Singing for better breathing: findings from the Lambeth & Southwark singing and COPD project.

Introduction Over the last eight years there has been a growth of interest in the potential value of participation in singing groups for people with chronic obstructive pulmonary disease (CODP) and other respiratory illnesses. This is shown by the increasing number of singing for breathing groups established across the UK over this period. The British Lung Foundation have taken a leading role in promoting this activity through their ‘Singing for Lung Health’ programme. A limited number of small-scale research studies have assessed the benefits of singing for people with COPD and other lung conditions. These include three randomised controlled trials, one in Brazil, and two conducted at the Royal Brompton Hospital in London. Further studies have been carried out in Canada, New Zealand, the UK and the USA. There is limited evidence that singing improves lung function and exercise capacity, but qualitative feedback from participants has been highly positive. Testimonies point to singing having substantial subjective benefits for physical, psychological and social wellbeing, and in enabling people with COPD to better manage their lung condition. The current study in Lambeth and Southwark, South London, was based on earlier research conducted in East Kent, UK. Morrison et al. (2013) established and evaluated a network of six community singing groups for people with COPD which ran over the course of ten months. Seventy-two people with COPD were followed up over this time and assessed using validated questionnaires, with St. George’s Respiratory Questionnaire (SGRQ) as the primary outcome measure. Spirometry was also used to assess lung function. Significant improvements were found on the total and impact scores from the SGRQ, and participants also improved in their lung function. Project and evaluation. The aim of the current study was to further test the feasibility of setting up a network of community singing groups for people with COPD to run over the course of ten months from end of September 2015 to end of July 2016. Recruitment took place over the period April-September 2015. The study involved two cohorts, assessed in September 2015 and January 2016. The two groups were comparable on all baseline measures, and were combined for the purpose of the evaluation. A total of 60 participants with breathing difficulties were recruited into the study. Assessment included a battery of validated questionnaires, with the SGRQ as the primary outcome measure. Questions were also included on use of health and social care services and medication, including the use of inhalers. Participants underwent a comprehensive assessment to measure lung function. The principal measures were the amount of air expelled forcibly from the lungs in one second (FEV1); the total volume of air forcibly expelled from the lungs (FVC), and distance walked in six minutes – the Six-Minute Walk Test (6MWT). Singing groups met weekly over the course of the project in four venues, led by two experienced and skilled facilitators. Three groups started in late September/early October 2015 and ran for 38-40 sessions and a fourth group, commenced in January 2016, and ran for 25 sessions. At follow-up, 44 participants completed the questionnaires again and 42 completed the lung and exercise assessments (attrition rate 27-30% due to health issues and family commitments). In addition, 37 participants took part in a structured interview in April/May 2016 to gather feedback on their experiences of the singing groups and their perceptions of any benefits gained. Average level of attendance was 26 sessions, with approximately 82% participants attending at least 20 sessions. Filming and photography was also used throughout to provide a documentary record of the project, and the final film giving an account of the whole project is included with this report. Sidney De Haan Research Centre for Arts and Health Findings from the Lambeth and Southwark Singing and COPD Project 3 Among the participants followed-up, 31 were shown to have COPD from the lung function tests at baseline (FEV1/ FVC