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Active Cycle of Breathing (p.137-141, 155-159)

Active Cycle of Breathing (p.137-141, 155-159). Aims. Clearance of bronchial secretions ↑ lung function. ACBT. BC. Huffing. TEE. Breathing control. Resting period between active parts of cycle Tidal breathing, own rate and depth Upper chest and shoulders relaxed Diaphragmatic breathing

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Active Cycle of Breathing (p.137-141, 155-159)

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  1. Active Cycle of Breathing(p.137-141, 155-159)

  2. Aims • Clearance of bronchial secretions • ↑ lung function ACBT BC Huffing TEE

  3. Breathing control • Resting period between active parts of cycle • Tidal breathing, own rate and depth • Upper chest and shoulders relaxed • Diaphragmatic breathing • Inspiration and expiration barely audible

  4. Thoracic expansion exercises • Deep breathing emphasizing inspiration • 3-second end-inspiratory hold • Collateral ventilation pathways • Repeat 3 times • Proprioceptive stimulation • “Sniff” • Combined with percussion, shaking or vibration

  5. Collateral ventilation pathways

  6. Forced expiratory technique“Huffing” • Combination of one or two huffs with BC (5-10s or 10-20s) • Huffing from low or high lung volumes • With forced expiratory manouvre = dynamic compression and airway collapse • This less with huffing • As effective, less effort, not as exhausting • Forced but not violent

  7. ACBT • Adapted for each patient • In sitting or PD-position • End of Rx = unproductive low lung volume cough (2 cycles)

  8. ACBT BC TEE BC FET HUFF BC

  9. ACBT BC TEE BC FET BC HUFF BC TEE HUFF BC FET

  10. Oscillating positive expiratory pressurep .149-154 • Flutter device • With expiration = PEP and oscillating vibration of air in airway • Slow breath in, little deeper than normal, hold for 3-5 s. • Expiration through flutter, little faster than normal, repeat 4-8 times • Deep breath, hold at full inspiration, forced expiration, can repeat • BC and huff or cough

  11. Flutter device

  12. Bubble PEP

  13. Incentive spirometryp. 163-169 • Increase inspiratory capacity • Slow, deep inspiration with visual feedback • Generate a predetermined flow or achieve certain volume • End inspiratory hold • Pattern of breathing = expansion of lower chest and diaphragmatic breathing

  14. Incentive spirometry

  15. References • Pryor, J.A. and Prasad, S.A. 2009. Physiotherapy for respiratory and cardiac problems. Adult and paediatrics. Edinburgh: Churchill Livingstone • Images courtesy of Google search engine

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