What is High Frequency Chest Wall Oscillation (HFCWO)?

A Breakthrough in Airway Clearance Therapy

Our lungs are constantly producing mucus. It is our natural way to keep the lungs clear of infection. In healthy lungs, patients swallow the mucus naturally. When a person is no longer able to effectively clear mucus from their lungs on their own, airway clearance therapy becomes increasingly important to help prevent infection and inflammation. Many people with cystic fibrosis (CF), bronchiectasis (BE) and other respiratory conditions use high-frequency chest wall oscillation (HFCWO) vests, as part of their daily airway clearance routine.

High-frequency chest wall oscillation (HFCWO) is an airway clearance technique where external chest wall oscillations are applied to the torso using a fitted vest. These vests produce vibrations at variable frequencies and intensities in order to help loosen and to thin mucus, and separate it from airway walls, so it can be coughed up.

If you are considering using an airway clearance therapy vest, you may have some questions that you’ll want to be answered before you decide whether HFCWO is right for you or your child.

How Do HFCWO Vests Work?

The goals of HFCWO treatment are to break up mucus and help bring it to the upper airways, where it can be coughed out or removed by suction.

Air-bladder style vests have flexible plastic hoses attached to the vest garment, that connect to an air compressor/generator, which require electrical outlet to operate, that delivers bursts of air to rapidly inflate and deflate the vest to oscillate the chest wall.

A newer type of mobile HFCWO vest, the AffloVest, features built-in oscillating mechanical modules that are battery operated to percuss and vibrate the chest wall that targets the upper and lower lobes of the lungs, front and back. The portability of AffloVest allows for freedom of movement during use without the restriction of hoses or generators and no electrical outlet is required.

The percussion and vibration during HFCWO vest therapy does three things:

  1. Breaks up mucus, making it thinner
  2. Creates “mini-coughs” in the lungs, which help push the mucus out
  3. Makes the cilia move faster, helping them carry the loosened mucus to the upper airways


AffloVest motors during Percussion Mode


Afflovest motors in Vibration Mode


AffloVest motors during Drainage mode

Which Patient’s Can Benefit from HFCWO?

There are a wide range of diseases and health conditions that cause increased mucus production and ineffective airway clearance. The diseases listed below are among those for which HFCWO has been prescribed and may be reimbursed by insurance providers:

  • Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease)
  • Bronchiectasis
  • Cerebral palsy
  • Emphysema
  • Chronic bronchitis
  • Cystic fibrosis
  • Multiple sclerosis
  • Muscular dystrophy
  • Disorders of the diaphragm
  • Pneumonia
  • Post-operative lung transplant
  • Post-polio syndrome
  • Primary ciliary dyskinesia
  • Quadriplegia
  • Scoliosis
  • Spinal cord injury
  • Spinal muscular atrophy
  • Tracheomalacia
  • Tracheal stenosis

Who Can Use HFCWO Vests?

There is no minimum age requirement for AffloVest HFCWO therapy. Generally, once a child’s chest measurement is big enough for the AffloVest to fit properly, he or she can begin using it with a prescription from their physician.

Advantages of HFCWO Vest Therapy

AffloVest offers a great alternative to manual chest physiotherapy (CPT).


  • Treatment can be self-administered.
  • Does not require a skilled professional, so every treatment will be done correctly.
  • Freedom to do other things during treatment, because no special position or breathing techniques are required.

How and Where Do You Get an HFCWO Vest?

HFCWO vests are only available by prescription. If you are considering using the vest, talk to your doctor about how AffloVest HFCWO vest therapy can benefit you.

AffloVest requires a doctor’s prescription for treatment by High Frequency Chest Wall Oscillation (HFCWO). The AffloVest has received the FDA’s 510k clearance for U.S. market availability, and is approved for Medicare, Medicaid, and private health insurance reimbursement under the Healthcare Common Procedure Coding System (HCPCS) code E0483 – High Frequency Chest Wall Oscillation. The AffloVest is also available through the U.S Department of Veterans Affairs/Tricare. Patients must qualify to meet insurance eligibility requirements.