ACBT active cycle of breathing technique Physiotherapy Medicine Health

1. ACTIVE CYCLE OF
BREATHING TECHNIQUE
(ACBT)
Dr.Krishna gohil (PT)

2. • Active cycle of breathing consists of a series of manoeuvres
performed by the patient to emphasize independence in
secretion clearance and thoracic expansion.
• ACBT is an airway clearance strategy renamed to clarify
the directed breathing and forced expiratory techniques
first described in the literature in 1979, (pryor et al 1979).

3. • Its used to:
Looses and clear secretions from the lungs that helps to
reduce the risk of chest infection.
Improve ventilation in the lungs.
Improve the effectiveness of a cough.

4. PURPOSE
• The purpose of this technique is to produce dynamic
compression and collapse of the airway downstream of
equal pressure point, creating a pinch point and increased
turbulent airflow.
• The technique can be performed in any breath enhancing
position and no equipment is required. When used to clear
secretions.

5. COMPONENTS
• It has 3 component:
breathing control
thoracic expansion exercise
huffing

6. BREATHING CONTROL
• BC is tidal volume breathing at patients own respiratory
rate and volume.
• The person is encouraged to breath with lower chest, using
diaphragmatic breathing pattern, with relaxation of the
upper chest and shoulders.
• Its allows recovery from fatigue, oxygen desaturation or
signs of bronchospasm and relieves breathlessness.

7. • Patients should be encouraged to breathe in through their nose to
humidify, warm and filter the air and to decrease the turbulence of
inspired flow.
• Breathing control should continue until the person feels ready to
progress to the other stages in the cycle.
• Breathing in a slow and relaxed manner reduces the work of
breathing and consequently the oxygen requirements.
Hyperventilation is also a known trigger for bronchospasm in some
people.

8. THORACIC EXPANSION EXERCISE
• TEEs are deep breathing exercise with an emphasis on slow,
controlled inspiration through the nose.
• Inspiration is active, with larger than normal volume breaths
which are often combined with a 3 sec. end inspiratory breath
hold with the glottis open, prior to passive expiration.
• The patient is instructed to breathe in slowly and deeply with
minimal accessory muscles use.
• This is repeated for up to five breaths.

9. • To facilitate a maximal inspiration, proprioceptive feedback, with the therapist, or
patient, placing their hands on the thoracic cage, can be beneficial.
• This has been associated with increased chest wall movement and improved
ventilation.

10. • Large inspiratory volumes are believed to facilitate collateral ventilation .
• This can be further enhanced by a breath hold.
• Resistance to airflow within the canals of Martin, channels of Lambert and
Pores of Kohn, (between the bronchioles and alveoli), is usually high, with
little movement during tidal volume breaths.
• With increasing inspired volumes, the resistance decreases and air flows
through these channels to enhance expiratory flow behind the secretions

11. • At high lung volumes, achieved during thoracic expansion
exercises, the expanding forces between alveoli are greater
than at tidal volume and may assist with the re-expansion
of lung tissue. This is known as alveolar inter-dependence
• During inspiration, the expanding alveoli exert forces on the
adjacent alveoli which enhance the recruitment of lung
units.

13. • https://bronchiectasis.com.au/resources/videos/the-active-cycle-of-breathing-
technique