Use of the mechanical vibrator (Wahl 4300) as a physiotherapy treatment modality for respiratory patients with retained secretions has increased markedly during the past decade. To determine the effectiveness of mechanical chest vibration in patients with exacerbation of chronic obstructive pulmonary disease, we studied 24 patients. Patients were their own controls and were randomized to receive either positioning with mechanical vibration or positioning with no intervention on the first day, and the opposite the next day. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), oxygen saturation and sputum volume were measured at 5 minutes, 30 minutes, and 1 hour following both procedures. There was no change in the FEV1 and FVC at 5 minutes, 30 minutes or 1 hour after vibration and positioning. Although statistically significant, the small increase in oxygen saturation 30 minutes post vibration in subjects receiving supplemental oxygen may not be clinically relevant. Patients expected more sputum in 60 minutes following vibration than on the control day with no intervention. Although the mean volume of sputum was small, this was statistically significant (p < 0.05). The clinical relevance of this is however questionable. Sputum volumes at 24 hours were not significantly different between treatment and control days. In the group of patients studied we conclude there was little clinical benefit following a single application of the Wahl 4300 mechanical vibrator. The effectiveness of more frequent use of vibrator remains to be determined.

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