唱歌促进慢性阻塞性肺病患者的肺部健康：在线授课的多中心随机对照试验

IF 3.6 3区医学 Q1 RESPIRATORY SYSTEM

BMJ Open Respiratory Research Pub Date : 2024-05-01 DOI:10.1136/bmjresp-2024-002365

Keir E J Philip, Sara C Buttery, Sarah Bowen, Adam Lewis, Edmund Jeffery, Saeed M Alghamdi, Parris Williams, Ali M Alasmari, Abdullah S Alsulayyim, Christopher M Orton, Francesca Conway, Ley Chan, Bavithra Vijayakumar, Anand Tana, James Tonkin, Alexis Perkins, Justin L Garner, Karthikan Srikanthan, Ahmed Sadaka, Matthew J Pavitt, Winston Banya, Adam Lound, Sarah Elkin, Michael I Polkey, William D-C Man, Keir Lewis, Phoene Cave, Daisy Fancourt, Nicholas S Hopkinson

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引用次数: 0

摘要

背景为肺部健康歌唱（SLH）是一种以艺术为基础的呼吸控制和运动干预方法，适用于长期呼吸系统疾病患者，旨在改善症状和生活质量。在线、远程提供的课程可能会提高可及性，但之前没有研究对这种方法的有效性进行过评估。方法我们进行了一项评估者盲法随机对照试验，比较 12 周每周一次的在线 SLH 课程与常规护理对健康相关生活质量的影响，采用兰德 36 项简表健康调查（SF-36）的心理健康综合评分（MHC）和身体健康综合评分（PHC）进行评估。结果我们招募了 115 名慢性阻塞性肺病（COPD）稳定期患者，中位数（IQR）年龄为 69（62-74）岁，56.5% 为女性，80% 曾接受过肺康复治疗，医学研究委员会呼吸困难量表为 4（3-4）分，1 秒内用力呼气量预测值为 49（35-63）分。每组各有 50 人完成研究。干预组在 RAND SF-36 的身体健康方面有所改善，但心理健康方面没有；PHC（回归系数（95% CI）：1.77（95% CI 0.11 至 3.44）；p=0.037），但 MHC（0.86（95% CI -1.68 至 3.40）；p=0.504）没有改善。基于从基线改善10%的预设应答者分析显示，SLH治疗组的PHC应答率为32%，常规护理组为12.7%（P=0.024）。在 MHC 方面未发现组间应答率差异（19.3% vs 25.9%；P=0.403）。讨论与结论为期12周的在线SLH项目可以改善慢性阻塞性肺病患者生活质量中的身体部分，但与使用面对面小组课程的研究相比，总体效果相对较小。进一步研究在线干预的内容、持续时间和剂量可能会有所帮助。试验注册号[NCT04034212][1]。如有合理要求，可提供相关数据。在向通讯作者提出合理申请后，可提供作为文章结果基础的参与者个人数据（文本、表格、数字和附录）。数据将在文章发表后立即提供，没有终止日期。任何人都可以出于任何目的访问数据。数据将无限期提供。[1]:/lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04034212&atom=%2Fbmjresp%2F11%2F1%2Fe002365.atom

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Singing for lung health in COPD: a multicentre randomised controlled trial of online delivery

Background Singing for lung health (SLH) is an arts-based breathing control and movement intervention for people with long-term respiratory conditions, intended to improve symptoms and quality of life. Online, remotely delivered programmes might improve accessibility; however, no previous studies have assessed the effectiveness of this approach. Methods We conducted an assessor-blind randomised controlled trial comparing the impact of 12 weeks of once-weekly online SLH sessions against usual care on health-related quality of life, assessed using the RAND 36-Item Short Form Health Survey (SF-36) Mental Health Composite (MHC) and Physical Health Composite (PHC) scores. Results We enrolled 115 people with stable chronic obstructive pulmonary disease (COPD), median (IQR) age 69 (62–74), 56.5% females, 80% prior pulmonary rehabilitation, Medical Research Council dyspnoea scale 4 (3–4), forced expiratory volume in 1 s % predicted 49 (35–63). 50 participants in each arm completed the study. The intervention arm experienced improvements in physical but not mental health components of RAND SF-36; PHC (regression coefficient (95% CI): 1.77 (95% CI 0.11 to 3.44); p=0.037), but not MHC (0.86 (95% CI −1.68 to 3.40); p=0.504). A prespecified responder analysis based on achieving a 10% improvement from baseline demonstrated a response rate for PHC of 32% in the SLH arm and 12.7% for usual care (p=0.024). A between-group difference in responder rate was not found in relation to the MHC (19.3% vs 25.9%; p=0.403). Discussion and conclusion A 12-week online SLH programme can improve the physical component of quality of life for people with COPD, but the overall effect is relatively modest compared with the impact seen in research using face-to-face group sessions. Further work on the content, duration and dose of online interventions may be useful. Trial registration number [NCT04034212][1]. Data are available upon reasonable request. Individual participant data that underlie the results in the article, after de-identification (text, tables, figures and appendices) will be available on reasonable application to the corresponding author. Data will be made immediately available following publication, no end date. Data will be available to anyone who wishes to access the data, for any purpose. Data will be available indefinitely. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04034212&atom=%2Fbmjresp%2F11%2F1%2Fe002365.atom

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来源期刊

BMJ Open Respiratory Research RESPIRATORY SYSTEM-

CiteScore

6.60

自引率

2.40%

发文量

审稿时长

12 weeks

期刊介绍： BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.