Oscillating Positive Expiratory Pressure (OscPEP) using the Acapella® in children
What is the technique?
Prescription of the Acapella® in Paediatrics
A mouthpiece or a mask can be used with this device
Initially the dial is set at a low resistance (number 1 or 2) and then slowly increased as necessary
Initially one may let the toddler or child blow for 5 to 10 times or more as able. Once the child has mastered the blowing, a more formal number of breaths and sets can be instructed
Ideally, following “mucus loosening” tidal breaths, the last breath of each cycle should be a deeper and faster “mucus clearing” breath with higher volume and faster flow
Incorporate huffing and coughing into the session (see paediatric FET section)


There is limited evidence regarding the use of the Acapella® in short term or long term studies. More recently, a study has shown that the resistor set at 4 is an optimal setting for secretion mobilisation as it has a similar beat frequency to the cilia (Mueller et al 2014).
For information on where to purchase this device in Australia and New Zealand – see the Resources section.