Active Cycle of Breathing Techniques - Stages and Benefits

Introduction:

The active cycle of breathing technique (ACBT) is a patient-performed active breathing method that can enhance lung function generally. It is a versatile therapy approach that may be altered for usage with most patients, along with posture. Depending on the patient's issue, each element may be employed alone or as a part of the ACBT cycle. After learning ACBT, the patient can be encouraged to practice it independently without a physiotherapist's supervision. No specialized equipment is needed for this activity.

What Are the Stages of the Active Cycle of Breathing Techniques?

Depending on the patient's state, the procedure might be changed. Additionally, if and when necessary, a manual technique (MT) or positive pressure can be used to make the cycle more complicated and aid in eliminating lung secretions. This can involve percussion or vibrations from breathing. There are three basic phases of ACBT are

Breathing Regulation -

• By controlling breathing, one may relax the airways and eliminate the tightness and wheezing that typically follow a cough or a lack of breath.

• It is the downtime between the technique's more active components. Additionally helpful in promoting relaxation is encouraging the patient to close their eyes while controlling their breathing.

• It is crucial to practice breathing control to relax the airways between the more strenuous ACBT exercises.

• Breathing control is also beneficial for those who are afraid, anxious, panicked, or show bronchospasm symptoms. Depending on how out of breath the patient feels, the duration of breathing control may change.

• The patient may be told to take six breaths when this approach is used with them as part of the ACBT.

• If they can, softly inhale and exhale via the nose. Breathe through the mouth if they cannot. It is preferable to practice breathing control with "pursed lips breathing" if they exhale through their mouth.

• With each exhalation, try to release any tension in the body and maintain the shoulders relaxed. Then, try gradually slowing the breathing.

• Try shutting the eyes to relax and concentrate on breathing,

• Until the person feels prepared to go on to the subsequent phases of the breathing exercises, breathing control should be maintained.

Exercises for Deep Breathing or Thoracic Expansion -

• The thoracic expansion exercise is a type of deep breathing exercise that concentrates on inspiration and helps to release pulmonary secretions.

• Before a passive, comfortable, and unforced expiration, inspiration is vigorous and typically accompanied by a three-second end-inspiratory hold.

• Make an effort to maintain a relaxed chest and shoulders.

• Inhale deeply and slowly for a long time, preferably through the nose.

• Hold the air in the lungs for two to three seconds after taking a breath before exhaling (known as an inspiratory hold).

• Exhale with ease and a sigh. Avoid squeezing the air out.

• Repeat three to five times. The patient must return to the breathing control phase of the cycle if they begin to feel dizzy.

• Placing one's hands on the thoracic cage might help the patient or therapist get maximum inspiration and proprioceptive input. This has been linked to better ventilation and more chest wall mobility.

• A breath-hold might be introduced to a deep breath to account for asynchronous ventilation that may be present in some respiratory disorders due to sputum retention and atelectasis (a lung disease that occurs when the airways do not expand properly during the process of breathing).

Forced Exhalation Technique or Huffing -

• This trick transports secretions downstream and toward the mouth after they have been stimulated by deep breathing and thoracic expansion exercises.

• Instead of coughing, a huff is an exhalation via an open mouth and throat. Since coughing alone cannot remove sputum from tiny airways, huffing aids in the movement of sputum, a transition from the smaller to the bigger airways, where it is then expelled by coughing.

• The patient is first taught to take a medium-sized breath in and to exhale with a mild to moderate effort and a lengthy expiratory flow while keeping their glottis open.

• To maximize air movement and improve clearance of secretions, the duration of the puff and the power with which the muscles tighten during expiration should be adjusted.

Huffing comes in two varieties:

• Huff at a Medium Volume - Lower-level secretions in the airways can be moved due to this. Breathe normally in, then actively exhale for a long time until the lungs are empty. Consider attempting to steam a mirror.

• Huff at a high volume - This aids in clearing the upper airways of secretions. Breathe in deeply, expand the mouth, and exhale fast. Huffing frequently might tighten the chest, so limit oneself to only one or two huffs.

• While puffing, keep an eye out for crackles. One might need to cough and spit out any secretions if heard; attempt to expel them with a spit into a basin or tissue.

• Coughing too much might make the approach less effective and more exhausting, so try to keep it under control.

• For around 10 minutes, repeat the entire cycle until the chest feels clearer.

• Use this huff when the sputum feels ready to come out but not before; huffs work by dynamic compression. Small lengthy huffs move sputum from low down into the chest, while huge short huffs push sputum from higher up into the chest.

• If puffing does not sufficiently remove the phlegm, one should also cough. However, one might not need to cough if it does clear the sputum.

• It is crucial to prevent protracted coughing fits since they may be exhausting, leave anyone feeling out of breath, and sometimes even cause the chest, throat, or lungs to become painful or tight.

• If clearing the sputum is simple, one may need merely cough; otherwise, start over at the beginning of the cycle.

How Active Cycle of Breathing Techniques Performed?

• A sitting posture or a postural drainage position can be used to accomplish ACBT.

• One might begin by sitting down first until one feels at ease and confident enough to explore other positions.

• A wealth of studies backs its usefulness in seated or gravity-assisted postures. However, the ideal posture for anyone to do the ACBT will depend on overall health and how well it works for oneself.

• Maintaining a proper breathing pattern when sitting, with the back supported and the shoulders and neck at ease can help the diaphragm operate and put less strain on the musculoskeletal system.

• Consider the comfort, support, and level of relaxation while choosing a posture.

• The ACBT can be carried out with or without a helper who provides shaking, vibrating, and percussion. In addition, the patient may engage in self-percussion or compression.

• It has been established that people prefer and are just as successful in the horizontal, side-lying posture as they are in the head-down, tipping position.

Conclusion:

Using a series of breathing techniques called ACBT, patients may clear their airways of sputum. The ideal person to teach people ACBT is a physiotherapist. Breathing control, deep breathing, and puffing are the three ACBT exercises that are cycled through until the chest feels clean. ACBT can successfully increase sputum production, cough effectiveness, lung function, blood gas analysis, and other indicators in patients with COPD. Throughout ACBT, monitoring for dizziness or increasing shortness of breath is critical. Healthy people only need to perform ACBT once or twice a day. However, they might need to do it more frequently if there is more sputum. Therefore, one should have shorter or more frequent sessions before they are sick or have more sputum.