Vincent Forknor is an 8-year-old boy from Ramsey, Cambridge in the United Kingdom who has Cystic Fibrosis (CF). He has recently started playing the bagpipes, and his family has noticed an improvement in his CF symptoms since he began this new hobby. Vincent takes common CF medications and undergoes physiotherapy, but is it possible that playing the bagpipes is improving his CF? And if so, why is this helpful?
Music has been used as therapy for a variety of illnesses for centuries. Often this is seen in the form of trained musicians performing for people who are ill, but having patients play instruments can be therapeutic as well. In the United States, music therapy is the evidence-based and clinical use of music as a part of the treatment plan for patients. Music therapy must be done by a trained professional who has completed the credentialing requirements from an approved music therapy program.
Music therapy is used to address the social, emotional, and cognitive needs of a patient when these cannot be addressed using other types of treatment. It can involve singing, creating, listening, playing, and moving to music. This type of therapy is commonly seen with patients who suffer from long term illnesses and/or who may be in the hospital for an extended period of time. This can be integrated as a part of the palliative care treatment plan. Many people believe that palliative care is only for individuals who are suffering from a life ending condition, but this is not the case. Palliative care is a special type of care that people who have serious illnesses can receive. It focuses on lessening the symptoms associated with the illness and improving quality of life for the patient and their family. CF patients are certainly candidates for palliative care and may benefit from the various types of music therapy. It is possible however, that in the Vincent’s case, he was benefiting from the direct effect that playing a wind instrument had on his lungs.
Decreased Lung Function
Declining lung function in patients with CF is due to a combination of factors. The first being that CF thickens the secretions in the lungs. This creates a chronic obstruction of the lungs and creates an ideal environment for bacteria to grow, which then leads to a chronic lung infection. Additionally, CF impacts the digestive system. Making the secretions of digestive organs thick means that nutrients are not absorbed properly. Many CF patients are malnourished and have muscle wasting as a result of this. When we breathe there are many muscles that are involved. If these are not strong enough to do their job, it can contribute to the overall decline in lung function. These factors are addressed by the healthcare team who will use medications, mechanical airway clearance, oxygen, and other treatments to help keep the lungs working. But what if music also had a role to play in improving lung function?
Music and lungs
It is a logical thought that since lungs and muscles in CF patients are weak, that exercising these could improve symptoms. Some health advice websites suggest that in particular, children and adolescents should sing or play wind instruments before their CF progresses too far. According to About Kids Health playing a wind instrument is an effective and fun way for kids to exercise their lungs. Playing wind instruments and singing requires immense control of the lungs. Since CF starts at birth, it is essential that treatment and therapy begin as soon as possible. It can be extremely challenging to get children to follow a strict schedule for exercising. Additionally, instructing and teaching a child to control his or her breathing is difficult regardless of whether or not he/she has CF. This is where learning to play a wind instrument or getting involved in singing could become a valuable alternative. Not only would having this as a hobby enhance the child’s emotional, cognitive, and social life, but it would also be a way for him/her to receive regular lung exercises. People with CF are much more prone to getting lung infections. When they do get an infection, they are often hospitalized and their overall quality of life decreases. It is therefore important that anyone who chooses to take up a wind instrument clean the instrument well before and after every use.
Finding accurate information on this subject can be difficult, especially when trying to figure out exactly how helpful this type of intervention would be. There has not been much research in this matter, and the few studies that have been done are not very reliable. One study showed that pulmonary function tests (PFTs) in patients who sang or played wind instruments were higher on the weeks that they were playing. Unfortunately, this study was extremely small with only 3 participants, one of whom dropped out. This decreases the validity of the study. One review discusses how trained singers, who learn to breathe more with their diaphragm muscle, have better lung capacity than people who are not trained singers. It is logical then to think that this would also apply to trained and untrained CF patients. Various abdominal and chest muscles are exercised with signing, and these are also used in breathing. This review sought to compare studies that looked at the effect that singing had on patients with CF. Unfortunately, they were not able to find enough studies that met their search criteria, and therefore could not form a conclusion on the matter.
While there is a lack of evidence showing exactly what effect playing a wind instrument or singing could have on CF symptoms, it is unlikely to do more harm than good. Even if there are no direct physical benefits from picking up an instrument or chasing after your lifelong dream of being the lead singer of your favorite band, music is therapeutic. Becoming involved in creating music can offer people more than physical benefits. Short term and long term musical goals can give patients something to look forward to when they are feeling frustrated with challenges of their condition. The potential for increased lung capacity and strength could be an added bonus. Vincent is an example of a young boy who fell in love with an instrument and is now passionate about music. As his mother has said, his symptoms have decreased since he picked up this new hobby as well. This could be due to physical benefits of playing the bagpipes, or it could be due to mental and emotional benefits.
There is an indisputable connection between the mind and the rest of the body. People with chronic conditions who spend much of their time in and out of the hospital often suffer from depression as well. Depression has been shown to have a negative effect on the immune system. Having hobbies, goals, and feeling a sense of purpose in the world can help patients overcome depression. Becoming involved in music can improve the health of CF patients in various ways including by decreasing the rate of depression. It is important to remember to talk with your healthcare team before initiating any new exercise routines.