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ORIGINAL RESEARCH article

Front. Physiol.
Sec. Exercise Physiology
Volume 15 - 2024 | doi: 10.3389/fphys.2024.1496243
This article is part of the Research Topic Biomechanical Performance and Relevant Mechanism of Physical Medicine and Rehabilitation for Neuromusculoskeletal Disorders, Volume II View all 9 articles

Optimal Vocal Therapy for Respiratory Muscle Activation in Patients with COPD: Effects of Loudness, Pitch, and Vowels

Provisionally accepted
Zhengtong Qiao Zhengtong Qiao 1Ziwei Kou Ziwei Kou 2Jiazhen Zhang Jiazhen Zhang 3Lv Daozheng Lv Daozheng 1Dongpan Li Dongpan Li 4Xuefen Cui Xuefen Cui 4Kai Liu Kai Liu 4*
  • 1 Binzhou Medical University, Binzhou, Shandong Province, China
  • 2 Qingdao University, Qingdao, Shandong Province, China
  • 3 Shandong Sport University, Jinan, Shandong Province, China
  • 4 Qingdao Municipal Hospital, Qingdao, China

The final, formatted version of the article will be published soon.

    Background: Vocal therapy, such as singing training, is an increasingly popular pulmonary rehabilitation program that has improved respiratory muscle status in patients with chronic obstructive pulmonary disease (COPD). However, variations in singing treatment protocols have led to inconsistent clinical outcomes.Objective: This study aims to explore the content of vocalization training for patients with COPD by observing differences in respiratory muscle activation across different vocalization tasks.Methods: All participants underwent measurement of surface electromyography (sEMG) activity from the sternocleidomastoid (SCM), parasternal intercostal muscle (PARA), seventh intercostal muscle (7thIC), and rectus abdominis (RA) during the production of the vowels /a/, /i/, and /u/ at varying pitches (comfortable, +6 semitones) and loudness (-10 dB, +10 dB) levels. The Visual Analog Scale (VAS) was used to evaluate the condition of patients concerning vocalization, while the Borg-CR10 breathlessness scale was utilized to gauge the level of dyspnea following the task. Repeated-measure (RM) ANOVA was utilized to analyze the EMG data of respiratory muscles and the Borg scale across different tasks.Results: Forty-one patients completed the experiment. Neural respiratory drive (NRD) in the SCM muscle did not significantly increase at high loudness levels (VAS 7-8) compared with that at low loudness levels (F (2, 120) = 1.548, P = 0.276). However, NRD in the PARA muscle (F (2, 120) = 55.27, P<0.001), the 7thIC muscle (F (2, 120) = 59.08, P < 0.001), and the RA muscle (F (2, 120) = 39.56, P < 0.001) were significantly higher at high loudness compared with that at low loudness (VAS 2-3). Intercostal and abdominal muscle activation states were negatively correlated with maximal expiratory pressure (r = -0.671, P < 0.001) and inspiratory pressure (r = -0.671, P < 0.001) in the same loudness.In contrast to pitch or vowel, vocal loudness emerges as a critical factor for vocalization training in patients with COPD. Higher pitch and loudness produced more dyspnea than lower pitch and loudness. In addition, maximal expiratory/inspiratory pressure was negatively correlated with respiratory muscle NRD in the same loudness vocalization task.

    Keywords: chronic obstructive pulmonary disease, vocalization training, Neural respiratory drive, Respiratory muscle, Surface electromyographic

    Received: 14 Sep 2024; Accepted: 25 Oct 2024.

    Copyright: © 2024 Qiao, Kou, Zhang, Daozheng, Li, Cui and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Kai Liu, Qingdao Municipal Hospital, Qingdao, China

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