Cuvelier Clémence, Hars Mélany, Zamorani-Bianchi Maria Pia, Herrmann François R, Wieczorkiewicz Catherine Ducharne, Zekry Dina, Gold Gabriel, Trombetti Andrea
Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland.
Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
Pilot Feasibility Stud. 2023 Aug 9;9(1):139. doi: 10.1186/s40814-023-01366-3.
Fear of falling is associated with numerous negative health outcomes in older adults and can limit the rehabilitation process. Hypnosis is now recognized as an effective treatment for a variety of conditions, especially anxiety and pain, which can be integrated safely with conventional medicine. The objective of this study was to assess the feasibility and acceptability of a hypnosis intervention in hospitalized older adults to reduce fear of falling.
In this feasibility randomized controlled trial, 32 older patients, hospitalized in geriatric rehabilitation wards, were randomly allocated (1:1 ratio) to either an intervention group (hypnosis, 2 sessions, one per week, plus usual rehabilitation program) or a control group (usual rehabilitation program only). Clinical assessors and statistician were blinded to group allocation. Primary outcomes were recruitment rate, retention rate, and adherence to the intervention. Exploratory outcomes, analyzed according to the intention-to-treat principle, included impact of hypnosis on fear of falling (assessed by a new scale perform-FES), functional status, in-hospital falls, and length of hospital stay.
Recruitment rate was 1.3 patients per week. The recruitment of the population sample was achieved in 5.5 months. The retention rate did not differ significantly between groups and a good adherence to the hypnosis intervention was achieved (77% of patients received the full intervention). No adverse event related to the hypnosis intervention was observed. Regarding exploratory clinical outcomes, no differences were found between groups on any outcome.
Hypnosis is feasible and well accepted in a geriatric hospitalized population undergoing rehabilitation. Further pilot work should be conducted, with an increased number of hypnosis sessions, before conducting a full-scale trial to conclude whether, or not, hypnosis is effective to reduce fear of falling.
NCT04726774.
害怕跌倒与老年人众多负面健康结果相关，且会限制康复进程。催眠现已被公认为是治疗多种病症的有效方法，尤其是焦虑和疼痛，它可以与传统医学安全结合。本研究的目的是评估催眠干预对住院老年人减少跌倒恐惧的可行性和可接受性。
在这项可行性随机对照试验中，32名在老年康复病房住院的老年患者被随机分配（1:1比例）至干预组（催眠，2次疗程，每周1次，加常规康复计划）或对照组（仅常规康复计划）。临床评估人员和统计人员对分组情况不知情。主要结局指标为招募率、留存率和对干预的依从性。根据意向性分析原则分析的探索性结局指标包括催眠对跌倒恐惧的影响（通过新的跌倒恐惧评估量表perform-FES评估）、功能状态、住院期间跌倒情况及住院时长。
每周招募1.3名患者。在5.5个月内完成了人群样本的招募。两组间留存率无显著差异，且对催眠干预的依从性良好（77%的患者接受了完整干预）。未观察到与催眠干预相关的不良事件。关于探索性临床结局，两组在任何结局指标上均未发现差异。
催眠在接受康复治疗的老年住院人群中是可行的且接受度良好。在进行全面试验以确定催眠是否有效减少跌倒恐惧之前，应开展进一步的试点工作，增加催眠疗程的数量。
NCT04726774。
