Singing teaching as a therapy for chronic respiratory disease--a randomised controlled trial and qualitative evaluation.
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.
Lord
Victoria M
VM
Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London SW3 6NP, UK.
Cave
Phoene
P
Hume
Victoria J
VJ
Flude
Elizabeth J
EJ
Evans
Amanda
A
Kelly
Julia L
JL
Polkey
Michael I
MI
Hopkinson
Nicholas S
NS
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*