DOI Number: 10.5958/j.0973-5674.7.2.

001

Immediate effect of Singing on Autonomic Functions and

Pulmonary Function Parameters in School Going Classical
Singers and Non Singers - An Observational Study

Anjali Kulkarni1, Ganesh B R2, Renu Pattanshetty3

1
Post Graduate Student, Department of Cardio Respiratory Physiotherapy, 2Associate Professor, 3Assistant Professor
K.L.E Institute of Physiotherapy, Belgaum, Karnataka

ABSTRACT

AIM: This study aimed to find the immediate effect of singing on autonomic functions and pulmonary
functions parameters in school classical singers.

Objectives:

1) To compare the autonomic and pulmonary functions in children singers before and after the singing
class.

2) To compare the differences in autonomic and pulmonary functions in children singers with non
singers of the same age group.

Material and Method: A total of 20 healthy children of age group 9 to 12 years were included in the
study. Autonomic parameters were assessed and pulmonary function tests were performed before and
immediately after singing in singers. The data was compared with the non singing group who were not
habitual singers.

Results: The data was analyzed using SPSS (windows version 13.0) both age and gender was well
matched in both the groups. The PEFR (peak expiratory flow rate) showed statistically significance
(p = 0.05) between both the groups. Results within the group demonstrated statistically significant in
FEV1 (force expiratory volume in one second) (p=0.004) and PEFR (p = < .001)

Conclusion: The results of present study demonstrated significant difference in FEV1 and PEFR in
singing group immediately after singing and better PEFR in the singing group was found when compared
to non singing group.

Keywords: Pulmonary Functions, Autonomic Functions, Classical Singing

INTRODUCTION paralinguistic features, and expressive markings such

as dynamic variations. While respiration is an
Respiration is an essential physical function in
automatic process controlled by the respiratory centre
classical singing. Sound is produced by repetitive
of the nervous system, the rate, depth and rhythm of
compression and decompression of inhaled air above
breathing can be modified unconsciously by mental
the glottis and through resonance and filtering in the
emotions or consciously by different breathing patterns.
vocal tract. The expressive elements that make classical
Both processes are non linguistic methods with which
singing performance interesting are closely linked with
a singer is able to communicate the expressive musical
the respiratory mechanism. Recent research has
intention of a vocal composition. As such, they may be
demonstrated that emotional stimulus and expressive
used as devices to reveal emotional subtexts and the
markings have an impact on respiratory patterns
expressive intentionality of the vocal performance.2
during singing.1
Singing is an activity with physiological
Respiratory regulation relates directly to the effective
implications. Within reasonable time, many or all
execution of expressive components of singing
aspects of human physiology while singing may be
performance, including timbral variations,
examined. Thoracic pressures created during the

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 2 Indian Journal of Physiotherapy & Occupational Therapy. April-June 2013, Vol.7, No. 2

singing process could produce increased levels of function parameters in school going children who are
pressure within the cardiovascular system and jugular involved in classical singing and to compare the values
venous distention could occur. Brown reports that by with non singers.
closing the mouth and nose and making a forcible
expiratory effort that it tended to inflate the Eustachian SUBJECTS AND METHOD
tube and to increase the intra thoracic pressure and
thus to check the return flow of blood which is Participants
manifested by engorged veins in the neck.3 A total of 20 children age group of 9 to 12 years who
Singing requires exquisite coordination between were healthy and who were attending regular singing
the respiratory and phonatory system to efficiently classes in K.L.E. school of music were included in Group
control glottal airflow. It is determined that both A after obtaining written permission from the principal
pulmonary function and vocal aerodynamics in school of music and K.L.E University Ethical Review
classically trained professional singers had a difference board and Healthy children who were not even
in pulmonary functions when compared to normal habitual singers in Group B. Children who were
individuals.4 suffering from any illness and who did not meet
inclusion criteria were excluded. This study was a
The singer’s respiration can be used as a variable observational study to assess the changes in autonomic
with which to measure and examine embodied and respiratory function parameters in school going
expression and the communication of emotional and singers and non singers of the same age.
musical intentions. Respiration can be seen as a
measure of corporeal intention and can potentially be As shown in TABLE-1, Participants had a mean age
used to quantify mutually adaptive behavioural of 10.2±1.55 in Group A and 10.7±1.33 in Group B and
resonances between musicians and audiences, as a Body mass index of 11.73±2.94 kg/m2 in Group A
articulated through the expressive intentions of the and 12.27±1.71kg/m2 in Group B.
singer. This is defined as non linguistic, bodily TABLE 1. Demographic Data
communication that creates shared intention, and
GROUPS AGE(yrs) Wt (kg’s) Ht (cm’s) BMI(kg/m2)
which is responsible for the feeling of being unified
SINGERS 10.2±1.55 31.7±8.58 131.9±11.05 11.73±2.94
with other people.5
NON SINGERS 11.7±1.33 30.2±5.33 130±6.05 12.27±1.71

Respiration for classical singing has been found to • BMI-Body Mass Index
differ from normal respiration in several significant
ways. The respiratory system and performance habits Study Protocol and Out Come Measures
of the singer affect phonation, intensity, acoustic
The Children of K.L.E School OF Music were
features, and muscular strategies used during singing.
assessed before and after their singing class of 45
Respiration in vocal students has been found to change
minutes for their Autonomic Functions and Respiratory
significantly between study semesters with both
Functions parameters which included Blood Pressure
increases and decreases in rib cage and abdominal
and Pulse Rate and FEV1 ( Force expiratory volume in
excursions during vocal training.6
one second) , FVC(Force Vital Capacity) , FEV1/FVC and
There are previous studies on effect of singing on PEFR(Peak Expiratory Flow Rate) respectively.
pulmonary function parameters and autonomic
Children who were not involved in any singing
functions , but however there is sparse in studies which
activity were assessed for both Autonomic Functions
shows effect of singing in children singers who are
and Respiratory Functions parameters.
trained in Indian classical singing on pulmonary
function parameters (FEV1,FVC , FEV1/FVC and PEFR) FEV1, FVC, FEV1/FVC were assessed by a hand held
and autonomic function parameters (B.P and Pulse Spirometer (VITALOGRAPH, ENNIS, IRELAND, model:
Rate) 4000) and PEFR was also assessed by a hand held
instrument showing the flow rate of expiration.
So, this study was aimed to find the immediate effect
(Spir-o-flow, peak flow pocket monitor).
of singing on autonomic functions and pulmonary

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 Indian Journal of Physiotherapy & Occupational Therapy. April-June 2013, Vol. 7, No. 2 3

Blood pressure was assessed manually by RESULTS

sphygmomanometer with the cuff placed on arms of
the children with brachial artery as the auscultation In both the groups age and gender were well
artery. Pulse rate was also measured manually by matched. In TABLE-2 the values show a statistically
placing the fingers on radial artery on the wrist of the significant difference with in the singing group before
children. and after singing in FEV1 (p=0.05) and in PEFR (P=.001).
Children had improvement in forced expiratory volume
DATA ANALYSIS
per second and peak expiratory flow rate after the
The Data was analyised using SPSS (windows singing class of 45 minutes when compared to before
version 13.0). The Fisher Exact Test was used to singing values.
determine p value and paired t test was used to compare
the difference between the groups.
Table 2. Comparision of Autonomic Functions and Respiratory Function Parameters in
Singing Group Before and After Singing
Singing Group S.B.P(mm/hg) D.B.P (mm/hg) P.R (b/min) FEV1 (%) FVC (%) FEV1/FVC (%) PEFR (%)
PRE 121.5±15.9 85.4±9.39 82.2±6.74 65.3±15.6 74.9±14.6 0.88±.16 164.5±34.0
POST 116±8.43 82±13.16 78.5±3.86 75.4±10.7 83.3±9.52 0.88±0.23 229±35.41
DIFFERENCE 5.5±14.23 3.4±8.75 3.7±7.64 10.1±13.8 8.4±13.54 0.08±.17 64.5±29.10
P Value .253 .251 .160 0.05 .081 .187 < .001

• FEV1 and PEFR.SBP-Systolic blood pressure, DBP-
Diastolic blood pressure FEV1-Force Expiratory
Volume per Second, FVC- Force vital capacity, PEFR-
Peak Expiratory Flow Rate.
In TABLE. 3 values show that there was a significant
difference in PEFR (Peak Expiratory Flow Rate) between
the groups (p=0.05). Children in Group A (singers) had
better PEFR measurement when compared to Group B
(Non singers).
Groups did not demonstrate any statistically
significant results in autonomic functions both before
and after singing in Group A and in between the groups
Group A and Group B.

Table 3. Comparision of Autonomic Functions and Respiratory Function

Parameters in between the Singing and Non Singing Group
Groups S.B.P (mm/hg) D.B.P (mm/hg) P.R (b/min) FEV1 (%) FVC (%) FEV1/FVC(%) PEFR (%)
SINGERS 121.5±15.99 85.4±9.39 82.2±6.74 65.3±15.64 74.9±14.99 .88±.16 164.5±34.03
NON SINGERS 117.5±7.90 84.5±4.97 82.8±4.48 72.7±5.48 78.3±6.44 .92±.03 192±25.29
P VALUE .487 .792 .824 .179 .511 .391 .055

• SBP-Systolic blood pressure, DBP-Diastolic group who were not even habitual singers.This study
blood pressure, FEV1-Force Expiratory Volume per demonstrated the difference in respiratory functions in
Second, FVC- Force vital capacity, PEFR-Peak Expiratory singers before and after singing and also when
Flow Rate compared to non singers.

DISCUSSION Collyer et al. (2009) found that instructions received

The chief objective of the study was to investigate
the immediate effect of singing on autonomic functions
and pulmonary function parameters in school going
classical singers and non singers. The study undertaken
included a total of 20 healthy children of age group 9 to
12 years were included in the study. Autonomic
parameters were assessed and pulmonary function tests
were performed before and immediately after singing
in singers. The data was compared with the non singing
during singing made significant differences in
respiratory patterns. He proposed that these findings
may suggest the differences in a technical and
performance oriented instructions. Changing
respiratory patterns could, therefore, one measure of
embodied music cognition when examining emotional
connectivity and interpersonal communication during
singing performance.7 This study has similar findings
with the present study’s conclusion that respiratory
patterns are effected after singing in singers.(p=<0.001)

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 4 Indian Journal of Physiotherapy & Occupational Therapy. April-June 2013, Vol.7, No. 2
In a previous study done by Foulds Elliot et al (2004),
identified a significant difference in the sound pressure
level, as well as time taken on inhalation and exhalation
in the rehearsal and performance environments for
classical singers. Subject demonstrated a higher lung
volume and utilized more air when having an emotional
connection to the sound. In the present study also there
were respiratory effects found in singing group.
However, instructions to sing with support did not
produce significant differences in lung onset volume.8
In a study done by Katty Kochman et al who
investigated effect of respiration in operatic singing
concluded that technically classical singers are trained
in respiratory production in order to efficiently develop
their natural instrument and to maintain good tone,
phrasing and expression.1
The study done by Peterson et al (2009) investigated
the effects of emotional stimulus on respiratory patterns
involving inter-costal and abdominal muscular
activation. This study found that emotional stimulus
resulted in an increased contribution from the lower
lateral abdomen, lower thorax and abdomen, as well
as less contribution from the anterior abdominal
muscles during phonation.9 Thus this study shows
similarity to the findings of the present study that
singers have an effect on respiratory functions.(p=0.05)
Kimberly Jaye et al studied blood pressure changes
in four normotensive classically trained singers of
varying age and experience. The results showed
changes during the systolic and diastolic phases of B.P
readings while singing.4 However the present study
did not demonstrate any significant changes in
autonomic function parameters that is systolic blood
pressure and diastolic blood pressure (p=0.253 and
p=0.251 respectively).
Schutte, (1984) proposed that one characteristic that
singers vary subglottal pressure not only with vocal
loudness but also with pitch. As a consequence, singers
have to constantly change their subglottal pressure,
carefully tuning it to the pitch of the tone sung.10
Sundberg et al (2000) stated that the tone following
the top pitch was produced with the highest pressure.
This would reflect the singer’s need to tailor subglottal
pressure according to both pitch and loudness
suggesting that the diaphragm is used for reducing
subglottal pressure at high lung volumes, when the
elastic recoil forces produced a pressure exceeding the
target pressure.11
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Thomason & Sundberg (1996) found that lung
volume or, more specifically diaphragm position affects
glottal adduction and hence the voice source. If this
were correct, it would be important for singers to adopt
a systematic breathing behaviour, void of random
variation. They also found that the effect of lung volume
on phonation was nearly nil in professional operatic
singers.12 This study findings can be correlated with
the present study findings that respiratory functions
are altered in the singers after singing.
Chul Min Ahn et al have done a study on both
pulmonary function and vocal aerodynamics in
classically trained professional singers and compares
the data obtained from singers with normal female
subjects who had no professional vocal training
respiratory muscle power was strengthened in singers
compared to non-singers, the data showed the
increased MIP (maximum inspiratory pressure) and
MEP (maximum expiratory pressure) ,
higher maximum phonation time and lower phonation
quotient in singers than do the non singers, while no
differences were found in vital capacity between the
groups.4
A study done by Irons JY et al (2010) to know the
effect of singing as a therapy for children and adults
with bronchiectasis concluded that therapies which
include breathing maneuvers, such as singing, may
have health benefits for respiratory function and
psychological well being.13
K.Price studied the effect of Vocal exercises on the
lung function on ten trained female singers concluded
that the vocal exercises are most likely to increase the
power of inspiratory muscles, greater muscular
coordination, strength and endurance of expiratory
muscles in singers.14
The study done by R.Leanderson on role of
diaphragmatic activity during singing in four male
professional singers performing singing tasks requiring
rapid changes of sub glottal pressure provided evidence
for a consistent use of the diaphragm in all
subjects.Some subjects punctually activate the
diaphragm when there is a need for a rapid decrease of
sub glottal pressure such as when singing a falling
octave interval, when shifting from a loud to a soft note,
to save air during explosion, and in performing a trillo
involving a repeated switching between glottal
adduction and abduction.15 Thus thiatiis supports the
present study that there is a variation in respiration in
singers.
 Indian Journal of Physiotherapy & Occupational Therapy. April-June 2013, Vol. 7, No. 2 5
The above studies have described the effect of
phonation on respiratory muscles and vice versa with
the subjects of adult age group but in this study the
study subjects were of pediatric age group getting
trained in Indian classical singing. These subjects were
assessed for both autonomic and respiratory function
parameters before and after singing class and then the
values were compared to non singers group of same
age children. There is a gap of research in such
population of singers.
CONCLUSION
As there are large studies done on adult age group
and less studies on Indian classical studies and few
studies on children classical children singers this study
gives a future scope of study on training the singers for
proper breathing manoeuvres involved in Indian
classical singing..The study showed difference in
respiratory function parameters FEV1 and PEFR in
singing group immediately after singing and better
PEFR in the singing group was found when compared
to non singing group , showing a strong expiration
maneuver in singers.
IMPLICATION
As there is an improvement in expiration the
classical singing may be used as an Intervention
incorporating asthma children where there is a
compromised expiration and as there is better
respiratory function in singers than in non singers it
can be stated that giving breathing exercises like
glossopharyngeal breathing exercises may help in
improving the phonation in children Indian classical
singers.
LIMITATIONS: Future study has to be carried out
in a larger sample size with a valid and realiable
spirometer to measure pulmonary functions.
REFRENCES
1. Katty Kochman, Michiel Demey, Dirk Moelants,
and Marc Leman, A case-study investigation of
respiration in operatic singing:An
implementation of research design and
applications journal of interdisciplinary music
studies spring 2011, volume 5, issue 1, art. #
11050103, pp. 41-55.
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2. Katty Kochman; Respiration as an Emotional Tool
in Operatic Singing. Proceedings CIM 10,
Sheffield, UK, FEB 2011.
3. kimberly jaye broadwater studied the effects of
singing on blood pressure in classically trained
singers a monograph submitted to the graduate
faculty of the louisiana state university in 2002.
4. Chul Min Ahn, MD studied Pulmonary Function
and Vocal Aerodynamics of Female Professional
Sopranos and Nonsingers ; chest (Americans
college of chest physicians) 2004.
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11. Sundberg J (2000). Grouping and
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