Mechanical behaviors of Flutter VRP1, Shaker, and Acapella devices.
BACKGROUND
Flutter VRP1, Shaker, and Acapella are devices that combine positive expiratory pressure (PEP) and oscillations.


OBJECTIVE
To compare the mechanical performance of the Flutter VRP1, Shaker, and Acapella devices.


METHODS
An experimental platform and a ventilator, used a flow generator at 5, 10, 15, 20, 26, and 32 L/min, were employed at angles of -30°, 0°, and +30° to evaluate Flutter VRP1 and Shaker, whereas Acapella was adjusted at intermediate, higher, and lower levels of resistance, including positive expiratory pressures (PEP) along with air outflow rates and oscillation frequencies.


RESULTS
When the relationships between pressure amplitudes of all air flows were analyzed for the 3 devices at low and intermediate pressures levels, no statistically significant differences were observed in mean pressure amplitudes between Flutter VRP1 and Shaker devices. However, both devices had different values from Acapella, with their pressure amplitude values being higher than that of Acapella (P = .04). There were no statistically significant differences in PEP for the 3 angles or marks regarding all air flows. The expected relationships between variables were observed, with increases in PEP, compared to those of air flows and resistance. Nevertheless, there was a statistically significant difference in frequency of oscillation between these devices and Acapella, whose value was higher than those of Flutter VRP1 and Shaker devices (P = .002). At intermediate pressure levels, the patterns were the same, in comparison to low pressures, although the Acapella device showed frequencies of oscillation values lower than those of Flutter VRP1 and Shaker (P < .001). At high pressures, there were no statistically significant differences among the 3 devices for frequency of oscillations.


CONCLUSIONS
The Flutter VRP1 and Shaker devices had a similar performance to that of Acapella in many aspects, except for PEP.
Departamento de Fisioterapia, Associação Salgado de Oliveira, Institutos Superiores de Ensino do Censa, Campos dos Goytacazes, Rio de Janeiro, Brazil.
Alexandre Pereira
AP
dos Santos
Rogério Contato
RC
Guimarães
Eliane Maria
EM
de Carvalho
Ada Clarice
AC
Gastaldi
D006612:High-Frequency Ventilation / Q000295:instrumentation*; D006801:Humans; D055595:Mechanical Phenomena; D009093:Mucus; D011175:Positive-Pressure Respiration; D011312:Pressure