Group Drumming for Improving the Health of Community-Dwelling Elderly

The study seeks to examine the effects that recreational group drumming has on the health of the community- dwelling elderly. It is hypothesized that it has positive and sustainable effects on various health outcome measures.

Study Overview

• Status: Active, not recruiting
• Conditions: Depression; Quality of Life; Sleep; Blood Pressure; Grip
• Intervention / Treatment: Other: Group Drumming

Detailed Description

The study seeks to examine the effects that recreational group drumming has on the health of the community- dwelling elderly. It is hypothesized that it has positive and sustainable effects on various health outcome measures.

One of the primary outcome measure is the quality of life of the participants, which will be measured using the European Quality of Life-5 Dimensions (EQ5D). It is a measure of health status from the EuroQoL. Group primarily designed for self-completion by respondents and is validated locally. The score ranges from 0 (death) to 1 (full health), with 5 dimensions comprising of mobility, self-care, usual activities, pain/discomfort and anxiety/ depression.

The other primary outcome measures include:

i. The Geriatric Depression Scale (GDS), which is a tool used for elderly population to evaluate the level of depressive symptoms of an individual over the past week, has been validated locally. It is a self-reported questionnaire consisting of 15 items. Maximum score of 15 and minimum of 0. Score equal or greater than 6 out of 15 is considered to be indicator of depression.

ii. The Pittsburgh Sleep Quality Index (PSQI) is a self-reported measure of sleep quality. It is a 19-item scale grouped into 7 equally weighted component scores. The global score ranges from 0 to 21, with poorer sleep quality indicated by a higher global score.

iii. (Social Effects) The Lubben Social Network Scale (LSNS) is a self-reported measure designed to gauge social isolation in the elderly. It measures frequency, size and closeness of contacts for the participant's social network by assessing the participant's perceived level of support received from friends and families.

The secondary outcomes are broadly categorized into psychological effects, social effects, and physical effects as listed below:

1. Psychological Effects The Mini Mental State Examination (MMSE) is a commonly used screening tool for cognitive impairment worldwide. A score of less than 25 out of maximum of 30 is often suggestive of an underlying cognitive impairment.

2. Physical Effects

   i. Resting blood pressure and heart rate

ii. Grip strength - popular indicator of physical functioning

iii. Minnesota Manual Dexterity Test

It is hypothesized that recreational group drumming has positive and sustainable effects on various health outcome measures.

The research study will be conducted in two phases. Phase 1 is the randomized controlled study comparing the intervention with independent concurrent controls. Phase 2 will involve providing the intervention to the control subjects from phase 1, where subjects act as their own controls pre to post intervention.

Each drumming session would have 20 participants, excluding two facilitators. This 'Bridging Rhythm with Wellness Programme' will be organised by Lions Befrienders Singapore. These drumming sessions will be held in the Active Ageing Centres (AACs) under Lions Befirenders.

Recruited study participants will be issued Study ID upon enrolment into study. Phase 1 Phase 1 is a randomized controlled trial with a planned ratio of participants of 1:1 in the intervention group (Group A) and control group (Group B). Unlike the pilot study, a crossover will not be conducted in view of (i) difficulties in quantifying a sufficient washout period for such an intervention and (ii) a possible learned effect being carried over.

Participants will be recruited from senior activity centre and randomized into either group within their respective senior activity centre.

All participants in phase 1, be it those randomised into control or intervention group, will be subjected to the following study procedures.

Clinical and patient related outcome data will be collected at the participants' respective senior activity centres at 4 time points:

1. At the start of the study
2. Midpoint of intervention (Week 4)
3. Completion of intervention (Week 8)
4. 4 Weeks post-intervention (Week 12) For assessments done at first study timepoint (i.e. start of study assessments), it can be completed 2-3 weeks prior to commencement of each centre's drumming session. This is to allow study team members to have time to complete the required baseline assessments prior to commencement of study intervention.

All study assessments to be completed within study timepoint week with 3 working date window period before and after study timepoint week.

Participants will be asked to complete the following questionnaires and clinical tests:

1. European Quality of Life-5 Dimensions (EQ5D)
2. Geriatric Depression Scale (GDS)
3. Pittsburgh Sleep Quality Index (PSQI)
4. Mini Mental State Examination (MMSE)
5. Lubben Social Network Scale (LSNS)
6. Katz ADL
7. Blood Pressure
8. Heart Rate
9. Grip Strength with Dynamometer
10. Minnesota Manual Dexterity Test
11. Study Data Collection Form Study participants may be contacted via phone calls to complete required questionnaires. Participants will be provided a research letter if any incidental finding have been found.

Phase 2 In phase 2, subjects in Group B or control group in phase 1, will be offered the opportunity to undergo the intervention at least 4 weeks after the intervention group has concluded Phase 1. Being control subjects in phase 1, these subjects have the baseline values for various measures accurately established prior to intervention. These subjects will act as their own controls, and the effect of the intervention will be assessed by comparing the post treatment values against the baseline measures prior to intervention.

Similar outcome measures will be measured at the time points relative to the baseline measurements, for both phase 1 and phase 2 studies.

Subjects (Group A of phase 1 and subjects of phase 2) will undergo a group drumming course under the Bridging Rhythm with Wellness Programme, comprising of 8 weekly sessions that last for an hour each. Participants cannot be blinded in the study as whoever playing instruments will be aware of the intervention. To protect against contamination, participants of the two groups will be assessed at different times.

In this group drumming course, a variety of percussion instruments will be used inn these sessions, including the conga, cowbell, Djembe, Ashiko, Tan-tans, Dunun, shakers and wood blocks. These instruments will be rotated among the participants from session to session. Participants will be seated comfortably in a circle on chairs within their assigned group, and the percussion instrument will be placed in front of them within reach. Each session will be led by 2 experienced artist-facilitators skilled in leading group drumming courses (1 fixed main facilitator, 1 co-facilitator). The artist-facilitators will be blinded to the participants' backgrounds, psychological and physical health profiles. Artist-facilitators will encourage free play, expression and interaction amongst participants through playing of instruments.

• Study Type: Interventional
• Enrollment (Estimated): 300
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Singapore
  • Singapore, Singapore, 229899
    • KK Women's and Children's Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

Individuals who are:

• Aged 60 years old and above (by year of age)
• Able to understand English and/or Mandarin, and
• Able to engage in the group drumming activity conducted (e.g. capable of light exercises while seated)

Exclusion Criteria:

Individuals who are:

• On palliative care, and/or
• Bed-bound
• Have severe hearing impairment such that they are unable to engage in group drumming sessions

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Sequential Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Drumming Arm; Participants in this arm will undergo weekly group drumming for 8 weeks.	Other: Group Drumming; Weekly group drumming for 8 weeks
No Intervention: Waitlist Control Arm; Participants in this arm will not undergo any intervention while the intervention arm is ongoing and assessed for comparison.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Health related quality of life	European Quality of Life-5 Dimensions (EQ5D) Will be measured. The score ranges from 0 (death) to 1 (full health), with 5 dimensions comprising of mobility, self-care, usual activities, pain/discomfort and anxiety/ depression.	12 weeks
Depression	Geriatric Depression Scores will be measured. Scores will range from 0-15. Those will lower scores will have higher risk of depression	12 weeks
Sleep Quality	Pittsburg Sleep quality index will be used to measure this outcome	12 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Psychological effects	Mini Mental State Examination (MMSE)will be measured. A score of less than 25 out of maximum of 30 is often suggestive of an underlying cognitive impairment.	12 weeks
Resting Blood Pressure	Resting Blood pressure will be measured at baseline and at 12 weeks. Both systolic and diastolic pressure would be captured in mmHg	12 weeks
Heart Rate	Resting Heart Rate will be measured at baseline and at 12 weeks. This would be in beats/minute	12 weeks

Collaborators and Investigators

• Sponsor: KK Women's and Children's Hospital
• Collaborators: Institute of Mental Health, Singapore; National University of Singapore; Lions Befriender; Toteboard

Publications and helpful links

General Publications

• Yap AF, Kwan YH, Tan CS, Ibrahim S, Ang SB. Rhythm-centred music making in community living elderly: a randomized pilot study. BMC Complement Altern Med. 2017 Jun 14;17(1):311. doi: 10.1186/s12906-017-1825-x.
• Smith C, Viljoen JT, McGeachie L. African drumming: a holistic approach to reducing stress and improving health? J Cardiovasc Med (Hagerstown). 2014 Jun;15(6):441-6. doi: 10.2459/JCM.0000000000000046.
• Miyazaki A, Okuyama T, Mori H, Sato K, Ichiki M, Nouchi R. Drum Communication Program Intervention in Older Adults With Cognitive Impairment and Dementia at Nursing Home: Preliminary Evidence From Pilot Randomized Controlled Trial. Front Aging Neurosci. 2020 Jul 2;12:142. doi: 10.3389/fnagi.2020.00142. eCollection 2020.

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2024
• Primary Completion (Estimated): September 30, 2025
• Study Completion (Estimated): June 30, 2026

Study Registration Dates

• First Submitted: June 28, 2024
• First Submitted That Met QC Criteria: July 4, 2024
• First Posted (Actual): July 8, 2024

Study Record Updates

• Last Update Posted (Estimated): September 3, 2025
• Last Update Submitted That Met QC Criteria: August 26, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Behavior; Depression
• Other Study ID Numbers: 2023-2642

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No