We read with great interest the recent article published in Holistic Nursing Practice, titled "The Effect of Music Therapy on Anxiety and Various Physical Findings in Patients With COPD in a Pulmonology Service."1 This interventional study found that statistically significant reductions in anxiety levels (Beck Anxiety Scale) and a significant decrease in systolic and diastolic blood pressure could be achieved using music therapy interventions for patients with chronic obstructive pulmonary disease (COPD). Our pulmonology services have been exploring the potential use of music and dance in pulmonary rehabilitation (PR) sessions for patients with chronic lung diseases, including COPD. Such approaches may also have the potential to impact the main symptom, breathlessness.
Our work in this area has been based on the following points: PR is one of the most cost-effective interventions for people with COPD, having been shown to improve people's quality of life, reduce symptoms of breathlessness, reduce exacerbations, reduce health service utilization, and even impact mortality.2,3 However, recent "real-world" observational studies have shown that the impact is limited by the acceptability of PR to patients.4 Dance can be an enjoyable alternative to standard exercise classes and has been shown to significantly improve muscle strength and endurance, balance, and other aspects of functional fitness in older people both with and without existing medical conditions.5
At Barts Health NHS Trust in London, United Kingdom, our initial questionnaire-based survey explored the opinions of 33 current PR attendees on this topic.6 The responses were generally positive, with 55% stating they would like to try PR to music and a further 18% responded "maybe." Forty-six percent stated they would like to try a dance-based version of PR, and a further 15% responded "maybe." Considering that only 6% currently danced regularly and only 33% danced regularly previously, this suggests that dance could be used as a holistic and enjoyable way to engage people in physical activity if appropriate services were provided.
In a pilot dance program for people attending the support group Breathe Easy Haringey (BE), in conjunction with Whittington Health, 10 people with breathlessness safely participated in 5 weeks of rehearsals and 4 had the confidence to perform a group dance at a BE meeting.7 All (100%) of those attending the BE performance participated safely in a group dance warm-up. For 8 of 10 (80%) participants, this experience met or exceeded their hopes and expectations, and 8 of 10 (80%) said they would like to continue to participate in dance sessions. As a result of this feedback, dance classes now run weekly for this BE group.
Our preliminary work, along with the findings of Horuz et al,1 supports the development and further investigation of music- and dance-based interventions for patients with chronic pulmonary disease to reduce their breathlessness and increase their quality of life.
-Keir Philip, MRCP
Barts Health NHS Trust
London, United Kingdom
Sian Williams, MSc, DLSHTM
International Primary Care
Respiratory Group
London, United Kingdom
Holly Townes, BSc (hons)
Physiotherapy
Whittington Health
London, United Kingdom
Jane Simpson, PGDip
Claire Davey, MSc
Brendan De Luca, PGDip
Rishi Gupta, MRCP
Richa Singh, MRCP
Barts Health NHS Trust
London, United Kingdom
REFERENCES