ACBT

Question 1

What does ACBT stand for?

Answer 1

Active cycle of breathing technique

Question 2

Why is ACBT used? 3

Answer 2

1. Normalise a patient’s breathing pattern.
2. Normalise their lung volumes.
3. Clear excessive bronchial secretions from the patient’s tracheobronchial tree.

Question 3

What are the components of ACBT? 3

Answer 3

1. Breathing control (BC)
2. Thoracic expansion exercises (TEE)
3. Forced expiratory technique (FET)

Question 4

Describe the the breathing control component of ACBT? 4

Answer 4

1. This is the relaxation component of ACBT. Also called diaphragmatic breathing.
2. Preceded by shoulder girdle relaxation exercises.
3. Physiotherapist places two fingers just under the patient’s xiphisternum and the patient is encouraged to take tidal volume (normal-sized) breaths while breathing with the diaphragm.
4. Physiotherapist should feel the patient’s diaphragm rise and fallunder her/his finger

Question 5

Describe the thoracic expansion component of ACBT. 3

Answer 5

1. Deeper breathing than breathing control to improve lung volumes.
2. Physiotherapist’s hands are placed over the patient’s lateral basal lung segments.
3. Patient is encouraged to take a deep breath and fill their lungs with air.

Question 6

What are the 3 types of TEE? 3

Answer 6

1. TEE only
2. TEE with 3-second hold
3. TEE with inspiratory sniff

Question 7

What is the effectiveness of TEE based on?

Answer 7

Effectiveness of TEE based on utilisation of collateral ventilation pathways between alveoli that facilitate movement of air to areas of the lungs that are less well ventilated.

Question 8

Describe the forced expiration technique component of ACBT. 7

Answer 8

1. Assists with clearance of secretions from the tracheobronchial tree.
2. FET is a combination of two forced expirations (huffs) and interspersed by periods of breathing control.
3. Start with patient doing long huffs to recruit secretions from periphery of lung lobes.
4. Followed by BC.
5. Then patient performs short huffs to bring secretions to trachea.
6. Followed by BC.
7. After FET the patient must cough to expectorate the recruited secretions from his/her trachea.

Question 9

What is equal pressure point? 4

Answer 9

1. The point in the airways where the pressure inside the airways = pressure in surrounding lung tissue.
2. EPP is usually around the central airways.
3. During FET or cough the EPP moves distally towards the smaller airways.
4. This causes dynamic compression and collapse of the airways in the direction of the mouth and assists in mobilising secretions towards the trachea to be expectorated.

Question 10

Are the any contraindications or precautions to ACBT? 3

Answer 10

1. No contraindications or precautions for the use of ACBT in patient care.
2. Patient must breathe away from the physiotherapist’s face for infection control purposes.
3. In the presence of pain, general weakness and dyspnoea, ACBT may only be effective if the patient sits with their back supported in bed or in a chair.