Acapella® Choice

If you find it difficult to clear sputum (phlegm) from your lungs, you might use the Acapella® Choice as part of your treatment at Great Ormond Street Hospital (GOSH).

The equipment is made up of a mouthpiece, cover, rocker assembly/platform base (counterweighted plug and magnet) and the base unit including the adjustment dial.

How it works

The Acapella® Choice

When you breathe out through the Acapella® Choice, air flows through a counterweighted plug which will help keep your airways wide open to get air behind sputum to help move it upwards. 

The magnet directs the air through a pivoting cone generating vibrations that are transmitted to the chest wall to help loosen sputum from the sides of your airways.

Using the Acapella® Choice

Your physiotherapist will show you how to use the Acapella® Choice. This guide is a reminder for you. You should hold the Acapella® Choice in a horizontal position to use it.

  1. Sit down, or move into any postural drainage position (where possible).
  2. Relax your stomach muscles and take a few normal breaths before using the Acapella® Choice.
  3. Close your lips around the mouthpiece of the Acapella® Choice, making sure there is a good seal.
  4. Take a slightly bigger breath in through your nose and then blow out through the Acapella® Choice. You may feel vibrations on your chest wall.
  5. Repeat eight to 10 times.
  6. Following this you should put the Acapella® Choice down and do huffing and coughing to clear any sputum. You should then have a period of relaxed breathing before continuing. 
This cycle should continue for 10-20 minutes or until you have cleared all your sputum.

The pressure and flow can be made harder or easier by changing the position of the frequency adjustment dial. By rotating the dial clockwise through numbers one to five the resistance gets harder.


As with all airway clearance devices it is very important that you keep the equipment clean to prevent infection. There have been no reported problems with the use of the Acapella® Choice or any other airway clearance techniques.

However, if you are worried about your chest, especially if you become short of breath, have chest pain or are coughing up blood, it is important that you contact the Cystic Fibrosis (CF) team at GOSH immediately.


It's recommended that you clean the Acapella® Choice after every use and disassemble it into its parts. 

  1. Detach the mouthpiece and then the cover by placing your forefinger and thumb on the three lines allocated toward the mouthpiece and gently pressing and lifting up. 
  2. Gently detach the rocker assembly from the platform base. 
  3. Wash the Acapella® Choice in warm soapy water and then rinse thoroughly with clean water and let the parts air dry.


You should sterilise the Acapella® Choice at least once a week using a steam steriliser or putting it in a clean bowl of boiling water. Do not use a microwave steriliser.


Do not store the Acapella® Choice on a windowsill or in direct sunlight. When it is dry, you should either wrap it in a lint-free cloth, place it in the bag provided or put it in a clean plastic container with a lid and keep it in a dust-free environment.

Compiled by:
Great Ormond Street Hospital
Last review date:
July 2014