Abstract
Background and ObjectivesSinging can have a range of health benefits; this paper reviews the evidence of the effects of group singing for chronic pain in people with long‐term health conditions.Database and Data TreatmentWe searched for published peer‐reviewed singing studies reporting pain measures (intensity, interference and depression) using major electronic databases (last search date 31 July 2018). After screening 123 full texts, 13 studies met the inclusion criteria: five randomized controlled trials (RCTs), seven non‐RCTs and one qualitative study. Included studies were appraised using Downs and Black and the Critical Appraisals Skills Programme quality assessments.ResultsIncluded studies reported differences in the type of singing intervention, long‐term condition and pain measures. Due to the high heterogeneity, we conducted a narrative review. Singing interventions were found to reduce pain intensity in most studies, but there was more equivocal support for reducing pain interference and depression. Additionally, qualitative data synthesis identified three key linked and complementary themes: physical, psychological and social benefits.ConclusionGroup singing appears to have the potential to reduce pain intensity, pain interference and depression; however, we conclude that there is only partial support for singing on some pain outcomes based on the limited available evidence of varied quality. Given the positive findings of qualitative studies, this review recommends that practitioners are encouraged to continue this work. More studies of better quality are needed. Future studies should adopt more robust methodology and report their singing intervention in details. Group singing may be an effective and safe approach for reducing persistent pain and depression in people with long‐term health conditions.SignificanceThis systematic review assesses research evidence for the effectiveness of group singing on chronic pain in people with long‐term health conditions. Narrative syntheses revealed that there is partial support for singing effects on some pain outcomes based on the limited available evidence of varied quality. Qualitative data provided additional support of physical, psychological and social benefits. The review highlights implications for practice and future studies.
Highlights
Singing requires the active involvement of both vocal apparatus and the respiratory system (Irons, Kenny, McElrea, & Chang, 2012; Irons, Kuipers, & Petoz, 2013; Irons, Petocz, Kenny, & Chang, 2019)
All randomised controlled trials (RCTs) and non-RCTs reported the effects of group singing on pain intensity and/or interference
Two Chronic Obstructive Pulmonary Disease (COPD) trials could not be included in the meta-analysis, as the trials’ authors were unable to provide data on pain interference (SF-12) (Lord et al, 2010; Lord et al, 2012)
Summary
Singing requires the active involvement of both vocal apparatus and the respiratory system (Irons, Kenny, McElrea, & Chang, 2012; Irons, Kuipers, & Petoz, 2013; Irons, Petocz, Kenny, & Chang, 2019). Singing encourages the active use of diaphragmatic breathing, which promotes deep and slow breathing This diaphragmatic breathing influences a number of important physiological functions, such as the cardiovascular system and the autonomic nervous system (Russo, Santarelli, & O’Rourke, 2017). Singing can have a range of health benefits; this paper reviews evidence of the effects of group singing for chronic pain in people with long-term health conditions. Database and Data Treatment: We searched for published peer-reviewed singing studies reporting pain measures (intensity, interference and depression) using major electronic databases (last search date 31/07/2018). Results: Included studies reported differences in the type of singing intervention, long-term condition and pain measures. Group singing may be an effective and safe approach for reducing persistent pain and depression in people with long-term health conditions
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