Background Management of Long COVID (LC) is hugely challenging for clinicians. This pilot study evaluated a breathing retraining and singing programme (SingStrong for LC) to address common LC symptoms. The study hypothesized that this intervention would improve symptoms impacting disordered breathing and participant wellbeing. Methods The 10-week, bi-weekly online programme was comprised of a 45-min class of mindfulness, breathing retraining, vocal exercises, and singing. Sessions were recorded for non-attenders and conducted by a trained vocal coach experienced in respiratory cohorts. Persons with a confirmed COVID-19 diagnosis and persisting symptoms were invited to participate. Demographic and COVID-19 data were collected, and the DePaul Symptom Questionnaire Short Form (DSQ- SF) and COVID-19 Yorkshire Rehab Screen questionnaires were administered. Post-intervention focus groups were also conducted. Results Of 27 ( F = 23(85%)) participants recruited, data from 21 who completed at least 10 (50%) classes were analysed. Participants showed significant pre–post-intervention improvements in all breathlessness symptoms (at rest: P < 0.001; dressing: P = 0.01; stairs: P < 0.001), fatigue ( P = 0.03), usual activities ( P = 0.04), pain/disability ( P = 0.03), voice quality ( P = 0.01), and communication/cognition ( P = 0.04). Pre–post number of instances meeting DSQ-SF criteria for myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) decreased by a net of nine cases (14.3%). No association between COVID-19 hospitalisation status and diagnosis of ME/CFS was identified. Qualitative feedback from eight participants was overwhelmingly positive with all reporting improvements in breathing and general well-being. Conclusion The SingStrong programme shows promise as a viable treatment option for LC sufferers. Future studies are required to further investigate the efficacy of this intervention.
Background: Chronic Obstructive Pulmonary Disease (COPD) affects up to 440,000 people in Ireland. Multiple domains of biopsychosocial health are affected. Community-based interventions supporting behavioral change and self-management are advocated. The aim of this pilot study was to evaluate the efficacy of an 8-week singing intervention, "SingStrong", to improve biopsychosocial wellness in persons with COPD. Methods: Seventy-eight adults with COPD were recruited from three COPD Support groups in the Irish Mid-west. Pre and post-intervention testing performed by physiotherapy and nursing staff comprised Six-Minute Walk Test (6MWT), COPD Assessment test (CAT), Hospital Anxiety and Depression Scale (HADS), and Spirometry: FEV1, FVC, FEV1/FVC. The intervention was a weekly onehour group class for eight weeks led by a trained choir leader at each site. This included physical and vocal warm-up, breathing exercises and singing. Participants were given a songbook based on their song preferences and a CD with vocal, breathing exercises and songs, and encouraged to practice daily. Semi-structured focus groups were conducted post intervention. Parametric or nonparametric t-tests were conducted to establish significance. Results: Fifty-eight (74%) participants who attended at least 4/8 session were re-tested. There was a statistically significant improvement in 6MWT (p = .02), non-significant improvements in CAT (p = .24) and HADS Depression (p = .238), and non-significant worsening in HADS Anxiety (p = .34). All qualitative feedback was positive, including improvements in breathing, quality of life and intervention enjoyment. Principal Conclusions: Singing for lung health has positive implications for persons with COPD. Future longer studies should examine outcomes of exacerbation level, hospitalization and medication use.
BACKGROUND & PURPOSE: Pulmonary fibrosis (PF) is a debilitating, incurable disease. Strategies to optimise health-related quality of life and minimise symptom impact are advocated. Available treatment options such as pulmonary rehabilitation have been severely disrupted due to COVID-19. This feasibility study explored the clinical efficacy and acceptability of an online singing and breathing retraining programme (SingStrong) for people with PF. METHODS: The weekly online programme conducted over 12 weeks was comprised of 45-minute classes of mindfulness, breathing retraining, vocal exercises and singing conducted by a trained vocal coach. People with PF were invited to participate and sessions were recorded for non-attenders. Demographic data were collected, and the St Georges Respiratory Questionnaire (SGRQ) and Idiopathic PF Patient Reported Outcome measure (IPF-PROM) were administered. The questionnaire also invited participants to provide feedback on the utility, enjoyability and main pros/cons of the intervention. Participation in the research element of the programme was not required to attend the weekly classes. RESULTS: Of 24 participants recruited, data from 15 (mean (Standard Deviation) age of 66 (8.7); male: n = 8) who completed both pre and post-intervention questionnaires were analysed. Statistically significant improvements were recorded in the IPF-PROM (p = 0.019) and self-reported quality of life (p = 0.028). Class attendance by study participants and the broader PF group cumulatively, increased from 14 to 25 participants between weeks 1 and 12. Qualitatively, strong satisfaction with classes and improved efficacy in self-management of lung health, in particular breathlessness, were reported. CONCLUSIONS: Singing and breathing retraining interventions may endow biopsychosocial benefits for people with PF, in the presence of modest objective clinical gains. Singing programmes are popular and may provide helpful adjuncts to existing clinical strategies such as pulmonary rehabilitation.
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