Active Cycle of Breathing Techniques - Patient education

Hi, I am a physio student on my first respiratory placement. Although I understand respiratory physio with regards to ACBT (active cycle of breathing) in my own mind, I am having difficulty explaining their importance, relevance and techniques to the patients themselves. I would be very grateful of any suggestions for effective wording of ACBT education! Just a few ideas to get me started!

Thank you. :)

ACBT
-is a tech which uses breathing exs to remove phlegm fr lungs. It's sometimes used alongside other clearence tech such as postural drainage or chest percussion.
-ACBT can be performed either in sitting, lying or postural drainage positions but initially u should start it in sitting position.
-ACBT uses alternating depth breathing to move phlegm from small airways at the bottom of your lungs to larger airways near the top where they can be cleared more easily with huffing or coughing.

HOW TO PERFORM ACBT
-try to maintain a good breathing pattern with relaxed shoulders and neck (avoid to use acessory muscle during the ACBT)
-breath through your nose and out through your mouth

The cycle is:

Breathing Control (also called abdominal breathing)
- Rest one hand on your abdomen, keeping shoulders and upper chest relaxed and
allow your hand to rise gently as you breathe in. (If you imagine air filling the abdomen
like a balloon this may help)
- Sigh out gently
- Ensure shoulders remain relaxed
- Over a few seconds, gradually increase depth of breathing while maintaining relaxation
Breathing control is an essential part of the cycle to allow rest.

Deep Breathing Exercises
- Take 3 – 4 deep breaths in, allowing the lower chest to expand
- Try to ensure neck and shoulders remain relaxed
- At the end of the breath in, hold the air in for 3 seconds
- Let the air out gently

Forced Expiration Technique
i.e. 1 or 2 “huffs” combined with breathing control
- Take a half breath in and blow air out steadily through an open mouth
- Follow this with breathing control
- Repeat
- As phlegm moves into larger airways take a deep breath in and blow air out again through an open mouth
- Breathing control
- Repeat the cycle until your chest is clear


A typical cycle consists of:

1)Breathing control
2)3 – 4 deep breaths (+/- 3 sec. Inspiratory hold)
3) reapeat breathing control
4)repeat 3 – 4 deep breaths (+/- 3 sec. Inspiratory hold)
5)repaeat breathing control
6)forced expiration technique

Hey Chiku,

Did u missed one TEE (Thoracic Expansion Exs) during ACBT???

I think that deep breathing or inspiration exercises are thoracic Expansion exercises and it has been discussed in the technique described above.

Google Hyperventilation Syndrome, you should get article by Edward Newton, MD. He explains how chronic breathing problems can be cause of anxiety disorders.

Has anyone here got good evidence-based articles re the effectiveness of ACBT on cystic fibrosis patients? I couldn't find much that indicates significant improvement in their pulmonary function via ACBT compared to other physio regimen such as PD, early mobilization, percussion etc.

My mother is suffering from diabetic.Is there any insurance for diabetic patient?
Thanks.....
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