s chest with bladder 30 adjacent the chest and shell 4 outward therefrom first end 14 overlaps second end 16 and ends 14 16 are moved relative to each other for the desired fit about the chest concave surfaces 16 are positioned to allow the vest to slide up under the patient 39 s arms so that the vest is suitably high on the patient 39 s chest and not about the abdomen adhesive strip 18 is then placed in contact with outer surface 6 fixing vest 2 about the patient 39 s chest flexible outer shell 4 is now in a generally cylindrical shape suspender straps 20 are placed over the patients shoulders from front to back and adhesive patches 24 are fixed to outer surface 6 of shell 4 in a location providing comfort and support for the patient once straps 20 are fixed vest 2 should be fixed about the patient 39 s chest and unable to slide downward toward the abdomen bladder 30 is then coupled with an airflow generating system via connection 38 bladder is flexible and as it receives air the inner surface conforms to the complex contoured surface of the patient 39 s chest the outer surface of bladder 30 is in contact with cylindrical non stretch outer shell 4 consequently as air pulses are delivered to bladder 30 the pulses are efficiently transferred to the patient due to the stable cylindrical structure and non stretch characteristics of outer shell 4 further this structure may be more efficient in delivering air pulses than the long term single user vests described above it is believed that the.