High-Frequency Chest Wall Oscillation (the Vest)

High-frequency chest wall oscillation involves an inflatable vest that is attached to a machine. The machine mechanically performs chest physical therapy by vibrating at a high frequency. The vest vibrates the chest to loosen and thin mucus. Every five minutes, the person stops the machine and coughs or huffs.

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The machine is made up of two pieces, an air-pulse generator and an inflatable vest that is connected to the generator by hoses. The generator sends air through the hoses, which causes the vest to inflate and deflate rapidly, as much as 20 times per second. This rapid inflation and deflation creates pressure on the chest similar to clapping. The vibrations not only separate mucus from the airway walls, they also help move it up into the large airways. Typically, a person uses the vest for five minutes and then coughs or huff coughs to clear the mucus. Sessions last about 20 to 30 minutes.

Maddie, a young adult with CF, doing chest physical therapy with a vest.
Maddie, a young adult with CF, doing chest physical therapy with a vest.

These machines may be known by their brand names (The Vest® System, inCourage®, Smart Vest®, and AffloVest®). These devices are expensive but covered by most insurance plans. Your CF care team will help you to order a vest device.

If you need help getting a vest, you may also contact Cystic Fibrosis Foundation Compass, a free and personalized service that can help you with insurance, financial, legal, and other issues. 

Contact Compass at:
844-COMPASS (844-266-7277)
Monday – Friday, 9 a.m. – 7 p.m. ET 


Reference to any specific product, process, or service does not necessarily constitute or imply its endorsement, recommendation, or favoring by the Cystic Fibrosis Foundation. The appearance of external hyperlinks does not constitute endorsement by the Cystic Fibrosis Foundation of the linked websites, or information, products, or services contained therein.

Information contained on this site does not cover all possible uses, actions, precautions, side effects, or interactions. This site is not intended as a substitute for treatment advice from a medical professional. Consult your doctor before making any changes to your treatment.

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