Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 1, 2025
Date Accepted: Mar 24, 2026
Smartphone App-based Music-Facilitated Pulmonary Rehabilitation Integrating Rhythm-Guided Walking and Singing for Patients with Chronic Obstructive Pulmonary Disease: A Multicenter Randomized Controlled Trial
ABSTRACT
Background:
Pulmonary rehabilitation (PR) is a cornerstone for chronic obstructive pulmonary disease (COPD) management but is underutilized. Music has been recognized for its physiological and psychological benefits, potentially bridging this gap.
Objective:
This study investigated the efficacy of smartphone application-based music-facilitated multicomponent PR on exercise capacity in COPD patients.
Methods:
A three-arm, parallel-group, multicenter randomized controlled trial was conducted in China. Patients with stable COPD were recruited and randomly assigned to three groups: multi-module training (MT) (including both rhythm-guided walking and singing training), rhythm-guided walking (RW) alone, or usual care (UC). Patients in the MT and RW received 12-week online home-based training. The primary outcome was the distance achieved in the incremental shuttle walking test (ISWT) at 12 weeks. Secondary outcomes included dyspnea, quality of life, and pulmonary function.
Results:
70 participants were included in the modified intention-to-treat analysis. At 12 weeks, the ISWT distances significantly differed between the MT and the UC , favoring the MT (mean difference: 56.35 m; 95% CI: 6.66 to 106.04 m; p = 0.03). The mMRC, CAT, HADS-Anxiety score and inspiratory capacity also improved significantly in the MT compared with the UC. Compared with the RW, MT was significantly better in decreasing the mMRC score. These differences were not observed between the RW and the UC.
Conclusions:
Music-facilitated home-based multicomponent PR, involving rhythm-guided walking and singing, significantly improved exercise capacity, dyspnea, and psychological health of COPD at 12 weeks. Clinical Trial: NCT05832814
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