Exhaling against resistance creates back pressure or positive pressure which allows mucus to move from peripheral airways to the larger central airways so it can be coughed out. There are two types of Acapella Valve. The green or high flow valve is for users who can exhale at 15 liters per minute or more for at least three seconds.
This works for most users. If your lungs are lower volume, you can use the blue or low flow valve. The Acapella Valve is designed to be easily cleaned and sterilized. To assist with drying the tubing, it can be hung up. The number of breaths may vary from 6 to When applied in adults with stable bronchiectasis, Bottle PEP improved sputum expectoration compared to no treatment and led to greater sputum expectoration at 60 minutes post treatment conclusion Santos a.
A recent study has evaluated that the height of the water in the bottle should be 5 cm for optimal mucus mobilisation Mueller et al, , Santos a. For information: Therabubble. With the correct attachment it can also be used with the Aeroeclipse breath actuated nebuliser Fig 7b. For information regarding the Aerobika device — www. See video link for how to use the Aerobika — Instruction video. Aerobika Instructions for Use — pamphlet.
The cornet Fig. Expiration through the tube creates an increasing pressure within the hose until it is sufficient to cause the hose end to open, allowing air to flow through the device, creating a positive expiratory pressure and oscillatory vibrations within the airways.
Oscillating Positive Expiratory Pressure Therapy. It is used for: clearance of excess secretions from the lungs reducing gas trapping and improving ventilation of the lungs Physiology — the PEP component encourages airflow behind secretions.
When the device is tilted a little more down there is a lower pressure and frequency to mobilise phlegm from the distal airways When the device is tilted a little more up there is a higher pressure and frequency to mobilise the phlegm form the proximal airways Physiology — During expiration, the stainless steel ball rolls up and down the cone, creating interruptions in expiratory flow and generating a positive expiration pressure PEP within the range of 18 to 35cmH Forced Expiration Technique Cycles of breaths are followed by the forced expiration technique FET , then coughing to further mobilise secretions.
See Oscillating PEP therapy for clinical precautions. Application of the Acapella has 2 components. Prescription This form of oscillating PEP therapy can be performed in either an upright seated position Fig. The forced expiration technique huffing followed by breathing control is repeated 1 to 3 times depending on the clinical status of the patient, either through or outside of the device The total number of cycles may range from 6 to There are several Acapella devices: Acapella Blue — produces a lower amplitude of vibrations compared to Acapella Green or Acapella Choice.
Breathing The breath in should be a little more than tidal volume and, with the lips sealed around the tubing, expiration needs to be active with longer than normal expiratory flow. Prescription The number of breaths may vary from 6 to Approximately forced expiratory technique huffing is generally performed after breathing.
Evidence for the clinical application of Bottle PEP. An alternative option is a Therabubble Fig. The pressures generated are listed in the instruction booklet and are similar to Flutter and Acapella.
Treatment can be carried out in sitting or any postural drainage position where possible. You may feel vibrations on your chest wall. Repeat eight to 10 times. You should then have a period of relaxed breathing before continuing. This cycle should continue for minutes or until you have cleared all your sputum.
Gently detach the rocker assembly from the platform base. How to Use the Flutter Valve? Typically, you should blow out about twice as fast as normal, but not as hard as you can. Repeat this process for approximately 10 breaths. What are the Parts of a Flutter Valve?
Removable mouthpiece Body of the device Expiratory resistance dial, which allows the patient to adjust the difficulty of breathing into the device One-way inspiratory valve Proximal 22 mm O.
Types of Acapella Flutter Valves. Green — The green model is more difficult. Blue — The blue model is less difficult. How does the Flutter Valve Work? What are the Contraindications for using a Flutter Valve? What are the Hazards of using a Flutter Valve? With that said, please keep the following hazards in mind:. Barotrauma in the lungs Increased intracranial pressure Decreased venous return to the heart Increased work of breathing Air swallowing that can lead to nausea or vomiting.
Please check with your doctor before attempting therapy with any device at home. Buy from Amazon. As an affiliate, we receive compensation if you purchase through this link. Final Thoughts. Chicayban, Luciano. Patterson, J. Recommended Reading.
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