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STUDY PROTOCOL article

Front. Public Health
Sec. Public Mental Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1541866
This article is part of the Research Topic The Intersection of Psychology, Healthy Behaviors, and its Outcomes View all 52 articles

Effectiveness of a Harmonica-Integrated, Tele-Supervised Home-Based Pulmonary Rehabilitation Program on Lung Function and Comprehensive Health Outcomes in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial Protocol

Provisionally accepted
Qiuxuan Zeng Qiuxuan Zeng 1Xiaohong Lin Xiaohong Lin 1Wenli Chen Wenli Chen 1Daniel YT Fong Daniel YT Fong 2Junxin LI Junxin LI 3Jiaying LI Jiaying LI 3*
  • 1 First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
  • 2 School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong, SAR China
  • 3 School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States

The final, formatted version of the article will be published soon.

    Harmonica playing mimics pursed-lip breathing and strengthens respiratory muscles.Combined with music therapy, it may improve both pulmonary and mental health in chronic obstructive pulmonary disease (COPD) patients, though its effects are not well understood. This protocol outlines a randomized controlled trial (RCT) to evaluate the effectiveness of integrating harmonica playing into pulmonary rehabilitation (PR) programs.This single-center, two-arm RCT will be conducted at a tertiary hospital in Guangzhou, China. A total of 248 adult patients (with a clinical diagnosis of COPD but without severe comorbidities, significant cognitive impairments, and prior experience with the intervention components) will be randomized in a 1:1 ratio to either a harmonica-integrated PR group (intervention) or a standard PR group (control) for six months of home-based, tele-supervised training. The intervention will incorporate harmonica sessions in addition to standard PR exercises (breathing and physical exercises). Both groups will undergo in-hospital training sessions, supplemented by daily home practice under remote supervision by PR staff. The primary outcome is lung function (measured by FEV1%), while secondary outcomes include respiratory muscle strength, exercise capacity, fatigue, dyspnea, symptom burden, mental health, self-efficacy, quality of life, social support, adherence, and patient satisfaction. Statistical analyses will employ mixed-effects models with an intention-to-treat approach.This trial will evaluate the efficacy of a harmonica-integrated, home-based PR program with tele-supervision for COPD patients on lung function, respiratory muscle strength, exercise capacity, and overall health. If effective, it could offer a novel, affordable, and accessible home-based PR approach for COPD management.

    Keywords: chronic obstructive pulmonary disease, harmonica playing, Music Therapy, Pulmonary Rehabilitation, tele-supervision, Home-based training

    Received: 08 Dec 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Zeng, Lin, Chen, Fong, LI and LI. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jiaying LI, School of Nursing, Johns Hopkins University, Baltimore, 21205, Maryland, United States

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