Tutti Toot Trumpet

A more creative approach to airways therapy

Cystic fibrosis (CF), asthma and Chronic Obstructive Pulmonary Disease (COPD) are respiratory conditions that affect millions of people globally. Airway Clearance Treatment (ACT) is one approach that can relieve some symptoms – especially in CF, which is characterized by the build-up of thick, sticky mucus. This is done by blowing through a restricted tube creating positive expiratory pressure (PEP), ideally twice a day.

“At the moment ACT is very laborious and a real chore, particularly for children, and as a result non-compliance is a major issue, leading to increased chance of lung infections and worse,” Ben says.

Ben and co-founder Gayle Storey, an interdisciplinary artist, began to think more creatively about ACT whilst doing outreach work at the Great Exhibition Road Festival, which involved Imperial and other partners in South Kensington.

Ben and Gayle initially worked with clinicians from the Royal Brompton Hospital and UCL Great Ormond Street Institute of Child Health. In controlled conditions they played brass and woodwind instruments, monitoring expiratory pressure within the mouth cavity using a piezoelectric pressure sensor. They found that playing a C major scale on the trumpet, euphonium, clarinet or flute was able to achieve expiratory pressures within or above the therapeutic target range for ACT.

From conception to reality

Successfully applying to the MTSC, the team was able to explore this potential further, for example using the facilities and expert assistance at the Imperial College Advanced Hackspace to build a prototype therapeutic trumpet. They used 3D printing for the casing and off-the-shelf electronic components in novel, proprietary configurations.

In essence, the Tutti Toot Trumpet is a specialised, easy-to-play digital trumpet that measures real time lung pressure, lung capacity and peak flow. It can provide feedback on both therapy targets and musical performance, through the implementation of interactive games. Their hope is that all captured data can be securely and wirelessly shared with clinicians.

Their initial focus is on children with CF and one aspiration is to create a remote, online community of patients who can play musical games together and build a shared experience.

“In the case of CF, where infections are a constant threat, hospital appointments present a risk and patients are limited in the social contacts they can have – all of which has been exacerbated by the coronavirus pandemic,” Gayle says. “We think we can mitigate some of that risk through at-home therapy and monitoring and also create a platform for interaction and engagement among patients that will be hugely beneficial, physically and mentally.”

The MTSC is an 8-month programme which provides teams with access to the funds and resources to help them assess the commercial viability of their technology and gain valuable business skills to increase the impact of their ideas.

Ben comments on the experience: “The Tutti Toot Trumpet is a very interdisciplinary undertaking – gathering musicians, clinicians and technologists – so making the right contacts and assembling a top team was absolutely vital. The MTSC was able to really help with that. It also forced us to think about issues such as IP [intellectual property] and regulations and standards, which is essential given that we’re essentially creating a medical device.”

Ben and Gayle and the team will take part in the NIHR Invention for Innovation (i4i) programme 2021. As part of i4i they are taking part in a series of Patient Public Involvement (PPI) workshops, listening and learning from the patients’ own lived experiences of their respiratory disease to inform the design and features of the device.

The team has also partnered with Conficio Design, Konglomerate Games and the Cystic Fibrosis Trust, amongst others.