Does adding an OPEP device to chest physiotherapy help children with bronchiectasis?
For children with bronchiectasis, airway clearance is a key part of daily care. Chest physiotherapy (CPT) helps clear mucus from the lungs. Oscillatory positive expiratory pressure (OPEP) devices are handheld tools that create vibrations to help loosen mucus. The question is whether adding an OPEP device to a standard CPT program provides extra benefits. Based on a 2025 randomized trial, the answer is no for clinical outcomes like exercise capacity and lung function, but yes for adherence: children using an OPEP device stuck with their therapy more consistently.
What the research says
A 2025 randomized trial involving 42 children with non-cystic fibrosis bronchiectasis compared a multicomponent chest physiotherapy (CPT) program alone to CPT plus an OPEP device 67. Both groups performed therapy at home twice daily for 8 weeks. The study measured exercise capacity (6-minute walk test), lung function (spirometry), oxygen levels during exercise, and cough-related quality of life. Both groups showed significant improvements from baseline, but there was no difference between the groups for any of these clinical outcomes 67. This means the OPEP device did not add extra benefit beyond CPT alone for these measures.
However, adherence to the therapy program was significantly higher in the CPT+OPEP group (85%) compared to the CPT-only group (74%) 67. This suggests that children may find the OPEP device easier or more engaging to use, leading to better compliance with the prescribed regimen.
Broader rehabilitation guidelines for bronchiectasis emphasize that airway clearance and exercise training are foundational, but implementation varies 5. The trial's findings align with the idea that while OPEP devices are widely used, their added value over a well-structured CPT program may be limited to improving adherence rather than enhancing physiological outcomes 67.
What to ask your doctor
- Would my child benefit from an OPEP device to help with daily airway clearance?
- How does an OPEP device compare with other airway clearance techniques for children?
- What is the recommended frequency and duration for chest physiotherapy in my child's case?
- Are there any costs or insurance coverage issues for OPEP devices that I should know about?
- How can we monitor if the therapy is working effectively for my child?
This question is drawn from common patient questions about Pulmonology & Critical Care and answered using cited medical research. We do not provide individualized advice.