SingStrong –singing for better lung health in pulmonary fibrosis: A feasibility study

BACKGROUND & PURPOSE: Pulmonary fibrosis (PF) is a debilitating, incurable disease. Strategies to optimise health-related quality of life and minimise symptom impact are advocated. Available treatment options such as pulmonary rehabilitation have been severely disrupted due to COVID-19. This feasibility study explored the clinical efficacy and acceptability of an online singing and breathing retraining programme (SingStrong) for people with PF. METHODS: The weekly online programme conducted over 12 weeks was comprised of 45-minute classes of mindfulness, breathing retraining, vocal exercises and singing conducted by a trained vocal coach. People with PF were invited to participate and sessions were recorded for non-attenders. Demographic data were collected, and the St Georges Respiratory Questionnaire (SGRQ) and Idiopathic PF Patient Reported Outcome measure (IPF-PROM) were administered. The questionnaire also invited participants to provide feedback on the utility, enjoyability and main pros/cons of the intervention. Participation in the research element of the programme was not required to attend the weekly classes. RESULTS: Of 24 participants recruited, data from 15 (mean (Standard Deviation) age of 66 (8.7); male: n = 8) who completed both pre and post-intervention questionnaires were analysed. Statistically significant improvements were recorded in the IPF-PROM (p = 0.019) and self-reported quality of life (p = 0.028). Class attendance by study participants and the broader PF group cumulatively, increased from 14 to 25 participants between weeks 1 and 12. Qualitatively, strong satisfaction with classes and improved efficacy in self-management of lung health, in particular breathlessness, were reported. CONCLUSIONS: Singing and breathing retraining interventions may endow biopsychosocial benefits for people with PF, in the presence of modest objective clinical gains. Singing programmes are popular and may provide helpful adjuncts to existing clinical strategies such as pulmonary rehabilitation.