title: The Effectiveness of Singing or Playing a Wind Instrument in Improving Respiratory Function in Patients with Long-Term Neurological Conditions: A Systematic Review.
abstract: BACKGROUND
  Many long-term neurological conditions adversely affect respiratory function. Singing and playing wind instruments are relatively inexpensive interventions with potential for improving respiratory function; however, synthesis of current evidence is needed to inform research and clinical use of music in respiratory care.
  
  
  OBJECTIVE
  To critically appraise, analyze, and synthesize published evidence on the effectiveness of singing or playing a wind instrument to improve respiratory function in people with long-term neurological conditions.
  
  
  METHODS
  Systematic review of published randomized controlled trials and observational studies examining singing or playing wind instruments to improve respiratory function in individuals with long-term neurological conditions.
  
  
  METHODS
  Articles meeting specified inclusion criteria were identified through a search of the Medline, Embase, PsycINFO, Cochrane Library, CINAHL, Web of Science, CAIRSS for Music, WHO International Clinical Trials Registry Platform Search Portal, and AMED databases as early as 1806 through March 2015. Information on study design, clinical populations, interventions, and outcome measures was extracted and summarized using an electronic standardized coding form. Methodological quality was assessed and summarized across studies descriptively.
  
  
  RESULTS
  From screening 584 references, 68 full texts were reviewed and five studies included. These concerned 109 participants. The studies were deemed of low quality, due to evidence of bias, in part due to intervention complexity. No adverse effects were reported. Overall, there was a trend toward improved respiratory function, but only one study on Parkinson's disease had significant between-group differences.
  
  
  CONCLUSIONS
  The positive trend in respiratory function in people with long-term neurological conditions following singing or wind instrument therapy is of interest, and warrants further investigation.
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore; King's College London, Cicely Saunders Institute, Division of Palliative Care, Policy and Rehabilitation.
authors.forename: Kexin
authors.initials: K
authors.lastname: Ang
authors.affiliation: King's College London, Cicely Saunders Institute, Division of Palliative Care, Policy and Rehabilitation.
authors.forename: Matthew
authors.initials: M
authors.lastname: Maddocks
authors.affiliation: Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore.
authors.forename: Huiying
authors.initials: H
authors.lastname: Xu
authors.affiliation: King's College London, Cicely Saunders Institute, Division of Palliative Care, Policy and Rehabilitation.
authors.forename: Irene J
authors.initials: IJ
authors.lastname: Higginson
mesh_terms: D015982:Bias; D006801:Humans; D009146:Music; D009422:Nervous System Diseases / Q000150:complications* / Q000503:physiopathology*; D064887:Observational Studies as Topic / Q000592:standards; D016032:Randomized Controlled Trials as Topic / Q000592:standards; D012119:Respiration; D063346:Singing / Q000502:physiology*
keywords: instruments; music; neurologic disorders; respiratory function; singing