Original Title: Utilisation thérapeutique des couvertures, vestes et autres objets lestés auprès de différentes clientèles

Authors' objectives: The aim of this project is to update the evidence concerning the effectiveness and safety of weighted equipment, as well as professional and organizational aspects related to this equipment.

Authors' results and conclusions: At the end of the selection process, 47 documents were retained, including 33 primary studies, two systematic reviews, two theses and 10 grey literature documents. Questionnaires were completed by 44 health professionals and managers from participating CISSSs and CIUSSSs. This work has enabled us to update the evidence on the therapeutic use of weighted equipment and to document current practices related to this equipment in Quebec, bringing back organizational and professional pertinent elements. The available evidence points to a certain effectiveness of weighted blankets for therapeutic applications in different populations (age groups). Compliance with safety instructions for blankets, vests and other weighted objects is essential to avoid any risks of adverse events associated with this type of equipment. These include professional assessment of risks and contraindications, proper supervision of the use of weighted equipment, and consent from users or their relatives. The therapeutic benefits demonstrated in the included studies point to a potential alternative nonpharmacological option in specific cases. However, professional judgement remains very important in making decisions about the use of this equipment. Field data documentation and clinical studies using robust designs, standardized tools and enough participants would be required to further document the effectiveness and safety of the various weighted devices, particularly for vulnerable populations or in specific contexts.

Authors' recommendations: ➢ The use of weighted blankets would be recommended to : • Improve sleep in children, adolescents, adults and seniors; • Reduce anxiety in both adults and seniors; • Improve daily and school activities in both children and adolescents; • Improve mood in children, adolescents and adults; • Improve the perception of general health and of quality of life in seniors; • Reduce the perception of various types of pain in adults; provided that the rules of use and contraindications are respected, and that users give their consent and are informed of any adverse events that may occur. ➢ The use of small, weighted objects (e.g. plush toys, cushions) is recommended to reduce anxiety in adults. ➢ More studies on efficacy and safety are needed regarding the use of the vest and of small, weighted objects. ➢ A partnership between the responsible healthcare provider and an interdisciplinary or multidisciplinary team remains possible and sometimes desirable for user’s assessment, recommendation of the suitable weighted equipment and monitoring its use. ➢ The recommendation of weighted equipment should consider (among other elements): • Contraindications; • Risks and benefits; • User’s needs; • User’s consent and preferences; • The intervention environment. ➢ A personalized intervention plan should be drawn up and revised periodically or according to the user's needs. ➢ Training should be developed and made available to health professionals who recommend or use weighted equipment. The occupational therapist could be the designated person for this purpose. This training should cover at least, but not be limited to, the following aspects: • Guidelines and parameters for the use of weighted equipments; • Risks and benefits associated with the use of weighted equipments; • Contraindications to the use of weighted equipments; • Basics of sensory integration. ➢ Awareness-raising, education and training activities should be available in accessible language for users of weighted equipments and their relatives. These activities would aim to: • Inform public about the risks associated with the use of weighted equipments; • Raise awareness about the importance of obtaining consent from the person using the weighted equipment; • Train users and their relatives (family, caregivers) to the proper and safe use of weighted objects.

Authors' methods: Literature search strategies were developed and used to query the bibliographic databases CINHAL (EBSCO), Medline (OVID), PsychINFO (OVID) and Embase (OVID). Grey literature was searched using Google and Google Scholar, as well as the websites of various organizations likely to provide data related to the topic of interest. The literature search covers the period from January 2019 to April 2024. Contextual data were compiled from clinico-administrative data (AH-223 form), interview with expert members of the l’Ordre des Ergothérapeutes du Québec (OEQ) and documents related to the Code des professions du Québec. Experiential data were collected through questionnaires sent to health professionals from the Centres intégrés de santé et de services sociaux (CISSS) de Chaudière-Appalaches, du Bas St-Laurent, de la Gaspésie and from the CIUSSS de la Capitale-Nationale et du Saguenay-Lac-Saint-Jean. All these data were triangulated with scientific evidence and recommendations were drawn up based on the findings and stakeholder consultation using an informal consensus method.

Project Status: Completed

Year Published: 2025

URL for published report: https://www.ciusss-capitalenationale.gouv.qc.ca/sites/d8/files/docs/MissionUniversitaire/Publications/Rapport-CVO.pdf

English language abstract: There is no English language summary available

Publication Type: Full HTA

Country: Canada

Province: Quebec

DOI: https://www.ciusss-capitalenationale.gouv.qc.ca/sites/d8/files/docs/MissionUniversitaire/Publications/Rapport-CVO.pdf

Organisation Name: Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale

Contact Address: 525, boulevard Wilfrid-Hamel, bureau A-122

Contact Name: Sylvie St-Jacques

Contact Email: uetmisss.deau.ciussscn@ssss.gouv.qc.ca