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Music Therapy as a Treatment Method for Improving Respiratory Muscle Strength in Patients with Advanced Multiple Sclerosis: A Pilot Study


  • Marlene E. Wiens BSc BPT,

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    • At the time of the study, Marlene E. Wiens was the supervisor of the department of physical therapy at CareWest in Calgary, AB.

  • Marlene A. Reimer PhD RN CNN(C),

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    • Marlene Reimer was an associate professor in the faculty of nursing at the University of Calgary in Calgary.

  • H. Lindsay Guyn BSc

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    • H. Lindsay Guyn was a statistician/data manager at the Centre for Advancement of Health at Calgary Regional Health Authority in Calgary.

Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada, T2N 1N4


Respiratory muscle weakness, predominantly of the expiratory muscles, is characteristic of individuals with advanced multiple sclerosis and can result in difficulty in clearing secretions and repeated episodes of pneumonia. This pilot study evaluated the effectiveness of music therapy in strengthening respiratory muscles through an emphasis on diaphragmatic breathing and coordination of breath and speech. Twenty patients were randomly assigned to one of two groups: one that received music therapy or one that attended music appreciation sessions. Participants' inspiratory and expiratory muscle strength was measured by testing mouth pressure before and after the intervention. The experimental group showed some improvement in terms of expiratory muscle strength, in contrast to the control group, which showed deterioration. The results were not statistically significant, however. Patients in both groups exhibited considerable weakness in their expiratory muscles, and results for 79% of the participants were below 30% of the predicted values. Variability, a major confounding factor that resulted in reduced statistical power, led the investigators to suggest an intercenter collaboration to amass sufficient numbers of patients for a future study. Early manifestation of respiratory muscle weakness warrants inclusion of respiratory muscle testing in examination protocols and early intervention efforts.