Acapella Vibratory PEP Therapy System

Acapella is Effective for:

• Secretion Clearance Therapy.
• Maintaining a prolonged expiratory airflow, which increases the capacity to carry airway secretions towards the larger airways, where they can be coughed out.
• Prolonging the expiratory phase, allowing for a reduction in respiratory rate.
• Increasing exhaled volumes, thus reducing FRC to a more physiologic level in patients that may suffer from hyperinflation.
• Achieving the above 2 may lead to a reduction in the sensation of dyspnoea.
• A reduction in hyperinflation may improve inspiratory breathing capacity, improve Vd/Vt ratio, and improve gas exchange.

Physiologic Basis for PEP and Airway Vibrations

Positive Airway Pressure (PEP) therapy imposes a resistance to exhalation at the mouth. This represents a technologic “simulation” of the normal physiologic action we know as pursed lip breathing. This expiratory mouth pressure is transmitted upstream, that is, back down through the many generations of airways. The resulting back pressure succeeds in splinting the airways open during the exhalation phase. The capacity of PEP therapy to prevent premature airway collapse, a common condition in patients with diseases involving mucus hypersecretion, is extremely valuable in facilitating secretion clearance. Splinting the airways open during the expiratory phase provides many benefits including.

Airway vibrations can be applied both externally over the chest wall, and internally via the mouth. Physiotherapists have been applying airway vibrations for over 40 years as part of their traditional postural drainage/percussion/vibrations CPT.

Acapella utilizes a vibratory Rocker Assembly to create vibrations at the mouth during exhalation. As with PEP, these forces are transmitted upstream during exhalation, so that various airway generations, and the mucus contained within them, is subjected to vibration, Selecting and applying the customised vibratory frequency, known as hertz (Hz), based upon each patients unique airway pathophysiology and breathing pattern, maximized the value of this therapy. Optimal vibration has been shown in vitro to produce several effects, including:

1. Reducing the visco-elasticity of mucus.
2. Increasing shear forces that disengage mucus from the airway walls.
3. Pulsating the mucus forward towards the larger airways.

Acapella has been designed to combine both PEP and vibrations into a single unit.

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