Singing in chronic obstructive pulmonary disease patients: A pilot study in Portugal

Pacheco, Cecília; Costa, Ana; Amado, Joana; Almeida, Paula

doi:10.1016/j.rppneu.2014.02.009

Cited by 14 publications

(7 citation statements)

References 4 publications

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“…A previous small COPD study showed a median fall in RV of 270 mL in the four patients able to be tested, out of eight patients originally recruited, after 10 weeks of singing classes. 19 On the other hand, Bonilha and colleagues did not find any significant change in RV in 15 participants after 24 weeks of singing classes. 18 They did report a small but statistically significant difference in RV 2 min after a short singing session in subjects from the singing group (where RV reduced) and a control group (where RV increased) but no difference between the groups at 30 min.…”

Section: Discussionmentioning

confidence: 90%

“… 15 16 One study examining the effects of adding therapeutic singing to PR programme showed no benefit in quality of life or exercise tolerance, 17 while two studies have reported improvement in maximal expiratory pressure. 18 19 The limitations of these studies include small sample sizes and short duration. 15–19 A non-experimental feasibility study of singing group intervention for people with COPD in the UK recruited 106 people into six singing groups, and followed the group for 10 months.…”

Section: Introductionmentioning

confidence: 99%

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Sing Your Lungs Out—a community singing group for chronic obstructive pulmonary disease: a 1-year pilot study

et al. 2017

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ObjectiveSinging group participation may benefit patients with chronic obstructive pulmonary disease (COPD). Previous studies are limited by small numbers of participants and short duration of generally hospital-based singing group intervention. This study examines the feasibility of long-term participation in a community singing group for patients with COPD who had completed pulmonary rehabilitation (PR).MethodsThis was a feasibility cohort study. Patients with COPD who had completed PR and were enrolled in a weekly community exercise group were recruited to a new community-based singing group which met weekly for over 1 year. Measurements at baseline, 4 months and 1 year comprised comprehensive pulmonary function tests including lung volumes, 6 min walk test (6MWT), Clinical COPD Questionnaire (CCQ), Hospital Anxiety and Depression Scale (HADS) and hospital admission days for acute exacerbation of COPD (AECOPD) for 1 year before and after the first singing group session.FindingsThere were 28 participants with chronic lung disease recruited from 140 people approached. Five withdrew in the first month. 21 participants meeting Global Initiative for Chronic Obstructive Lung Disease criteria for COPD completed 4-month and 18 completed 1-year assessments. The mean attendance was 85%. For the prespecified primary outcome measure, total HADS score, difference between baseline and 12 months was −0.9, 95% CI −3.0 to 1.2, p=0.37. Of the secondary measures, a significant reduction was observed for HADS anxiety score after 1 year of −0.9 (95% CI −1.8 to −0.1) points, p=0.038 and an increase in the 6MWT at 1 year, of 65 (95% CI 35 to 99) m compared with baseline p<0.001.ConclusionsOur findings support the feasibility of long-term participation in a community singing group for adults with COPD who have completed PR and are enrolled in a weekly community exercise group and provide evidence of improved exercise capacity and a reduction in anxiety.Trial registration numberACTRN12615000736549; Results.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Sing Your Lungs Out—a community singing group for chronic obstructive pulmonary disease: a 1-year pilot study

et al. 2017

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“…A major confounding variable across previous respiratory, group singing studies is whether the participant in the singing program had undertaken PR or not at the same time as participating in guided, group singing activities. Two previous singing interventions recruited participants directly from PR groups [ 28 , 55 ] however, this makes it difficult to separate benefits from singing programs from those arising from recent PR. Later trials have specifically targeted patients with no recent PR involvement [ 32 ] in an attempt to better control this variable.…”

Section: Discussionmentioning

confidence: 99%

SINFONIA study protocol: a phase II/III randomised controlled trial examining benefits of guided online group singing in people with chronic obstructive pulmonary disease and interstitial lung disease and their carers

et al. 2022

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Background Chronic obstructive pulmonary disease (COPD) and interstital lung disease (ILD) are incurable conditions characterised by airflow limitation, persisting respiratory symptoms, and progressive respiratory failure. People living with COPD or ILD often suffer from chronic and severe breathlessness, with limited treatment options and low engagement rates with current therapies. Group singing represents a potential community-based therapy to improve quality of life for patients with COPD or ILD and breathlessness. Methods This protocol papers describes SINFONIA, a parallel, double-arm, randomised, blinded-analysis, mixed-methods phase II/III trial of guided, online group singing that will be conducted over 24 months. Adults with confirmed COPD or ILD, on stable treatment for at least four weeks at time of recruitment, with a modified Medical Research Council (mMRC) dyspnoea score of two or greater, who are capable and willing to give consent, and not currently participating in pulmonary rehabilitation will be eligible to participate. Carers may optionally enrol in the trial. Data will be collected on quality of life, anxiety and depression, breathlessness, mastery of breathing, exercise tolerance, loneliness, healthcare utilisation, and carer quality of life (optional). Participants will be randomised 1:1 to intervention or control arms with intervention arm attending one 90 min, guided, online, group singing session per week for 12 weeks and control arm continuing routine care. Phase II of the trial aims to determine the feasibility and acceptability of guided, online group singing and will collect preliminary data on effectiveness. Phase III aims to determine whether guided, online group singing has an effect on quality of life with the primary outcome being a between arm difference in quality of life (36-item Short Form Survey) measured at 12 weeks. Discussion SINFONIA is the first study is the first of its kind in Australia and to our knowledge, the first to deliver the singing intervention program entirely online. Determining the feasibility, acceptability, and effectiveness of guided, online group singing is an important step towards improving low-cost, low-risk, community-based therapeutic options for patients living with COPD or ILD and breathlessness. Trial registration: Phase II—ACTRN12621001274864, registered 20th September 2021; Phase III—ACTRN12621001280897, registered 22nd September 2021.

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“…It is not known whether singing might be considered similarly and what the impact of this might be on recruitment to a randomised controlled trial. Nonetheless, qualitative research studies have reported high satisfaction with singing by people with COPD, including self-reported improvements in both breathing and psychological outcomes (Goodridge 2013; Pacheco 2014; McNaughton 2016). …”

Section: Discussionmentioning

confidence: 99%

Singing for adults with chronic obstructive pulmonary disease

McNamara

Epsley

Coren

et al. 2017

Cochrane Database of Systematic Reviews

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Background Singing is a complex physical activity dependent on the use of the lungs for air supply to regulate airflow and create large lung volumes. In singing, exhalation is active and requires active diaphragm contraction and good posture. Chronic obstructive pulmonary disease (COPD) is a progressive, chronic lung disease characterised by airflow obstruction. Singing is an activity with potential to improve health outcomes in people with COPD. Objectives To determine the effect of singing on health-related quality of life and dyspnoea in people with COPD. Search methods We identified trials from the Cochrane Airways Specialised Register, ClinicalTrials.gov, the World Health Organization trials portal and PEDro, from their inception to August 2017. We also reviewed reference lists of all primary studies and review articles for additional references. Selection criteria We included randomised controlled trials in people with stable COPD, in which structured supervised singing training of at least four sessions over four weeks’ total duration was performed. The singing could be performed individually or as part of a group (choir) facilitated by a singing leader. Studies were included if they compared: 1) singing versus no intervention (usual care) or another control intervention; or 2) singing plus pulmonary rehabilitation versus pulmonary rehabilitation alone. Data collection and analysis Two review authors independently screened and selected trials for inclusion, extracted outcome data and assessed risk of bias. We contacted authors of trials for missing data. We calculated mean differences (MDs) using a random-effects model. We were only able to analyse data for the comparison of singing versus no intervention or a control group. Main results Three studies (a total of 112 participants) were included. All studies randomised participants to a singing group or a control group. The comparison groups included a film workshop, handcraft work, and no intervention. The frequency of the singing intervention in the studies ranged from 1 to 2 times a week over a 6 to 24 week period. The duration of each singing session was 60 minutes. All studies included participants diagnosed with COPD with a mean age ranging from 67 to 72 years and a mean forced expiratory volume in one second (FEV1) ranging from 37% to 64% of predicted values. The sample size of included studies was small (33 to 43 participants) and overall study quality was low to very low. Blinding of personnel and participants was not possible due to the physical nature of the intervention, and selection and reporting bias was present in two studies. For the primary outcome of health-related quality of life, there was no statistically significant improvement in the St George’s Respiratory Questionnaire total score (mean difference (MD) −0.82, 95% confidence interval (CI) −4.67 to 3.02, 2 studies, n = 58, low-quality evidence). However, there was a statistically significant improvement in the SF-36 Physical Component Summary (PCS) score favouring the sin...

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Singing in chronic obstructive pulmonary disease patients: A pilot study in Portugal

Cited by 14 publications

References 4 publications

Sing Your Lungs Out—a community singing group for chronic obstructive pulmonary disease: a 1-year pilot study

Sing Your Lungs Out—a community singing group for chronic obstructive pulmonary disease: a 1-year pilot study

SINFONIA study protocol: a phase II/III randomised controlled trial examining benefits of guided online group singing in people with chronic obstructive pulmonary disease and interstitial lung disease and their carers

Singing for adults with chronic obstructive pulmonary disease

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