A phase 3 clinical trial examining the effects of SingINg For breathing in chronic obstructive pulmonary disease (COPD) aNd interstitial lung disease (ILD) pAtients

Phase 3 is a double-arm, randomised, analysis, mixed-methods intervention study of online singing group classes compared to standard care for participants with lung disease. Arm 1: Intervention – Participation in an online group singing class each week for 12 weeks. Group singing classes will run for 90 minutes and include a warm-up exercise (~15-20 minutes), group singing exercises (~45-60), and a cool-down period (~15-20 minutes). Group singing content will be informed by international singing for lung health interventions and will be modified where required to suit the needs of individual participants. Participants are telephoned monthly to complete study questionnaires and encouraged to optionally sing regularly at home including using the currently available “Singing for breathing” CD developed by Phoene Cave (UK Singing for Lung Health investigator and group leader; description and download available from http://www.themusicalbreath.com/2021/05/13/singing-for-breathing-cd-downloads/). The "Singing for Breathing" CD contains physical warm-ups, breathing exercises, vocal exercises and songs. Attendance in group singing classes will be recorded by the group singing leader and additional use of singing exercises will be recorded during monthly phone reviews. Arm 2: Control – 12 weeks of standard of care. Participants are telephoned monthly to complete study questionnaires. Control arm participants will have the option of enrolling in 12-weeks of free online singing group classes at the completion of the study. No data will be collected for that period. Carer enrolment is optional for both arms of both phases. If enrolled, carers will have the option to participate in singing groups and additional singing at home exercises. Carers will be asked to complete quality of life questionnaires at baseline, 4-weeks, 8-weeks, and 12-weeks.