If you have a disease that results in sputum production, your physiotherapist will prescribe respiratory physiotherapy for you. Initially, this will involve the physio assessing you to identify the problem. As a result, management techniques and a treatment plan will be put in place. This will include airway clearance techniques, such as oscillating PEP. Different types of mucus clearance device use oscillating PEP, including the Shaker by POWERbreathe. Such devices combine the techniques of positive expiratory pressure (PEP) with oscillations. Your physio will refer to these as ‘oscillatory positive expiratory pressure’, or OPEP devices.
Shaker mucus clearance devices
The Shaker device will help to shift your bronchial secretions by combining PEP and oscillations. This combination will help you to expectorate the increasing amount of mucus you’re producing. By coughing out more mucus, you’re helping to prevent infections of your respiratory tract. It is also helpful if you have hay fever, which can make symptoms of asthma, such as coughing and wheezing, feel worse. Devices like the Shaker are easy-to-use without medical supervision, so you may decide to use it as an alternative, or additional, treatment to your prescribed medical respiratory physiotherapy.
Although it works similarly to the older Acapella mucus clearance device, research reveals the Shaker to have better linearity at higher airflows. The same research also finds the pressure amplitude produced by the Shaker and Flutter mucus clearance device to be greater at low and high pressures. Finally, the same study shows a higher frequency of oscillation for the Shaker and Flutter at an intermediate pressure. This is all beneficial in helping you get the most from your therapy.
The Shaker Classic, Shaker Deluxe and Shaker Medic Plus by POWERbreathe all mobilise mucus using oscillatory positive expiratory pressure (OPEP). An important point to note is that the Shaker devices are all gravity-dependent, as opposed to gravity-independent. This is worth bearing in mind as a 2018 study finds,
“the gravity-dependent devices were the ones to display close mechanical performances and produce optimal operational parameters at the simulated exhalation settings.”
By contrast, this same study finds that the two gravity-independent OPEP devices, the Acapella Choice and Aerobika, “probably require higher expiratory pressure to reach theoretical therapeutic effectiveness.”
Therapeutic effects of the Shaker
If you have a condition such as chronic bronchitis, cystic fibrosis, bronchiectasis or asthma, then you’ll be only too aware of the excessive amount of mucus you produce. You may also notice a change in the type of mucus you’re producing. Because of this, it’s no surprise that you’ll be having difficulty clearing the mucus, even after coughing. But this is where using the Shaker by POWERbreathe for respiratory physiotherapy can help you.
The Shaker uses a stainless-steel ball, weighing 30g, to help clear bronchial secretions. It does this by ‘shaking’ and causing a vibration, or percussion, in your chest. This happens as you exhale through the mouthpiece. As you breathe out through the device, the 30g steel ball provides a resistance. This causes the ball to move and shake and makes it more difficult for you to breathe out. All this shaking and vibration loosens the mucus. After breathing out through it a few times, you’ll find you’ll need to huff, or cough, to expel the mucus. You can see this being demonstrated in the video above. After a few uses, you'll begin to work out for yourself how long and how frequently you'll need to use your Shaker device, as everyone is different.
To further enhance the therapeutic effect of your Shaker airway clearance device, its mouthpiece is designed to allow you to use it in a sitting or lying position.
Respiratory physiotherapy techniques
In respiratory physiotherapy, no one technique fits all. A therapist must take into consideration the strength of their patient, the thickness of their mucus and where it is located. However, as a patient, the price may be a criterion for selecting the most suitable device. In this 2013 study, assessment of the Flutter, Acapella and Shaker shows all three mechanical behaviours to be reliable. However, the Shaker is likely to be the most cost-effective.
This type of respiratory physiotherapy aims to help you clear excessive phlegm, sputum, mucus and catarrh. Consequently, breathing effort reduces and exercise tolerance improves, helping you return to a better quality of life.
Young children benefit from respiratory physiotherapy too, but they will require something with a lighter resistance to exhale against. If you have children, you’ll know that you’ll also need to make their therapy more fun. Blowing games using the Flowball by POWERbreathe can help them to clear secretions.
You should always consult a doctor before starting any treatment if you’re concerned about any medical issue.