During cupping, edges of one or two downwardly facing cupped hands strike the skin in quick succession. As cuppped hands are brought down in quick succession, a vaccum is created, which ceases when the hands are lifted. The sound should be hollow, similar to horse hooves striking the ground. The client is asked to take a deep breath, and cupping begins upon the exhalation. Cupping tapotement specifically is part of postural drainage and percussion (PD&P), an airway clearance