Acbt Breathing 86406

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Association of Chartered Physiotherapists in Respiratory Care
Leaflet No. GL-05 Page 1 ACPRC
The Active Cycle of Breathing Techniques
People with a lung problems often cough and and shoulders relaed. reathe out gently and
produce more phlegm (sputum) than is usual. relaed, like a sigh. ou should do deep
It is important to remove sputum from your breaths. Ask your physiotherapist to help you
lungs to help you breathe more easily, prevent choose the right number of deep breaths for
chest infections and reduce bouts of coughing. you. ome people find it helpful to hold their
Leaving sputum in your chest can make your breath for about seconds at the end of the
condition worse. breath in, before breathing out. Try the deep
The Active ycle of reathing Techniues breathing eercises both with and without
(ACBT) is one way to help you to clear sputum holding your breath and see which works best
from your chest. AT is a set of breathing for you.
eercises that loosens and moves the sputum
from your airways. It is best to be taught AT Huffing
by a physiotherapist.
The AT eercises are breathing control, deep A huff is ehaling through an open mouth
breathing and huffing which are performed in a and throat instead of coughing. It helps move
cycle until your chest feels clear. sputum up your airways so that you can clear
it in a controlled way. To ‘huff’ you sueee air
Breathing Control uickly from your lungs, out through your open
mouth and throat, as if you were trying to mist
reathing control is breathing gently, using as up a mirror or your glasses. se your tummy
little effort as possible also see leaflet L muscles to help you sueee the air out, but do
• reathe in and out gently through your nose not force it so much that you cause wheeing
if you can. If you cannot, breathe through your or tightness in your chest. uffing should
mouth instead always be followed by breathing control. There
• If you breathe out through your mouth you are types of huff, which help to move sputum
can use breathing control with ‘pursed lips from different parts of the lungs.
breathing’
• Try to let go of any tension in your body with The Small-long huff
each breath out
• radually try to make the breaths slower This will move sputum from low down in your
• Try closing your eyes to help you to focus on chest. Take a small to medium breath in and
your breathing and to rela then huff (squeeze) the air out until your lungs
feel uite empty, as detailed above.
It is very important to do reathing ontrol
in between the more active eercises of AT The Big-short huff
as it allows your airways to rela. reathing
control can also help you when you are short of This moves sputum from higher up in your
breath or feeling fearful, anious or in a panic. chest, so use this huff when it feels ready to
come out, but not before. Take a deep breath in
Deep Breathing Exercises and then huff the air out uickly. This should
clear your sputum without coughing. 
Take a long, slow, deep breath in, through
your nose if you can. Try to keep your chest
Association of Chartered Physiotherapists in Respiratory Care
Leaflet No. GL-05 Page ACPRC
How do I know I am huffing orretl If you find it hard to keep your mouth and
throat open when huffing, you may find it
our huff should move the sputum in your useful to use a small tube (eg the mouthpiece
chest by making it ‘rumble’ or ‘rattle’. This for a peak flow meter) when practising. Ask
will mean you are moving the sputum up the your physiotherapist to show you how.
airways, it should then clear easily.
If you are wheeing with each huff you may Putting it together to for a ‘cycle’
be huffing too hard or for too long. ake sure
you do not huff too hard and always do some our physiotherapist may adust the Active ycle
breathing control after each two huffs. of reathing Techniues to suit your needs. 
The le
Deep reathing
Breathing control Breathing control
or
alllong huff Bigshort huff
Association of Chartered Physiotherapists in Respiratory Care
Leaflet No. GL-05 Page ACPRC
 hen should I ough breathing eercises around your life and your
daily routine, so that you are able to do them
If huffing clears your sputum you should not regularly. Try to avoud doing AT straight
need to cough. owever if it does not clear after a meal. ou should discuss this with your
your sputum, then you may need to. ou should physiotherapist.
only cough if the sputum can be cleared easily.
It is very important to avoid long bouts of How long should I do BT for
coughing as these can be very tiring and may
make you feel breathless, or make your throat ou should aim to continue your eercises for
or chest sore or tight. about 1 minutes and ideally until your chest
feels clear of sputum.
How often do I need to do BT
learing your chest should be done often hat osition should I do BT in
enough to keep it reasonably clear between The best position for you to do the AT in
doing the eercises. hen you are well you will depend on your medical condition and
may need to do AT only once or twice a day. how well it works for you. It can be done
hen you have more sputum, you may need to in sitting or in a postural drainage position
do it more often. hen you are unwell or have see leaflet L, as advised by your
more sputum, you may need to do shorter and physiotherapist. hatever position you use
or more freuent sessions. make sure you are comfortable, well supported
and relaed. If you have any uestions about
hen should I do m reathing eerises the information in this leaflet, please contact
your physiotherapist.
ou should do your eercises when it is easiest
for you to move the sputum from your chest,
or if you feel sputum has built up in your
lungs. The first sign may be that you feel
more breathless or that you are coughing
more. It is also important to try and fit your
seful ontats
Association of hartered Physiotherapists in hartered ociety of Physiotherapy
espiratory are www.csp.org.uk
wwwacprcorguk Asthma
ritish Thoracic ociety wwwasthmaorguk
wwwritthoracicorguk
ritish Lung oundation
www ugukorg
ased on recommendations from uidelines for Physiotherapy management of adult, medical, spontaneously breathing patient
www.britthoracic.org.ukclinicalinformationphysiotherapyphysiotherapyguideline.asp
This fact sheet is Copyright © ACPRC 2 a protecte uer a iteratioa aw

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...Association of chartered physiotherapists in respiratory care leaflet no gl page acprc the active cycle breathing techniques people with a lung problems often cough and shoulders relaed reathe out gently produce more phlegm sputum than is usual like sigh ou should do deep it important to remove from your breaths ask physiotherapist help you lungs breathe easily prevent choose right number for chest infections reduce bouts coughing ome find helpful hold their leaving can make breath about seconds at end condition worse before try ycle reathing techniues eercises both without acbt one way clear holding see which works best set that loosens moves airways be taught huffing by are control huff ehaling through an open mouth performed throat instead helps move until feels up so controlled sueee air uickly as if were trying mist using mirror or glasses se tummy little effort possible also l muscles but nose not force much cause wheeing cannot tightness uffing always followed there types use pu...

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