Vibrating vests are one of the many tools used by those living with cystic fibrosis to break up mucus in their lungs and encourage coughing, helping prevent respiratory infections from returning more frequently and keeping them out of hospital.
New Zealand provides access to the Vest for people with cystic fibrosis who meet certain criteria and are referred by their respiratory physiotherapist. The Vest replaces chest wall percussion performed by carers, and requires specialist training for setup and use by carers.
What is it?
A vibrating vest is a machine that produces vibrations to loosen mucus from the lungs and trachea, offering relief to people living with cystic fibrosis and chronic obstructive pulmonary disease (COPD). The device works by using air pulses to stimulate and vibrate chest wall, loosening mucus so it’s easier to cough out. COPD vests may also be combined with other therapies like bronchodilators or antibiotics to provide complete treatment of their symptoms.
Cystic fibrosis patients must use various airway clearance techniques, including manual chest wall percussion. Sometimes doctors will also recommend high-frequency chest wall oscillation vests (HFCWOs). This device thins and shears mucus in the lungs before shifting it towards larger airways where it can be coughed off more easily.
The HFCWO vest has been approved by the FDA as an aid for treating various pulmonary conditions, including COPD and cystic fibrosis. It often serves as an alternative to manual chest percussion which can be both uncomfortable and time consuming; powered by an air pulse generator which sends rapid bursts of air that inflate and deflate it like clapping; according to Cystic Fibrosis Foundation this action may help thin mucus production by encouraging it out of your lungs more quickly.
Studies conducted between 2023-2025 on this device concluded it to be more effective than other manual airway clearance techniques for improving sputum volume, frequency of production, ease of breathing, antibiotic use (piperacillin and tazobactam were more likely used) as well as use with various respiratory medications. The authors of the 2023-2025 studies concluded it as more beneficial to patients living with CF than traditional manual techniques alone.
HFCWO Vest manufacturer claims their device is used in 36 NHS organizations; however, many specialist commentators maintain it is funded on an individual basis and does not fall within routine NHS operations. Commentators point out it might be more useful for people who cannot move as it allows a carer to administer treatment instead of the patient directly.
How does it work?
The device vibrates the chest wall to generate an air wave that thins and shears mucus before pushing it away from lung walls for coughing up. In addition, this air wave increases movement of other lung secretions.
The vest is connected to a generator which produces alternating positive and negative pressure changes (inflation/deflation). These help mucus move towards airway openings in the lungs. It can be combined with other forms of physical therapy techniques like manual percussion or postural drainage exercises or nebulizer treatments with normal or hypertonic saline, to further loosen secretions and make coughing out easier.
Utilizing this device minimizes the need for chest wall physiotherapy, which typically entails lying in various positions several times each day while being manually clapped upon by a therapist or caregiver to break up and move mucus from your lungs. However, this exercise may need to be repeated multiple times daily in order for it to work effectively and may become exhausting over time.
The vest’s ability to provide full 360-degree chest coverage enables people to use it while performing other activities, such as watching television, playing with grandchildren or gardening. This makes manual percussion therapy much less convenient as it requires many hours a day spent lying still in different positions.
Two recent and carefully conducted studies have demonstrated that those who use vests as their preferred airway clearance technique may develop respiratory complications more quickly or increase them quickly than those using alternative techniques; possibly because vests don’t clear as many secretions.
For this reason, physiotherapists working with people living with cystic fibrosis often suggest that the vest not be used as the only airway clearance technique and that other techniques such as manual percussion therapy, PEP and huff coughing be implemented concurrently or after using the vest for at least some cycles. Furthermore, it’s vital that oxygen saturations be closely monitored during and post treatment if using the vest is to be effective.
What is the cost?
High-frequency chest wall oscillation is an noninvasive, painless treatment option for people suffering from chronic airway disease. It helps alleviate symptoms, prevent exacerbations and increase quality of life by clearing mucus and mobilizing secretions from the airways. Furthermore, high frequency oscillation increases ventilation to promote lung tissue health while helping avoid collapse caused by trapped secretions that accumulates within them.
COPD vests feature a generator that produces bursts of air to quickly inflate and deflate the vest quickly, producing vibrations to loosen chest secretions so you can cough away excess mucus. Sessions usually last 20 to 30 minutes; you can use these vests both at home and while travelling without an electrical outlet; some mobile vests even do not require generators or hose attachments so that movement may be more free-flowing.
Cost of vibrating vests varies based on brand, model and size chosen; you will require a valid prescription from your physician in order to purchase one; some insurance plans may cover this expense as well. It is wise to consult your physician prior to making a decision about long-term treatment with any device before making a purchase decision; it may be worthwhile spending out-of-pocket temporarily to give yourself time to try out potential devices before making your final choice. The Cystic Fibrosis Foundation advises consulting them first when considering vibrating vest purchases; cost may differ accordingly depending on which one(s) they select.
Vibrating vests may provide an effective and less painful alternative to manual percussion therapy for certain patients, particularly those living with cystic fibrosis who can not or do not wish to perform the latter method of therapy. They’re especially helpful for people who require treatment but cannot or do not want to perform manual percussion therapy sessions themselves.
Comparing SmartVest with its standard of care control group, the clinical outcomes study discovered that it reduced healthcare utilization costs by 58% for those suffering with bronchiectasis – including antibiotic costs, emergency department visits and hospitalizations. Data for this analysis came from patient medical records as well as phone interviews.
SmartVest is an FDA-cleared airway clearance system for adults living with bronchiectasis or COPD. Using a portable wireless air pulse generator with an inflatable vest to deliver high frequency oscillations. Additionally, its unique triangle waveform provides more comfortable therapy than sine waves found in other air pulse systems.
Is it safe?
HFCWO vests are airway-clearing devices used to thin, shear and propel mucus towards major airways for coughing out. When combined with other clearing techniques such as huff and cough or manual percussion of the chest wall, they help break up thick mucus deposits in your lungs – typically taking 20 to 30 minutes with patients required to cough during and after their session.
Vibrating vest therapy may reduce hospital costs by decreasing antibiotic usage, chest x-rays and lung function tests; however, the cost and additional time necessary for therapy sessions must also be taken into account. According to experts in this field, outcomes that demonstrate clinical effectiveness would include hospital admissions, antibiotic use and number of chest infections in addition to lung function testing results.
The SmartVest fills with air that begins to pulse, compressing and releasing chest wall at an adjustable frequency, treating all lobes of lungs simultaneously and helping loosen mucus build-up. An assistant should then manually clap on their chest several times daily as part of an airway clearance technique.
There are various airway clearance techniques, which physiotherapists will advise against depending on an individual’s age and personal choices and circumstances. There are also devices which can help loosen and move mucus; all are recommended as additional tools to try for people living with CF in addition to airway clearance techniques.
Before making recommendations about any device or treatment, physiotherapists take into account all costs involved for the individual and their health and care needs, as well as eligibility criteria for healthcare funding, as well as type(s) of funding that might be available to them.
