Nicolini A, et al. - This study was designed to test the hypothesis that adding intrapulmonary percussive ventilation (IPV) or high-frequency chest wall oscillation (HFCWO) to the best pharmacological therapy (PT) may provide additional clinical benefit over chest physiotherapy in patients with severe COPD. With these techniques, an improvement was seen in daily life activities and lung function in patients with severe COPD. IPV vs HFCWO was found to be significantly more effective in improving some pulmonary function tests linked to the small bronchial airways obstruction and respiratory muscle strength and scores on health status assessment scales [Breathlessness, Cough, and Sputum scale (BCSS) and COPD Assessment Test (CAT)] as well as a reduction of sputum inflammatory cells.