational therapy students.

Results

This study found that all four interventions significantly reduced state anxiety. The sensory-based interventions of adapted dive reflex and weighted lap object appeared to have a longer duration of impact than the traditional interventions of deep breathing and PMR.

Conclusion

These results suggest that both traditional and sensory-based approaches may be effective in reducing anxiety before a testing situation.

Weighted Blanket Use: A Systematic Review

IMPORTANCE

Sensory integration modalities, such as weighted blankets, are used in occupational therapy practice to assist with emotional and physical regulation. However, the research related to the use and effectiveness of weighted blankets is sparse.

OBJECTIVE

To identify, evaluate, and synthesize the current literature to help develop the impetus needed to launch a research study into the effectiveness of using weighted blankets to decrease anxiety and insomnia.

DATA SOURCES

A literature search was conducted between January 23, 2018, and March 1, 2018. Databases and sites included the Cochrane Library, PubMed, PsycINFO, CINAHL, OTseeker, Web of Science, and Nursing Reference Center Plus. Search terms included weighted blanket, deep pressure, and occupational therapy as well as combinations of these terms.

STUDY SELECTION AND DATA COLLECTION

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were included if the study used weighted blankets as the modality of deep pressure stimulation. Data from presentations, conference proceedings, non-peer-reviewed literature, dissertations, and theses were excluded.

FINDINGS

Only 8 studies were included: 4 Level I, 2 Level III, and 2 Level IV studies. The outcomes of these studies suggest that weighted blankets have the potential to be beneficial in limited settings and populations.

CONCLUSION AND RELEVANCE

Weighted blankets may be an appropriate therapeutic tool in reducing anxiety; however, there is not enough evidence to suggest they are helpful with insomnia.

WHAT THIS ARTICLE ADDS

Evidence-based research on the effectiveness of weighted blankets in reducing anxiety and insomnia is sparse. More research is needed to define guidelines for the use of weighted blankets in clinical practice and to investigate the underlying mechanism of action. This systematic review can be used to begin an investigation of the use of weighted blankets for larger and more diverse populations.

Clinical Utility of Multisensory Environments for People With Intellectual and Developmental Disabilities: A Scoping Review

IMPORTANCE

Adults with intellectual and developmental disabilities (IDD) are twice as likely as their peers without disabilities to have had a physical exam in the past year; however, as a result of challenging behavior during office visits, they are significantly less likely to have received recommended health screenings. Challenging behaviors in clinical settings have been identified as a barrier to providing adequate care for this population.

OBJECTIVE

This scoping review examined the within-session effects of multisensory environments (MSEs) on people with IDD to determine the clinical utility of MSEs for this population.

DATA SOURCES

Studies published between January 1, 2000, and August 1, 2018, were identified using Summon and Google Scholar.

STUDY SELECTION

Studies were included in the review if they systematically collected and reported data on within-session effects of an MSE intervention on people with IDD.

FINDINGS

Thirteen studies met criteria for this review: 4 with Level I evidence, 2 with Level II evidence, 3 with Level III evidence, and 4 with Level IV evidence. Studies examined the effects of MSEs on maladaptive behaviors, positive behaviors, distress and discomfort, activity and alertness states, and cost of care for people with IDD.

CONCLUSION AND RELEVANCE

Preliminary support was found for the use of MSEs in clinical settings to reduce anxiety and challenging behaviors in patients with IDD during clinical care. Further research is needed to determine the efficacy of MSEs for producing the effects described in this review.

WHAT THIS ARTICLE ADDS

The findings support the potential of MSEs as a tool that occupational therapy practitioners can use to support their clients with IDD who have sensory sensitivities in clinical settings. This article also highlights a multidisciplinary approach whereby medical providers and occupational therapy practitioners could work together in nontraditional ways to support this population.