title: The active cycle of breathing techniques--to tip or not to tip?
abstract: The active cycle of breathing techniques (ACBT) in gravity-assisted drainage positions is an effective airway clearance regimen for individuals who produce excess bronchial secretions. This study compared the ACBT in positions with and without a head-down tilt. Nineteen subjects (11 men), mean age 37.1 years (range 18-76 years), with bronchiectasis who produced more than 20 g of sputum per day and had a mean forced expiratory volume in 1 s (FEV1) of 56.9% predicted (range 23-90% pred.) were studied. There was no significant difference in the wet weight of sputum expectorated when using the ACBT in gravity-assisted drainage positions with or without a head-down tilt. Mean (SD) score for perception of breathlessness, measured on a visual analogue scale, increased significantly following treatment with a head-down tilt [2.3 (1.6) to 3.3 (2.0) cm, P = 0.02]. There was no significant difference in oxygenation or lung function (FEV1). Eighteen subjects preferred the ACBT without a head-down tilt. The ACBT in the horizontal position is a simple airway clearance regimen suitable for individuals who produce greater than 20 g of sputum per day. Subjects were less breathless and preferred the ACBT in the horizontal position, thus providing a treatment alternative that may improve adherence in individuals who are required to carry out daily airway clearance treatments.
authors.affiliation: School of Physiotherapy, Curtin University of Technology, Perth, Western Australia.
authors.forename: N M
authors.initials: NM
authors.lastname: Cecins
authors.forename: S C
authors.initials: SC
authors.lastname: Jenkins
authors.forename: J
authors.initials: J
authors.lastname: Pengelley
authors.forename: G
authors.initials: G
authors.lastname: Ryan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001987:Bronchiectasis; D015916:Drainage, Postural / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013183:Sputum