How to clear your chest with breathing techniques

12) Positive Expiratory Pressure and Oscillatory Positive Expiratory pressure

These techniques involve the use of devices. These are not commonly used by people with COPD. They can be used on their own, or at the same time as other breathing exercises such as Autogenic Drainage. For this reason you may also hear these devices being referred to as ‘adjuncts’.

    Devices include:

  • Positive Expiratory Pressure mouthpiece.
  • Positive Expiratory Pressure mask.
  • Oscillatory Positive Expiratory Pressure, for example Flutter, Acapella, Aerobika.
    You should discuss this with your physiotherapist if you:

  • Feel that Active Cycle of Breathing Technique or Autogenic Drainage is not effective.
  • Feel Active Cycle of Breathing Technique or Autogenic Drainage is making you wheezy or cough a lot.
  • Regularly produce a lot of sputum.
  • Your sputum is very sticky despite good hydration.

The following film shows one of these devices called Acapella.

Acapella from Cat Young on Vimeo.

View text transcript

We are now going to show you a short clip using a device called an Acapella. This is an oscillatory device which helps to clear secretions. What we are going to do first of all. I have set the dial to three, so that is your resistance and you will need to take a slightly bigger than normal breath in.

Put your lips around the mouthpiece and blow out through the machine. When you do that the machine will vibrate the air into your airways and loosen off the secretions.

We are going to do five breaths with the Acapella. Once you have done your five breaths we will go on to your huff. This is a medium sized breath in and you breathe out as if you are steaming up your mirror. You may hear the secretions moving. Keep huffing until you feel the urge to cough to clear the secretions.

Take five slightly bigger than normal breaths in. Blow into the Acapella machine.

Have a few normal relaxed breaths and repeat the five breaths and Acapella again. Some relaxed breaths followed by your huffing until you feel the urge to cough.

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