Physiological demands of singing for lung health compared with treadmill walking

Keir Ej Philip, Adam Lewis, Sara C Buttery, Colm McCabe, Bishman Manivannan, Daisy Fancourt, Christopher M Orton, Michael I Polkey, Nicholas S Hopkinson, Keir Ej Philip, Adam Lewis, Sara C Buttery, Colm McCabe, Bishman Manivannan, Daisy Fancourt, Christopher M Orton, Michael I Polkey, Nicholas S Hopkinson

Abstract

Introduction: Participating in singing is considered to have a range of social and psychological benefits. However, the physiological demands of singing and its intensity as a physical activity are not well understood.

Methods: We compared cardiorespiratory parameters while completing components of Singing for Lung Health sessions, with treadmill walking at differing speeds (2, 4 and 6 km/hour).

Results: Eight healthy adults were included, none of whom reported regular participation in formal singing activities. Singing induced acute physiological responses that were consistent with moderate intensity activity (metabolic equivalents: median 4.12, IQR 2.72-4.78), with oxygen consumption, heart rate and volume per breath above those seen walking at 4 km/hour. Minute ventilation was higher during singing (median 22.42 L/min, IQR 16.83-30.54) than at rest (11 L/min, 9-13), lower than 6 km/hour walking (30.35 L/min, 26.94-41.11), but not statistically different from 2 km/hour (18.77 L/min, 16.89-21.35) or 4 km/hour (23.27 L/min, 20.09-26.37) walking.

Conclusions: Our findings suggest the acute metabolic demands of singing are comparable with walking at a moderately brisk pace, hence, physical effects may contribute to the health and well-being benefits attributed to singing participation. However, if physical training benefits result remains uncertain. Further research including different singing styles, singers and physical performance impacts when used as a training modality is encouraged.

Trial registration number: ClinicalTrials.gov registry (NCT04121351).

Keywords: COVID-19; exercise; lung physiology; pulmonary rehabilitation.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.

Figures

Figure 1
Figure 1
Protocol in brief.
Figure 2
Figure 2
Box and whisker plots of physiological parameters during each component of the protocol. For box and whisker plots, the line in the centre of the box represents the median, the box includes the first to third quartiles, the whiskers indicate upper and lower values (excluding outliers), the dots represent possible outliers. Friedman tests demonstrated that the protocol components included differences in all physiological parameters, p2, carbon dioxide; METs, metabolic equivalents; VE, minute ventilation; VO2, oxygen consumption.

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