NCT05350436

More Singing, Less Swinging - Is Singing Related to Improved Postural Control?

• Status: Unknown
• Phase: N/A
• Study type: Interventional
• Enrollment: 160 (estimated)
• Sponsor: Brunel University · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Accepted

Summary

This study will investigate the extent to which singing affects balance and breathing. 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.

Detailed description

Singing has become a popular arts-in-therapy activity used by physiotherapists as part of their clinical treatment. For example, Singing for Lung Health (SLH) programmes are used in the management of long-term respiratory conditions. These programmes involve group-based singing activities with a focus on breathing control and posture. There are indications that SLH is effective at alleviating symptoms of respiratory disease, likely due to a combination of physical, psychological and social mechanisms. 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

• Healthy Aging
• Balance; Distorted
• Singing

Interventions

Type	Name	Description
BEHAVIORAL	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.
BEHAVIORAL	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

Timeline

• Start date: 2022-02-25
• Primary completion: 2023-04-10
• Completion: 2023-04-10
• First posted: 2022-04-28
• Last updated: 2022-09-19

Locations

1 site across 1 country: United Kingdom