SingStrong-A singing and breathing retraining intervention for respiratory and other common symptoms of long COVID: A pilot study

Background: Management of Long COVID (LC) is hugely challenging for clinicians. This pilot study evaluated a breathing retraining and singing programme (SingStrong for LC) to address common LC symptoms. The study hypothesized that this intervention would improve symptoms impacting disordered breathing and participant wellbeing.Methods: The 10-week, bi-weekly online programme was comprised of a 45-min class of mindfulness, breathing retraining, vocal exercises, and singing. Sessions were recorded for non-attenders and conducted by a trained vocal coach experienced in respiratory cohorts. Persons with a confirmed COVID-19 diagnosis and persisting symptoms were invited to participate. Demographic and COVID-19 data were collected, and the DePaul Symptom Questionnaire Short Form (DSQ- SF) and COVID-19 Yorkshire Rehab Screen questionnaires were administered. Post-intervention focus groups were also conducted.Results: Of 27 (F = 23(85%)) participants recruited, data from 21 who completed at least 10 (50%) classes were analysed. Participants showed significant pre-post-intervention improvements in all breathlessness symptoms (at rest: P < 0.001; dressing: P = 0.01; stairs: P < 0.001), fatigue (P = 0.03), usual activities (P = 0.04), pain/disability (P = 0.03), voice quality (P = 0.01), and communication/cognition (P = 0.04). Pre-post number of instances meeting DSQ-SF criteria for myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) decreased by a net of nine cases (14.3%). No association between COVID-19 hospitalisation status and diagnosis of ME/CFS was identified. Qualitative feedback from eight participants was overwhelmingly positive with all reporting improvements in breathing and general well-being.Conclusion: The SingStrong programme shows promise as a viable treatment option for LC sufferers. Future studies are required to further investigate the efficacy of this intervention.