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Printed at: 06:52:00 / 23-09-2021

Active cycle of breathing technique (ACBT) Breathing exercises to clear sputum from your chest

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What is it?

The Active Cycle of Breathing Technique (or ACBT) is a flexible set of breathing exercises designed to make your breathing feel easier and help clear sputum off your chest. It is usually done in a relaxed upright seated position. Keeping your chest clear of sputum will help reduce the frequency and severity of chest infections.

How does it work?
ACBT uses the movement of air in your lungs. The exercises are made up of restful breathing, deep breathing and huffing, which when done in combination help to move the sputum so that you
can cough it out.

Restful Breathing
Relax the chest and shoulders. Gently place your hand on top of your stomach, just under your breastbone. Stay relaxed and feel the gentle movement of your stomach as you breathe in and out through your nose. Nose breathing cleans, warms and moisturises the air that you breathe. Continue like this until your breathing feels relaxed and calm. Some people find it helpful to have their eyes closed when performing this part of the exercise. If you become short of breath during any part of the ACBT, use restful breathing to allow your breathing to settle.

Deep Breathing
Keeping shoulders relaxed take a deep breath in through your nose. Feel the breath go down to the bottom of your lungs. Your Physiotherapist may advise you to hold your breath for a few seconds, before gently sighing the breath out. Take two to three restful breaths between each deep breath. More detailed instructions can be found on the last page.

A cough will only clear sputum which is in the windpipe. A huff will move sputum from the deeper part of the lungs towards the windpipe. The sputum can then be cleared effectively with a cough and excessive coughing can be avoided. A huff is a smooth, forceful way of blowing out a breath, after you have taken the breath in through your nose. It is like misting up your glasses or a mirror. They are small or medium in size, as varying the size of the huff will clear sputum from different parts of the lungs. The force of a huff comes from the tummy muscles, with the mouth open and the throat relaxed. Do not completely empty your lungs when performing a huff and keep your shoulders relaxed throughout. Take two or three restful breaths between each huff.

Sometimes a huff will move sputum straight away and trigger a productive cough. At other times a productive cough may be triggered later.

General Advice
In general it is best to do the ACBT in a relaxed upright sitting position. You should spend 10 to 15 minutes performing these exercises. Your physiotherapist may suggest additional positions. They will also advise you how often to do the cycle each day. With a chest infection, you will need to dedicate more time to doing the ACBT. This could be achieved by carrying out shorter, more frequent sessions during the day.

Twenty minutes before you do your exercises you may find it helpful to use your inhalers and have a hot drink. This will mean your lungs are more responsive to the breathing exercises. Your Physiotherapist will discuss with you the best routine for your inhalers. Remember that inhaler use, nose breathing, plenty of fluids, ACBT and physical exercise are invaluable ways of keeping your chest clear. The Physiotherapist will discuss physical exercise with you.