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Randomized Controlled Trial
. 2022 May 19;59(5):2101142.
doi: 10.1183/13993003.01142-2021. Print 2022 May.

Use of Singing for Lung Health as an alternative training modality within pulmonary rehabilitation for COPD: a randomised controlled trial

Mette Kaasgaard  1   2 , Daniel Bech Rasmussen  3   4 , Karen Hjerrild Andreasson  3   4   5 , Ole Hilberg  4   6 , Anders Løkke  6 , Peter Vuust  2 , Uffe Bodtger  3   4   7
Affiliations
Randomized Controlled Trial

Use of Singing for Lung Health as an alternative training modality within pulmonary rehabilitation for COPD: a randomised controlled trial

Mette Kaasgaard et al. Eur Respir J. .

Abstract

Background: Pulmonary rehabilitation (PR) is a cornerstone in chronic obstructive pulmonary disease (COPD) management. However, PR adherence is generally low, and barriers include availability, economic issues, motivation and an inability to attend or perform physical training. Therefore, alternative, evidence-based PR activities are required. Singing may have benefits for quality of life (QoL), respiratory control and well-being in COPD, but the impact on the PR key outcome, physical exercise capacity, is uncertain.

Methods: In this randomised controlled trial (NCT03280355), we investigated the effectiveness of 10 weeks of PR, including either "Singing for Lung Health" (SLH) training or standard physical exercise training (PExT). The primary outcome was a change in exercise capacity (6-min walk distance (6MWD)) from baseline to post-PR. Secondary outcomes were changes in QoL (St George's Respiratory Questionnaire (SGRQ)), Hospital Anxiety and Depression Score (HADS), lung function, dyspnoea and adherence.

Results: We included 270 COPD patients, and 195 completed the study. Demographics across groups were comparable, and both groups improved significantly in 6MWD and SGRQ score. SLH was non-inferior to PExT in improving 6MWD (mean±sd 13.1±36.3 m versus 14.1±32.3 m, p=0.81; difference 1.0 m, 95% CI -7.3-9.3 m) with 21.8% and 25.0%, respectively (p=0.57), reaching the 6MWD minimal important difference of 30 m. We found no significant between-group differences concerning SGRQ, HADS, lung function, dyspnoea or adherence.

Conclusion: Our study suggests that SLH is non-inferior to PExT in improving 6MWD during a 10-week PR programme. Future studies addressing reproducibility, long-term effects and health economics are needed.

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Conflict of interest statement

Conflict of interest: M. Kaasgaard holds a diploma graduate degree from the Royal Danish Academy of Music in Voice and Voice Pedagogy. Conflict of interest: D.B. Rasmussen has nothing to disclose. Conflict of interest: K.H. Andreasson has nothing to disclose. Conflict of interest: O. Hilberg has nothing to disclose. Conflict of interest: A. Løkke has nothing to disclose. Conflict of interest: P. Vuust is leader of the research centre, Center for Music in the Brain. Conflict of interest: U. Bodtger has nothing to disclose.

Figures

FIGURE 1
FIGURE 1
CONSORT flow diagram. COPD: chronic obstructive pulmonary disease; PR: pulmonary rehabilitation; 6MWD: 6-min walk distance.
FIGURE 2
FIGURE 2
Change in 6-min walk distance (6MWD). SLH: Singing for Lung Health; PExT: physical exercise training.
FIGURE 3
FIGURE 3
Change in St George's Respiratory Questionnaire (SGRQ) scores. SLH: Singing for Lung Health; PExT: physical exercise training.
See this image and copyright information in PMC

Comment in

References

    1. Gibson GJ, Loddenkemper R, Sibille Y, et al. , eds. European Lung White Book. Sheffield, European Respiratory Society, 2013. - PubMed
    1. McKeough Z. Community-based pulmonary rehabilitation is effective for people with chronic obstructive pulmonary disease (COPD). Aust J Physiother 2009; 55: 287. doi:10.1016/S0004-9514(09)70013-3 - DOI - PubMed
    1. Rochester CL, Vogiatzis I, Holland AE, et al. . An official American Thoracic Society/European Respiratory Society policy statement: enhancing implementation, use, and delivery of pulmonary rehabilitation. Am J Respir Crit Care Med 2015; 192: 1373–1386. doi:10.1164/rccm.201510-1966ST - DOI - PubMed
    1. Oates GR, Niranjan SJ, Ott C, et al. . Adherence to pulmonary rehabilitation in COPD: a qualitative exploration of patient perspectives on barriers and facilitators. J Cardiopulm Rehabil Prev 2019; 39: 344–349. doi:10.1097/HCR.0000000000000436 - DOI - PMC - PubMed
    1. Peixoto Boaventura RD, Meira L, Santos V, et al. . Factors influencing pulmonary rehabilitation adherence – surely is not simple. Rehabil Chronic Care 2016; 48: PA694. doi:10.1183/13993003.congress-2016.PA694 - DOI

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