A comparison of the Acapella and a threshold inspiratory muscle trainer for sputum clearance in bronchiectasis - A pilot study

Background: Inspiratory muscle training is used to specifically strengthen the respiratory muscles. Controversy exists regarding the use of inspiratory muscle training as a method of facilitating airways clearance. Acapella is already known to be effective in airway clearance. Objective: The objective of the study was to compare the effects of the Acapella and a threshold inspiratory muscle trainer as a method of airway clearance in subjects with bronchiectasis and to determine patient preference between the two techniques. Methods: Thirty patients (10 males, 20 females) mean age of 50.67±6.37 (mean±SD) with a history of expectoration of more than 30ml sputum per day were recruited. The sequence of therapy was allocated by block randomization. Assessment and familiarization session was perfomed on day 1. Treatments employing the Acapella and inspiratory muscle trainer were done on days 2 and 3. Treatment order and allocation was determined by block randomization. Sputum volume was measured during and 2 hours after the treatment and patient treatment preference was recorded. Results: A statistically significant difference was found in the sputum volume expectorated after treatment with the Acapella (7.16±1.12ml) compared with the threshold inspiratory muscle trainer (6.46±1.08ml). Patients preferred Acapella in terms of usefulness of clearing secretions. Conclusion: The present study demonstrated increased sputum clearance following the use of the Acapella when compared to the threshold inspiratory muscle trainer. In addition, the Acapella was preferred by patients who judged that it was more useful in clearing secretions.