Singing is a commonly used tool for meeting non-musical goals in music therapy. We often have people sing for breath support/control, for vocal volume, and for overall respiratory heath. This week I have noticed several articles on the topic of singing for different populations. Find out which ones have found singing to be effective for respiratory functioning in this research mash-up.

Recent Cochran Reviews have shown that there is not enough evidence to support or discredit the use of singing for children and adults with Cystic Fibrosis  (Irons, Kenny, & Chang, 2010a) and for children and adults with Bronchiectasis (Irons, Kenny, & Chang, 2010b). A meta-analysis couldn’t be completed in either of these studies due to a lack of research meeting selection criteria.

In a study by Bonilha et al. (2009), patients with Chronic Obstructive Pulmonary Disease (COPD) who participated in group singing exercises significantly maintained their maximal expiratory pressure whereas the control group decreased in the same measure. Also worth noting, is that singing increased dyspnea scale scores (worsened) for a short period – possibly due to more respiratory “work”. This study completed some measures pre and post; but then completed a separate set of measures only after a short period of singing (no pre-test). I wondered why they didn’t have these measures re and post to see if there was a difference after weeks of training. Were these added on or planned from the beginning? This does not use the term “music therapy”, but has music faulty on the research team.

Lastly, mental singing. A recent study by Satoh and Kuzuhara (2008) found that patients with Parkinson’s disease who are trained to complete mental singing while they walk can improve gait parameters. Cool research, but much more needed. The measures in this study included an observation of videotaped gait by one volunteer (it would be much better to have multiple people score the video and establish inter-rater reliability, or use something less subjective such as kinematics recording).  This study uses the term “music therapy” but does not clearly identify that a music therapist was involved.

What this means for the clinic: These studies illustrate some evidence supporting singing for different populations and also some areas that more research is needed before we can use singing within EBP. Perhaps the most promising is the use of singing for patients with COPD. If you are working with persons with COPD these results indicate that singing may be useful for maintaining peak flow.  However, you should only use singing if you have someone who can monitor the patient’s dypsnea level. Mental singing is a nice idea for gait training since the clients wouldn’t need any device to walk to if they could self-generate a stimulus for entrainment; however, more research is needed.

References:

Bonilha AG, Onofre F, Vieira ML, Prado MY, Martinez JA. (2009). Effects of singing classes on pulmonary function and quality of life of COPD patients. Int J Chron Obstruct Pulmon Dis., 4, 1-8. PMID: 19436683

Irons JY, Kenny DT, Chang AB. (2010a). Singing for children and adults with cystic fibrosis. Cochrane Database Syst Rev. 2010 May 12;5:CD008036. PMID: 20464761

Irons JY, Kenny DT, Chang AB. (2010b). Singing for children and adults with bronchiectasis. Cochrane Database Syst Rev., 17(2), CD007729. PMID: 20166097

Satoh, M., & Kuzuhara S. (2008). Training in mental singing while walking improves gait disturbance in Parkinson’s disease patients. Eur Neurol., 60(5), 237-43. PMID: 18756088