Active Cycle of Breathing (ACBT)

The Active Cycle of Breathing is a critical tool for secretion mobilization. It can also be modified in several ways to address patient-specific needs. But the basic cycle is more than enough for most patients. The goal is to loosen secretions and get air underneath them so they can be mobilized (or coughed) out.

I teach this to my patients pretty often across multiple settings, but there are a few things specific to COVID-19 that we need to remember:

  • These patients have an active viral infection that is easily spread
  • The ACBT is an aerosol-generating procedure, which can aerosolize COVID-19
  • Others in the room may be at risk so the patient should only be performing this in a closed room
  • Performance of the ACBT with a COVID-19 patient put YOU at risk, especially if you do not have the proper PPE
  • As COVID-19 is a restrictive disease state, you may not need airway clearance techniques. But that doesn’t mean you won’t need many other interventions.

I thought this post would be a little more entertaining if you guys had a video so here goes…

I’ve provided you with a downloadable printout to hand to your patients when you are instructing this. I have also not included any reps or times on this hand out so that you can change it for your specific patient tolerance. I’ve found that my home care patients could typically tolerate 5-10 reps of each activity around the cycle, but my SNF patients max out around 5. That original cycle recommends 20-30 seconds at each activity, but my patients simply can’t do that most of the time. The overall recommended duration of performance is 10 minutes.

Download the patient education handout here!

How did your patients like the handout? What modification do you find yourself making most often as you instruct this intervention? Let me know in the comments!

More from the Pulmonary Rehab Toolbox…

Blow Out the Candles…

If there is any treatment that I feel like gets used in a cookie-cutter fashion, it’s pursed-lip breathing. As much as I hate seeing this technique used for every single patient that has shortness of breath, it does have clinical usefulness. So let’s talk about how to implement pursed-lip breathing properly based on patient presentationContinue reading “Blow Out the Candles…”

Postural Drainage

We’ve all seen that dreaded picture in our textbooks… All the human figures laying in so many different positions with pillows and tables tilted all over… and I very clearly remember thinking, “How on earth am I supposed to remember all of those?” Well, good news. You really don’t have to. It’s great if youContinue reading “Postural Drainage”

Spilling the Box of Pearls: All the Tips on Supplemental Oxygen Management

In my recent post on COPD management, I mentioned that there are some really important parts of supplemental oxygen management that you need to be aware of and consider in your practice. If you are assisting patients who utilize supplemental oxygen regularly, you need to keep these things in mind. You also may be workingContinue reading “Spilling the Box of Pearls: All the Tips on Supplemental Oxygen Management”


Something went wrong. Please refresh the page and/or try again.

Follow @DoctorBthePT on Twitter for regular updates!

10 thoughts on “Active Cycle of Breathing (ACBT)

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: