High frequency chest wall oscillation (HFCWO) is an established airway clearance therapy, proven to improve lung function, reduce chest infections and antibiotic use, as well as hospital admissions, while also being covered by insurance companies.
The vest uses vibrations at various frequencies and intensities to loosen and thin mucus, separate it from lung walls, and move it into upper airways where it can be coughed out or suctioned away for coughing or suctioning. Sessions usually last 20-30 minutes.
Mucus Loosening
A vibrating vest uses a generator to deliver rapid air pulses into its vibrational fabric, creating vibrations that loosen mucus deep within your lungs and make it easier for expectoration, or coughing out, mucus to occur.
Breaking up sputum, which is a thick liquid, helps reduce inflammation and toxicity and ultimately enhance lung function over time. Treatment also results in less coughing and shortness of breath as well as less infections, antibiotic usage, hospital admissions and exacerbations.
HFCWO device’s additional benefit lies in its capacity to assist autogenic drainage, an essential breathing technique for those suffering from bronchiectasis, cystic fibrosis and other chronic lung conditions. Autogenic drainage comprises three stages of mucus clearance that begin by loosening it from airway walls before moving the loose mucus from smaller to larger airways and finally expulsion from the lungs.
Noninvasive approaches include using an ET tube or tracheostomy tube for intubation or noninvasive methods like using a mouthpiece and mask, with noninvasive options like threshold positive expiratory pressure (PEP) being the more popular and self-administered methods such as oscillatory PEP; handheld devices equipped with one-way valves and resistances generate positive pressure during exhalation as well as oscillations to mobilize mucus for expectoration – these devices include AffloVest and Quake devices which CF care teams provide and most insurance plans offer coverage.
Postural Drainage
Chest physiotherapy techniques are used to clear sticky mucus from your airways. This therapy employs various positions designed to mobilize and transport mucus more easily for coughing up. Which position you select will depend on which areas of your lung require drainage; following an evaluation by a respiratory therapist, they’ll give instructions as to which positions and for how long.
Postural drainage is a positioning technique which uses gravity to drain excess pulmonary secretions from your lungs and airways, helping reduce inflammation, improve lung function, and enhance quality of life. Postural drainage can be performed either alone or combined with chest percussion or vibration therapy to achieve maximum effectiveness. While it is best performed while lying on a bed, you can also do it on the floor or recliner; just ensure there’s enough space between each position.
Chest percussion or vibration therapy is another effective way to clear mucus out of the lungs without using a vest, and involves clapping chest and back while performing breathing exercises. This process typically lasts 30-40 minutes per session and should be done twice daily at least. For added benefit, controlled coughing involves taking deep breaths while forcing mucus out.
Some individuals living with cystic fibrosis must use additional forms of airway clearance therapy – beyond manual chest clapping – such as high-frequency chest wall oscillation vests (HFCWOs). HFCWOs can help loosen any sticky phlegm that accumulates within your lungs or airways and are an ideal option for those lacking mobility or strength to perform manual chest percussion or other forms of airway clearance therapy themselves.
Vests that treat an illness or injury such as cystic fibrosis typically fall under the purview of insurance, though you’ll require a doctor’s prescription in order to get one. Be sure to discuss with your insurer what coverage there may be before ordering one; some people may qualify for Social Security disability payments or Medicare before turning 65 and receive one through these programs as well.
Rhythmic Pressure
Pulsations create pressure similar to clapping on the chest wall, breaking up mucus stuck in smaller airways of the lungs and opening them up to promote coughing and get thickened mucus out of them. HFCWO devices are commonly used by those living with bronchiectasis to help clear their lungs of thickened mucus while providing vital oxygen for breathing. Rhythmic Pressure Entrainment Pressure Therapy, more commonly referred to as oscillatory PEP therapy can be performed either along with postural drainage or as stand-alone therapy treatment options.
HFCWO devices are worn over clothing and linked to an electronic generator, which when activated produces rapid air pulses that cause oscillations within the lungs. This air pulse can either be delivered invasively via an endotracheal tube (ETT) or tracheostomy tube or noninvasively through a mouthpiece/mask interface.
Oscillations not only facilitate airway clearance therapy, but can also increase treatment adherence through mobility. The AffloVest is a mobile high frequency chest wall oscillation vest designed to maximize patient adherence and mobility during use of treatment. Equipped with eight anatomically placed motors producing individual pressure waveforms to loosen, thin, mobilize secretions in your lungs – mimicking manual chest physical therapy while making use easy and enjoyable – AffloVest makes using treatment comfortable for patients allowing users to follow an effective therapy protocol without difficulty or difficulty using manual physical therapy sessions in most situations compared with manual physical therapy sessions in terms of ease of use by mimicry compared with manual physical therapy making use effortless for patients themselves!
Based on your CF diagnosis, you may qualify to receive a vibrating vest device through your healthcare team. While they are usually covered by insurance plans, in order to order one you’ll require a valid prescription from a physician. Need help understanding insurance? Reach out to Cystic Fibrosis Foundation Compass; our free personalized support service that can assist with insurance-related concerns such as financial and legal concerns.
Safety
Patients living with bronchiectasis, cystic fibrosis and other neurologic and neuromuscular conditions have reduced abilities to actively clear secretions from their lungs. Airway clearance therapy (ACT), such as chest physiotherapy with manual percussion and vibration treatments are often recommended to loosen and mobilize lung secretions.
The AffloVest is an FDA-cleared device that uses high-frequency chest wall oscillation to promote pulmonary rehabilitation and increase patient mobility, increasing patient adherence by increasing mobility. It’s portable, battery-powered, wireless device features seven custom size variations from XXS-XXL as well as adjustable shoulder and chest straps for greater treatment compliance.
Cystic Fibrosis Foundation Compass services provide essential guidance to people living with CF and bronchiectasis as they navigate health care, insurance, legal, financial, and other issues related to care. Their team is available Monday – Friday 9am-5pm ET; its service is confidential and free; for more information visit cffcompass.org or call 1-800-CF-COMPASS for further assistance. For those residing in MassachusettsHealth services they require prior Authorization prior to authorizing High Frequency Chest Wall Oscillation Air-Pulse Generator Systems before approval; their PA only assesses medical necessity while payment will depend upon other policies/guidelines set by MassHealth policies/guidelines/policies/guidelines applicable for payment policies/guidelines applicable from MassHealth policies/guidelines that apply for this application process if applicable (ie the PA determining medical necessity only), payment will depend upon other policies/guidelines applicable and policies/guidelines as per policies/guidelines applicable; For further details/MassHealth/MassHealth requires PA before approval of High Frequench Oscillation Air-Pulse Generator System Vest payment policy guidelines regarding payment consideration and MassHealth payment guidelines/policies guidelines/policies guidelines related payment policies/guidelines from MassHealth policies/guidelines (MassHealth policies governing reimbursement policies/guis/guidelines/). MassHealth require PA approval before payment). MassHealth requires PA before approving it being subject to all general policies/guidelines).
