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The effect of harmonica-based breathing and airway clearance exercises on pulmonary function in children with cystic

Hanie Tavasoli1, Mohammad Mehdi Rajabi1, Akram Sadat Sadat Hoseini1

  • 1Department of Pediatric Nursing and Neonatal Intensive Care, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

Journal of Pediatric Nursing
|May 21, 2026
PubMed

Insights

Harmonica exercises significantly improved forced expiratory volume in one second (FEV₁) in children with cystic fibrosis (CF). These exercises offer a practical, low-cost addition to standard airway clearance for CF patients.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Therapy
  • Cystic Fibrosis Research

Background:

  • Cystic Fibrosis (CF) necessitates effective airway clearance techniques.
  • Pulmonary function decline is a key concern in pediatric CF management.
  • Novel, accessible interventions are needed to complement routine CF care.

Purpose of the Study:

  • To evaluate the impact of harmonica-based breathing and airway clearance exercises on pulmonary function in children with CF.
  • To assess changes in forced expiratory volume in one second (FEV₁) and forced vital capacity (FVC) following a two-month intervention.

Main Methods:

  • A randomized controlled trial involving 70 children (aged 8-18) with CF.
  • Intervention group performed harmonica exercises twice daily for 15 minutes over two months, alongside routine care.
  • Control group received routine care only. Pulmonary function was measured at baseline and post-intervention.

Main Results:

  • Post-intervention, the harmonica exercise group showed a statistically significant improvement in FEV₁ compared to the control group (P=0.002).
  • No significant difference in forced vital capacity (FVC) was observed between the groups.
  • Initial baseline measurements for FEV₁ and FVC showed no significant group differences.

Conclusions:

  • Harmonica-based exercises represent a valuable, cost-effective adjunct to conventional airway clearance for pediatric CF patients.
  • Significant improvement in FEV₁ suggests potential benefits for airflow obstruction.
  • Longer intervention durations may be required to observe improvements in lung volumes (FVC).
Abstract

Keywords:
Airway clearanceBreathing exercisesCystic fibrosisHarmonicaPulmonary function

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