Spotlight: Music as Medicine – SingStrong

ONE evening a couple of years ago I strolled into the Outback at Nancy Blake’s bar for the early (7-9pm) session to listen to one of my favourite Limerick bands, ‘Sidewinders’. A young woman stepped up to the microphone and I was captivated by her voice! Her name is Ciara Meade. Many will know her from her time as vocalist with ‘Funk Junkies’ and occasionally with ‘Trees Fall Down’.

Chime out

Ciara has been involved with a programme called ‘SingStrong’ which is a singing programme designed for people who suffer from Chronic Obstructive Pulmonary Disorder (COPD) and lung disease. COPD is estimated to affect up to 200,000 people in Ireland with some yet to be diagnosed. SingStrong was founded in 2019 by Ciara Meade, (singer/songwriter and vocal coach) together with Dr Rosin Cahalan (lecturer in pulmonary physiotherapy at UL). Apparently singing is a good respiratory exercise that has positive emotional and health benefits.

Ciara trades under the name ‘Chime Out’, her community music business. She is a song writing facilitator with the Irish Chamber Orchestra’s (ICO’s) Sing out with Strings programme, the learning hub Limerick and operates five choirs within schools and the community. One of those choirs is Chimers mental health choir, the first of its kind in Ireland where the participants are comprised of staff and service users of the mid-west mental health services in the HSE.

As a musician and singer Ciara is extremely interested in how the voice can be used as a tool for wellbeing and health within the community. She visits schools as a Singing and Song-writing tutor for the ICO under their community outreach programme Sing out with Strings.

Dr Roisin Cahalan, is a lecturer in respiratory and cardiovascular physiotherapy in the School of Allied Health, Faculty of Education and Health Sciences at the University of Limerick. She is also the Course Director for the MSc Physiotherapy (PQ) programme. Roisin was a professional Irish dancer in ‘Riverdance’ prior to her physiotherapy studies, performing as both troupe and lead female dancer. Her final year physiotherapy students have evaluated the SingStrong project in a research paper with very positive findings.

Training

Ciara went to Cardiff to receive training in singing for lung health as similar work was already being carried out to great success in the UK. As this was the first time such work was seen in Ireland the pair ran a number of sessions with three COPD support groups from Limerick, Clare and Tipperary over the course of 12 weeks from a research perspective. They tested the benefits of singing as an intervention for participant’s physical and emotional health and wellbeing by conducting tests before and after the course of singing classes. This culminated in a launch event at the Irish World Academy of Music at UL where all three groups sang together as a choir, led and conducted by Ciara Meade.

The course was a great success with 100 percent positive reaction from the participants claiming that the classes benefited their breathing as well as their physical and emotional health.

When covid began the groups were no longer able to meet face to face so SingStrong went online operating two Zoom classes a week to participants nationwide with the help of COPD Support Ireland and Menarini Pharmaceuticals. As the participants are part of the at risk group and have been cocooning throughout the pandemic these singing classes online have also offered a fantastic social outlet to them. When the singing part finishes the participants have time to stay on the call and chat, meeting new people from all over Ireland.

SingStrong is a great example of how the Arts can be beneficial within a health context – using singing as a tool to help patients with lung disease, which in turn boosts their physical and emotional health and wellbeing. Ciara is very positive about this project, “We hope to have SingStrong groups in every County in Ireland by the time the pandemic subsides” she says.

SingStrong has successfully delivered many online classes (several per week) during the covid crisis. Those involved are drawn from all over the country, with strong representation from existing COPD Support Ireland (CSI) members as well as individuals not affiliated with CSI. The majority of participants have a diagnosis of COPD, but a number have other lung conditions including cancer and Idiopathic Pulmonary Fibrosis (IPF). Currently SingStrong is running 4 classes per week, facilitating 120 participants.

The process

Each session begins with a mindfulness focus and physical and vocal warm-up. Vocal exercises then follows, and finally song practice. Song suggestions are frequently led by participants.

In the later weeks several participants perform solos, with many individuals claiming that they would not have been able to physically sing prior to the programme. Following the singing sessions, people are invited to stay on and engage with others in online meeting rooms. Uptake for this varies week to week, but typically about 25 percent of participants engage in this aspect of the sessions. “Initially people requested to join breakout rooms with their friends, but as people got to know each other, a more relaxed approach was adopted where people were happy to be randomly allocated to any group” says Ciara.

Positives

The feedback is very positive, in terms of both improvements in physical wellbeing and social benefits. Many people speak of how their breathing has improved, in particular their breathlessness and breathing control. People also commented on the community feel and psychosocial benefit derived, with participants stating that it brought great focus to their week and was something to look forward to. One participant, Louise Smith, says, “I couldn’t speak a full sentence but now I can sing a full song without a break. I was actually able to hold that note and such a joy it brought to me because I love to sing. In my youth I was able to sing. Now, because of SingStrong, I can sing again and it has brought joy, not only to me but to my family.” Sadly, Louise passed away in February, 2021 but clearly SingStrong had improved the quality of her in her final months.

Negatives

Unfortunately, due to variability in broadband speeds, synchronous singing was not really possible. Ciara explains, “Participants were muted for the vast majority of the sessions and only unmuted for the final section of songs. At first, this was a cacophony of voices, but participants got used to it. However, it did limit the ability of participants to sing along in harmony.

Plans

There is much enthusiasm to continue and grow SingStrong and they intend to return to classes (real, as distinct from virtual) as soon as possible. “Our hope is to continue with the existing groups and introduce more beginner classes as well” says Ciara.

SingStrong is working with COPD Support Ireland to host their videos on their website to allow people to access as needed. Recordings typically feature Ciara as instructor.

As covid restrictions are relaxed SingStrong would like its members to meet in person at a one-day event/conference with lunch, where they can sing together and get to network in person.

As part of the ongoing vision for the expansion of the programme they would also like to revisit a ‘Train the Trainer’ event to support SingStrong in COPD Support groups around the country. Meade will lead this training initiative. “Once things return to normal and people return to support groups in person, it would be preferable to have someone local who could build SingStrong in the local community” says Ciara. If this programme is to continue and expand further funding will be required. The total budget for all classes at existing numbers is approximately €3,000 – not a huge sum for such a worthy art/health programme with such positive outcomes.

Ciara wishes to express her gratitude to Menarini Pharmaceuticals and COPD support Ireland for funding classes. “The amount of joy and support that this programme has brought to so many people cannot be overstated” says Ciara.