Active Cycle of Breathing Technique (ACBT)

by Ruth Skinner

Avoiding catching Covid 19 is a priority for all of us right now. But what if we do find ourselves developing symptoms? Here’s what you can do to help keep your lungs clear. The ACBT, it’s been around for many years and is used daily by physiotherapists on hospital wards and with conscious ICU patients with respiratory problems or simply to prevent respiratory issues. For example after surgery when we are less mobile or in pain and hence less likely to take those lovely, deep restoratative breaths. The active cycle of breathing technique (ACBT) combines different breathing techniques to help clear mucus from the lungs in three phases:

  1. Breathing control to relax the airways.
  2. Chest expansion exercises to get air behind mucus ready to clear it.
  3. Forced expiration/Huffing to force the mucus out of your lungs.

1. Breathing control

Breathing control helps relax the airways. Breathe in through your nose and out through your mouth with very little effort. Use normal, gentle breathing with the lower chest while relaxing the upper chest and shoulders.

A good way to do this is to place one hand on your stomach as you breathe. Remember to breathe gently so you relax the airways. By using the pursed lip technique when breathing out (pursing your lips like you are kissing someone), you create back pressure in the airways that stents the airway open longer. Repeat breathing control for six breaths before moving to chest expansion exercises.

2. Chest expansion exercises

Breathe in deeply. (Some people use a three-second breath hold to get more air into smaller airways and behind the mucus.) Then breathe out without forcing the air out. This may be done with chest clapping or vibrating, followed by another cycle of breathing control.

3. Forced expiration/huffing

A huff is exhaling through an open mouth and throat instead of coughing, It’s like breathing onto your glasses to clean them. Only perform 1-2 huffs together, as repeatedly huffing can make your chest tight.

If you feel breathless then please call 111 for medical advice and assistance. If you are so short of breath you cannot speak in full sentences then call 999.