I was contacted recently by a customer asking about safe practices for use of a respiratory muscle training device during the COVID 19 pandemic.

Respiratory muscle training (RMT) devices are handheld devices used to strengthen the muscles of inhalation and exhalation. Some devices, like the Acapella, are percussive devices used to loosen or mobilize respiratory secretions making it easier to clear them from the lower airways. PEP devices also provide some back pressure to the airways and thereby improve oxygen exchange. Other devices like the Breather® or EMST-150 are usually recommended as tools for strengthening the breathing muscles, and are often incorporated into speech and swallowing treatment.

Most RMT devices fall broadly into the family of PEP devices (positive expiratory pressure devices. Depending on the device design, they provide low, medium, or high resistance to airflow on inhalation, exhalation, or both, which in turn, improves ventilaton, helps loosen pulmonary secretions, improves strength of the muscles for speech production, cough, and swallowing by helping to improve the timing and coordination of breathing and swallowing or, in some instances, reducing aspiration events.

So, given all the potential benefits of respiratory muscle training, it is not something you would want to relinquish during the current pandemic, but you may need to take some extra precautions.

Why Are Aerosol Generating Procedures More Risky?

COVID-19 typically presents as a respiratory illness accompanied by cough and is mainly spread via droplets (aerosols) produced when an infected person coughs or sneezes. Aerosol generating procedures (AGPs) are medical procedures that are “more likely to generate higher concentrations of infectious respiratory aerosols than coughing, sneezing, talking, or breathing” and result in “uncontrolled respiratory secretions.” (Source CDC).

For those of you living at home, and presumed to be COVID-19 negative or asymptomatic, you should continue to use your RMT device with these added precautions:

  • All RMT devices are single patient use and should never be shared with another person, even your spouse.
  • Handwashing before and after use is recommended, and it is also recommended that you clean your RMT device daily following the instructions that came packaged with the device or you can check on the manufacturer’s website.
  • If at home, use your device in a room away from others.
  • If you have symptoms of the coronavirus, and you are at home you should check with your physician and follow their recommendations. If isolated in a separate bedroom, it may be safe to continue to use your RMT device in this “recovery room.”

If you are a patient in a hospital or rehabilitation facility, check with your nurse, respiratory therapist, or speech-language pathologist before using an RMT device, as their policies will likely be more restrictive and require staff to use PPE if in the room while you are performing RMT.

If you have recently obtained a respiratory muscle trainer and feel that you would like some additional coaching, online coaching and telepractice are convenient and safe options. If you have purchased a product, including the Breather® from Voice Aerobics, you are always eligible for a no cost coaching session. Visit our website or contact us to schedule a session.

For the most up to date information specific to COVID 19 visit: https://www.cdc.gov/coronavirus/2019-ncov/index.html


My MissionTo enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate  and empower. Mary Spremulli, MA, CCC-SLP * FiTOUR® Group Exercise Instructor * Voice Aerobics® A Whole Body Approach to Voice Practice

Voice Aerobics the heART and Science of Voice Practice