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Abstract Objective: the objective of the study was to compare efficacy of intra versus extra-thoracic oscillations in chronic obstructive pulmonary disease (COPD) patients. Subjects and methods: Sixty male patients with COPD of age ranged 50-60 years were randomized into two groups (30 patients in each group). group (A) were treated by Oscillatory Positive Expiratory Pressure Quake device while group (B) were treated by High frequency chest wall oscillation vest (HFCWO). Both groups were treated with COPD medications in addition to either Quake or HFCWO Devices, four sessions per week, for six weeks. All patients were evaluated before and after treatment by spirometry and impulse oscillometry. Results: Pre and Post study comparison demonstrated that spirometric indices (FEV1, FVC, FEV1/FVC, FEF25%-75%) and impulse oscillometry parameters (R5, X5) were significantly improved in both groups. A statistical significant difference was also found between vest HFCWO and the Quake device in most of the measured post treatment parameters in favor of Quake device. Conclusion: Both vest HFCWO and Quake devices are highly effective in treatment of patients with COPD in terms of improvement in ventilatory functions and Impulse oscillometry parameters with better results in favor of Quake device |