From the Guidelines
Acapella devices should be used 2-3 times daily, with each session consisting of 10-20 breaths through the device, as this frequency has been shown to improve quality of life, sputum volume expectorated, and exercise capacity in patients with bronchiectasis 1. The use of Acapella devices is supported by the British Thoracic Society guideline for bronchiectasis in adults, which states that oscillating positive expiratory pressure (Acapella) is effective and safe to use during an acute exacerbation 1. Key points to consider when using Acapella devices include:
- Using the device 2-3 times daily, with each session consisting of 10-20 breaths through the device
- Performing 3-5 sets during each session, taking short breaks between sets
- Increasing the frequency to every 2-3 hours for patients with significant secretions or during respiratory infections
- Adjusting the resistance dial based on comfort and therapeutic need, typically aiming for an exhalation lasting 3-4 seconds
- Performing huffing coughs to clear mobilized secretions after each session The effectiveness of Acapella devices comes from the combination of positive pressure maintaining airway patency and the vibrations that help mobilize secretions, as demonstrated in a study published in the journal Thorax 1. Overall, the use of Acapella devices as part of a comprehensive treatment plan can help improve morbidity, mortality, and quality of life in patients with bronchiectasis, and the recommended frequency of 2-3 times daily should be prioritized to achieve optimal results.
From the Research
Acapella Frequency
- The Acapella device produces continuous and oscillatory pressure levels when a patient exhales through it, with an oscillation frequency varying from 8 Hz to 21 Hz 2.
- The optimal frequency for secretion mobilization is around 13 Hz, which is close to the frequency of ciliary movement 2, 3.
- A study found that the Acapella device can produce vibration frequencies between 12 and 15 Hz, which is theoretically optimal for secretion mobilization, when used at setting 4 3.
- The frequency of the Acapella device can be adjusted to match the respiratory-system resonance frequency and/or the frequency of ciliary movement, which can aid in effective secretion removal 2.
- A software tool has been developed to optimize the clinical application of the Acapella device, which can calculate the necessary instrument adjustment, mean pressure, and oscillation amplitude based on the desired frequency and patient air flow 2.