Singing and COPD: a pilot randomized controlled trial of wellbeing and respiratory outcomes

Aims/objectives
To test whether a ten-week regular weekly group singing programme, with guided home practice, leads to improvement in COPD-specific health status, as assessed by the COPD Assessment Test (CAT, primary outcome).
To test whether the programme results in changes to health-related quality of life, mental health, breathlessness, lung function, functional exercise performance and breathing patterns (secondary outcomes).

Rationale
A number of randomized controlled trials (RCTs) exist which suggest that there are potential benefits to health and wellbeing of regular singing for people with COPD (Chronic Obstructive Pulmonary Disease). However, most rely on small samples, and findings across the different outcome measures are inconsistent, while interview studies tend to report consistent positive physical and psychological outcomes. Further research is therefore needed.

Approach
A single-blind, randomized controlled trial compared a structured, weekly group singing programme plus home practice between sessions over ten weeks, with a usual COPD treatment control. The sample was drawn from a local NHS population of people with COPD. Following baseline assessments, participants were allocated to a 10 week singing programme or a control.

Findings
Twenty-four individuals completed to follow-up. Measures at 12 weeks showed no significant differences between singing and control groups except for one item on the health status questionnaire (SF-36) which suggested the singers were less limited in their activities of daily living post-singing. Final follow-up, planned for 6 months post intervention, was aborted due to the COVID-19 pandemic.

Discussion and conclusion
The study failed to recruit to target. There remains a recruitment problem in RCTs of singing for COPD, resulting in inconclusive findings, which conflict with the positive qualitative evidence. A wide variety of reseach methods, as well as RCTs, are suggested to enable a better understanding of the impact of singing on COPD.

Trial registration number: ISRCTN42943709.

Trial registration number: ISRCTN42943709.