Acapella vs. PEP mask therapy: a randomised trial in children with cystic fibrosis during respiratory exacerbation.

The Acapella is a positive pressure device designed to assist mucociliary clearance. This study investigated the effectiveness of the Acapella in comparison to PEP mask therapy. Twenty-three participants with cystic fibrosis (CF) with a median age of 12 years (range 7-18 years), who were admitted to hospital for a respiratory exacerbation were randomised to either the PEP mask or Acapella treatment group. Both groups completed two treatment sessions each day (10 sets of 10 breaths in sitting) over a 10-day period. Outcome measures were change in lung function (FEV1, FVC, FEF(25-75), and PEF) and exercise performance (modified 10-metre shuttle). In addition, total sputum production during treatment (wet weight) and patient satisfaction were assessed over the 10-day period. At the end of 10 days there were no statistically significant differences between the groups for any of the outcome measures. Participants were highly satisfied with both devices. The results suggest that there is no statistically significant difference between the Acapella device and the PEP mask for use in CF during an acute exacerbation. Larger studies are required to determine whether differences between PEP mask and Acapella noted in this trial are clinically worthwhile.