title: Effect of singing on respiratory function, voice, and mood after quadriplegia: a randomized controlled trial.
abstract: OBJECTIVE
  To explore the effects of singing training on respiratory function, voice, mood, and quality of life for people with quadriplegia.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Large, university-affiliated public hospital, Victoria, Australia.
  
  
  METHODS
  Participants (N=24) with chronic quadriplegia (C4-8, American Spinal Injury Association grades A and B).
  
  
  METHODS
  The experimental group (n=13) received group singing training 3 times weekly for 12 weeks. The control group (n=11) received group music appreciation and relaxation for 12 weeks. Assessments were conducted pre, mid-, immediately post-, and 6-months postintervention.
  
  
  METHODS
  Standard respiratory function testing, surface electromyographic activity from accessory respiratory muscles, sound pressure levels during vocal tasks, assessments of voice quality (Perceptual Voice Profile, Multidimensional Voice Profile), and Voice Handicap Index, Profile of Mood States, and Assessment of Quality of Life instruments.
  
  
  RESULTS
  The singing group increased projected speech intensity (P=.028) and maximum phonation length (P=.007) significantly more than the control group. Trends for improvements in respiratory function, muscle strength, and recruitment were also evident for the singing group. These effects were limited by small sample sizes with large intersubject variability. Both groups demonstrated an improvement in mood (P=.002), which was maintained in the music appreciation and relaxation group after 6 months (P=.017).
  
  
  CONCLUSIONS
  Group music therapy can have a positive effect on not only physical outcomes, but also can improve mood, energy, social participation, and quality of life for an at-risk population, such as those with quadriplegia. Specific singing therapy can augment these general improvements by improving vocal intensity.
authors.affiliation: Institute for Breathing and Sleep, Austin Health, Melbourne, Australia; Victorian Spinal Cord Service, Austin Health, Melbourne, Australia. jeanette.tamplin@austin.org.au
authors.forename: Jeanette
authors.initials: J
authors.lastname: Tamplin
authors.forename: Felicity A
authors.initials: FA
authors.lastname: Baker
authors.forename: Denise
authors.initials: D
authors.lastname: Grocke
authors.forename: Danny J
authors.initials: DJ
authors.lastname: Brazzale
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Pretto
authors.forename: Warren R
authors.initials: WR
authors.lastname: Ruehland
authors.forename: Mary
authors.initials: M
authors.lastname: Buttifant
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Brown
authors.forename: David J
authors.initials: DJ
authors.lastname: Berlowitz
mesh_terms: D000328:Adult; D000339:Affect; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009147:Music Therapy / Q000379:methods*; D010699:Phonation; D011782:Quadriplegia / Q000523:psychology* / Q000534:rehabilitation*; D011788:Quality of Life; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000502:physiology*; D063346:Singing; D016896:Treatment Outcome; D014833:Voice Quality; D014834:Voice Training