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

• Published in: BMJ open respiratory research Vol. 11; no. 1; p. e002365
• Main Authors: Philip, Keir E J, Buttery, Sara C, Bowen, Sarah, Lewis, Adam, Jeffery, Edmund, Alghamdi, Saeed M, Williams, Parris, Alasmari, Ali M, Alsulayyim, Abdullah S, Orton, Christopher M, Conway, Francesca, Chan, Ley, Vijayakumar, Bavithra, Tana, Anand, Tonkin, James, Perkins, Alexis, Garner, Justin L, Srikanthan, Karthikan, Sadaka, Ahmed, Pavitt, Matthew J, Banya, Winston, Lound, Adam, Elkin, Sarah, Polkey, Michael I, Man, William D-C, Lewis, Keir, Cave, Phoene, Fancourt, Daisy, Hopkinson, Nicholas S
• Format: Journal Article
• Language: English
• Published: England British Thoracic Society 02.05.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Aged; Anxiety; Breathing Exercises - methods; Chronic obstructive pulmonary disease; Complementary Medicine; Confidence; COVID-19; Electronic mail systems; Emphysema; Exercise; Female; Forced Expiratory Volume; Health surveys; Humans; Internet resources; Intervention; Lung - physiopathology; Lung diseases; Male; Medical research; Mental health; Middle Aged; Musical performances; Pandemics; Participation; Physical fitness; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - rehabilitation; Pulmonary Disease, Chronic Obstructive - therapy; Pulmonary Rehabilitation; Quality of Life; Questionnaires; Repertoire; Respiratory Muscles; Singing; Single-Blind Method; Systematic review; Treatment Outcome; Video teleconferencing; Respiratory Muscles; Exercise; Complementary Medicine; Pulmonary Rehabilitation; Emphysema
• ISSN: 2052-4439; 2052-4439
• DOI: 10.1136/bmjresp-2024-002365

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 number NCT04034212.