PEP-therapy or flutter

Question

My daughter, nearly 5, has a stay in hospital behind her, where the physiotherapy has been shown to us.
We have been up to now several times at a physiotherapist, who recommended the usage of the flutter to us.
Now, at the CF center, they have shown us the therapy with the PEP-mask. What is more efficient? Or does it not matter, what we use? It seems to me, that the PEP-mask is more difficult to handle than the flutter.
On the other hand, one can control the expiration better with the PEP-mask.
What would you recommend?
Many thanks.

Answer

Hello,
You are certainly right that the usage of the flutter is easier. Similarly the hygiene preparation. Alternatively to the PEP-mask the PEP-system of the company PARI has to be mentioned. This system is identically to the flutter concerning the hygienic preparation.
Which of the two expiration-therapy devices is more sensible for the performance of the physiotherapy with your daughter, is always a decision in the single case, means dependent on the findings, e.g. amount and consistance of the secretions, urge to cough, over-filling of the lungs with air, ability of cooperation, force of the breating muscles, etc.
In general, the autogenic drainage resp. the breathing-physiotherapy can however be performed totally without the mentioned breathing-therapy devices, alternatively with the persued lips breathing. Please adress to the physiotherapist of trust concerning the physiotherapy of your daughter and discuss with him the forms of therapy. I would be happy to support when needed.
Yours sincerely,
K. Könecke

09.07.2009