POWERbreathe EX1 Expiratory Muscle Trainer (EMT) – Medic

POWERbreathe EX1-Medic EMT Device Is Recommended For:

• Patients who need to forcefully empty air from their lungs.
• Patients with dysphagia and dysarthria (difficulty swallowing & speaking).
• Older adults with reduced expiratory strength due to advancing age.

Features

• An easily adjustable ‘light’ expiratory load.
• Comfortable Mouthpiece with inside bite tabs as well as an outer flange to keep it in place and provide a tight seal around the lips.
• Easy identification and precise adjustment of expiratory load using the 0 – 10 training levels.
• An ergonomic design that is to be held vertically so that the user doesn’t accidentally obstruct the airflow.
• An easy-to-clean design.

What Is Expiratory Muscle Strength Training (EMST)?

POWERbreathe EMST breathing devices use expiratory pressure threshold loading to exercise the expiratory muscles. This is also the method of breathing training that is used in the POWERbreathe Medic Inspiratory Muscle Training (IMT) device.  It is also the most widely studied type of breathing training and now the most used.

The POWERbreathe EX1-Medic features an internal, precisely calibrated, adjustable spring that provides the breathing load to the expiratory muscles.

Who Is Expiratory Muscle Training For?

The POWERbreathe EX1-Medic EMT device is helpful to patients who need to forcefully empty air from their lungs. It is particularly beneficial for patients with dysphagia and dysarthria, as well as for older adults as they begin to lose muscle strength due to advancing age.
Expiratory muscles are also often recruited in critically ill ventilated patients. Weakness of abdominal expiratory muscles leads to poor cough, and ineffective clearance of secretions from airways, and increases the risk for re-intubation. The four abdominal expiratory muscles that help in weaning, are the rectus abdominis, internal oblique, external oblique, and transversus
abdominis.

The POWERbreathe EX1 expiratory muscle training – Medic is for:

• Dysphagia
• Amyotrophic lateral sclerosis
• Cough, such as chronic bronchitis
• Subacute stroke
• Dysarthria
• Multiple sclerosis
• Parkinson’s disease
• Tracheostomy patients / ICU patients
• Speech therapy
• Sleep apnea
• Respiratory issues such as dyspnea due to obesity or older age decline in functions
• Cervical or spine injury

How Expiratory Muscle Training Works

The POWERbreathe EX1-Medic is a pressure threshold EMT breathing device developed to exercise the expiratory muscles. It uses a one-way, spring-loaded valve to maintain a constant breathing load while the patient exhales through the device. This breathing load is sustained throughout the exhalation, regardless of the patient’s airflow.

The internal, calibrated, spring-loaded valve requires the patient to produce an expiratory pressure sufficient to overcome the threshold load set and open the valve to enable expiration through the device.

When the patient generates enough expiratory power, the one-way valve opens at the set breathing load, allowing exhalation through the device. The spring-loaded valve requires a constant flow of exhalation for the valve to remain open. It’s this that presents a challenge to the expiratory muscles. The valve will then close completely as soon as the pressure is less than the breathing load set.

If, however, the patient is not able to produce enough expiratory force, the spring-loaded, pressure-threshold valve will remain closed, and no air will flow through the device. To rectify this and allow the patient to continue training, the training load can be reduced by using the adjustable external dial.

How To Do Expiratory Muscle Training

When you generate enough power and force as you breathe out, the spring-loaded valve opens at the load you set using the training levels. This then allows you to breathe out through the device.

The typical training protocol for expiratory muscle training is 5 x 5 x 5 (5 x exhales, 5 times a day, for 5 days a week):

1. After taking an initial deep breath in, place the POWERbreathe EX1 EMT device in your mouth and maintain a tight lip seal around the mouthpiece.
2. Then, forcefully exhale through the device until the valve opens and you can hear the air rushing out. Repeat this 5 times. After each set, rest for 1 minute before attempting the next set.
3. Do this set of 5 exhalations, 5 times per day, and perform this training 5 days a week.

When you find your training becomes easier to perform, it means your expiratory muscles have become stronger and require more of a challenge. You can challenge them further by increasing the resistance using the adjustable dial on the handle. You can increase the training level by a full turn, but it might be better if you turn the dial a quarter-turn first to assess if this is enough of an increase in resistance.

Adjustable Load Setting Range

POWERbreathe EMT devices use cmH2O as the unit of pressure. This is because it is what other, long-established devices use to determine lung health. It is the unit for measuring breathing on ventilators, CPAP and BiPAP machines, as well as, breathing training devices. By having the spring-loaded valve calibrated to increments of cmH2O, the adjustable load settings on the POWERbreathe EX1-MR EMT device mean that your training improvements are quantifiable. Having adjustable training levels also ensures that your expiratory muscles will always reach an appropriate training intensity for eliciting benefits, such as increasing your expiratory muscle strength and endurance.

Adjustable Dial

You can easily adjust the breathing load using the adjustable dial on the handle of your device. To make training easier you will need a lighter resistance. You can easily do this by reducing the training level. To make training harder you will need a heavier resistance. This is achieved by increasing the training level. The load (in cmH2O) is easily set on the POWERbreathe EX1-Medic device by using the marked training levels on the handle. Think of ‘load’ as weight lifted. So, the higher the load/weight (cmH2O), the harder it will be to exhale against the resistance and open the valve.

Adjustable Load Selection Range – cmH₂O

10 Reasons to Choose POWERbreathe EX1

What’s In The Box?

The following items come as standard with every POWERbreathe purchase:

1. POWERbreathe EX1 EMT Device – Medic
2. Mouthpiece
3. Storage pouch
4. 4 x Cleansing Tablets – except for in the USA. Genuine POWERbreathe devices will not contain POWERbreathe Cleansing Tablets in the USA, as these tablets are not approved for sale and/or
   distribution within the USA by the regulatory authorities. Read more about Counterfeit products.
5. French/English User Manual.

Precautions & Contraindications

POWERbreathe EMT breathing training is drug-free, suitable for almost anyone and should cause no harmful side effects when used properly. Please read the following precautions and contraindications to ensure that your POWERbreathe EX1 EMT breathing device is used safely and appropriately. You must always consult your healthcare professional before embarking on any new form of exercise and this includes POWERbreathe breathing training.

General Precautions

Please also see Medical Precautions (below).

• A patient must not make changes to any prescribed medication or prescribed treatment programme without consulting their doctor.
• Do not use the POWERbreathe EMT device whilst taking part in other activities where you may become distracted, such as walking, running, and driving.
• To prevent the potential transmission of infections, we recommend that your POWERbreathe EMT device is not shared with other users, including family members.
• POWERbreathe EMT is not intended to diagnose, treat, cure or prevent any disease.
• POWERbreathe EMT devices are designed for exercising the expiratory muscles only. No other use is intended or implied.
• Anyone who is under the age of 16 should only use a POWERbreathe EMT device with supervision from an adult. POWERbreathe EMT devices contain small parts and are not suitable for children under 7 years.
• Whilst training with the POWERbreathe EMT device, you should feel resistance when exhaling but it should not be painful. If you feel pain whilst using the POWERbreathe EMT device, stop immediately and consult your healthcare professional.
• Some users may experience slight ear discomfort when training with the POWERbreathe EMT device, especially if they are recovering from a cold. This is caused by inadequate equalisation of pressure between the mouth and ears. If symptoms persist, you should consult your doctor.
• If you are suffering from a cold, sinusitis, or respiratory tract infection, we advise that you do not use your POWERbreathe EMT device until symptoms have disappeared.
• If you start to feel dizzy using POWERbreathe EMT, please pause until recovered and take longer gaps between breaths.
• POWERbreathe EMT should not be used if you are suffering from a ruptured eardrum or any other condition of the eardrum.
• It is not recommended to use POWERbreathe EMT if you have suffered from or are likely to suffer from Costochondritis.
• POWERbreathe EX1 EMT devices should not be used if you are suffering from excessive intraocular eye pressure.
• If you are or might be pregnant.

Medical Precautions

Healthcare Professionals should take into consideration the following conditions before prescribing the use of POWERbreathe EMT to patients and assess its use on a case-by-case basis:

1. A history of spontaneous pneumothorax (a collapsed lung that was not due to traumatic injury e.g., broken rib), as this may lead to a recurrence of the condition.
2. Pulmonary hypertension or large bullae on chest x-ray.
3. Marked osteoporosis with a history of rib fractures.
4. Seek medical advice and approval before using POWERbreathe EX1 with a Patient who is undergoing Cerebrospinal Fluid Drainage (CSF drainage).
5. Chest trauma or surgery, including cardiac surgery, as well as any recent oral, face or neck and skull surgery.
6. Epistaxis (nosebleeds).
7. A patient undergoing or recovering from oesophageal surgery.
8. Active haemoptysis.
9. A patient undergoing or recovering from a lung resection or lung transplant.
10. Tracheostomy patients.
11. A patient suffering excessive intraocular eye pressure.

Medical Contraindications

When determining if a patient is suitable for EMT, it is worth considering if a Valsalva manoeuvre would be contraindicated for their condition. This is because like the Valsalva manoeuvre, EMT involves exhaling as hard as possible while the nose is pinched closed. Therefore, if the generation of intrathoracic pressure (ITP) and/or intracranial pressure (ICP) is contraindicated for the Valsalva manoeuvre, then so too is the use of EMT.
Expiratory muscle training, such as the POWERbreathe EX1, is not recommended for patients with certain conditions, which include the following:

• Patients who have undergone recent abdominal surgery and those with an abdominal hernia.
• Asthma patients who have a very low symptom perception and suffer from frequent, severe exacerbations or with an abnormally low perception of dyspnoea.
• If a patient is suffering from a ruptured eardrum or any other condition of the ear.
• Patients with marked elevated left ventricular end-diastolic volume and pressure.
• Patients with worsening heart failure signs and symptoms after Respiratory Muscle Training (RMT).
• Patients who are or might be pregnant.
• Patients with untreated or uncontrollable heartburn and gastroesophageal reflux (GERD).
• Patients with untreated and uncontrollable high blood pressure (hypertension).