Neural Regeneration Research ›› 2022, Vol. 17 ›› Issue (5): 1065-1071.doi: 10.4103/1673-5374.324856

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Effect of vocal respiratory training on respiratory function and respiratory neural plasticity in patients with cervical spinal cord injury: a randomized controlled trial

Xiao-Ying Zhang1, 2, 3, 4, 5, #, Wei-Yong Yu1, 6, #, Wen-Jia Teng1, 2, 3, 4, Yi-Chuan Song1, 5, De-Gang Yang1, 7, Hong-Wei Liu1, 7, Song-Huai Liu1, 5, Xiao-Bing Li8, Wen-Zhu Wang1, 2, 3, 4, Jian-Jun Li1, 2, 3, 4, *   

  1. 1School of Rehabilitation Medicine, Capital Medical University, Beijing, China; 2China Rehabilitation Science Institute, Beijing, China; 3Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China; 4Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China; 5Music Therapy Center, Department of Psychology, China Rehabilitation Research Center, Beijing, China; 6Department of Imaging, China Rehabilitation Research Center, Beijing, China; 
    7Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China; 8Department of Music Artificial Intelligence and Music Scientific Technology, Central Conservatory of Music, Beijing, China
  • Online:2022-05-15 Published:2021-11-22
  • Contact: Jian-Jun Li, MD, crrclijj@163.com.
  • Supported by:
    This work was supported by Scientific Research Project of Establishment of the Winter Olympics Sports Injury Rehabilitation Diagnosis and Treatment System and Green Channel Demonstration of China, No. 2018YFF0301104 (to JJL);  China Rehabilitation Science Institute, No. 2020cz-10 (to WZW), and Scientific Research Foundation of China Rehabilitation Research Center, No. 2017zx-32 (to XYZ).

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Abstract: In previous studies, researchers have used singing to treat respiratory function in patients with spinal cord injury. However, few studies have examined the way in which vocal training affects respiratory neural plasticity in patients with spinal cord injury. Vocal respiratory training (VRT) is a type of vocal muscle-related treatment that is often a component of music therapy (MT) and focuses on strengthening respiratory muscles and improving lung function. In this randomized controlled study, we analyzed the therapeutic effects of VRT on respiratory dysfunction at 3 months after cervical spinal cord injury. Of an initial group of 37 patients, 26 completed the music therapy intervention, which comprised five 30-minute sessions per week for 12 weeks. The intervention group (n = 13) received VRT training delivered by professional certified music therapists. The control group (n = 13) received respiratory physical therapy delivered by professional physical therapists. Compared with the control group, we observed a substantial increase in respiratory function in the intervention group after the 12-week intervention. Further, the nerve fiber bundles in the respiratory center in the medulla exhibited a trend towards increased diversification, with an increased number, path length, thickness, and density of nerve fiber bundles. These findings provide strong evidence for the effect of music therapeutic VRT on neural plasticity. This study was approved by the Ethics Committee of China Rehabilitation Research Center (approval No. 2020-013-1) on April 1, 2020, and was registered with the Chinese Clinical Trial Registry (registration No. ChiCTR2000037871) on September 2, 2020. 

Key words: cervical spinal cord injury, music therapy, neural plasticity, respiratory center, respiratory function, vocal respiratory training

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