Positive Expiratory Pressure Device Research Articles

Efficacy of Bubble Positive Expiratory Pressure Device in Post Thoracic Surgery Patients

Efficacy of Bubble Positive Expiratory Pressure Device in Post Thoracic Surgery Patients

Short-term effects of positive expiratory pressure mask on ventilation inhomogeneity in children with cystic fibrosis: A randomized, sham-controlled crossover study.

Can physiotherapy with a positive expiratory pressure (PEP) mask improve peripheral ventilation inhomogeneity, a typical feature of children with cystic fibrosis (cwCF)? To answer this question, we used the nitrogen multiple-breath washout (N2MBW) test to measure diffusion-convection-dependent inhomogeneity arising within the intracinar compartment (Sacin*VT). For this randomized, sham-controlled crossover trial, two N2MBW tests were performed near the hospital discharge date: one before and the other after PEP mask therapy (1 min of breathing through a flow-dependent PEP device attached to a face mask, followed by three huffs and one cough repeated 10 times) by either a standard (10-15 cmH20) or a sham (<5 cmH20) procedure on two consecutive mornings. Deception entailed misinforming the subjects about the nature of the study; also the N2MBW operators were blinded to treatment allocation. Study outcomes were assessed with mixed-effect models. The study sample was 19 cwCF (ten girls), aged 11.4 (2.7) years. The adjusted Sacin*VT mean difference between the standard and the sham procedure was -0.015 (90% confidence interval [CI]: -∞ to 0.025) L-1. There was no statistically significant difference in Scond*VT and lung clearance index between the two procedures: -0.005 (95% CI: -0.019 to 0.01) L-1 and 0.49 (95% CI: -0.05 to 1.03) turnovers, respectively. Our findings do not support evidence for an immediate effect of PEP mask physiotherapy on Sacin*VT with pressure range 10-15 cmH20. Measurement with the N2MBW and the crossover design were found to be time-consuming and unsuitable for a short-term study of airway clearance techniques.

Use of the Lung Flute ECO to assist in sputum collection for tuberculosis testing: a randomised crossover trial.

The Lung Flute ECO, a self-powered, low-cost oscillatory positive expiratory pressure device, assisted people with presumptive tuberculosis to produce an adequate sputum volume for diagnostic testing and was well tolerated https://bit.ly/47sDq8W.

Effects of Acapella versus Blow Bottle Positive Expiratory Pressure on Airway Clearance and Peak Expiratory Flow Rate in Post-Covid-19 Patients

Background: The COVID-19 pandemic has led to significant respiratory complications in affected individuals. Positive Expiratory Pressure (PEP) devices, specifically Acapella and blow bottle devices, have been widely used in respiratory rehabilitation, particularly in patients with pulmonary diseases and post-surgical respiratory complications. However, their efficacy in post COVID-19 patients has been less explored. Objective: This study aimed to compare the effectiveness of Acapella and blow bottle devices in improving oxygen saturation, peak expiratory flow rate, shortness of breath, and six-minute walk distance in post COVID-19 patients. Methods: This randomized clinical trial was conducted at Tehsil hospital Kot Addu over six months. Forty-eight post COVID-19 patients were divided equally into two groups: one group received treatment with the Acapella device, and the other with a blow bottle device. Baseline and post-treatment measurements of oxygen saturation, peak expiratory flow rate, and six-minute walk distance were recorded using a pulse oximeter, peak expiratory flow meter, and six-minute walk test, respectively. Results: On day 1, the Acapella group showed a mean oxygen saturation rank of 20.98 with a sum of ranks of 503.50 (p=0.79), while the Blow Bottle group had a mean rank of 28.02 and a sum of ranks of 672.50. By day 7, the Acapella group's mean rank was 17.31 (sum of ranks = 415.50, p=0.000) compared to the Blow Bottle group's 31.69 (sum of ranks = 760.50). For peak expiratory flow rate, no significant differences were found between the groups at day 1 (Acapella: mean rank = 28.06, sum of ranks = 673.50, p=0.078; Blow Bottle: mean rank = 20.94, sum of ranks = 502.50) and day 7 (Acapella: mean rank = 23.77, sum of ranks = 570.50, p=0.717; Blow Bottle: mean rank = 25.23, sum of ranks = 605.50). Similar trends were observed in the six-minute walk test results. Conclusion: The study found that both Acapella and blow bottle devices effectively improve oxygen saturation in post COVID-19 patients, but do not significantly affect peak expiratory flow rate, shortness of breath, and six-minute walk distance. These findings suggest that while these devices are beneficial for enhancing oxygenation, a more comprehensive respiratory rehabilitation approach is necessary for addressing the full spectrum of respiratory complications in post COVID-19 patients.

Impact of combined Russian current and threshold PEP on dyspnoea and functional capacity in patients with COPD: a randomised controlled trial

IntroductionExpiratory muscle weakness and dyspnoea are common in patients suffering from chronic obstructive pulmonary disease (COPD) and negatively affect their exercise capacity. We aimed to highlight the combined effect of Russian current and a threshold positive expiratory pressure (PEP) device on expiratory muscle strength, dyspnoea, and functional capacity in patients with COPD.MethodsA total of 60 males with COPD were involved in this controlled randomised trial (age ranged 55–65 years and median body mass index [BMI] was 28.68–25.96) and randomly assigned into two equal groups (30 for each), to receive combined Russian current and PEP device (study group) or PEP device only (control group), for three sessions per week over a ten-week period. Maximum expiratory pressure (MEP), dyspnoea (modified Borg scale – MBS), and functional capacity (6-minute walk test) were assessed before and after the intervention.ResultsThere was statistically significant improvement in all measured variables (MEP, MBS, and 6-minute walk test) in either the study group or the control group according to Wilcoxon’s sign rank test (all were p &lt; 0.001 and p &lt; 0.01, respectively), however, the study group showed a more significant improvement compared to the control group according to the Mann–Whitney U-test (p &lt; 0.001).ConclusionsCombined Russian current and PEP device had a superior beneficial effect on improving dyspnoea and functional capacity by boosting the expiratory muscle strength in COPD patients, which could be implemented in their management, although further studies are needed to evaluate its maintenance effect.

The use of oscillatory positive expiratory pressure devices for voice therapy

Over the last three years, a variety of oscillatory positive expiratory pressure (OPEP) devices have been commonly used by voice therapist and trainers (e.g. Acapella Choice, Shaker Deluxe, Shaker Medic Plus, New Shaker), even if they were not originally created for voice-treatment purposes. OPEP are intended to be used by physiotherapists to mobilize secretions from the lower airway when treating excessive sputum or secretion retention. The mechanism of oscillatory OPEP is based on a continuous and rapid shuttering of airflow, which in turn produces modulation of the oral and tracheal air pressure as patients blows into them. People diagnosed with cystic fibrosis and neurogenic diseases are usually recommended using OPEP devices [1, 2]. OPEP devices are different from expiratory/inspiratory muscle strength training devices, which have no oscillatory mechanisms inside.

Comparison between biofeedback Acapella and biofeedback flutter devices in COPD: A new way to improve airway clearance

Introduction and Aim: In recent years, biofeedback systems have been integrated into a variety of devices. Biofeedback system is the process of gaining awareness of one's physiological functions by an apparatus which provides participants feedback of their performance. Respiratory training with a biofeedback system provides the correct breathing pattern, reduces respiratory rate and tension, enhances respiratory function, improves gaseous exchange, improves ventilation and perfusion mismatch. Therefore, it reduces sympathetic nervous system activity by clearing secretions. As clearing the mucous from the airways is the initial stage of respiratory rehabilitation, this study sought to implement a biofeedback system in an Acapella and flutter device and compared the effectiveness of both the positive expiratory pressure (PEP) devices (Acapella and Flutter) with biofeedback on lung functions in chronic obstructive pulmonary disease (COPD) patients.&#x0D; &#x0D; Materials and Methods: 30 patients were assigned randomly to the acapella group or the flutter group with 15 patients in each group. The Acapella biofeedback group used the Biofeedback Acapella device for 15-20 minutes per day for five days, while the Flutter biofeedback group used the Biofeedback Flutter device simultaneously.&#x0D; &#x0D; Results: The biofeedback acapella group and the biofeedback flutter group showed significantly higher increases in forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and oxygen saturation (SpO2). There was no significant difference between the groups. In addition, there was a significant difference in sputum weight, within both the groups reducing significant amounts of sputum and improving symptoms.&#x0D; &#x0D; Conclusion: These results suggest that both Biofeedback Acapella device and the Biofeedback Flutter device help in improving lung function and oxygen saturation in COPD patients. Further scientific studies are needed to be performed to confirm the results and to determine the optimal durations and frequencies used in these devices. We also recommend further improvement and development of airway clearance devices.

A Comparison of the Effects of Phonation into a Positive Expiratory Pressure Device and Silicone Tube in Water on the Vocal Mechanism

A Comparison of the Effects of Phonation into a Positive Expiratory Pressure Device and Silicone Tube in Water on the Vocal Mechanism

Modified forced expiration technique using expiratory resistance in adults with cystic fibrosis.

Participation in airway clearance techniques (ACT) is important to minimise development of irreversible airway obstruction in patients with cystic fibrosis (CF). Positive expiratory pressure (PEP) and expiratory resistance devices (ERD) are often used as they can improve collateral ventilation and aid in the shearing of mucus from airways. This project looked to identify whether utilising an ERD during a forced expiration technique (FET) improves ease of expectoration, sputum amount and coughing frequency in patients with CF. Patients with CF admitted for a respiratory exacerbation completed two sessions of 10 cycles of their usual ACT with half of the FET components performed with an ERD, half with FET alone. EOE, sputum wet weight, cough frequency and patient preference were similar between groups. Improved EOE without the ERD was found in participants who usually use PEP for their ACT regime. Combining the FET with a PEP mask did not improve EOE and other outcomes in this small study. Investigating the efficacy of this technique within a larger population is warranted.

Breathing better: A tech-monitored study of positive expiratory pressure and reading aloud for chronic obstructive pulmonary disease.

Breathing exercises, such as diaphragmatic breathing and positive expiratory pressure (PEP), relieve breathlessness in people with chronic obstructive pulmonary disease (COPD). This study aimed to investigate the effects of breathing exercises with PEP and reading aloud on vital signs, fatigue level, severity of dyspnoea and respiratory function parameters in patients with COPD. The study followed a randomized controlled trial of COPD patients from a single hospital in eastern Turkey. The study included 103 patients who were randomly assigned to receive pre-reading exercises, breathing exercises with a PEP device or no intervention for 8 weeks. The use of a PEP device improved oxygen saturation, forced expiratory volume in 1 s (FEV1 ) and FEV1 /forced vital capacity (FVC) values and reduced fatigue and dyspnoea severity. Reading aloud lowered the mean arterial pressure and reduced fatigue and dyspnoea severity. The study concludes that PEP devices and reading aloud can improve respiratory function in patients with COPD. Additionally, reading aloud is an accessible, easy-to-implement and economically feasible method for treating COPD symptoms.

Impact of Aerobika® oscillating positive expiratory pressure in improving small airway resistance, lung function, symptoms and exercise capacity in chronic obstructive pulmonary disease.

Aerobika® oscillating positive expiratory pressure (OPEP) device promotes airway clearance in many respiratory diseases. However, studies have yet to focus on its effectiveness in improving small airway resistance via impulse oscillometry (IOS) measurement in COPD subjects. We aim to evaluate the improvement of small airway resistance (via IOS), lung function (spirometry), exercise capacity [via 6-min walking test (6MWT)], symptoms [COPD assessment test (CAT)] and severe exacerbation events among COPD subjects using Aerobika® OPEP. This was a prospective, single-arm interventional study among COPD subjects with small airway disease. Subjects were instructed to use twice daily Aerobika® OPEP (10 min each session); for 24 weeks; as an additional to standard therapy. IOS, spirometry, 6MWT, CAT score and severe exacerbation events were evaluated at baseline, 12 weeks and 24 weeks. Fifty-three subjects completed the study. Aerobika® usage showed improvement of IOS parameters; e.g. measurement of airway resistance at 5 Hz (R5), cmH20/L/s, (12-week p = 0.008, 24-week p < 0.001), R5% predicted (12-week p = 0.007, 24-week p < 0.001) and small airway resistance (R5-R20), cmH20/L/s, (12-week p = 0.021, 24-week p < 0.001). There were improvement of lung function; e.g. FEV1, L (12-week p = 0.018, 24-week p = 0.001), FEV1% predicted (12-week p = 0.025, 24-week p = 0.001), FEF25-75, L (12-week p = 0.023, 24-week p = 0.002), and FEF25-75% predicted (12-week p = 0.024, 24-week p < 0.001). CAT score improved at 12 weeks (p < 0.001) and 24 weeks (p < 0.001). Subjects had improved exercise capacity (6MWT, metres) after 24 weeks (p = 0.016). However, there was no significant difference in severe exacerbation events 24 weeks before and after Aerobika® usage. Aerobika® OPEP demonstrated significant improvement in small airway resistance as early as 12 weeks of usage, with sustained improvement at 24 weeks. Aerobika® OPEP administration had significantly improved lung function, 6MWT, and CAT scores over 24 weeks. There was no difference in severe exacerbation events.

P423 A low-cost positive expiratory pressure device for people with cystic fibrosis in developing countries

Positive expiratory pressure (PEP) is a commonly used airway clearance technique, involving breathing against an expiratory pressure of 10 to 20 cmH2O. PEP temporarily increases functional residual capacity and allows an increased volume of air to accumulate behind airway obstructions, promoting the movement of secretions towards the large airways. The cost of PEP devices can prohibit their widespread use in developing countries, therefore a simple, low-cost PEP was designed and manufactured for this purpose, and pressure and flow were tested.

Effectiveness of the use of an oscillating positive expiratory pressure device in bronchiectasis with frequent exacerbations: a single-arm pilot study.

Impaired airway clearance in patients with non-cystic fibrosis bronchiectasis causes frequent bacterial infection, chronic inflammation, and progressive tissue destruction. We aimed to evaluate whether an oscillating positive expiratory pressure (OPEP) device could allow effective sputum expectoration and prevent acute exacerbations in patients with bronchiectasis who had frequent acute exacerbations. This open-label, single-arm, prospective study included 17 patients who experienced three or more acute exacerbations in the past year. We evaluated the prevention of acute exacerbations, subjective symptom improvement, and change in sputum amount during the use of the Aerobika (Trudell Medical International, London, ON) OPEP device twice daily for 6 months. Of all enrolled patients, only two acute exacerbations occurred during the study period, indicating a significant decrease compared with the number of acute exacerbations before the device use (p < 0.001). Additionally, Bronchiectasis Health Questionnaire score changed from 58.7 to 66.6, showing significant improvement over the treatment period (p < 0.001). The largest sputum volume was observed 3 months after OPEP device use (baseline: 10 ml, 3rd month 25 ml, p = 0.325). There were no major adverse events related to the use of OPEP devices. Twice-daily physiotherapy with OPEP device in patients with bronchiectasis who have frequent exacerbations may facilitate symptomatic improvement and prevention of acute exacerbations without serious adverse events.

Conventional chest physiotherapy compared to other airway clearance techniques for cystic fibrosis.

Conventional chest physiotherapy compared to other airway clearance techniques for cystic fibrosis.

Evaluation of outcome reporting in clinical trials of physiotherapy in bronchiectasis: The first stage of core outcome set development.

The aim of this study is to explore outcomes currently reported in physiotherapy trials for bronchiectasis and investigate the level of consistency in outcome reporting. This mapping of outcomes will be used to inform the development of a core outcome set (COS) for physiotherapy research in bronchiectasis. Outcomes reported in randomised clinical trials (RCTs) and RCT protocols were reviewed and evaluated. We included trials with physiotherapy as the main intervention, including pulmonary rehabilitation, exercise prescription, airway clearance, positive expiratory pressure devices, breathing training, self-management plans, and home exercise program. Medline, CINAHL, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and the physiotherapy evidence database (PEDro) were searched from inception using a prespecified search strategy. Records including adult patients with bronchiectasis were included. Outcomes were listed verbatim and categorised into domains based on a pre-specified system, frequency of reporting and sources of variation were inspected. Of 2158 abstracts screened, 37 trials (1202 participants) and 17 trial protocols were identified. Eighteen different physiotherapy techniques were investigated. A total of 331 outcomes were reported. No single outcome was reported by all trials. The most reported outcomes were lung function (27 trials, 50%), health related quality of life (26 trials, 48.1%), and dyspnoea (18 trials, 33.3%). A list of 104 unique outcomes covering 23 domains was created. Trials focus on physiological outcomes, mainly those related to respiratory system functions. Outcomes related to functioning and life impact are often neglected. Outcome reporting in physiotherapy research for bronchiectasis was found to be inconsistent in terms of choosing and defining outcomes. Developing a core outcome set in this area of research is needed to facilitate aggregation of future trial results in systematic reviews that will in turn inform the strength of evidence for the effectiveness of physiotherapy. Outcome choice should include all stakeholders, including patients. This study is registered in the PROSPERO registry under the number CRD42021266247.

Early physiotherapy management of patients with Covid-19 admitted to a university hospital in Norway (March 2020 to July 2021).

The aim of this retrospective observational study was to describe the scope of physiotherapy, the population and the physiotherapy management of Covid-19 patients referred to physiotherapy at a university hospital in the period from March 2020 to July 2021. A descriptive observational study with access to data from a quality register, which contains clinical data of all patients admitted with Covid-19 to a university hospital in Norway. Data was obtained from electronic data sheets, where daily parameters for physiotherapy treatment were registered. In total, 729 Covid-19 patients were admitted during this period. Of these, 507 (69.6%) received treatment by a physiotherapist (3510 sessions). The physiotherapy treatments were performed on intensive care units (ICU) (50%), intermediate care units (11%) and general medical units (39%), respectively. Patients were mainly treated during the day (98.5%) and 21% of the sessions were given on weekends or holidays. Within the 3510 sessions, 9459 interventions were performed in total (one to seven interventions per session). The most common intervention provided was positioning (35.4%). The most common interventions in medical units and intermediate care units were training with a positive expiratory pressure device (17.3% and 15.9% respectively), and techniques for reducing work of breathing (13% and 15% respectively). The most common intervention in the ICUs was passive mobilization (21.3%), mostly in combination with positioning, manual techniques and/or airway clearance. This study provides characteristics of, and experiences with early physiotherapy, in sequentially hospitalized patients at a university hospital in Norway.

Airway clearance therapy in the school environment: Retrospective analysis of a cohort of pediatric patients with cystic fibrosis

BackgroundAdherence to airway clearance therapy (ACT) in pediatric cystic fibrosis (CF) patients is reported to be below 50% and inability to sustain daily care is linked to poor health outcomes7,8,9. Through a collaboration between a CF care center and several schools, we hypothesized that ACT completed at school by pediatric CF patients will improve lung function while decreasing pulmonary exacerbations (PEx), days of antibiotics (abx) and hospitalizations. MethodsThis was a retrospective case-control study at a single CF care center consisting of 50 CF patients age < 18 at time when data was recorded (2012–2020). The case group used high-frequency chest wall oscillation or positive expiratory pressure devices at school for at least 1 year after self-reported or physician identified inadequate use at home. Lung function and measures of healthcare utilization were collected. ResultsIn the case group (n = 14), paired t-tests showed that after initiation of ACT at school, there were significant reductions in PEx requiring IV or PO abx (P = 0.010), total days of abx (P = 0.032), and visits to the CF care center (P = 0.037). There was no change in these outcomes in the matched control group (n = 36). ConclusionsThis is the first known study to highlight an initiative between a CF care center and schools which utilized airway clearance devices at school to ensure pediatric CF patients completed ACT. Through increased adherence, this relationship was associated with improved health outcomes. Use of alternative strategies may help patients with CF sustain adequate airway clearance.

Efficacy and safety of long-term use of a positive expiratory pressure device in chronic obstructive pulmonary disease patients, a randomized controlled trial

BackgroundExercise intolerance is among the most common symptoms experienced by patients with chronic obstructive pulmonary disease (COPD), which is associated with lung dynamic hyperinflation (DH). There was evidence that positive expiratory pressure (PEP), which could be offered by less costly devices, could reduce DH. The purpose of this study was to evaluate the efficacy and safety of long-term domiciliary use of PEP device in subjects with COPD.MethodsA randomized controlled trial was conducted and 25 Pre-COPD or mild-to-very severe subjects with COPD were randomized to intervention group (PEP device, PEP = 5 cmH2O, n = 13) and control group (Sham-PEP device, PEP = 0 cmH2O, n = 12). PEP device was a spring-loaded resistor face mask. Subjects were treated 4 h per day for a total of 2 months. Six-minute walk test (6MWT), pulmonary function, the Modified British Medical Research Council score, and partial pressure of end-tidal carbon dioxide were evaluated at baseline and after two months.ResultsThe 6MWD (− 71.67 ± 8.70 m, P < 0.001), end-dyspnea (P = 0.002), and end-fatigue (P = 0.022) improved significantly in the intervention group when compared with the control group. All subjects in the intervention group reported that 4 h of daily use of the PEP device was well tolerated and accepted and there were no adverse events.ConclusionRegular daily use of PEP device is safe and may improve exercise capacity in subjects with COPD or pre-COPD. PEP device could be used as an add-on to pulmonary rehabilitation programs due to its efficacy, safety, and low cost.Trial registration: The study was prospectively registered on ClinicalTrials.gov (NCT04742114).

Effect of Aerobika Device versus Acapella Device on Sputum Volume and Lung Functions in Chronic Obstructive Lung Disease Patients- A Research Protocol

Introduction: Chronic Obstructive Lung Disease (COPD) is an incurable, gradually worsening respiratory condition characterised by airflow limitation and blockage that cannot be completely reversed. Productive cough caused due to mucus hypersecretion is a common symptom of COPD. Clearing the lungs may aid in the conservation of energy and oxygen, as well as the prevention of lung infections. Therefore, Oscillating Positive Expiratory Pressure (OPEP) devices are designed to aid in sputum clearing in COPD patients. They are available in a variety of sizes and shapes and clear the airway with air pressure, oscillation, or high-frequency sound waves. Need of the Study: Chronic Obstructive Pulmonary Disease (COPD) makes it challenging for air to flow freely into and out of the lungs. Shortness of breath, cough, and mucus in the lungs are all possible symptoms. Clearing the lungs may aid in the conservation of energy and oxygen, as well as the prevention of lung infections. To help clear away excess sputum, numerous airway clearance devices can be used. They are available in a variety of sizes and shapes and clear the airway with air pressure, oscillation, or high-frequency sound waves. Aim: To compare the effect of Aerobika vs. Acaplla device on sputum volume and lung function in COPD patients. Materials and Methods: A comparative study will be performed in respiratory medicine OPD of Ravi Nair Physiotherapy College, Sawangi (Meghe), Wardha. Ethical approval was received from the Ethical Review Committee of Datta Meghe Institute of Medical Sciences, Deemed to be University. In this study 30 patients diagnosed with COPD will be categorised into two groups one group will receive aerobika device with conventional physiotherapy and another group will receive acapella device with conventional physiotherapy twice a day. Treatment will be given five days for one week. The assessment will be done on day one of the treatment and at the end of treatment which is first week. Sputum volume and lung function will be assessed by sputum collector and Pulmonary Function Test (PFT), respectively. The statistical analysis will be done using chisquare test. The parameters will be compared between both the groups for sputum volume and lung function over a period of one week. Data will be analysed in a statistical software SPSS 27.0.V.

The Effect of Aerobika Device and Acapella Device on Rehospitalisation and Pulmonary Functions in Patients with Chronic Obstructive Pulmonary Disease-A Systematic Review

Introduction: Controlling and preventing symptoms of exacerbations, shortness of breath, cough and mucus in the lungs are important goals of Chronic Obstructive Pulmonary Disease (COPD) treatment. Oscillating Positive Expiratory Pressure (OPEP) devices have been shown to improve clinical results. The conservation of energy and oxygen, as well as, the prevention of lung infections and reducing rehospitalisation may be facilitated by clearing the lungs. There are several airway clearance devices, that can be used to help clear excessive sputum. Aim: To identify the effect of aerobika device versus acapella device on rehospitalisation and lung functions in COPD patients. Materials and Methods: This systematic review was conducted in the Department of Physiotherapy at Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, India. The duration of the study was three months, from march 2022 to june 2022. Five databases (PubMed, scopus, web of science, google scholar) were searched from 2012 to 2022. Inclusion criteria consisted of studies on the effect of aerobika device and acapella device on rehospitalisation and lung functions only in COPD patients. Data extraction included baseline features, treatment intervention, training frequency, supervision level, breathlessness, acute exacerbation, and outcomes. High quality experimental trials and comparative studies were chosen for the study. Results: A total of 20 articles were extracted; five were utilised for the purpose of writing the review, emphasising the effect of aerobika device versus acapella device on rehospitalisation and lung functions in COPD patients. Studies had showed inconsistent results on the effect of aerobika device versus acapella device on rehospitalisation and lung functions in COPD patients. Conclusion: Rehospitalisation, readmission and length of the stay can be reduced by using both, aerobika and acapella devices. Both devices are effective in improving lung function in COPD patients.