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.
- 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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Table of Contents: ERS 2021
Featured articles
Letter from the Editor
COVID-19 Research: Looking Back and Moving Forward
Higher inflammation markers in COVID-19 patients with a first negative PCR test
Persistent fatigue following COVID-19
Risk of COVID-19-related morbidity and mortality in young and middle-aged adults
Respiratory Viral Infections: Insights from Recent Studies
Rhinovirus bronchiolitis increased risk of recurrent wheezing and asthma
COPD: Evidence Update
Livestock farming affected the airway microbiome of COPD patients
Reduction of COPD severe acute exacerbations by candidate vaccine
Paediatrics and Vaccinology
Better lung function in children with a healthy diet
Need for validated severity score in the assessment of bronchiolitis
Increased impact of air pollution on lung function in preterm infants
Pearls in Asthma Research
Biomarkers do not discriminate severe from severe uncontrolled asthma
Increased blood neutrophiles in patients with obesity and asthma
Blood inflammatory phenotypes associated with clinical symptoms of asthma
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