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What is Active cycle of breathing technique (ACBT)?

Active cycle breathing technique is an exercise that helps remove excess secretions (phlegm) from the lungs.

Active cycle of breathing exercises supervised by a specialist physiotherapistAbove: Active cycle of breathing exercises supervised by a specialist physiotherapist

Active cycle of breathing technique uses alternating depths of breathing to push phlegm from the small airways at the bases of your lungs to larger airways at the top so they can be cleared more easily through huffing and coughing techniques.

Body position is important before you begin your technique, as this will open up your chest which will facilitate better airflow. It is also important to cough up the phlegm into a pot so it can be analysed later if necessary.

The technique is modified for each patient depending on their condition. A respiratory physiotherapist at will be able to advise you on the technique you should use for the removal of your secretions; however a basic outline of the process is presented below:

Active cycle breathing technique consists of 4 stages:
  1. Breathing control – This is gentle breathing to allow you to relax and concentrate. With your hands gently resting on your tummy, concentrate on feeling your tummy rise and fall with each gentle breath in and out. Your breath out should be slow, almost like a sigh.
  2. Thoracic expansion (deep breaths) – This gets the air right down to the bottom of the lungs where it can loosen the phlegm. The breath in through your nose should be nice and slow, you should be able to feel your lungs filling up, when you feel like you have as much air in as is possible I want you to hold it there just for a few seconds, then gently breathe out through your mouth nice and slowly.
  3. Forced expiration (huff) – This helps force the phlegm up and out of your lungs. To carry out the technique effectively you need to pretend you have a mirror in front of you; take a normal breath in then huff the air out as if you are steaming up the mirror. This sometimes causes an acute onset of coughing.
  4. Cough – This allows you to get the phlegm up and out of your mouth, coughs are tiring and so should only be completed when you feel like the phlegm is just in the back of your throat. If the technique is used following surgery, a towel can be held over the scar site to ease the pressure on the wound and reduce pain whilst coughing.

What are the benefits of active cycle of breathing technique?

Removing secretions will help reduce the risk of chest infection, active cycle breathing technique is a very effective technique, and particularly beneficial for a number of reasons including:
  • Once taught it can be carried out independently without supervision from your physiotherapist
  • Easy technique that can be carried out whether you are lying in bed or sitting up in your chair watching television
  • Thoracic expansion component will allow you to improve your lung volume and therefore function
  • The exercise does not require any specialist equipment
  • Can be modified easily to be used by most patients

Who would benefit from active cycle of breathing technique?

Any person with excess phlegm in their lungs will benefit from active cycle breathing techniques. These include:
  • Following surgery – the anaesthetic will have depressed respiratory system making it more prone to chest infections
  • People with chronic lung disease
  • People with an acute chest condition
To speak to someone about whether active cycle breathing techniques might be able to help you, please call today on 0330 088 7800. Alternatively, make an appointment online today by using our online booking system.

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