Adherence to singing training similar to standard physical therapy in COPD patients

A randomised controlled trial found an equal adherence in COPD patients receiving singing training compared to physical training, making vocal training an attractive form of rehabilitation.

Pulmonary rehabilitation is essential to COPD care. However, maintaining high adherence rates can be challenging. In a previous multicentre, randomised controlled trial ‘Sing-a-Lung’, the authors already demonstrated that singing training was as effective as standard physical therapy in terms of change in 6-minute walking test (6MWT) and St George’s Respiratory Questionnaire (SGRQ). The current analysis focused on the impact of adherence on these parameters [1].

The non-inferiority randomised controlled trial (NCT03280355) included subjects who had a prescription for pulmonary rehabilitation from August 2017 to August 2019. Participants were randomised to receive singing training or physical training. The primary outcome was a change in 6MWT from baseline to follow-up 2 weeks post-pulmonary rehabilitation. In a post hoc analysis, multivariable logistic regression analyses were performed on the relationship between adherence and achieving clinically significant improvement of 6MWT (30 metres) and SGRQ score (4 units) from baseline to post-pulmonary rehabilitation.

A total of 270 participants were included in the analysis, of which 195 (72%) completed the study. Proportions of patients with high adherence were similar between groups: 61% for singing and 57% for physical training (P=0.90). Medium adherence and high adherence were associated with higher odds of improving 6MWT (medium: OR 5.6; 95% CI 1.4–22.4; P=0.02 vs high: OR 10.5; 95% 3.0–36.6; P=0.001) and SGRQ (medium: OR 8.3; 95% CI 2.1–32.7; P=0.003 vs high: OR 17.0; 95% CI 4.9–58.3; P<0.001).

A positive dose-response relationship between adherence and improvements of 6MWT and SGRQ scores was found. In addition, equal adherence to singing versus physical training was observed. Although singing training sounds promising for COPD rehabilitation, there is still a way to go before the optimal content of vocal training is researched and standardised.

1. Kaasgaard M, et al. Adherence to singing training vs. physical training in COPD rehabilitation. Abstract 320. ERS 2021, 5–8 September.

 

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Posted on 9 November 2021