Objective: To assess the effects of weekly group singing on PD patients’ objective vocal and motoric function, cognition, mood, self-efficacy and quality of life.

Background: PD frequently causes communication difficulties due to several voice impairments. There are few treatment options for vocal/communication complaints. Accessible rehabilitative therapies that encourage active participation and promote socialization may be self-reinforcing, potentially improving voice volume and quality of life.

Methods: In a randomized controlled comparative effectiveness study, 32 participants were assigned to either a singing group or facilitated discussion weekly over 12 weeks. After 12 weeks, participants crossed over for an additional 12 weeks. Evaluations were performed at baseline and every 6 weeks for 30 weeks. Objective voice measures included loudness (decibels), held vowel duration, jitter, shimmer, and harmonic-to-noise ratio. Additional outcome measures included patient-centered quality of life, voice-related quality of life, MDS-UPDRS  scores,  Montreal Cognitive Assessment, and subjective scales of depression, self-efficacy and overall well-being. Group means were compared using repeated measures ANOVA, and linear mixed models were used to assess changes in variables over time controlling for age, gender and PD stage.

Results: Twenty-six patients (16M/10F; Hoehn&Yahr stage 2.3(2-3); Age 68.6(55-89)) completed the study. There was significant improvement from baseline in average loudness on the Cookie theft picture description(2.06 dB) at 24 weeks as well as decreased volume range at 30 weeks(7.7 dB), corresponding with improved minimal reading volumes at 24 weeks (4.4 dB) and 30 weeks (8.1dB). Similarly, there were significant decreases in the volume range (4.9dB at 24 weeks, 8.8dB at 30 weeks) and improvements in minimal loudness on Rainbow passage reading at 24 (4.3dB) and 30 weeks (7.2dB) for both). Participants also improved on the MDS-UPDRS Motor scale between baseline and 24 (5.9 points) and 30-week visits(8.4), regardless of intervention order.

Conclusions: Weekly group singing is a feasible intervention that may improve some aspects of conversational voice volume in PD. Some improvements were sustained at least 6 weeks after interventions ended. Further investigations of the mechanism of benefit and longitudinal effects of singing in PD are necessary.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsonics-a-prospective-randomized-blinded-cross-over-trial-of-group-singing-for-motor-and-non-motor-symptoms-in-idiopathic-parkinson-disease-pd/