Late Breaking Abstract - Effect of dyspnea-oriented hypnosis as an adjunct to pulmonary rehabilitation on the affective dimension of dyspnea: a randomized controlled trial.

Pulmonary rehabilitation (PR) is poorly effective in increasing physical activity (PA) in COPD patients. A major limiting factor for PA is dyspnea-related anxiety, a component of the affective dimension (AD) of dyspnea. We aimed to evaluate the effect of a hypnosis intervention primarily oriented on dyspnea-related anxiety management on the evolution of AD of dyspnea and physical activity levels. 105 COPD patients enrolled in an inpatient PR program were included and randomized into 2 arms: hypnosis group (HG) (5 individual hypnosis and self-hypnosis training sessions mainly oriented on dyspnea-related anxiety management + PR; n=52) vs control group (CG) (PR only; n=53). The main outcome was the AD score on the Multidimensional Dyspnea Profile scale at 6 months after PR. Impact and sensory dyspnea dimensions, psychological parameters and PA levels were also assessed before, just after and 6 months after PR. At baseline, median values for all parameters were comparable between groups (all p>.05). At 6 months, median AD score was lower in HG compared to CG (39 [27-48] vs 52 [32-60]; p<.05). Moreover, lower sensory dyspnea score and higher level of PA were found in HG compared to CG (all p<.01). Hypnosis as an adjunct to PR helps contain deterioration of the AD at 6 months in HG compared to CG. Moreover, patients in HG have better sensory experiences of breathlessness and practice more PA than patients in CG. Hypnosis oriented on the management of dyspnea during PR appears to be a particularly interesting treatment to prolong the PR effects on dyspnea and to facilitate PA practice in the medium term.