The mechanical vibrator has become a popular adjunct in the physical therapy management of patients with pulmonary disease. The purpose of this paper is to review the physiological literature to determine if a rationale for the tool exists, and to review of the clinical trial literature examining the efficacy of the mechanical vibrator in different patient populations. The physiological literature suggest there is a rationale to support the usefulness of the mechanical vibrator. However, this has only been demonstrated using low frequency vibration (< 60Hz). Vibration with higher frequencies (100Hz) has demonstrated deleterious effects on subjects' perception of breathlessness, decreased tidal volume and increased respiratory rate. In the clinical trial literature, only experimental and quasi-experimental designs were examined. The search yielded 17 studies and all were graded for methodologic quality. Most studies examined patient populations of cystic fibrosis and chronic obstructive pulmonary disease. The existing clinical trial evidence is non-conciusive. Most of the studies were poorly designed with small sample sizes. At this time the use of mechanical vibrators in the clinical setting cannot be supported by the literature and thus should be re-examined.

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