Well it'll change depending on who you ask. But me personally, I prefer manual PT. I've tried the Vest (two different times, two different vests -- one about 9 years ago, and one this year) and I hated it. I don't have or use one.
My fiance beats me for half an hour every night, and imo, it's the better way to go. Obviously, it's not convenient for everyone to be able to do that. So the Vest is certainly practical. But if he's sounding crappier, and you have the time, I'd say beat him.