RT Journal Article
SR Electronic
T1 Use of Singing for Lung Health as an alternative training modality within pulmonary rehabilitation for COPD: an RCT
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2101142
DO 10.1183/13993003.01142-2021
A1 Mette Kaasgaard
A1 Daniel Bech Rasmussen
A1 Karen Hjerrild Andreasson
A1 Ole Hilberg
A1 Anders Løkke
A1 Peter Vuust
A1 Uffe Bodtger
YR 2021
UL http://erj.ersjournals.com/content/early/2021/09/29/13993003.01142-2021.abstract
AB 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 inability to attend or perform physical training. Therefore, alternative, evidence-based PR activities are required. Singing may have benefits within quality of life (QoL), respiratory control, and wellbeing in COPD, but impact on PR key outcome, physical exercise capacity, is uncertain.Methods In this RCT (NCT03280355), we investigated effectiveness of 10-weeks of PR, including either “Singing for Lung Health” (SLH)-training or standard physical exercise training (PExT). Primary outcome: Change in exercise capacity (6-Minute Walk Test, distance (6 MWD)) from baseline to post-PR. Secondary outcomes: 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 6 MWD and SGRQ. SLH was non-inferior to PExT in 6 MWD (13.1 m±36.3/14.1 m±32.3; p=0.81 [95%CI=−7.28;9.30]) with 21.8% respectively 25.0% (p=0.57) reaching 6 MWD Minimal Important Difference of 30 m. We found no significant between-group differences concerning SGRQ, HADS, lung function, dyspnoea, or adherence.Conclusions Our study suggests that SLH is non-inferior to PExT in improving 6 MWD during a 10-weeks PR programme. Future studies addressing reproducibility, long-term effects and health-economics are needed.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Kaasgaard reports: Hold a Diploma Graduate Degree from The Royal Danish Academy of Music in Voice and Voice Pedagogy.Conflict of interest: Dr. Bech Rasmussen has nothing to disclose.Conflict of interest: Dr. Hjerrild Andreasson has nothing to disclose.Conflict of interest: Dr. Hilberg has nothing to disclose.Conflict of interest: Dr. Løkke has nothing to disclose.Conflict of interest: Dr. Vuust reports: Leader of the research center, Center for Music in the Brain, Dept. of Clinical Medicine, Aarhus University, Denmark.Conflict of interest: Dr. Bodtger has nothing to disclose.