An online breathing programme that uses singing techniques and has been developed by the English National Opera, can significantly improve quality of life and breathlessness for people with long Covid, according to the results of the first clinical trial.
The programme, developed with Imperial College Healthcare NHS Trust, is led by professional singers from the ENO and focuses on breathing retraining through singing techniques, using lullabies as its musical starting point. No experience or interest in singing is required.
The trial had 150 participants who had suffered breathlessness for an average of 320 days since the onset of Covid symptoms.
It was found after those taking part in the breathing programme experienced a 10.48 point (out of 100) reduction in breathlessness while running, compared to people who just continued with usual care alone.
They also experienced a 2.42 point improvement in the mental component of quality of life, according to the study.
“Our study suggests that the improvements in symptoms experienced by participants, resulted from both practical breathing techniques learnt,” said Dr Keir Phillip, Clinical Research Fellow at the National Heart and Lung Institute at Imperial College London.
“It suggests that arts-in-health interventions can be effective tools for carefully selected participants, especially when successfully integrated with clinical services,” he said.
The ‘ENO Breathe’ programme, which involves doctors from Imperial College Healthcare NHS Trust, aims to improve wellbeing for patients with persistent breathlessness due to Covid.
It has been available free to people in London and across England since September 2020, in areas such as Blackpool, Peterborough, North Somerset, and Stoke on Trent. The Welsh National Opera is piloting a similar scheme in Wales.
Patients need to be referred from their NHS post-Covid assessment clinics. So it’s not available to everyone to do online, but if you are under the care of a post-Covid assessment clinic it may be something that would be suitable for you, the organisers say.
The six-week programme is delivered online, starting with a one-to-one session, once-weekly group sessions, and a range of online resources throughout the programme. To date, more than 1,000 people have accessed it.
Additional analyses focusing on participants who went to all the sessions, found improvements in a wider range of respiratory symptoms, anxiety, and had larger quality of life improvements.
For example, 40 per cent of participants experienced a five-point improvement in the mental component of quality of life, compared with 17 per cent in the usual care group. This suggests the participants who engaged most with the programme got the biggest benefit.
James Sanderson, chief executive of government body, The National Academy for Social Prescribing (NASP), which supported the project, said: “It is exciting to see clinical evidence published which demonstrates the effectiveness of a social prescribing programme…..ENO’s ‘Breathe’ classes are improving the lives of hundreds of people living with long COVID.”
Dr Harry Brunjes, Chair of the English National Opera, said: “Research like this demonstrates the enormous benefit the arts can have when applied in a medical context.”
Trial participants were all recovering from Covid with ongoing breathlessness, either with or without associated anxiety, and had been referred from post-Covid assessment clinics after appropriate investigations and treatment.
The majority of participants, 81 per cent, were female, which is broadly representative of the wider population of patients with long Covid.
Participants were split into two groups. One group of 74 people took part in the six-week ENO Breathe programme and a control group of 76 people continued with their usual care as directed by their post-COVID assessment clinic.
Both groups were assessed after six weeks, when the control group were then also offered the opportunity to take part in the programme.
The researchers collected information about participants’ health and wellbeing via online questionnaires, and used focus groups and feedback questions to assess participant experience.
They measured mental and physical components of a validated ‘Health-Related Quality of Life’ tool that assesses key indicators of quality of life, including difficulties resulting from health problems, social impacts, pain and impact on daily activities.
The researchers also assessed other disease impacts including breathlessness, anxiety, and a range of other symptoms.