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 20g of sputum per day and had a mean forced expiratory volume in 1s (FEV 1) 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 (FEV 1). 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.

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