Sing-a-Lung: Group singing as training modality in pulmonary rehabilitation for patients with Chronic Obstructive Pulmonary Disease (COPD): A multicenter, cluster-randomised, non-inferiority controlled trial

Kaasgaard, Mette; Rasmussen, Daniel Bech; Løkke, Anders; Vuust, Peter; Hilberg, Ole; Bødtger, Uffe

doi:10.1183/13993003.congress-2020.4663

Cited by 4 publications

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“…Although no other studies have investigated this topic in low-resource settings, our findings echo those of research in related contexts. Research on Singing for Lung Health (SLH) in the UK suggests participants perceive a range of physical, psychological and social benefits in keeping with our findings 11 18 20 27-29 . Similarly, studies regarding the perceived impacts of dance for people with long-term respiratory conditions in the UK and Canada identify a range of biopsychosocial benefits 10 12 30 .…”

Section: Discussionsupporting

confidence: 87%

“…Singing and dance have become increasingly popular adjuncts to conventional disease management strategies for people with long-term respiratory conditions in the UK 9 and other high-income countries 10 . Existing research suggests participants experience a range of biopsychosocial benefits including those related to physical performance, mental health and wellbeing, and social isolation 9 11- 14 . Music as distractive auditory stimuli during exercise training for people with CRD can reduce breathlessness and increase exercise capacity 15 .…”

Section: Introductionmentioning

confidence: 99%

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Music and Dance in respiratory disease management in Uganda: A qualitative study of patient and healthcare professional perspectives

Philip

Cartwright

Westlake

et al. 2021

Preprint

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IntroductionMusic and dance are increasingly used as adjunctive arts-in-health interventions in high-income settings, with a growing body of research suggesting biopsychosocial benefits. Such low-cost, low-resource interventions may have application in low-resource settings such as Uganda. However, research on perceptions of patients and healthcare professionals regarding such approaches is lacking.MethodsWe delivered taster music and dance for chronic respiratory disease (CRD) sessions to patients and healthcare professionals. We then conducted an exploratory qualitative study, using thematic analysis of semi-structured interviews with the healthcare professionals and patients regarding i) the role of music and dance in Ugandan life and ii) the perceived acceptability and feasibility of using music and dance in CRD management in Uganda.ResultsEleven patients with long-term respiratory conditions and eight healthcare professionals were interviewed after selection by purposeful convenience sampling. Four key themes were identified from (interview) analysis: Music and dance: 1) were central components of daily life; 2) had an established role supporting health and wellbeing; 3) had strong therapeutic potential in respiratory disease management; 4) the importance of modulating demographic considerations of culture and religion, and age.ConclusionMusic and dance are central to life in Uganda, with established roles supporting health and wellbeing. These roles could be built on in the development of music and dance interventions as adjuncts to established components of CRD disease management like pulmonary rehabilitation. Through consideration of key contextual factors, and co-development and adaptation of interventions, such approaches are likely to be well received.Summary Box: Key QuestionsWhat is already known?Music and dance are increasingly being used as adjunctive components of CRD management in high resource settings, with a growing body of research suggesting such approaches are effective, well-received, and can be delivered at low cost. However, the perceptions of patients and healthcare professionals about potential application of such approaches in low-resource settings, such as Uganda, is not known.What are the new findings?Music and dance have central roles in the social, religious and cultural life in Uganda, including a clear view that participation supports both collective and individual health and wellbeing. In this study, both healthcare professionals and patients saw great potential for the use of music and dance as interventions for people with CRD, and highlighted important factors for consideration for successful implementation.What do the new findings imply?Music and dance interventions for people with long-term respiratory conditions in Uganda are likely to be accepted with enthusiasm due to the existing role of such activities in daily life. Delivery is likely to be feasible, but interventions would need to be co-developed with patients, their family members, and healthcare professionals, considering a number of key factors. Suggested approaches to address these considerations are provided. More generally, this study highlights how genuine co-design processes can provide valuable insights into health intervention development.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Music and Dance in respiratory disease management in Uganda: A qualitative study of patient and healthcare professional perspectives

Philip

Cartwright

Westlake

et al. 2021

Preprint

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“…Lung choirs have been shown to improve respiratory control and wellbeing, but the impact on physical capacity was unclear. K aasgaard et al [ 8 ] conducted a multicentre randomised controlled trial to evaluate the effectiveness of singing training in increasing physical capacity compared with usual physical training. Singing training was as efficacious as physical training in improving physical capacity and superior for improving quality of life.…”

Section: Pulmonary Rehabilitation and Chronic Carementioning

confidence: 99%

ERS International Congress 2020: highlights from the General Pneumology Assembly

et al. 2021

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The European Respiratory Society (ERS) accepted 4062 abstracts for presentation at the ERS International Congress in 2020. Although the conference was held virtually, making it possible to replay presentations, it remains a challenge to keep abreast of all the clinical and scientific advances. Therefore, this article provides highlights from the General Pneumology Assembly. Selected presentations from rehabilitation and chronic care, general practice and primary care, and electronic/mobile health (e-health/m-health) are summarised. The highlights incorporate novel findings from laboratory-based science, randomised controlled trials and qualitative research together with insights from newly available clinical guidelines.

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“…Singing-based interventions, incorporating elements of breathing control and physical activity, have been identified as potentially useful for breathless people with chronic respiratory diseases, including COPD 7–12. Participants in singing for lung health (SLH) programmes report high levels of enjoyment, symptom improvement and improved quality of life 7 8 13.…”

Section: Introductionmentioning

confidence: 99%

“…A Cochrane systematic review from 2017 found low to very low-quality evidence suggesting that SLH could improve physical health and called for longer term, adequately powered studies to allow greater confidence regarding its effect 14. Most recently, one large randomised controlled trial (RCT) suggested that SLH could have non-inferior impacts on physical performance (assessed with the 6-minute walk test (6MWT)) when substituted for the physical training component of pulmonary rehabilitation (PR) for people with COPD,11 and a 2002 systematic review of the effect of singing in COPD demonstrated improvements in quality of life (36-Item Short Form Health Survey (SF36) Physical Health Composite (PHC)) and respiratory muscle strength 15. Interest in developing digitally delivered interventions, including singing-based interventions, has been increased by the COVID-19 pandemic and related public health measures 12 16–18…”

Section: Introductionmentioning

confidence: 99%

Singing for lung health in COPD: a multicentre randomised controlled trial of online delivery

Philip,

Buttery,

Bowen

et al. 2024

BMJ Open Resp Res

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BackgroundSinging for lung health (SLH) is an arts-based breathing control and movement intervention for people with long-term respiratory conditions, intended to improve symptoms and quality of life. Online, remotely delivered programmes might improve accessibility; however, no previous studies have assessed the effectiveness of this approach.MethodsWe conducted an assessor-blind randomised controlled trial comparing the impact of 12 weeks of once-weekly online SLH sessions against usual care on health-related quality of life, assessed using the RAND 36-Item Short Form Health Survey (SF-36) Mental Health Composite (MHC) and Physical Health Composite (PHC) scores.ResultsWe enrolled 115 people with stable chronic obstructive pulmonary disease (COPD), median (IQR) age 69 (62–74), 56.5% females, 80% prior pulmonary rehabilitation, Medical Research Council dyspnoea scale 4 (3–4), forced expiratory volume in 1 s % predicted 49 (35–63). 50 participants in each arm completed the study. The intervention arm experienced improvements in physical but not mental health components of RAND SF-36; PHC (regression coefficient (95% CI): 1.77 (95% CI 0.11 to 3.44); p=0.037), but not MHC (0.86 (95% CI −1.68 to 3.40); p=0.504). A prespecified responder analysis based on achieving a 10% improvement from baseline demonstrated a response rate for PHC of 32% in the SLH arm and 12.7% for usual care (p=0.024). A between-group difference in responder rate was not found in relation to the MHC (19.3% vs 25.9%; p=0.403).Discussion and conclusionA 12-week online SLH programme can improve the physical component of quality of life for people with COPD, but the overall effect is relatively modest compared with the impact seen in research using face-to-face group sessions. Further work on the content, duration and dose of online interventions may be useful.Trial registration numberNCT04034212.

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Sing-a-Lung: Group singing as training modality in pulmonary rehabilitation for patients with Chronic Obstructive Pulmonary Disease (COPD): A multicenter, cluster-randomised, non-inferiority controlled trial

Cited by 4 publications

References 0 publications

Music and Dance in respiratory disease management in Uganda: A qualitative study of patient and healthcare professional perspectives

Music and Dance in respiratory disease management in Uganda: A qualitative study of patient and healthcare professional perspectives

ERS International Congress 2020: highlights from the General Pneumology Assembly

Singing for lung health in COPD: a multicentre randomised controlled trial of online delivery

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