"The standard PEP device may further include a stem receiver at an end of the tube. The stem may be received in the stem receiver for rotation. The knob may be situated adjacent one end of the stem receiver and an opposite end of the stem receiver may be open. The tube of the standard PEP device may have a first segment and a second segment that may be perpendicular to the first segment.
"In some embodiments, an adjuster may be coupled to the knob. The adjuster may engage a member of the oscillatory PEP device to adjust a characteristic of oscillation of the oscillatory PEP device, such as frequency or amplitude. The adjuster may include, for example, an eccentric disk having an edge that engages the member of the oscillatory PEP device. The member may have a rounded end and the edge of the eccentric disk may have a plurality of notches. The rounded end may index from notch to notch as the knob is rotated.
"In some embodiments, the standard PEP device may include a tube having a tube wall that may define an interior region and that may have a plurality of apertures extending through the tube wall. The standard PEP device may further include a knob and a stem that may extend from the knob into the interior region defined by the tube wall. The knob may be rotatable by the knob to select how many of the plurality of apertures are blocked by the stem.
"The oscillatory PEP device may include a flexible tube having a first end coupled to the third port. The flexible tube may have an opening near a second end. The oscillatory PEP device may include a stopper that may be movable to change a frequency at which the flexible tube may oscillates when the person's exhaled breath passes through the flexible tube and exits the opening.
"According to this disclosure, the stopper may include a flexible stick that may be flexed by varying amounts to change the amount by which the flexible tube is able to flex in at least a first direction. The person's exhaled breath may exit the opening in the flexible tube toward the flexible stick. The flexible stick may be longer than the flexible tube in some embodiments. The oscillatory PEP device may include a member coupled to the flexible stick. The member may engage an adjustment device of the standard PEP device so that the same adjustment device may be used to adjust operation of the standard PEP device and the oscillatory PEP device. The adjustment device may include a rotatable knob, for example.
"Also according to this disclosure, the stopper may include a fulcrum that may be moved along a length of the flexible tube. The flexible tube may be coupled to the third port by a substantially rigid tube and the stopper may include a collar that may be slidable along the substantially rigid tube. The stopper may include a connector that may interconnect the collar and fulcrum so that movement of the collar along the substantially rigid tube may move the fulcrum along the flexible tube. In some embodiments, the fulcrum may be cylindrical in shape.
"In some embodiments, the housing has a fourth port and the respiratory therapy device may further have a nebulizer connector that may be coupled to the fourth port. The nebulizer connector may have a first one-way valve that may be located adjacent the fourth port. The first one-way valve normally may be closed and may open when the person inhales through the first port. The nebulizer connector may have a second one-way valve that may be spaced from the first one-way valve. The second one-way valve normally may be closed and may open when the person inhales to permit ambient air to enter into an interior region of the nebulizer connector. Thus, the first and second one-way valves may inhibit or minimize losses of nebulized medication during a patient's exhalation.
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