Active cycle of breathing p 137 141 155 159
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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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Active cycle of breathing p 137 141 155 159

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

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


Thoracic expansion exercises

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


Collateral ventilation pathways

Collateral ventilation pathways


Forced expiratory technique huffing

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


Active cycle of breathing p 137 141 155 159

ACBT

  • Adapted for each patient

  • In sitting or PD-position

  • End of Rx = unproductive low lung volume cough (2 cycles)


Active cycle of breathing p 137 141 155 159

ACBT

BC

TEE

BC

FET

HUFF

BC


Active cycle of breathing p 137 141 155 159

ACBT

BC

TEE

BC

FET

BC

HUFF

BC

TEE

HUFF

BC

FET


Oscillating positive expiratory pressure p 149 154

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


Flutter device

Flutter device


Bubble pep

Bubble PEP


Incentive spirometry p 163 169

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


Incentive spirometry

Incentive spirometry


References

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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