Table 1

Singing actions and proposed/potential physiological basis of benefits for individuals with COPD

Singing actionProposed benefits for individuals with COPD
Expiration during singing requires controlled muscle activityControlling expiratory flow,20 37 lower operating lung volumes and make breathing more comfortable.
Regulation of glottic aperture and improved glottic efficiencyControlling of expiratory flow.20
Alters abdominal and thoracic contribution to lung volume changes.Doming the diaphragm supports exhalation, also improving length-tension ratio and force-generation capacity on inspiration.36 37
Inspiratory muscle trainingGreater inspiratory strength is required to generate higher pressures to inspire at large lung volumes (hyperinflation).78 Facilitates active phases of breathing, when required.
Enhancing airway shear forcesPotential to promote airway clearance, reduces symptom burden59
Training of posture and balanceOptimises lung function, potential to reduce risk of falls and increase balance confidence68
Singing is a moderately intense physical activity (shown specifically with core components of SLH)Increasing physical activity levels69 in a population significantly physically inactive79
  • COPD, chronic obstructive pulmonary disease; SLH, Singing for Lung Health.