Common Misconceptions About HFCWO Therapy

HFCWO Therapy, Airway clearance vestHigh frequency chest wall oscillation (HFCWO) therapy is an effective approach to managing bronchiectasis and other chronic pulmonary conditions, such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis. As annual bronchiectasis incidence (i.e. the number of patients newly diagnosed with bronchiectasis) increases, common misconceptions surrounding its treatment may prevent patients from choosing the most effective approach to managing their chronic symptoms and finding relief.  

Bronchiectasis (brong-kee-EK-tuh-sis) is a progressive lung disease that damages a patient’s airways through a recurring cycle of inflammation and infection. Within our airways, tiny hair-like structures, called cilia, help to clear mucus, allowing us to breathe naturally.1 When someone is living with bronchiectasis, the recurring damage to the airways reduces cilia function, making it difficult for the lungs to mobilize and clear mucus on their own, resulting in them being more vulnerable to infection.

HFCWO Therapy, Airway clearance vest

When patients are unable to clear mucus in the lungs, airway clearance therapy, which includes HFCWO, becomes the best defense against inflammation and infection. HFCWO therapy works by producing an alternating flow of air into an inflatable garment that rapidly compresses and releases the chest wall at a variety of selectable frequencies and pressures, resulting in an oscillation in airflow within the airways.

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Common Misconceptions About HFCWO Therapy:

Although HFCWO therapy is an effective approach to managing chronic lung conditions, there are misconceptions about HFCWO therapy and how it works.

HFCWO Therapy, Airway clearance vest

HFCWO Therapy Vests Perform the Same

HFCWO Therapy, Airway clearance vest

SmartVest has been clinically proven to relieve bronchiectasis-related symptoms.

As HFCWO therapy gains traction as a bronchiectasis treatment, it’s not uncommon for patients, and even prescribers, to think that all respiratory vests on the market are designed equally. The truth is that only one respiratory vest has multiple published outcomes studies to support it effects on treating and relieving bronchiectasis-related symptoms: SmartVest Airway Clearance System.

HFCWO therapy via the SmartVest Airway Clearance System is clinically proven to help clear the lungs of excess mucus, reducing the risk of respiratory infections and hospitalizations. In spring 2018, a longitudinal outcome-based study demonstrated a reduction in bronchiectasis-related exacerbations after long-term use (2.5 years) of SmartVest. Patients experienced a 42% decrease in hospitalizations, a 38% reduction in antibiotic therapy, and a 75% decrease in hospital visits due to severe exacerbations when compared to prior treatment.2

HFCWO Therapy, Airway clearance vest

HFCWO Therapy is Uncomfortable

HFCWO Therapy, Airway clearance vest

Low oscillation pressure makes SmartVest a comfortable HFCWO therapy option.

Because HFCWO vest therapy works by delivering rapidly repeating pulses of air that squeeze and release the upper body, a patient may experience discomfort if pressure against the chest wall prevents them from taking deep breaths. In a third-party study, three HFCWO therapy vests were compared to determine their variances in oscillatory trough pressure, or the constant “squeezing pressure” applied to the chest during treatment.3

The study’s findings revealed that the SmartVest Airway Clearance System consistently delivered lower oscillatory trough pressure compared to the other two respiratory vests that were evaluated. This indicates SmartVest provides a more comfortable HFCWO treatment by eliminating unnecessary, constant “squeezing pressure” against the chest.

HFCWO Therapy, Airway clearance vest

HFCWO Therapy is Time-Consuming

HFCWO Therapy, Airway clearance vest

The average therapy session is only 30 minutes long.

On average, HFCWO therapy is performed 7 days a week and approximately 30 minutes per session, depending on the prescriber’s instructions. With the SmartVest, patients generally perform their sessions twice a day, during the morning and evening. Like brushing your teeth, SmartVest fits seamlessly into a patient’s daily routine to ensure an uninterrupted day.

HFCWO Therapy, Airway clearance vest, bronchiectasis treatmentsAnd because SmartVest is the lightest and quietest HFCWO generator on the market, weighing less than 16 pounds, patients can easily perform each session while traveling or in the comforts of their home, allowing them to experience airway clearance on their own schedule. In comparison to perceived mobile technologies, which weigh up to 13 pounds, the simple to use and lightweight SmartVest garment weighs less than two pounds and can be more easily applied, used, and removed independently.

HFCWO Therapy, Airway clearance vest

HFCWO Vests are Awkward to Use

HFCWO Therapy, Airway clearance vest

SmartVest has programmable settings and a simple, user-friendly design.

Using Velcro-like closures, rather than buckles, SmartVest fits securely around the chest without the patient feeling constricted. It can also be easily adjusted for added relief. Made from soft-touch microfiber material with a single-hose design, SmartVest uses a unique, proprietary patented design feature known as “active inflate – active deflate,” making deep and easy breaths possible during treatment. Patients can also preset their therapy protocols once they receive the device, allowing them to use a one-touch start feature repeatedly for consistent therapy.

HFCWO Therapy, Airway clearance vest

HFCWO Therapy is Expensive

HFCWO Therapy, Airway clearance vest

SmartVest is covered by nearly all insurance providers.

The SmartVest Airway Clearance System is covered by most private insurance, Medicare, state medical assistance, a combination of all three, or the U.S. Department of Veterans Affairs. In addition, patients who are prescribed a SmartVest may be eligible for Electromed’s financial assistance programs to help ease any financial burdens that would prevent them from receiving the airway clearance device. SmartVest has also been clinically proven to reduce hospitalization and drug costs for bronchiectasis patients.


For additional resources on airway clearance, or to learn more about improving lung function, contact Electromed today! From clinical evidence on the effectiveness of SmartVest in managing bronchiectasis-related symptoms to patient brochures available for download, we offer patients the support they need to help them find a smart solution to treating their impaired breathing conditions. 

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  1. Bronchiectasis Toolbox (n.d.). Airway clearance in the normal lung. Retrieved from
  2. Sievert, CE et al. 2018. Incidence of Bronchiectasis-Related Exacerbation Rates After High Frequency Chest Wall Oscillation (HFCWO) Treatment – A Longitudinal Outcome-Based Study. Respiratory Therapy, 13(2), 38-41.
  3. Electromed (n.d.). Comparison of oscillatory trough pressures generated by high frequency chest wall oscillation (HFCWO) systems: A White Paper