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Does Addition of Oscillatory Positive Expiratory Pressure (OPEP) Device to a Chest Physiotherapy Program Provide

Melih Zeren1, Meral Barlik2, Beyza Nur Caglar Tosun3

  • 1Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Bakircay University, Izmir, Turkey.

Pediatric Pulmonology
|March 31, 2026
PubMed

Insights

Adding an oscillatory positive pressure (OPEP) device to chest physiotherapy (CPT) for children with bronchiectasis (BE) did not improve exercise capacity. However, OPEP use did enhance program adherence, suggesting individualized treatment decisions.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Therapy

Background:

  • Airway clearance is crucial for children with bronchiectasis (BE).
  • Oscillatory positive pressure (OPEP) devices are commonly used, but their added benefit to multicomponent chest physiotherapy (CPT) is unclear.
  • OPEP device access can involve significant out-of-pocket expenses.

Purpose of the Study:

  • To evaluate if adding an OPEP device to a CPT program offers additional benefits in exercise capacity and dynamic ventilatory responses in children with BE.
  • To assess the impact of OPEP on key clinical outcomes in pediatric BE patients.

Main Methods:

  • A randomized trial included 42 children with non-cystic fibrosis BE, allocated to CPT or CPT + OPEP groups.
  • Both groups underwent home-based training twice daily for 8 weeks.
  • Assessments included the 6-minute walk test (6MWT), spirometry, quadriceps strength, and the Leicester Cough Questionnaire (LCQ).

Main Results:

  • Both CPT and CPT + OPEP groups showed significant improvements in 6MWT distance, inspiratory capacity during exertion, SpO2 levels, and spirometry (FVC, FEV1, PEF).
  • No significant differences in clinical outcomes were observed between the groups.
  • Program adherence was significantly higher in the CPT + OPEP group (85%) compared to the CPT group (74%).

Conclusions:

  • A multicomponent CPT program effectively improves exercise capacity and respiratory function in children with BE.
  • Adding an OPEP device to CPT did not provide additional clinical benefits but significantly increased adherence.
  • Individualized decisions regarding OPEP use should consider patient engagement and feasibility rather than solely expecting enhanced clinical outcomes.
Abstract

Keywords:
airway clearancebronchiectasischest physiotherapychildrenoscillatory positive expiratory pressure

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