219 - The Effectiveness of a Structured Music Therapy Protocol on Phonation and Respiratory Endurance in the Recovery of Persons with Post-Acute Sequelae SARS-CoV-2 Infection

Objectives: To analyze the effectiveness of diaphragmatic breathing (DB), vocal intonation therapy (VIT) and therapeutic singing (TS) on improvement in phonation and respiratory endurance in persons with early recovery from acute Coronavirus Disease 2019 (COVID-19) or with post-acute sequelae of SARS-CoV-2 infection (PASC).

Design: Sixty-seven adults ages 29-88 with neurologic or musculoskeletal impairments and recent acute COVID-19 or PASC received standard physical, occupational, speech and respiratory therapy. Individuals were given either vibratory positive expiratory pressure (PEP) therapy with nebulizers or a handheld vibratory oscillation device for strengthening muscles and secretion management. Each neurologic music therapy (NMT) participant received the above interventions plus diaphragmatic breathing (DB) instruction, VIT and TS between 1 and 3 times weekly for the duration of hospitalization. Perceived participant experience was obtained at the end of the study, rated as positive, negative, or neutral for 1) change in breathing function and vocalization and 2) psychological value. Main outcome measures were: Oxygen use at discharge, disposition at discharge, and for music participants only, breath control, and perceived participant experience with NMT.

Results: The NMT group required significantly more oxygen during activity at both admission (p=0.010) and discharge (p=.007) yet had equivalent durations in rehab but a higher rate of home discharge than the non-NMT group (p =0.018). Positive correlations were found in change in phonation abilities measured by number of NMT sessions completed (p=0.021) and minutes of NMT received (p=0.009). Nearly 82% of participants rated the experience as positive, while 9% rated it as negative and 9% as neutral.

Conclusions: Proper DB with VIT and TS can have a significant effect on sustained phonation that may translate to breathing tolerance and vocal performance, with fewer pauses for breathing while speaking. Participants also reported fewer rest breaks due to breathing difficulties while walking or maneuvering wheelchairs. Nearly 82% felt the experience was beneficial.