Group Singing for Hearing Loss

Recruiting at 6 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

Trial Summary

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 data supports the effectiveness of the treatment Group Singing for Hearing Loss?

Research shows that participating in group audiologic rehabilitation classes, which include communication strategies and auditory training, can help people with hearing loss use communication strategies more effectively and feel less handicapped by their hearing loss. This suggests that group activities like singing, which also involve auditory and vocal training, might offer similar benefits. ^{1 2 3 4 5}

How is group singing treatment different from other treatments for hearing loss?

Group singing treatment is unique because it uses music and singing in a group setting to potentially improve hearing and communication skills, unlike traditional treatments that might focus on medical or technological interventions. This approach may enhance social interaction and quality of life by engaging participants in a communal and enjoyable activity. ^{6 7 8 9 10}

What is the purpose of this trial?

Unaddressed age-related hearing loss is highly prevalent among older adults, typified by negative consequences for speech-in-noise perception and psychosocial wellbeing. There is promising evidence that group singing may enhance speech-in-noise perception and psychosocial wellbeing. However, there is a lack of robust evidence, primarily due to the literature being based on small sample sizes, single site studies, and a lack of randomized controlled trials. Hence, to address these concerns, this SingWell Project study utilizes an appropriate sample size, multisite, randomized controlled trial approach, with a robust preplanned statistical analysis. The objective of the study is to explore if group singing may improve speech-in-noise perception and psychosocial wellbeing for older adults with unaddressed hearing loss. The investigators designed an international, multisite, randomized controlled trial to explore the benefits of group singing for adults aged 60 years and older with unaddressed hearing loss. After undergoing an eligibility screening process and completing an information and consent form, the investigators intend to recruit 210 participants that will be randomly assigned to either group singing or an audiobook club (control group) intervention for a training period of 12-weeks. The study has multiple timepoints for testing, that are broadly categorized as macro (i.e., pre- and post-measures across the 12-weeks), or micro timepoints (i.e., pre- and post-measures across a weekly training session). Macro measures include behavioural measures of speech and music perception, and psychosocial questionnaires. Micro measures include psychosocial questionnaires and heart-rate variability. The investigators hypothesize that group singing may be effective at improving speech perception and psychosocial outcomes for older adults with unaddressed hearing loss-more so than participants in the control group.

Research Team

Frank Russo, PhD

Principal Investigator

Toronto Metropolitan University

Eligibility Criteria

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

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)

Treatment Details

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.

Participant Groups

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+

Findings from Research

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 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]

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 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]

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 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]

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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

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

2. United States pubmed.ncbi.nlm.nih.gov

Short- and long-term outcomes of adult audiological rehabilitation. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

The effects of intervention strategy on self-perception of hearing handicap. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Normative Values for the Inner EAR Scale. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Single-Sided Deafness-Outcomes of Three Interventions for Profound Unilateral Sensorineural Hearing Loss: A Randomized Clinical Trial. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Voice Therapy Outcome-A Randomized Clinical Trial Comparing Individual Voice Therapy, Therapy in Group, and Controls Without Therapy. [2021]

7. England 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. [2012]

8. England pubmed.ncbi.nlm.nih.gov

Conceptualizing how group singing may enhance quality of life with Parkinson's disease. [2014]

9. United States pubmed.ncbi.nlm.nih.gov

Multidimensional Assessment of the Effectiveness of Group Voice Therapy. [2018]

10. Germany pubmed.ncbi.nlm.nih.gov

[Group music therapy in multiple sclerosis: initial report of experience]. [2006]