Usefulness of harmonica playing to improve outcomes in patients with chronic obstructive pulmonary disease

Pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) includes a multidisciplinary approach of exercise and pursed-lip diaphragmatic breathing. Pursed-lip diaphragmatic breathing reduces alveolar collapse during exhalation, and diaphragmatic breathing improves inspiratory pressures. Harmonica playing has maneuvers similar to those taught in pursed-lip diaphragmatic breathing, with diaphragmatic breathing to create musical tones. Hence, we designed a trial to determine whether patients with COPD would benefit from harmonica playing. COPD patients who completed pulmonary rehabilitation at least 6 months prior were eligible for this trial. Patients attended 12 weeks of harmonica training sessions for 2 hours a week and were encouraged to practice at home. Participants completed pre- and postspirometry testing, maximum inspired and expired pressure (PImax, PEmax) testing, and 6-minute walk tests. Eleven of the 14 participants completed the 12-week trial. PImax and PEmax increased by an average of 15.4 ± 12.0 cm H₂O (P = 0.0017) and 14.4 ± 14.0 cm H₂O (P = 0.0061), respectively. Additionally, 6-minute walk distance increased by approximately 60 m (61 ± 78, P = 0.03). This pilot study showed that a 12-week harmonica program significantly improved PImax, PEmax, and 6-minute walk distance in COPD patients after rehabilitation. Larger-scale harmonica studies are warranted to evaluate this program's adjunctive potential benefit to formal pulmonary rehabilitation.