I have an InCourage vest. You select a percentage for your therapy. I am not able to tolerate 100%. Was doing OK at 65% until I cracked a rib from coughing. I moved it down to 50% for 2 months, now doing it at 55%, and will work back up to 65% over time. The therapist for my machine suggested I loosen the bottom strap and sit up very straight until my rib healed and that helped a lot. I was getting neck and shoulder pain when doing 65%. They sent me a different size vest (hopefully this is now the correct size) to see if that will help with the neck and shoulder issues (that was right before I broke the rib). I use my vest for 30 minutes at 6 AM (before Breakfast) and between 3:30-4:00 PM (2-3 hours after eating lunch). I cannot use the vest if I have a full stomach.