Breathing Exercises guide

Active Cycle of Beathing Technique

The active cycle of breathing technique consists of three separate exercises:

• breathing control
• deep breathing exercises
• huffs. These are combined into the cycle shown below.

• only cough if secretions are there to clear
• continue treatment for up 20 minutes or until tired
• repeat regularly when secretions present.

Breathing

Breathing in COPD

People with COPD tend to breathe using the upper part of their chest, with shoulders hunched forward, often fixing their arms on their knees.

This is inefficient and uses a lot of energy. In this position, the oxygen you breathe is not being used effectively.

What is breathing control? (Diaphragmatic / Abdominal Breathing)

This is a more efficient way of breathing and can help you to relax and feel in control. When you take a deep breath in, the diaphragm flattens, which squashes the abdominal contents causing your abdomen to gently expand.

Unfortunately, having COPD for many years may make breathing in this relaxed way difficult.

Test your breathing

Place one hand on your upper chest and one hand on your stomach, just below your ribs. You will probably feel your top hand move more than your bottom hand as you take a breath in.

This is an ineffective way of breathing, common in patients with chest problems.

How to practice diaphragmatic breathing (breathing control)

Get in a comfortable, well supported position, for example sitting in an armchair or sitting up in bed. Relax your head, neck, shoulders and upper chest. Place one hand on your stomach, just below your ribs.

Breathe in slowly through your nose and then sigh the air out, either through your nose or mouth (whichever is most comfortable). This should be a normal sized breath not a deep breath.

You should feel your stomach rise as you breathe in and fall as you breathe out. It is very difficult to change your breathing pattern, however, if you practice daily it will become more natural.

Once you have mastered this at rest, you can use this exercise independently, to recover from doing any activity for example walking and climbing stairs. We will encourage you to use breathing control to recover your breath during the exercise sessions.

Secretion Retention

People with COPD can keep hold of mucous (Phlegm) within their lungs. Mucous pooling within the lungs encourages infection and prevents the exchange of gas.

It is beneficial to clear secretions that may be present in your chest.

Deep Breathing Exercises

This improves even circulation of air to the whole of the lungs and starts to unstick the secretions. Take slow breath in through your nose until your lungs are full up with air. When you breathe out remember to extend it blowing the air out.

Huff

Take a slow half breathe in through your nose. Feel your lower chest expand. Open your mouth wide to make a big O with your lips and blow the air out through an open mouth.

Positions of Ease

Body positions can help relieve breathlessness.

Position 1

Lean against a wall.

Let your head fall forwards and your arms hang loosely by your sides.

Position 2

Sitting forwards, rest your hands or elbows on your lap.

Let your head and shoulders relax.

Position 3

Find a wall or window ledge to lean on.

Rest your arms and let your head fall forwards.

Our patients matter

Mersey Care NHS Foundation Trust listens and responds to patients and their carers to help improve the services we deliver.

If you have any comments, compliments or concerns you can speak with a member of staff or contact our Patient Advice and Liaison Service (PALS) and Complaints Team.

Telephone: 0151 471 2377 Freephone: 0800 328 2941 Email: palsandcomplaints@merseycare.nhs.uk