Table 2

Physiological research questions and proposed clinical effectiveness studies required in SLH

Physiological research questionsClinical effectiveness studies
Do SLH techniques and participation in SLH groups change sputum expectoration volume, cough and exacerbation frequency?SLH group participation vs generic community choir participation.
How do different SLH techniques change laryngeal function and airflow compared with passive breathing?SLH group participation as a maintenance intervention post-PR completion vs standard care.
How do SLH techniques change respiratory and abdominal muscle activity compared with passive breathing?SLH as one-to-one inpatient and outpatient option vs traditional physiotherapy for symptom management (breathlessness, airway clearance).
How do SLH techniques change thoracoabdominal volumes compared with passive breathing?Online SLH group participation vs face-to-face group participation.
How does participation in SLH groups change posture and balance?Post-exacerbation SLH vs standard care.
Does long term participation in SLH groups alter the trajectory of lung function decline in COPD?PR vs SLH for those who decline PR.
What level of physical activity is performed by individuals in a SLH group?SLH vs usual care in different settings and populations.
Does participation in SLH groups improve inspiratory and expiratory muscle strength?
Is there a difference in breathing pattern between SLH repertoire directed performance and other repertoire such as pop and classical?
  • COPD, chronic obstructive pulmonary disease; PR, pulmonary rehabilitation; SLH, Singing for Lung Health.