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Active Cycle of Breathing Technique (ACBT)

Physiotherapy Instructions
Physiotherapy Department 01 2936692

Patient Information
Active Cycle of Breathing Technique (ACBT)

What is ACBT?
The ACBT is a technique to help you clear secretions from your chest.

Coughing alone can be tiring and ineffective. The ACBT uses different types of breaths
to make it easier to clear secretions by shifting them from the outer part of your lungs
towards the main airways.

It is important that you are in a comfortable position with shoulders relaxed. Upright
sitting and side lying are recommended.

A typical Cycle:

HUFF/ Deep
COUGH Breathing

Deep Relaxed
Breathing Breathing
x4-5 x 10sec

Relaxed Deep
Breathing Breathing
x 10sec x4-5

Physiotherapy / Last revised April 2010

Deep Breathing
1. Breath in deeply feeling your lower chest expand as far as possible. Try to keep
your neck and shoulders relaxed.

2. Hold the breath for up to three seconds.

3. Let the air out gently.

4. Repeat this step x 4 – 5times.

5. Your physiotherapist may advise you to use your Incentive Spirometer at this

Relaxed Breathing / Breathing Control

This is normal, gentle breathing using the lower chest.

1. Rest one hand on your abdomen so that you can feel it rise and fall with your

2. Breathe in gently feeling your hand rise and your lower chest expand.

3. Breathe out gently allowing your shoulders to relax down. The breath out should
be slow, like a “sigh”.

This is a short sharp breath out through an open mouth that helps to force the secretions
To perform this, imagine you are trying to fog up a glass or mirror.

Remember the huff needs to be through an open mouth, using your abdominals muscles.

Only Cough if you feel the secretions are ready to be cleared.

How often?
Your physiotherapist will advise you on how often you should perform the Active Cycle
of Breathing Techniques.

Ref: 1: Hough, A (Third Edition, 2001); Physiotherapy in Respiratory Care

2: Pryor, J & Prasad, S. (Third Edition, 2002): Physiotherapy for Respiratory and
Cardiac Problems