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Adherence to singing training vs. physical training in COPD rehabilitation

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  • Mette Kaasgaard
  • Daniel Bech Rasmussen, University of Southern Denmark
  • ,
  • Karen Hjerrild Andreasson, University of Southern Denmark
  • ,
  • Anders Løkke, Lungemedicinsk Afd., Århus Universitetshospital, Aarhus University Hospital, Aarhus County Hospital, Hospital Little Belt, University of Southern Denmark, Denmark
  • Peter Vuust
  • Ole Hilberg
  • ,
  • Uffe Bodtger, Roskilde Hosp, Dept Resp & Internal Med, Næstved Sygehus, University of Southern Denmark, Univ Southern Denmark, University of Southern Denmark, Inst Reg Hlth Sci, University of Copenhagen, Sjællands Universitetshospital
Pulmonary rehabilitation (PR) is a cornerstone in COPD care, however, maintaining high adherence rates is challenging. In a multicenter, randomized, controlled trial (RCT), we demonstrated that singing training (ST) was as effective as standard physical training (PT) in PR in improving Six-Minute Walk Test (6MWT) and superior concerning quality of life. There is no knowledge about impact of adherence on change in 6MWT and St George’s Respiratory Questionnaire (SGRQ), or factors related to adherence. Thus, we performed Post hoc analyses of the RCT (effects of ST compared to PT in a 10 weeks’ PR programme in COPD). We did multivariable logistic regression analyses of 1) relationship between adherence (low: 0-49%; medium: 50-74%; high: 75-100%) and achieving clinically significant improvement of 6MWT (30 meters) and SGRQ score (4 units) from baseline to post-PR, and 2) factors related to medium or high adherence. We adjusted the regression models for training modality (ST or PT), baseline characteristics, COPD severity, and expectations towards singing. We included 270 patients in the RCT and found the proportions of patients with high adherence were similar between groups (ST: 60.7%; PT: 56.8%, p=0.90). Medium adherence and high adherence carried higher odds for improving 6MWT (medium: OR 5.6 [95%CI 1.4-22.4], p=0.02; high: OR 10.5 [3.0-36.6], p<0.001) and SGRQ (medium: OR 8.3 [2.1-32.7], p=0.003; high: OR 17.0 [4.9-58.3], p<0.001) (reference: low adherence) in the full sample. No single factor was related to adherence. We found positive dose-response relationships between adherence and improvements of 6MWT and SGRQ, and equal adherence in patients receiving singing training or physical training as part of PR.
Original languageEnglish
Publication year2021
Publication statusSubmitted - 2021
EventERS International Congress 2021 -
Duration: 4 Sep 20218 Sep 2021


ConferenceERS International Congress 2021

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