A potential game-changer in the treatment of chronic respiratory conditions
A unique collaboration at the interface of medicine, technology and music has led to the creation of a therapeutic musical trumpet which incorporates fun, engaging games, whilst capturing vital data.
Co-founder Ben Storey, Assistant Head of Junior Programmes at The Royal College of Music (RCM), took part in Cohort Three of the MedTech SuperConnector (MTSC) in 2019-2020. This helped the team to forge clinical and business contacts; establish a company; and build a prototype of the ‘Tutti Toot Trumpet,’ which is undergoing testing and feedback in small groups of patients.
Following the success of the MTSC, the team has been accepted onto the prestigious Invention for Innovation (i4i) programme 2021, run by the National Institute for Health Research (NIHR), which also carries around £150,000 in funding support. The ultimate aim is to gain approval to use the Trumpet in the NHS and healthcare systems globally, to bring benefit to as many patients as possible.
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.
“I was diagnosed with asthma as a child and took up playing the trumpet on the recommendation of my doctor, which eventually led me to becoming a professional trumpet player. So, the basis of the idea has been there in the background, but through the MTSC, Gayle and I were able to pursue that further.”
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.”
Support for innovation
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.