Saturday, April 3, 2010

Acapella vs Flutter


I often get questions on which form of therapy I feel works best for CFers. My answer is pretty much always the same, "Different strokes for different folks". Now, I myself prefer hand pounds, but that doesn't work for everybody. I ran across this article comparing the performance of the acapella vs the flutter and wanted to share it with you guys. It basically says that performance wise there is no difference, but the acapella is easier to use. My question for you guys though would be different. Did you feel that either of these worked for you in terms of moving mucus up and out? And if you have done both, which do you prefer??

Performance comparison of two oscillating positive expiratory pressure devices: Acapella versus Flutter.

Volsko TA, DiFiore J, Chatburn RL.

University Hospitals of Cleveland, Case Western Reserve University, Ohio, USA.

BACKGROUND: Oscillatory positive expiratory pressure (PEP) with the Flutter device facilitates secretion removal. In the Flutter a steel ball vibrates inside a cone, causing air flow vibration. A new device, the Acapella, uses a counterweighted plug and magnet to create air flow oscillation....We hypothesized that the Acapella and Flutter would produce similar mean PEP, oscillatory pressure amplitude, and frequency over a clinically relevant range of flows. METHODS: We measured oscillatory amplitude, PEP, and frequency. Values for frequency, peak, trough, and mean pressure were recorded automatically every 3 seconds at flows of 5, 10, 15, 20, 25, and 30 L/min. The pressure waveform for 1 second was also graphically displayed and recorded. The devices were adjusted to give low, medium, and high mean expiratory pressure (Flutter angle at 0, 20, and 40 degrees; Acapella by dial setting)...RESULTS: There were statistically significant differences between the devices for mean pressure, pressure amplitude, and frequency, for all experimental conditions. However, the differences were relatively small and may not be clinically important. Both devices produced similar pressure waveforms at the medium flows. At 5 L/min the Acapella produced a more stable waveform, with a lower frequency, higher amplitude, and a slightly wider range of PEP than the Flutter. CONCLUSIONS: Acapella and Flutter have similar performance characteristics. Acapella's performance is not gravity-dependent (ie, dependent on device orientation) and may be easier to use for some patients, particularly at low expiratory flows.

In the interest of full disclosure, I have never done the acapella and the last time I did the flutter, I threw it against the wall and it broken into a handful of pieces. Oh, and I guess I better mention that I neither represent nor do I have any monetary interest in either company that provide these devices. Stupid blog laws.