Why is this study being done? Chronic Obstructive Pulmonary Disease (COPD) causes airflow blockage creating breathing issues, distress, and lower well-being. COPD also causes hyperinflation of the lungs. The investigators are doing the study to learn more about improving lung function for patients with COPD by using voice-based experiences.

What is being tested in this study? If singing/vocalizing can improve lung function.

How long will I be in the study? The study will last 4 weeks and involve 2 in-person visits to KUMC with virtual vocal sessions two times a week over Zoom.

Study Significance: This study is intended to show if air trapping in functional small airways disease (fSAD) in COPD patients is reduced by a targeted music-based singing intervention.

Air trapping in fSAD in COPD is associated with the experience of breathlessness or dyspnea, which is a primary source of patient distress. Air trapping may be mitigated by activities that support slow, controlled, and more complete exhalation. Because singing requires sustained delivery of consistent air pressure for sound production, training in this activity aims to strengthen respiratory musculature to improve airflow control and increase efficient use of each breath. The investigators believe that singing training will be beneficial in strengthening the respiratory musculature and emptying the lungs, possibly reducing the amount of trapped air.

A major gap exists in understanding whether singing is effective for improving lung function in COPD. Previous interventions based in group singing have been focused on improving social and emotional outcomes, but they do not specifically address the potential physiological benefits of singing as described above. The investigators aim to show specific targeted manipulation of music elements within tailored vocalization activities can successfully improve lung function and reduce dyspnea in patients with COPD, while preserving social and emotional benefits of other more generalized singing interventions. The investigators are focusing on air trapping due to small airways disease as a key symptom that leads to patient experience of dyspnea.(13, 14) Other aspects of COPD pathology and symptoms may be improved by the singing intervention, including a sense of hope through a sense of agency in their own psychological health.

The goal of the pilot study is to determine the feasibility of providing a music-based intervention targeting the issue of air trapping, improve functional small airways disease, and improve other symptoms of COPD and further define the details of the intervention.

This study will determine participant acceptability of a newly developed music-based intervention hoped to be beneficial for people with COPD. If successful, our proposed singing intervention will improve lung function health through reduced air trapping due to hyperinflation, improve patient experience of dyspnea and foster positive psychological health.

Inclusion Criteria:

• Participants 18 years of age or older
• Diagnosis of COPD
• Airflow obstruction and resting hyperinflation of the lung
• Able to hear within normal range with correction if needed

Exclusion Criteria:

• Pregnancy will be excluded for CT imaging safety and radiation safety
• Alpha-1 antitrypsin

Data from this feasibility pilot may be shared upon reasonable request.