Group Singing for Hearing Loss

Recruiting at 8 trial locations

Overseen By Kay F Wright-Whyte, MSc

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Toronto Metropolitan University

Must not be taking: Anti-arrhythmics

Disqualifiers: Hearing aid use, Cognitive impairment, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 15

Duration: 12 weeks

210 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether group singing can help older adults hear better in noisy environments and improve their overall mood. It compares the effects of a 12-week group singing program with an audiobook club to determine which is more effective. The trial targets individuals aged 60 and older with mild to moderate hearing loss who do not use hearing aids or other listening devices. Participants will be randomly assigned to either the singing group or the audiobook group to compare outcomes. As an unphased trial, this study provides a unique opportunity to contribute to research that could enhance social and auditory experiences for older adults.

Will I have to stop taking my current medications?

The trial does not specify whether you need to stop taking your current medications, but you cannot use a pacemaker or take anti-arrhythmic medications.

What prior data suggests that group singing is safe for older adults with hearing loss?

Research has shown that group singing is generally safe and well-tolerated. Studies have found that joining a choir or singing in a group can improve hearing and even help with chronic pain. No major risks have been reported for group singing activities, as it is non-invasive and does not involve entering the body or causing harm.

Additionally, singing regularly can strengthen the muscles used for breathing and speaking, allowing people to sing longer without fatigue. Overall, evidence suggests that group singing is a safe and beneficial activity for improving hearing and overall well-being. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike the standard treatments for hearing loss, which typically involve hearing aids or cochlear implants, group singing offers a unique, non-invasive approach that engages participants in a social and auditory activity. Researchers are excited about this treatment because it could enhance auditory processing and social interaction skills, potentially offering benefits beyond traditional medical or technological interventions. This method taps into the brain's ability to adapt and reorganize itself through enjoyable, community-based activities, making it a promising alternative or complement to existing options.

What evidence suggests that group singing might be an effective treatment for hearing loss?

This trial will compare the effects of a group singing program with an audiobook club for older adults with hearing loss. Research has shown that group singing might help these individuals better understand speech in noisy environments. One study found that joining a choir for ten weeks improved older adults' ability to hear speech in such settings. Another study found that singing in a group can also enhance social and emotional well-being by fostering social connections. Participation in a community choir has been linked to better singing skills, such as improved pitch control. These findings suggest that group singing could be a promising way to enhance both hearing and social experiences for those with hearing loss. ^{6 7 8 9 10}

Who Is on the Research Team?

Frank Russo, PhD

Principal Investigator

Toronto Metropolitan University

Are You a Good Fit for This Trial?

This trial is for adults aged 60 and older with mild-to-moderate hearing loss who don't currently use a hearing aid or similar devices. They should be able to understand English, Dutch, or German depending on the study site location, have no significant cognitive issues (score ≥ 24 on MoCA-H), not use pacemakers or certain heart medications, and not be engaged in regular music learning or audiobook clubs.

Inclusion Criteria

I do not use a pacemaker or take heart rhythm medications.

I haven't been actively learning music or participating in audiobook clubs this past year.

Unaddressed hearing loss (participants must not currently use a hearing aid, cochlear implant, or assistive listening device)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Treatment

Participants are randomly assigned to either group singing or audiobook club intervention for a 12-week training period

12 weeks

12 visits (in-person, weekly)

Follow-up

Participants are monitored for speech-in-noise perception and psychosocial wellbeing after the intervention

4 weeks

2 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Group Singing

Trial Overview The study tests if group singing can improve speech-in-noise perception and psychosocial wellbeing in older adults with unaddressed hearing loss compared to an audiobook club control group. Participants will join one of these activities for 12 weeks, with their speech perception and wellbeing measured before and after this period.

How Is the Trial Designed?

Group I: Group Singing Experimental Treatment 1 Intervention

12 week group singing program consisting of 1.5 hours of in-person choir instruction per week.

Group II: Audiobook Club Active Control 1 Intervention

12 week group program consisting of 1.5 hours of in-person audiobook club discussion per week.

Who Is Running the Clinical Trial?

Toronto Metropolitan University

Lead Sponsor

Trials

95

Recruited

19,300+

University of Southern California

Collaborator

Trials

956

Recruited

1,609,000+

Flinders University

Collaborator

Trials

49

Recruited

142,000+

Concordia University, Montreal

Collaborator

Trials

30

Recruited

5,200+

University of Oldenburg

Collaborator

Trials

11

Recruited

4,200+

University of Nottingham

Collaborator

Trials

540

Recruited

2,317,000+

Memorial University of Newfoundland

Collaborator

Trials

73

Recruited

1,836,000+

University of Groningen

Collaborator

Trials

63

Recruited

119,000+

Bionics Institute

Collaborator

Trials

4

Recruited

230+

The Bionics Institute of Australia

Collaborator

Trials

10

Recruited

690+

Published Research Related to This Trial

A study involving 77 patients with functional voice disorders found that both individual and group voice therapy led to significant long-term improvements in voice quality and reduced voice-related handicap, as measured by the Voice Handicap Index (VHI) and other assessments.

Group therapy showed greater benefits over individual therapy, particularly in the physical aspects of voice handicap, suggesting that the group setting may enhance the application of voice techniques in everyday communication.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Voice Therapy Outcome-A Randomized Clinical Trial Comparing Individual Voice Therapy, Therapy in Group, and Controls Without Therapy. Ohlsson, AC., Dotevall, H., Gustavsson, I., et al.[2021]

A study involving 222 patients established that the Inner Effectiveness of Auditory Rehabilitation (Inner EAR) scale can effectively differentiate between normal hearing and varying degrees of hearing loss, with significant differences in scores across groups.

An Inner EAR score threshold of 50 was identified as a key value for distinguishing between normal hearing and both unilateral and bilateral hearing loss, which can aid in assessing the functional impact of hearing loss and responses to treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Normative Values for the Inner EAR Scale. Zhou, AS., Corrales, CE., Prince, A., et al.[2023]

In a study of 34 adult women with functional dysphonia, group voice therapy led to significant improvements in voice quality across multiple assessments, including perceptual, acoustic, and aerodynamic measures.

Participants also reported better self-perception of their voice fatigue, suggesting that group therapy not only enhances voice quality but may also improve patients' motivation and compliance with treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multidimensional Assessment of the Effectiveness of Group Voice Therapy. Cantarella, G., Torretta, S., Ferruta, S., et al.[2018]

In a study involving 15 participants with profound unilateral sensorineural hearing loss, the remote microphone intervention showed the best performance in speech recognition in noisy environments compared to other methods.

While participants did not significantly prefer one intervention over another based on questionnaires, 53% chose the CROS system as their preferred option, indicating a general trend towards favoring this method for managing their hearing loss.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Single-Sided Deafness-Outcomes of Three Interventions for Profound Unilateral Sensorineural Hearing Loss: A Randomized Clinical Trial. Fogels, J., Jönsson, R., Sadeghi, A., et al.[2021]

Participation in group audiologic rehabilitation classes significantly improved the use of communication strategies among adults with hearing loss, as reported by the majority of participants after attending six 90-minute classes.

Subjects who attended the classes with their significant others experienced the greatest reduction in hearing handicap, highlighting the importance of SO involvement in the rehabilitation process.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Should significant others be encouraged to join adult group audiologic rehabilitation classes? Preminger, JE.[2022]

A study involving 106 veterans showed that while hearing aids significantly improved self-perception of communication performance in both short- and long-term, there were no additional benefits from a counseling-oriented audiological rehabilitation (AR) program in the long run.

However, the AR program did provide short-term benefits in communication strategy usage, leading to better interaction and reaction scores, suggesting that it may help users adjust to hearing aids initially.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Short- and long-term outcomes of adult audiological rehabilitation. Chisolm, TH., Abrams, HB., McArdle, R.[2019]

A pilot study involving a group-based singing intervention for Parkinson's disease patients, consisting of twelve 90-minute sessions, showed no significant improvement in vocal loudness or other voice-related measures immediately after or 13 weeks post-intervention.

Secondary outcomes, including voice-related quality of life and voice handicap index, also did not show any significant changes, indicating that this specific singing therapy may not be an effective rehabilitation method for speech and voice impairments in Parkinson's disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Singing in groups for Parkinson's disease (SING-PD): a pilot study of group singing therapy for PD-related voice/speech disorders. Shih, LC., Piel, J., Warren, A., et al.[2012]

Group singing may help people with Parkinson's disease synchronize their movements to musical rhythms, potentially improving their motor skills and overall quality of life.

The practice is hypothesized to create feelings of connectedness and flow, which could enhance rhythmic entrainment during and after singing, leading to better emotional processing and reduced motor timing deficits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Conceptualizing how group singing may enhance quality of life with Parkinson's disease. Buetow, SA., Talmage, A., McCann, C., et al.[2014]

Group music therapy was offered to 225 patients with multiple sclerosis over 4-6 weeks, focusing on issues like disability, anxiety, and depression related to their condition.

The results indicate that group music therapy is beneficial for providing psychological support and enhancing individual coping strategies for patients with MS.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Group music therapy in multiple sclerosis: initial report of experience]. Lengdobler, H., Kiessling, WR.[2006]

A study involving 31 postlingually hearing-impaired adults showed that both hearing aid use and a counseling-based aural rehabilitation program significantly reduced self-perceived hearing handicap after 2 months.

Participants who received both hearing aids and counseling-based aural rehabilitation experienced a greater reduction in their hearing handicap compared to those who used hearing aids alone, suggesting that counseling may enhance the benefits of hearing aids.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of intervention strategy on self-perception of hearing handicap. Abrams, HB., Hnath-Chisolm, T., Guerreiro, SM., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6892838/

Short-Term Choir Singing Supports Speech-in-Noise ... The current study investigates whether 10 weeks of choir participation can improve aspects of auditory processing in older adults, particularly speech-in-noise ...

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0892199721002101

Perceptions of Vocal Performance Impairment in Singers ... This study investigates the effect of hearing loss on self-reported vocal production in singers, specifically in the domains of pitch matching, pitch ...

3. journals.plos.org journals.plos.org/plosone/article?id=10.1371/journal.pone.0314473

Speech-in-noise, psychosocial, and heart rate variability ... The strongest evidence that group singing enhances SIN for older adults with hearing loss, was a study involving a choir-singing group and ...

4. e-ceo.org e-ceo.org/journal/view.php?doi=10.21053/ceo.2023.00815

The Effects of Music-Based Auditory Training on Hearing ... The music-based auditory training resulted in a significant improvement in auditory function and a partial enhancement in cognitive ability ...

5. jvoice.org jvoice.org/article/S0892-1997(22)00391-5/fulltext

Community Choir Improves Vocal Production Measures in ... Results showed that group singing significantly improved some, though not all, measures of vocal production. Group singing improved lowest pitch ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6972717/

A systematic review on the effects of group singing on ... This systematic review assesses research evidence for the effectiveness of group singing on chronic pain in people with long‐term health conditions.

7. clinicaltrials.gov clinicaltrials.gov/study/NCT03604185

Effects of Short-term Choir Participation on Auditory ... It is hypothesized that musical training - in particular, group singing practice - will result in improved outcomes of auditory perceptual measures in hearing- ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S0892199725002462

Singing Voice Handicap Index: Research & Clinical Review Examine how hearing loss affects singers' vocal production, Higher SVHI-10 scores linked to hearing loss, age, and recent paid singing.

9. pubs.asha.org pubs.asha.org/doi/10.1044/2024_JSLHR-23-00641

Systematic Review: Singing-Based Interventions to ... Frequent singing training can strengthen the laryngeal and respiratory muscles and increase the fatigue resistance of the vocal structures ( ...

10. mdpi.com mdpi.com/2624-599X/6/4/57

Music Exposure & Hearing in Vocal Students This study aimed to assess the immediate and long-term effects of music and singing practice on the peripheral auditory system of vocal performers.