title: Singing teaching as a therapy for chronic respiratory disease--a randomised controlled trial and qualitative evaluation.
abstract: BACKGROUND
  Despite optimal pharmacological therapy and pulmonary rehabilitation, patients with COPD continue to be breathless. There is a need to develop additional strategies to alleviate symptoms. Learning to sing requires control of breathing and posture and might have benefits that translate into daily life.
  
  
  METHODS
  To test this hypothesis we performed a randomised controlled trial, comparing a six week course of twice weekly singing classes to usual care, in 28 COPD patients. The experience of singing was assessed in a qualitative fashion, through interviews with a psychologist. In addition, we surveyed patients with chronic respiratory conditions who participated in a series of open singing workshops.
  
  
  RESULTS
  In the RCT, the physical component score of the SF36 improved in the singers (n = 15) compared to the controls (n = 13); +7.5(14.6) vs. -3.8(8.4) p = 0.02. Singers also had a significant fall in HAD anxiety score; -1.1(2.7) vs. +0.8(1.7) p = 0.03. Singing did not improve single breath counting, breath hold time or shuttle walk distance. In the qualitative element, 8 patients from the singing group were interviewed. Positive effects on physical sensation, general well-being, community/social support and achievement/efficacy emerged as common themes. 150 participants in open workshops completed a questionnaire. 96% rated the workshops as "very enjoyable" and 98% thought the workshop had taught them something about breathing in a different way. 81% of attendees felt a "marked physical difference" after the workshop.
  
  
  CONCLUSIONS
  Singing classes can improve quality of life measures and anxiety and are viewed as a very positive experience by patients with respiratory disease; no adverse consequences of participation were observed.
  
  
  BACKGROUND
  Current Controlled Trials--ISRCTN17544114.
authors.affiliation: Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London SW3 6NP, UK.
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Lord
authors.forename: Phoene
authors.initials: P
authors.lastname: Cave
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Hume
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Flude
authors.forename: Amanda
authors.initials: A
authors.lastname: Evans
authors.forename: Julia L
authors.initials: JL
authors.lastname: Kelly
authors.forename: Michael I
authors.initials: MI
authors.lastname: Polkey
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Hopkinson
mesh_terms: D000368:Aged; D001007:Anxiety / Q000517:prevention & control; D001945:Breathing Exercises; D004493:Education / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009147:Music Therapy / Q000379:methods*; D010348:Patient Care Team; D017060:Patient Satisfaction; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology / Q000534:rehabilitation* / Q000628:therapy*