Distractive Auditory Stimuli in the Form of Music in Individuals With COPD: A Systematic Review.
BACKGROUND
Music has been used as a distractive auditory stimulus (DAS) in patients with COPD, but its effects are unclear. This systematic review aimed to establish the effect of DAS on exercise capacity, symptoms, and health-related quality of life (HRQOL) under three conditions: (1) during exercise training, (2) during exercise testing, and (3) for symptom management at rest.


METHODS
Randomized controlled or crossover trials as well as cohort studies of DAS during exercise training, during formal exercise testing, and for symptom management among individuals with COPD were identified from a search of seven databases. Two reviewers independently assessed study quality. Weighted mean differences (WMDs) with 95% CIs were calculated using a random-effects model.


RESULTS
Thirteen studies (12 of which were randomized controlled or crossover trials) in 415 participants were included. DAS increased exercise capacity when applied over at least 2 months of exercise training (WMD, 98 m; 95% CI, 47-150 m). HRQOL improved only after a training duration of 3 months. Less dyspnea was noted with DAS during exercise training, but this was not consistently observed in short-term exercise testing or as a symptom management strategy at rest.


CONCLUSIONS
DAS appears to reduce symptoms of dyspnea and fatigue when used during exercise training, with benefits observed in exercise capacity and HRQOL. When applied during exercise testing, the effects on exercise capacity and symptoms and as a strategy for symptom management at rest are inconsistent.
Respiratory Medicine Service, University of Toronto, Toronto, ON, Canada; West Park Healthcare Centre, the Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
Annemarie L
AL
Lee
Respiratory Medicine Service, University of Toronto, Toronto, ON, Canada; West Park Healthcare Centre, the Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
Laura
L
Desveaux
Respiratory Medicine Service, University of Toronto, Toronto, ON, Canada; West Park Healthcare Centre, the Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada.
Roger S
RS
Goldstein
Respiratory Medicine Service, University of Toronto, Toronto, ON, Canada; West Park Healthcare Centre, the Department of Physical Therapy, University of Toronto, Toronto, ON, Canada. Electronic address: dina.brooks@utoronto.ca.
Dina
D
Brooks
D000161:Acoustic Stimulation; D001288:Attention; D004417:Dyspnea / Q000209:etiology / Q000628:therapy*; D005080:Exercise Test; D017079:Exercise Tolerance; D005221:Fatigue / Q000209:etiology / Q000628:therapy*; D006304:Health Status; D006801:Humans; D009146:Music; D009147:Music Therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000534:rehabilitation*; D011788:Quality of Life