Breathing Pattern and Chest Wall Kinematics during Phonation in Chronic Obstructive Pulmonary Disease Patients

There is growing interest in Singing for Lung Health (SLH), an approach where patients with respiratory disease take part in singing groups, intended to improve their condition. A consensus group was convened in early 2016 to address issues including: the specific features that make SLH distinct from other forms of participation in singing; the existing evidence base via a systematic review; gaps in the evidence base including the need to define value-based outcome measures for sustainable commissioning of SLH; defining the measures needed to evaluate both individuals' responses to SLH and the quality of singing programmes. and core training, expertise and competencies required by singing group leaders to deliver high-quality programmes. A systematic review to establish the extent of the evidence base for SLH was undertaken. Electronic databases, including Pubmed, OVID Medline and Embase, Web of Science, Cochrane central register of controlled trials and PEDro, were used. Six studies were included in the final review. Quantitative data suggest that singing has the potential to improve health-related quality of life, particularly related to physical health, and levels of anxiety without causing significant side effects. There is a significant risk of bias in many of the existing studies with small numbers of subjects overall. Little comparison can be made between studies owing to their heterogeneity in design. Qualitative data indicate that singing is an enjoyable experience for patients, who consistently report that it helps them to cope with their condition better. Larger and longer-term trials are needed.

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“…Inspiratory capacity manoeuvres 6 and chest wall kinematics confirm that singing lowers end-expiratory lung volumes in COPD. 14 …”

Section: By What Mechanisms Can Slh Be Beneficial?mentioning

confidence: 99%

Singing for Lung Health—a systematic review of the literature and consensus statement

Lewis

Cave

Stern

et al. 2016

npj Prim Care Resp Med

122

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“…COPD is a structural and functional disorder of the lungs, which has an effect on lung parenchyma and lung mechanics (2,5,21,41). As a basic feature of emphysema, the alveolar wall can be destroyed and the surface of gas exchange can reduce.…”

Section: Anatomical Characteristics In Copdmentioning

confidence: 99%

Mechanisms to dyspnoea and dynamic hyperinflation related exercise intolerance in COPD

Varga¹

2015

Acta Physiologica Hungarica

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Expiratory flow limitation can develop in parallel with the progression of COPD, and as a consequence, dynamic hyperinflation and lung mechanical abnormalities can develop. Dynamic hyperinflation can cause increased breathlessness and reduction in exercise tolerance. Achievement of critical inspiratory reserve volume is one of the main factors in exercise intolerance. Obesity has specific lung mechanical effects. There is also a difference concerning gender and dyspnoea. Increased nerve activity is characteristic in hyperinflation. Bronchodilator therapy, lung volume reduction surgery, endurance training at submaximal intensity, and heliox or oxygen breathing can decrease the degree of dynamic hyperinflation.Keywords: COPD, dyspnoea, expiratory flow limitation, dynamic hyperinflation, lung mechanics, exercise toleranceOne of the main symptoms in chronic obstructive pulmonary disease (COPD) is dyspnoea, and initially it is manifested during exercise and later at rest with the progression of the disease. Dyspnoea leads to exercise intolerance in parallel with physical inactivity, and as a consequence, disability may develop (28). The main causes of exercise intolerance may be lung mechanical abnormalities and patient's deconditioning (28). Dyspnoea is characterised by an increase in the following factors: respiratory work/ effort ratio, breathing load, end-expiratory lung volume (EELV) related dynamic hyperinflation, intrinsic positive end-expiratory pressure (PEEP) related elastic effort, and neurological sensation (Fig. 1) (28). Dyspnoea manifestation is often associated with dynamic hyperinflation (DH) in patients with COPD from moderate to severe obstruction (26,28,29,35,42). The discrepancy between respiratory centre induced respiratory muscle work and muscle load, and capacity related lung volume changes lead to neuromechanical dissociation (Fig. 2). The consequence of this process is the development of dynamic hyperinflation as a cause of chronic and exertional dyspnoea (28).

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“…A further potential therapeutic mechanism is the alteration of breathing patterns for people living with COPD, which has potential clinical utility. 50 Binazzi et al 60 investigated the breathing pattern of people with COPD singing a Christmas carol using optoelectric plethysmography. None of the participants in the study had professional or amateur singing experience.…”

Section: Potential Physiological Impact Of Singing In People With Copdmentioning

confidence: 99%

The physiology of singing and implications for ‘Singing for Lung Health’ as a therapy for individuals with chronic obstructive pulmonary disease

et al. 2021

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Singing is an increasingly popular activity for people with chronic obstructive pulmonary disease (COPD). Research to date suggests that ‘Singing for Lung Health’ may improve various health measures, including health-related quality-of-life. Singing and breathing are closely linked processes affecting one another. In this narrative review, we explore the physiological rationale for ‘Singing for Lung Health’ as an intervention, focusing on the abnormalities of pulmonary mechanics seen in COPD and how these might be impacted by singing. The potential beneficial physiological mechanisms outlined here require further in-depth evaluation.

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Breathing Pattern and Chest Wall Kinematics during Phonation in Chronic Obstructive Pulmonary Disease Patients

Cited by 7 publications

References 16 publications

Singing for Lung Health—a systematic review of the literature and consensus statement

Singing for Lung Health—a systematic review of the literature and consensus statement

Mechanisms to dyspnoea and dynamic hyperinflation related exercise intolerance in COPD

The physiology of singing and implications for ‘Singing for Lung Health’ as a therapy for individuals with chronic obstructive pulmonary disease

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