In CF, thick sticky mucus clogs the airways and traps bacteria. Airway clearance therapy (ACT) physically loosens that mucus so it can be coughed out. Methods include chest physiotherapy (clapping/percussion and postural drainage), high-frequency chest wall oscillation using an inflatable “Vest,” positive expiratory pressure (PEP) and oscillating-PEP devices (like the Flutter or Acapella), and breathing techniques such as the active cycle of breathing and huff coughing. Most people with CF do some form of ACT every day, often paired with inhaled medicines.
Usually done once or more daily, typically for 20–30 minutes, and often combined with inhaled mucus-thinners and antibiotics (which are timed around clearance). The specific technique and device are chosen with the CF care team and respiratory therapist based on age, ability, and preference.
ACT is an ongoing daily routine, not a one-time procedure. Consistency matters — regular clearance helps reduce infections and slow lung decline. Techniques are adjusted over time and during illness (“tune-ups”).