More Singing, Less Swinging - Is Singing Related to Improved Postural Control?
NCT ID: NCT05350436
Last Updated: 2022-09-19
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
UNKNOWN
NA
160 participants
INTERVENTIONAL
2022-02-25
2023-04-10
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
Singing therapy has potential as an adjunct or component of falls prevention programmes and in the treatment of breathing hypervigilance. Reducing fall risk, and levels of hypervigilance and anxiety could have widespread benefits on participants participation and quality of life.
Investigators will aim to recruit both singers and non singers from older and younger adult age groups. Investigators will then be able to determine the balance response in untrained healthy young adults to understand the affects of singing training and aging on balance. The participants' balance will be measured via a force plate as they perform a series of speaking and singing tasks. Other outcomes will include breathing specific anxiety and attention to breathing, and balance specific anxiety and attention to balance.
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
Singing and Cardiovascular Health in Older Adults
NCT04121741
Effect of Music Breathing for Promoting Sense of Coherence in Young People: RCT
NCT05655234
The Effects of Singing-based Music Therapy Program on the Level of Psychoemotional Benefits in Caregivers of ICU Patients
NCT03389568
danceSing Care Evaluation: Testing the Effectiveness
NCT05601102
SingStrong: Strong Lungs Through Song - Long COVID-19 Study
NCT04810065
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
One main factor that could directly impact on breathing are affective and attentional changes. Reduced anxiety and depression through singing therapy has been suggested to improve breathing control and functioning in those with chronic respiratory conditions. Qualitative surveys have reported that participants find singing to be an "uplifting" activity and that singing with a group of peers may also help to combat isolation.
These changes may be accompanied by changes in allocation of attention. I.e., it is thought that anxiety leads to heightened vigilant monitoring of breathing, and that this hypervigilance leads to a switch in control of breathing from automatic to consciously processed, resulting in breathing dysfunction and breathlessness. Notably, normalisation of such excessive anxiety related vigilance may underpin the improvements that patients report after singing therapy, in terms of control of breathing and breathlessness during exacerbations. Singing therapy may therefore improve breathing control through reducing anxiety as well as associated attention to breathing. One aim of this study is to test this idea further, and to determine if singing impacts on breathing vigilance.
An additional potentially very important effect of singing interventions is that people may improve their balance control as well, both directly and indirectly. Breathing and postural control are tightly linked. We continuously need to make postural adjustment in response to disturbances due to (changes in) breathing - and especially so when breathing is effortful and accelerated. Several studies of SLH in patients with COPD report participants perceive singing had a positive impact on their posture. Also, recent studies suggest that expert singers have better postural control compared to novices. Better control over breathing thus may also improve postural control.
Indirectly, and similar to breathing vigilance, singing interventions may also help normalise individual's attention toward posture and balance. Fear of falling is common in people with respiratory conditions such as COPD. Typically, such fear / anxiety will lead to a strong, potentially excessive, increase in attention to balance. As with breathing, this "hypervigilance" can itself lead to distorted perception of unsteadiness. Singing therapy may therefore improve balance control through reducing anxiety and associated attention to movement.
Therefore, this study will also explore the effects of singing on balance control and associated changes in balance-related hypervigilance.
To investigate these questions, investigators planned a scoping study in which they:
* Aim to investigate the effects of singing on breathing control (e.g., breathing rate, breathing pattern assessment; see all outcomes below)
* Immediate: Effects of singing (varying demands) vs no-singing condition
* Long-term: differences between people with and without regular singing experience in terms of breathing control during no-singing vs singing conditions.
* Aim to investigate the effects of singing on breathing-related anxiety \& vigilance (state anxiety, breathing vigilance; self-reported)
* Immediate effects (balance vs. balance + singing) \& long-term effects (differences between groups with and without singing experience)
* Aim to investigate the effects of singing on balance control (sway, sway frequency)
* Immediate effects (balance vs. balance + singing) \& long-term effects (differences between groups with and without singing experience)
* Aim to investigate the effects of singing on balance-related anxiety and vigilance (state anxiety, balance hypervigilance, conscious processing of balance; all self-reported)
* Again, immediate effects (balance vs. balance + singing) \& long-term effects (differences between groups with and without singing experience)
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
NON_RANDOMIZED
FACTORIAL
OTHER
NONE
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
Young adult non singers
Balance Conditions
Balance Conditions: (\~ 5 minutes in total)
* Balance Condition 1 (Feet 20cm apart)
* Balance Condition 2 (Feet together)
* Balance Condition 3 (Tandem stance)
Initial measurements of balance conditions serve two purposes: it generates a postural control baseline for us without the attribution of singing conditions, furthermore it allows us to separately measure long-term singing experience's effect on postural control, by assessing tasks differing in difficulty level. Balance conditions will be randomised to prevent a learning effect.
Singing
Singing Conditions: (\~ 15 minutes)
* Warmup - including jaw and breathing exercises
* Singing Condition 1 (Spoken Happy Birthday - Traditional Tempo)
* Singing Condition 2 (Sung Happy Birthday - Traditional Tempo
* Singing Condition 3 (Spoken Happy Birthday - Fast Tempo)
* Singing Condition 4 (Sung Happy Birthday - Fast Tempo)
* Singing Condition 5 (Spoken Happy Birthday - Slow Tempo)
* Singing Condition 6 (Sung Happy Birthday - Slow Tempo)
Link to singing instructional video:
https://www.dropbox.com/s/tro58i6vx6i6w3a/Singing%20Balance%20Exercise%20Video.mp4?dl=0
Time stamps for the video:
* Warmup (including jaw exercises and breathing exercises) - beginning at 2:55 until 6:06
* Happy Birthday protocol - beginning at 15:26 until 20:21
Young adult singers
Balance Conditions
Balance Conditions: (\~ 5 minutes in total)
* Balance Condition 1 (Feet 20cm apart)
* Balance Condition 2 (Feet together)
* Balance Condition 3 (Tandem stance)
Initial measurements of balance conditions serve two purposes: it generates a postural control baseline for us without the attribution of singing conditions, furthermore it allows us to separately measure long-term singing experience's effect on postural control, by assessing tasks differing in difficulty level. Balance conditions will be randomised to prevent a learning effect.
Singing
Singing Conditions: (\~ 15 minutes)
* Warmup - including jaw and breathing exercises
* Singing Condition 1 (Spoken Happy Birthday - Traditional Tempo)
* Singing Condition 2 (Sung Happy Birthday - Traditional Tempo
* Singing Condition 3 (Spoken Happy Birthday - Fast Tempo)
* Singing Condition 4 (Sung Happy Birthday - Fast Tempo)
* Singing Condition 5 (Spoken Happy Birthday - Slow Tempo)
* Singing Condition 6 (Sung Happy Birthday - Slow Tempo)
Link to singing instructional video:
https://www.dropbox.com/s/tro58i6vx6i6w3a/Singing%20Balance%20Exercise%20Video.mp4?dl=0
Time stamps for the video:
* Warmup (including jaw exercises and breathing exercises) - beginning at 2:55 until 6:06
* Happy Birthday protocol - beginning at 15:26 until 20:21
Older adult non singers
Balance Conditions
Balance Conditions: (\~ 5 minutes in total)
* Balance Condition 1 (Feet 20cm apart)
* Balance Condition 2 (Feet together)
* Balance Condition 3 (Tandem stance)
Initial measurements of balance conditions serve two purposes: it generates a postural control baseline for us without the attribution of singing conditions, furthermore it allows us to separately measure long-term singing experience's effect on postural control, by assessing tasks differing in difficulty level. Balance conditions will be randomised to prevent a learning effect.
Singing
Singing Conditions: (\~ 15 minutes)
* Warmup - including jaw and breathing exercises
* Singing Condition 1 (Spoken Happy Birthday - Traditional Tempo)
* Singing Condition 2 (Sung Happy Birthday - Traditional Tempo
* Singing Condition 3 (Spoken Happy Birthday - Fast Tempo)
* Singing Condition 4 (Sung Happy Birthday - Fast Tempo)
* Singing Condition 5 (Spoken Happy Birthday - Slow Tempo)
* Singing Condition 6 (Sung Happy Birthday - Slow Tempo)
Link to singing instructional video:
https://www.dropbox.com/s/tro58i6vx6i6w3a/Singing%20Balance%20Exercise%20Video.mp4?dl=0
Time stamps for the video:
* Warmup (including jaw exercises and breathing exercises) - beginning at 2:55 until 6:06
* Happy Birthday protocol - beginning at 15:26 until 20:21
Older adult singers
Balance Conditions
Balance Conditions: (\~ 5 minutes in total)
* Balance Condition 1 (Feet 20cm apart)
* Balance Condition 2 (Feet together)
* Balance Condition 3 (Tandem stance)
Initial measurements of balance conditions serve two purposes: it generates a postural control baseline for us without the attribution of singing conditions, furthermore it allows us to separately measure long-term singing experience's effect on postural control, by assessing tasks differing in difficulty level. Balance conditions will be randomised to prevent a learning effect.
Singing
Singing Conditions: (\~ 15 minutes)
* Warmup - including jaw and breathing exercises
* Singing Condition 1 (Spoken Happy Birthday - Traditional Tempo)
* Singing Condition 2 (Sung Happy Birthday - Traditional Tempo
* Singing Condition 3 (Spoken Happy Birthday - Fast Tempo)
* Singing Condition 4 (Sung Happy Birthday - Fast Tempo)
* Singing Condition 5 (Spoken Happy Birthday - Slow Tempo)
* Singing Condition 6 (Sung Happy Birthday - Slow Tempo)
Link to singing instructional video:
https://www.dropbox.com/s/tro58i6vx6i6w3a/Singing%20Balance%20Exercise%20Video.mp4?dl=0
Time stamps for the video:
* Warmup (including jaw exercises and breathing exercises) - beginning at 2:55 until 6:06
* Happy Birthday protocol - beginning at 15:26 until 20:21
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
Balance Conditions
Balance Conditions: (\~ 5 minutes in total)
* Balance Condition 1 (Feet 20cm apart)
* Balance Condition 2 (Feet together)
* Balance Condition 3 (Tandem stance)
Initial measurements of balance conditions serve two purposes: it generates a postural control baseline for us without the attribution of singing conditions, furthermore it allows us to separately measure long-term singing experience's effect on postural control, by assessing tasks differing in difficulty level. Balance conditions will be randomised to prevent a learning effect.
Singing
Singing Conditions: (\~ 15 minutes)
* Warmup - including jaw and breathing exercises
* Singing Condition 1 (Spoken Happy Birthday - Traditional Tempo)
* Singing Condition 2 (Sung Happy Birthday - Traditional Tempo
* Singing Condition 3 (Spoken Happy Birthday - Fast Tempo)
* Singing Condition 4 (Sung Happy Birthday - Fast Tempo)
* Singing Condition 5 (Spoken Happy Birthday - Slow Tempo)
* Singing Condition 6 (Sung Happy Birthday - Slow Tempo)
Link to singing instructional video:
https://www.dropbox.com/s/tro58i6vx6i6w3a/Singing%20Balance%20Exercise%20Video.mp4?dl=0
Time stamps for the video:
* Warmup (including jaw exercises and breathing exercises) - beginning at 2:55 until 6:06
* Happy Birthday protocol - beginning at 15:26 until 20:21
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* For older adults: 60 years of age or older
* The "Older Adult" age group will be defined as adults aged 60 and older, based on the specifications of the World Health Organization (2017).
* The "Younger Adult" age group will be defined as adults aged 18 to 35 inclusive. There will be a buffer range of ages 36 to 59. This is being done to get a clear delineation between age groups.
Exclusion Criteria
* Any respiratory, neurological, cardiac disease or deficit (and are on regular medication for it), and/or mobility issues.
* Have tested positive for COVID-19 in the last 15 days (van Kampen et al., 2021)
* Are diagnosed with Chronic COVID Syndrome
* Conditions limiting the ability to stand for \>1 minute independently (e.g., chronic fatigue, recent injury affecting balance)
* Pregnancy (although this will not apply to older adults)
* Conditions limiting participating in singing activities (aphasia, dysarthria, dysphonia, speech impairments)
Investigating young adults allows to better isolate the effects of singing, as these individuals will not suffer from co-morbidities that may confound, modify or attenuate the effects. Conversely, the older adult group is relevant to study from a clinical point of view.
18 Years
ALL
Yes
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
Brunel University
OTHER
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Adam Lewis
Lecturer in Physiotherapy
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Brunel University London Division of Physiotherapy
Uxbridge, , United Kingdom
Countries
Review the countries where the study has at least one active or historical site.
Central Contacts
Reach out to these primary contacts for questions about participation or study logistics.
Elmar Kal, PhD
Role: CONTACT
Facility Contacts
Find local site contact details for specific facilities participating in the trial.
References
Explore related publications, articles, or registry entries linked to this study.
Burdon JG, Juniper EF, Killian KJ, Hargreave FE, Campbell EJ. The perception of breathlessness in asthma. Am Rev Respir Dis. 1982 Nov;126(5):825-8. doi: 10.1164/arrd.1982.126.5.825.
Hodges PW, Gurfinkel VS, Brumagne S, Smith TC, Cordo PC. Coexistence of stability and mobility in postural control: evidence from postural compensation for respiration. Exp Brain Res. 2002 Jun;144(3):293-302. doi: 10.1007/s00221-002-1040-x. Epub 2002 Apr 13.
Lewis A, Cave P, Stern M, Welch L, Taylor K, Russell J, Doyle AM, Russell AM, McKee H, Clift S, Bott J, Hopkinson NS. Singing for Lung Health-a systematic review of the literature and consensus statement. NPJ Prim Care Respir Med. 2016 Dec 1;26:16080. doi: 10.1038/npjpcrm.2016.80.
Lord VM, Cave P, Hume VJ, Flude EJ, Evans A, Kelly JL, Polkey MI, Hopkinson NS. Singing teaching as a therapy for chronic respiratory disease--a randomised controlled trial and qualitative evaluation. BMC Pulm Med. 2010 Aug 3;10:41. doi: 10.1186/1471-2466-10-41.
Lord VM, Hume VJ, Kelly JL, Cave P, Silver J, Waldman M, White C, Smith C, Tanner R, Sanchez M, Man WD, Polkey MI, Hopkinson NS. Singing classes for chronic obstructive pulmonary disease: a randomized controlled trial. BMC Pulm Med. 2012 Nov 13;12:69. doi: 10.1186/1471-2466-12-69.
Oliveira CC, McGinley J, Lee AL, Irving LB, Denehy L. Fear of falling in people with chronic obstructive pulmonary disease. Respir Med. 2015 Apr;109(4):483-9. doi: 10.1016/j.rmed.2015.02.003. Epub 2015 Feb 14.
Peultier-Celli L, Audouin M, Beyaert C, Perrin P. Postural Control in Lyric Singers. J Voice. 2022 Jan;36(1):141.e11-141.e17. doi: 10.1016/j.jvoice.2020.04.019. Epub 2020 May 24.
Philip KE, Lewis A, Jeffery E, Buttery S, Cave P, Cristiano D, Lound A, Taylor K, Man WD, Fancourt D, Polkey MI, Hopkinson NS. Moving singing for lung health online in response to COVID-19: experience from a randomised controlled trial. BMJ Open Respir Res. 2020 Nov;7(1):e000737. doi: 10.1136/bmjresp-2020-000737.
Skingley, A. et al. 'Singing for Breathing': participants' perceptions of a group singing programme for people with COPD. Arts Health 6, 59-74 (2014).
van Kampen JJA, van de Vijver DAMC, Fraaij PLA, Haagmans BL, Lamers MM, Okba N, van den Akker JPC, Endeman H, Gommers DAMPJ, Cornelissen JJ, Hoek RAS, van der Eerden MM, Hesselink DA, Metselaar HJ, Verbon A, de Steenwinkel JEM, Aron GI, van Gorp ECM, van Boheemen S, Voermans JC, Boucher CAB, Molenkamp R, Koopmans MPG, Geurtsvankessel C, van der Eijk AA. Duration and key determinants of infectious virus shedding in hospitalized patients with coronavirus disease-2019 (COVID-19). Nat Commun. 2021 Jan 11;12(1):267. doi: 10.1038/s41467-020-20568-4.
Vidotto LS, Bigliassi M, Jones MO, Harvey A, Carvalho CRF. Stop Thinking! I Can't! Do Attentional Mechanisms Underlie Primary Dysfunctional Breathing? Front Physiol. 2018 Jun 22;9:782. doi: 10.3389/fphys.2018.00782. eCollection 2018. No abstract available.
Vidotto LS, Carvalho CRF, Harvey A, Jones M. Dysfunctional breathing: what do we know? J Bras Pneumol. 2019 Feb 11;45(1):e20170347. doi: 10.1590/1806-3713/e20170347.
World Health Organisation (WHO) (2017). Mental Health of Older Adult. Available at: https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults. Accessed 17/01/22)
World Health Organisation (WHO) (2021). Falls. Available at: https://www.who.int/news-room/fact-sheets/detail/falls (Accessed: 12/01/22)
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
35423
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.