Active Cycle of Breathing Techniques(ACBT)

The gold standard physiotherapy treatment for most respiratory conditions is now to teach the patient the ACBT.

In Kilkenny Physiotherapy and Sports Injury Clinic we use this in conjunction with manual therapies to help you get immediate relief as well as long term help at home.

The Active Cycle of Breathing Techniques (ACBT) is an active breathing technique which should be used to loosen and clear secretions from the chest. It consists of three main phases.

  1. Control of breathing
  2. Deep Breathing Exercises
  3. Forced Expiratory Technique (F.E.T)

Breathing Control

This stage of the cycle is used to get the patient to relax between the more strenuous parts of the cycle. The patient should be comfortable and try to relax.

It involves bringing the air deep into the lungs causing the stomach to rise and the bases of the lungs to expand on inspiration, while encouraging the shoulders to remain relaxed.

Deep Breathing

  1. Relax your upper chest and shoulders.
  2. Breathe in slowly and deeply through an open mouth.
  3. Breathe out gently through pursed lips until your lungs are empty.
  4. Repeat 3 to 4 times.
  5. At the end of the breath in, hold the air in your lungs for 3 seconds

 Deep Breathing with Thoracic Expansion

  1. Relax your shoulders.
  2. Place both hands on either side of ribs.
  3. Breathe in deeply as your ribs expand.
  4. Breathe out gently as far as you can until your lungs feel empty.
  5. Repeat 3 – 4 times.


Huffing or FET

The Forced Expiratory Technique, FET or “Huff” is an important part of the ACBT

A huff is breathing out through a relaxed open mouth and throat. It is used when there is an urge to cough, to stiffle the cough and so prevent spasm developing in the chest. This huffing moves sputum from the small airways in the lungs to the larger airways, so they can be more easily removed by coughing.

Technique of FET

  1. Take a small breathe in.
  2. Contract your tummy muscles keeping your mouth and throat open to form a huffing sound.
  3. When the sputum is felt in the higher parts of the lungs take a large breath in.
  4. Squeeze the air out as before to perform a huff. You can use your elbows to assist this by pressing in sharply on the ribs as you huff.
  5. Cough andclear the secretions.
  6. Allow your breathing to settle again with breathing control
  7. Repeat the cycle until your chest feels clear.