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Dr. Mark E. Esterle, MD

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Harmonica Therapy with Pulmonary Rehab


Patients with severe lung disease frequently ask what they can do to exercise their lungs because they are so short of breath with activity. We send patients to pulmonary rehabilitation classes to help with endurance and breathlessness which includes strength training in both an aerobic and anaerobic capacity with treadmill or bicycle exercises usually and weight training. Some rehab programs are offering music therapy as well and some may be surprised that therapy using a harmonica has been beneficial. Patients with chronic lung diseases such as COPD, pulmonary fibrosis and transplant recipients are seeing benefit from this and having fun at the same time.

One of the problems with things such as deep breathing techniques and incentive spirometer use has been compliance because, lets face it, it is boring. Yes, patients will do it, but the time spent is less than doing something that has some entertainment value as well.

Harmonica use for therapy is a fun way to encourage breathing exercises and help teach breath control in pulmonary rehab classes. Blowing into a harmonica and inhaling through these small holes will allow patients to create musical notes which mimics exercises such as pursed-lip breathing. This creates back pressure and helpful for patients with obstructive lung diseases such as COPD. This breath control exercise can be good for patients with other lung diseases as well. It helps improve diaphragmatic tone. The diaphragm plays a critical role in breathing and many people do not use their diaphragm efficiently, especially when they become short of breath.

Often when someone becomes breathless they take quick, short breaths from their upper chest and tighten their lower chest wall muscles, further constricting lung expansion. But when you belly breathe, you use your diaphragm more effectivity, which promotes deeper breaths and better gas exchange. As you play the harmonica, it facilitates belly breathing and may improve the strength of the diaphragm. Rather than confining treatment to using an inhaler or taking medicine, patients are using music therapy to learn how to use their breath when they start to have symptoms.

Playing the harmonica helps promote better breath control because some songs may involve blowing into the harmonica in quick succession. Other songs may require alternating inhaling and exhaling at varying speeds. When you play, you learn to become more aware and in control of your breathing.

Patients have found that playing the harmonica in pulmonary rehab classes has also helped them emotionally. Music Therapy is an established health profession. Music is used within a therapeutic relationship to address emotional, physical and social needs of patients. Music therapy has been very effective at helping to relieve the depression experienced by many COPD patients. It can improve mood and patients are having fun playing the instrument together in rehab classes giving them a chance for socialization.

Most pulmonary rehab programs that have implemented harmonic therapy use a 10-hole diatonic harmonica. There are several types of harmonicas, but the diatonic is considered one of the best for beginners. It is not difficult to learn, and you do not need a musical background to learn to play recognizable songs.

Learning to play a musical instrument takes time and patients that are having fun enjoying playing the instrument are spending more time with their breathing exercises and breath control techniques than they may have otherwise. Every time you practice, you’re also getting a little workout for your lungs. To get the most out of harmonic therapy, it’s helpful to practice for at least ten minutes a day.

If you are not sure if you are focusing on diaphragmatic breathing correctly and want some form technique training to know how it should feel, try this:

  • Step 1: Lay flat on your back

  • Step 2: Place one hand on your stomach and one hand on your chest

  • Step 3: Inhale deeply, but make sure the hand on your chest remains still and the hand on your stomach moves with each breath in and out.

  • Step 4: When you inhale, the hand on your stomach will rise. When you exhale, the hand on your stomach will fall.

So, I know you are all excited about playing the harmonica and wanting to know where to start and how to play songs that are recognizable. It’s easy and if you follow these directions you will be on your way in no time.

Reading Harmonica Tablature: Made Easy

The number listed corresponds with the hole you need to go to on your harmonica (1-10).

If the number is positive, blow (breathe out).

If the number is negative, draw (breathe in).

Some may say, what types of songs can you really play with a harmonica? Just about anything and to prove it here is Harmonica Tablature for a few vastly different songs. Some songs are easier than others of course and if you want to really get into it check out the listed web site at the bottom of this blog article for learning harmonica in depth.

Gangsta’s Paradise by Coolio (for diatonic harmonica)

7 4 7 4 7 4 7 -3 -7 -3 -7 4 7 -2 6

Ode To Joy by Beethoven (for diatonic harmonica)

5 5 -5 6 6 -5 5 -4 4 4 -4 5 5 -4 -4

4 4 -4 5 5 -4 4 -3 3 3 -3 4 4 -3 -3

3 3 -3 4 4 -3 3 -2 2 2 -2 3 3 -2 -2

5 5 -5 6 6 -5 5 -4 4 4 -4 5 -4 4 4

4 4 -4 5 5 -4 4 -3 3 3 -3 4 -3 3 3

Love Me Do by The Beatles (for diatonic harmonica)

INTRO -5 5 -4 3 3 3 3

-5 -5 -5 5 5 5 -4 3 3 3 3

-5 5 -4 3 3 3 4 -3

3 3 3 3 3 3 4 -3

-3″ 3 -2′

-3″ 3 -2′

-3″ 3 -2′

-2 -2″ 2 -1

-3″ 3 -2′

-2 -2″ 2 -1

https://www.harmonica.com/

Have fun!

Mark Esterle, MD

"Well done is better than well said"

Benjamin Franklin

Dr. Mark Esterle, MD

Louisville Pulmonary Care, PLLC

(502) 899-7377

4003 Kresge Way #312, Louisville, KY 40207, USA

©2018 by Dr. Mark E. Esterle, MD.