Rhythm and song: breath management in Idiopathic Interstitial Pneumonias (IIP's). Pilot study

Russell, Anne-Marie, Cave, Phoene, Taylor, Karen, Lewis, Adam, Hopkinson, Nicholas S. and Wells, Athol U. (2017) Rhythm and song: breath management in Idiopathic Interstitial Pneumonias (IIP's). Pilot study. European Respiratory Journal, 50. (doi:10.1183/1393003.CONGRESS-2017.PA2536).

Abstract

Introduction: breathlessness is a distressing symptom. Current therapies offer little relief in IIP’s. Breathlessness management utilising techniques for breathing control, mindfulness and posture, specifically tailored to IIP’s may be helpful.

Methodology: participants attended a 12 week programme. Weekly sessions were based on concepts of Singing for Breathing (Lewis et al npj Prim Care Respir M 2016;26:16080) using physical and vocal warm-ups; breathing exercises; rhythm / pitch games; songs and relaxation. Participants completed a diary recording reflective, retrospective thoughts before and immediate responses after each class. The music therapist completed a weekly reflective diary. Later sessions were audio recorded. Measures of symptom burden were completed at weeks 1 and 12.

Results: ten participants, 7 male; mean age 72, (range 64-81 years) enrolled. Baseline Characteristics: FVC 2.58 ±1.46; PHQ-9 scores minimal (n=5) or no depression (n=4); GAD-7 scores mild (n=1) or no anxiety (n=8); SGRQ Total 40.31 (±26.2); mMRC Breathlessness Scale Mean score 2.5 (±1.5). Actual scores appear to conflict with diary entries. Qualitative data demonstrated that singing impacted participant’s physical; psychological well-being; cognitive and social functioning. Notably through camaraderie / friendship; stress management; breathing control and technique. FVC remained stable.

Discussion: although symptom scores showed no significant change at 12 weeks, participants highly valued the positive impact across the four domains. This small pilot study suggests that larger and longer innovatively designed trials with appropriate end points are needed to better quantify the impact of signing in IIP’s.

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Contributors

Author: Adam Lewis

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