Singing Intervention for Chronic Obstructive Pulmonary Disease (COPD) (EMPOWER)

Why is this study being done? Chronic Obstructive Pulmonary Disease (COPD) causes airflow blockage creating breathing issues, distress, and lower well-being. COPD also causes hyperinflation of the lungs. The investigators are doing the study to learn more about improving lung function for patients with COPD by using voice-based experiences.

What is being tested in this study? If singing/vocalizing can improve lung function.

How long will I be in the study? The study will last 4 weeks and involve 2 in-person visits to KUMC with virtual vocal sessions two times a week over Zoom.

Study Overview

• Status: Completed
• Conditions: COPD (Chronic Obstructive Pulmonary Disease)
• Intervention / Treatment: Behavioral: singing intervention for COPD

Detailed Description

Study Significance: This study is intended to show if air trapping in functional small airways disease (fSAD) in COPD patients is reduced by a targeted music-based singing intervention.

Air trapping in fSAD in COPD is associated with the experience of breathlessness or dyspnea, which is a primary source of patient distress. Air trapping may be mitigated by activities that support slow, controlled, and more complete exhalation. Because singing requires sustained delivery of consistent air pressure for sound production, training in this activity aims to strengthen respiratory musculature to improve airflow control and increase efficient use of each breath. The investigators believe that singing training will be beneficial in strengthening the respiratory musculature and emptying the lungs, possibly reducing the amount of trapped air.

A major gap exists in understanding whether singing is effective for improving lung function in COPD. Previous interventions based in group singing have been focused on improving social and emotional outcomes, but they do not specifically address the potential physiological benefits of singing as described above. The investigators aim to show specific targeted manipulation of music elements within tailored vocalization activities can successfully improve lung function and reduce dyspnea in patients with COPD, while preserving social and emotional benefits of other more generalized singing interventions. The investigators are focusing on air trapping due to small airways disease as a key symptom that leads to patient experience of dyspnea.(13, 14) Other aspects of COPD pathology and symptoms may be improved by the singing intervention, including a sense of hope through a sense of agency in their own psychological health.

The goal of the pilot study is to determine the feasibility of providing a music-based intervention targeting the issue of air trapping, improve functional small airways disease, and improve other symptoms of COPD and further define the details of the intervention.

This study will determine participant acceptability of a newly developed music-based intervention hoped to be beneficial for people with COPD. If successful, our proposed singing intervention will improve lung function health through reduced air trapping due to hyperinflation, improve patient experience of dyspnea and foster positive psychological health.

• Study Type: Interventional
• Enrollment (Actual): 5
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Kansas
    • Kansas City, Kansas, United States, 66160
      • University of Kansas Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Participants 18 years of age or older
• Diagnosis of COPD
• Airflow obstruction and resting hyperinflation of the lung
• Able to hear within normal range with correction if needed

Exclusion Criteria:

• Pregnancy will be excluded for CT imaging safety and radiation safety
• Alpha-1 antitrypsin

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: 4-week singing intervention; Individual virtual singing sessions with a board-certified music therapist designed to target complete exhalation and reduce air trapping

Behavioral: singing intervention for COPD; Using the Therapeutic Function of Music Plan, this individually tailored music therapy used singing and vocal exercises, guided by a board-certified music therapist, to aid in complete exhalation and reduce air trapping that occurs in chronic obstructive pulmonary disease (COPD).; Other Names: Engaging Music for Pulmonary Obstruction With Expiratory Restoration (EMPOWER)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quantitative Computed Tomography (qCT) Air Trapping	Functional Small Airways Disease Percent (range 0-100), indicating non-emphysematous air trapping percentage (fSAD) as lung volume percent of low attenuation areas below a radiodensity of -856 Hounsfield units (HU) on expiratory computed tomography (CT) and above -950HU on inspiratory CT. Higher values indicate greater air trapping and worse lung function.	Change from baseline after four weeks of the EMPOWER intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Forced Expiratory Volume in 1 second (FEV1)	FEV1 measures the maximum volume of air (in Liters) forcefully exhaled in the first second of a coached spirometric assessment or pulmonary function test (PFT). Lower FEV1 indicates worse lung function and obstructive defect in the lungs.	Change from baseline after four weeks of the EMPOWER intervention
Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT)	Patient reported symptoms of COPD. The CAT scale contains eight patient-completed questions to assess and monitor COPD symptoms, including the impact on daily life, cough, phlegm, breathlessness, sleep, confidence, and energy. Scores range from 0-5 on each question for a total scale range of 0-40, with higher scores indicating worse respiratory symptoms.	Change from baseline after four weeks of the EMPOWER intervention

Collaborators and Investigators

• Sponsor: University of Kansas Medical Center
• Investigators: Principal Investigator: Rebecca J Lepping, PhD, University of Kansas Medical Center

Study record dates

Study Major Dates

• Study Start (Actual): July 25, 2024
• Primary Completion (Actual): November 26, 2024
• Study Completion (Actual): November 26, 2024

Study Registration Dates

• First Submitted: April 13, 2026
• First Submitted That Met QC Criteria: April 28, 2026
• First Posted (Actual): May 4, 2026

Study Record Updates

• Last Update Posted (Actual): May 4, 2026
• Last Update Submitted That Met QC Criteria: April 28, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: music; singing; small airways disease
• Additional Relevant MeSH Terms: Pathologic Processes; Chronic Disease; Disease Attributes; Respiratory Tract Diseases; Lung Diseases; Lung Diseases, Obstructive; Pathological Conditions, Signs and Symptoms; Pulmonary Disease, Chronic Obstructive
• Other Study ID Numbers: STUDY00160422

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: Data from this feasibility pilot may be shared upon reasonable request.

Drug and device information, study documents

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