Chronic Obstructive Pulmonary Disease (COPD) is characterized by mucus hypersecretion and impaired mucociliary clearance, and significantly contributes to the morbidity and mortality of this disease. According to World Health Organization, 5% of all deaths globally occurred due to COPD in 2005 and it is estimated to be the third leading cause of death by 2030. In this condition, patients complain of chronic symptoms of cough, sputum production, shortness of breath, and/or wheezing.

             Currently available mucolytics and expectorants are not proven to be effective in COPD. The available evidence indicates that Active Breathing Techniques such as Active Cycle of Breathing Techniques (ACBT), Autogenic Drainage and Forced Expiration, can be effective in treatment of COPD. The Passive Techniques such as Postural Drainage, Percussion as well as Supporting Techniques such as Intrapulmonary Percussive Ventilation, PEP and Non-Invasive Ventilation have little evidence due to the small number of studies.

             The Lung Flute is a new, Food and Drug Administration (FDA) approved Oscillatory Positive Expiratory Pressure (OPEP) device which has been shown to be effective in inducing sputum when used once. It produces a low frequency acoustic wave with an exhalation vigorous enough to make the reed oscillate thereby increasing mucociliary clearance. Threshold PEP has a flow independent one way valve, ensuring consistent resistance through adjustable specific pressure settings (in cm H2O) set by healthcare professionals. When patients exhale through it, the resistive load creates positive pressure that helps open the airways and allows mucus to be expelled during “huff” coughing (Forced Expiratory Technique) thus helping in airway clearance, bronchial hygiene and can be used as an alternate to Chest Physical Therapy.