As reported in Warta Saya; for kids with cystic fibrosis (CF), a daily exercise needed to clear the lungs of the disease’s characteristic build-up of mucus can feel long and tiring. The problem is the demanding nature of the therapy often causes kids to give up before carrying it out in full, and a lack of compliance comes at the expense of good health. Daily airway clearance therapy (ACT) is an important piece of preventing infections, hospitalizations and flair-ups.

Researchers wanted to help kids through the therapy to encourage better adherence. They hypothesized that they could make the exercise less daunting and more effective by putting it to music.

In the new study “Benefits of music therapy as an adjunct to chest physiotherapy in infants and toddlers with cystic fibrosis,” published in PLOS One, researchers studied how music composed specifically to guide CF breathing exercises affected children’s enjoyment and perceived duration of the exercises, and thus hopefully increasing adherence to their daily therapy. They hoped that the music would encourage adherence that would mitigate later risks of hospitalization. Their study had a secondary objective to assess how the music could cut costs of healthcare by preventing hospitalizations.

When the results came in- the scientists were pleased: the music did it’s job. The patients and parents reported notable improvements in the perception of time and enjoyment while carrying out the routine to the tailored music, as opposed to the groups not listening to music or preforming their exercise to popular music. The differences were considered statistically significant, and all but one of the children and their parents reported they would use the music again.

 Cystic fibrosis is a rare genetic disease that causes the build up of thick mucus, over time damaging the respiratory and digestive system. This mucus clogs up airways causing breathing issues and the accumulation of bacteria which leads to infection. It also causes lung damage and respiratory failure. Symptoms include a chronic cough, wheezing, trouble exercising, a stuffy nose, difficulty breathing, salty tasting skin, constipation, frequent lung infections, and male infertility. The recessive disorder varies in severity depending on the mutation.  While there is no cure, there are many treatments such as antibiotics, anti-inflammatory and other symptomatic medications, a range of therapies, and surgeries to remove blockages or replace the lungs.

Prior research has examined how music tailored for the exercises helped toddlers with CF endure longer and enjoy the therapy more. This study, however, expanded that to the full range of youth, with participants from ages 2 to 17.

The researchers hoped the composed music would achieve four primary goals: make the therapy more enjoyable; encourage deep breaths beneficial to the therapy; better the patient’s exercises so that more mucus is cleared; and distract children from the time spent on the ACTs.

To determine the music’s impact, researchers at the Universidad de Málaga split up 43 youth with CF into three groups. A control group carrying out the therapy as they traditionally do without music, a placebo group performing the therapy to popular music, and the treatment group, who carried out their therapy to the music made specially for the exercise. The music was created in a collaboration between CF specialists and a professional musician and music teacher.

During the three months of the trial, the children and their parents were asked for feedback on how much they enjoyed the session and their estimation on the duration of the therapy.

The music worked.

They found the patients who listened to the designated music reported that their exercises felt like they endured 11.1 minutes less than in actuality. This is in comparison to the patients listening to popular music who felt like the exercises went on for four minutes longer than it did, and the group without any music who reported feeling the exercise lasted nine minutes longer.

The biggest improvement was measured in the enjoyment of the children in the treatment group.  Enjoyment was measured on a seven point scale from -3 to 3. The children who listened to the tailored music on average reported +0.9 the placebo groups reported +0.56, and the control group averaged at -0.6.

Parents followed a similar trend — their feedback on changes in enjoyment over the trial resulted in a change of +1.7 units for the treatment group, versus the placebo groups +0.56 and control groups -0.06.

The researchers also attempted to answer another question: could this music therapy save money on healthcare by preventing hospitalization and CF’s characteristic episodes? They asked patients how often they had experienced episodes of symptom flair-ups known as ‘pulmonary exacerbations’ in the three months before the study and during the three months of the trial.

Two participants in the treatment group and one in both the placebo and control groups reported experiencing pulmonary exacerbations in the three months proceeding the study. However, during the three months of the study, six children in the control group, three in the placebo, and one participant in the treatment group reported pulmonary exacerbations.

Considering that the average hospitalization of a CF patient costs €6,704.87 ($8,030), the researchers make the case that the music can benefit patients and hospitals by saving them stress and money by preventing medical mayhem.

Sometimes helping a disease doesn’t mean creating something new, but taking options and making them better. With the creative ingenuity of doctors and musicians together, children with CF may not only have better health, but a better quality of life.