Singing actions and proposed/potential physiological basis of benefits for individuals with COPD
| Singing action | Proposed benefits for individuals with COPD |
| Expiration during singing requires controlled muscle activity | Controlling expiratory flow,20 37 lower operating lung volumes and make breathing more comfortable. |
| Regulation of glottic aperture and improved glottic efficiency | Controlling 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 training | Greater 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 forces | Potential to promote airway clearance, reduces symptom burden59 |
| Training of posture and balance | Optimises 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.