Music Therapy in Adults With COPD

The Application of Self-Made Disseminating and Descending Breathing Exercises in Home Rehabilitation of Stable COPD

To investigate the clinical effects and application value of self-made disseminating and descending breathing exercises on home rehabilitation of patients with stable chronic obstructive pulmonary disease (COPD). Seeking to generate concepts for creating novel, convenient, and efficient COPD prognosis rehabilitation exercises aimed at enhancing the well-being and rehabilitation confidence of both COPD patients and their families. A total of 70 COPD patients admitted to our outpatient department from July 2019 to September 2021 were randomly divided into the exercise group (n = 35) and the control group (n = 35). The control group received routine breathing training, while the exercise group was treated with self-made disseminating and descending breathing exercises. The respiratory function, including pulmonary function (FVC, FEV1, FEV1/FVC) and respiratory muscle strength (MIP, MEP), exercise tolerance (6-min walking distance, 6MWT), Modified Medical Research Council Dyspnea Scale (mMRC, Borg), COPD quality of life score (CAT, SGRQ), anxiety and depression scores (HAMA, HAMD) were compared between the two groups after 12-week exercise. After 12-week training, the FEV1, MIP, and MEP in the exercise group were significantly higher than those in the control group (p < 0.001), and the 6MWT was significantly increased in the exercise group compared to the control group (p < 0.001); while the mMRC, Borg score, the scores of CAT, SGRQ, HAMA, and HAMD were found significantly lower than those in the control group (p < 0.001). The self-made disseminating and descending breathing exercises can improve respiratory function and reduce symptoms of dyspnea in COPD patients, while enhancing exercise tolerance and relieving anxiety and depression, and are worthy of clinical application.

Effects of a choral program combining wind instrument performance and breathing training on respiratory function, stress, and quality of life in adolescents: A randomized controlled trial

BACKGROUND

Choral activities are correlated with various health and wellbeing parameters. However, an intervention combining a music program using wind instruments and choral activities has not yet been investigated. Thus, this study aimed to assess the effects of a 12-week intervention combining a wind instrument performance program and a choral program on stress factors, quality of life, and respiratory function in adolescents located in a metropolitan city with exposure to air pollution.

METHOD

This randomized controlled trial consisted of 50 adolescents, and the subjects were randomly assigned to a combination wind instrument and choral training group, a choral training group, and a control group. Following a 12-week intervention program, respiratory function, stress factors, and quality of life were compared between the three groups.

RESULTS

Regarding respiratory function, with the exception of maximal inspiratory pressure, all measured variables exhibited an interaction to indicate a variation in the pattern of change(p<0.05). Furthermore, regarding stress factors and quality of life, all measured variables exhibited an interaction to indicate a variation in the pattern of change(p<0.05). As a result of the post-hoc analysis, significant differences were found in all variables in experimental group 1 compared to other groups (p<0.05).

CONCLUSION

The results showed that the 12-week intervention combining a wind instrument performance program and a choral program had positive effects in improving the respiratory function, stress factors, and quality of life in adolescents. This study findings are expected to support future studies aimed at promoting overall health including respiratory function and psychological factors through various music-based programs.

Music Therapy Intervention to Reduce Symptom Burden in Hospice Patients: A Descriptive Study

Background: Music therapy (MT) offers benefits of improved symptom relief and quality of life at the end of life, but its impact on hospice patients and caregivers needs more research. Objective: To assess the impact of MT intervention on symptom burden and well-being of hospice patients and caregivers. Methods: A total of 18 hospice patients, selected based on scores ≥4 on the revised Edmonton Symptom Assessment System (ESAS-r) items on pain, depression, anxiety, or well-being, participated in MT sessions provided by a board-certified music therapist. Over a period of 2-3 weeks, 3-4 MT sessions were conducted for each. Patient Quality of life (QOL) was assessed using the Linear Analogue Self-Assessment (LASA). Depression and anxiety were measured with the Patient Health Questionnaire-4 (PHQ-4). For the 7 caregivers enrolled, stress levels were measured using the Pearlin role overload measure and LASA. Results: Patients reported a reduction in symptom severity and emotional distress and an increase in QOL. All patients endorsed satisfaction with music therapy, describing it as particularly beneficial for stress relief, relaxation, spiritual support, emotional support, and well-being. Scores on overall QOL and stress were worse for caregivers. Conclusion: This study provides evidence that MT reduces symptom burden and enhances the quality of life for hospice patients. Hospice patients and their caregivers endorsed satisfaction with MT. Given the benefits observed, integrating MT into hospice care regimens could potentially improve patient and caregiver outcomes. Larger studies should be conducted to better assess the impact of MT in this population.

Music and Medicine: Promoting Harmony for Health

A multitude of clinical trials measuring hemodynamic and psychological parameters have shown the beneficial effects of music on health. However, there are no clear instructions on how to utilize the potential benefits of music to improve health outcomes. Moreover, whether the effect of music is transient or enduring has yet to be determined. To address the effect of music on vital parameters and emotional well-being of patients we provide an overview of methods and findings of some studies that have evaluated the physiological or psychological impacts of music. This review puts forward a proposed model for fostering an individualized approach that can examine the therapeutic effects of music.

Effectiveness of Medical Music Therapy Practice: Integrative Research Using the Electronic Health Record: Rationale, Design, and Population Characteristics

Background: Several clinical trials support the efficacy of music therapy (MT) for improving outcomes in hospitalized patients, but few studies have evaluated the real-world delivery and integration of MT across multiple medical centers. This article describes the rationale, design, and population characteristics of a retrospective study examining the delivery and integration of MT within a large health system. Methods: A retrospective electronic health record (EHR) review was conducted of hospitalized patients seen by and/or referred to MT between January 2017 and July 2020. MT was provided across ten medical centers, including an academic medical center, a freestanding cancer center, and eight community hospitals. Discrete demographic, clinical, and MT treatment and referral characteristics were extracted from the EHR, cleaned, and organized using regular expressions functions, and they were summarized using descriptive statistics. Results: The MT team (average 11.6 clinical fulltime equivalent staff/year) provided 14,261 sessions to 7378 patients across 9091 hospitalizations. Patients were predominantly female (63.7%), White (54.3%) or Black/African American (44.0%), 63.7 ± 18.5 years of age at admission, and insured under Medicare (51.1%), Medicaid (18.1%), or private insurance (14.2%). Patients' hospitalizations (median length of stay: 5 days) were primarily for cardiovascular (11.8%), respiratory (9.9%), or musculoskeletal (8.9%) conditions. Overall, 39.4% of patients' hospital admissions included a mental health diagnosis, and 15.4% were referred to palliative care. Patients were referred by physicians (34.7%), nurses (29.4%), or advanced practice providers (24.7%) for coping (32.0%), anxiety reduction (20.4%), or pain management (10.1%). Therapists provided sessions to patients discharged from medical/surgical (74.5%), oncology (18.4%), or intensive care (5.8%) units. Conclusions: This retrospective study indicates that MT can be integrated across a large health system for addressing the needs of socioeconomically diverse patients. However, future research is needed to assess MT's impact on health care utilization (i.e., length of stay and rates of readmission) and immediate patient-reported outcomes.

A randomized controlled trial on the effects of different music genres on physiologic parameters and emotion

BACKGROUND

Listening to music has psychophysiological effects on individuals' body and emotions, and it is known as one of the most influential stimuli to create emotions. The aim of this study was to explore the effect of different music genres on some physiological parameters and emotion.

METHODS

This was a randomized controlled trial. For 5 days, forty-six healthy undergraduate students were randomly assigned to several types of music (pop, rock, western classical, and Persian traditional), as well as silence. Physiologic parameters were checked five times (before, during, immediately, 15, and 30 min after the interventions). Before and after the interventions, the Self-Assessment Manikin questionnaire was completed.

RESULTS

There was no statistically significant difference in heart rate, diastolic blood pressure, temperature, silence, or other approaches between the groups. Silence and other ways did not reduce systolic blood pressure as much as listening to the pop. Peripheral oxygen saturation increased significantly only when listening to Persian traditional music, and when there was silence however, the differences were not statistically significant. In terms of valence, arousal, and dominance, none of the five treatments were shown to be more effective.

CONCLUSION

The results of the present study showed that statistically and clinically, there was no difference between silent music and other types of music, including pop, rock, western classical, and Persian traditional, in reducing physiological parameters. Different genres of music had no additional impact on emotion when compared to silence.

Nonpharmacological management of psychological distress in people with COPD

Psychological distress is prevalent in people with COPD and relates to a worse course of disease. It often remains unrecognised and untreated, intensifying the burden on patients, carers and healthcare systems. Nonpharmacological management strategies have been suggested as important elements to manage psychological distress in COPD. Therefore, this review presents instruments for detecting psychological distress in COPD and provides an overview of available nonpharmacological management strategies together with available scientific evidence for their presumed benefits in COPD. Several instruments are available for detecting psychological distress in COPD, including simple questions, questionnaires and clinical diagnostic interviews, but their implementation in clinical practice is limited and heterogeneous. Moreover, various nonpharmacological management options are available for COPD, ranging from specific cognitive behavioural therapy (CBT) to multi-component pulmonary rehabilitation (PR) programmes. These interventions vary substantially in their specific content, intensity and duration across studies. Similarly, available evidence regarding their efficacy varies significantly, with the strongest evidence currently for CBT or PR. Further randomised controlled trials are needed with larger, culturally diverse samples and long-term follow-ups. Moreover, effective nonpharmacological interventions should be implemented more in the clinical routine. Respective barriers for patients, caregivers, clinicians, healthcare systems and research need to be overcome.

[Chronic obstructive pulmonary disease: somato-psychological dimensions]

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide and is a poorly understood lung disease. It is accompanied by significant psychological co-morbidities (anxiety, depression, identity and body image disorders) which are under-diagnosed and have an impact on quality of life and the frequency of  re-hospitalization. The management of COPD is multidisciplinary and its role is to prevent complications, relieve symptoms and slow the progression of the disease. Therapeutic education of the patient brings a real added value in this multidisciplinary management.

Effects of expressive art therapy on health status of patients with chronic obstructive pulmonary disease: a community-based cluster randomized controlled trial

Background and objective:

This study was performed to investigate the effect of expressive art therapy (EAT) on the health status of patients with chronic obstructive pulmonary disease (COPD).

Methods:

This community-based cluster randomized controlled trial involved patients with COPD from 16 communities in China. Participants received either EAT plus usual care (UC) or UC only. General practitioners were trained in EAT before the intervention. The primary outcomes were depression and anxiety symptoms, measured with the Hospital Anxiety and Depression Scale (HADS) and expressed as the HADS score for depression or anxiety (HADS-D or HADS-A, respectively). The secondary outcomes were the quality of life and dyspnoea, measured with the COPD assessment test (CAT). Dyspnoea was assessed using the modified Medical Research Council (mMRC) dyspnoea scale. Lung function was expressed as the forced expiratory volume in 1 s as a percentage of the predicted value [FEV₁ (% pred)]. Outcome data were collected from all participants at baseline, 2 and 6 months.

Results:

In total, 360 participants with COPD and comorbid depression were included in the analysis with the control group of 181 receiving UC only and the intervention group of 179 receiving EAT plus UC. The EAT group showed significantly greater improvement in the HADS-D and HADS-A scores than the UC group at 2 months (p < 0.0001 and p < 0.001, respectively) and 6 months (p < 0.001 for both). The CAT and mMRC scores were significantly lower in the EAT group than in the UC group at 2 and 6 months (p < 0.001 for all). The FEV₁ (% pred) was significantly higher in the EAT group than in the UC group at 6 months (p < 0.01).

Conclusion:

General practitioners can deliver EAT interventions. EAT can effectively reduce anxiety and depression symptoms and dyspnoea, improve quality of life and improve the pulmonary function of patients with COPD.

Playing the harmonica with chronic obstructive pulmonary disease. A qualitative study

Objectives: To investigate the experience of playing the harmonica for individuals with COPD.

Methods: A qualitative, phenomenological study using semi-structured interviews and reflexive thematic analysis.

Results: Eight people living with COPD (six females, two males) were recruited, who had attended at least six weeks of harmonica group sessions, either face-to-face prior to the COVID-19 pandemic or remotely. Five themes were generated. Themes included ‘hard in the beginning’, ‘holding the condition’, ‘breathing control’, ‘gives you a high’ and ‘needing the Zoom class’.

Discussion: Playing the harmonica with COPD is difficult at first, particularly drawing a breath through the harmonica. With practice, experience in a fun activity and quality teaching, individuals were able to become more attuned and embodied with their breathing, and playing the harmonica offered a breathing control strategy. Songs, rather than breathing, became the focus, and participants were able to escape living with respiratory disease when playing. Participants reported the harmonica helped mucous expectoration. The group was a priority in the weekly lives of participants, even though the ‘buzz’ of being part of a group was lost when participating online. Further mechanistic studies and randomised controlled trials are needed to investigate the biopsychosocial benefits of playing the harmonica with COPD.

Effects of music therapy on COVID-19 patients' anxiety, depression, and life quality: A protocol for systematic review and meta-analysis

BACKGROUND

Whether music therapy improves coronavirus disease 2019 (COVID-19) patients' anxiety, depression, and life quality are still controversial. Therefore, to provide evidence-based medical evidence for clinical non-pharmacological interventions, we performed a meta-analysis of randomized controlled trials of music therapy for COVID-19 patients' anxiety, depression, and life quality.

METHODS

Cochrane Central Register of Controlled Trials Repositories, PubMed, Embase, Web of Science and Chinese Science Citation Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan-Fang database were searched to identify studies on the evaluation of the effectiveness of the music-based intervention on COVID-19 patients' anxiety, depression, and life quality from inception to May 2021. Two researchers independently carried out data extraction and literature quality evaluation of the quality and the meta-analysis on the included literature was performed with Revman5.3 software.

RESULTS

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

CONCLUSION

This study will provide reliable evidence-based evidence for the effects of music therapy on COVID-19 patients' anxiety, depression, and life quality.

Chronic Obstructive Pulmonary Disease Treatment and Pharmacist-Led Medication Management

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death across the globe. Its repeated exacerbation will seriously worsen the quality of life, aggravate the patients’ symptoms, and bring a heavy burden on the patients and the society. Understanding the current status of drug therapy and the role of pharmaceutical care is essential for the management of COPD. In addition to the drugs already on the market, recent clinical trials also show that emerging novel drugs for treating COPD are being developed to prevent the symptoms, reduce the frequency of acute exacerbation, and improve the quality of life. Recent progress in new drug research should lead to novel treatment options for COPD patients in future clinical practice. The pharmaceutical care has shown significantly favourable impacts on addressing drug-related problems, supporting its vital role in the management of COPD, especially when there are a wide range of therapeutic agents. This review not only provides an overview of current treatment strategies but also further underlines the importance of new drug development and pharmaceutical care for patients with COPD.