Patient Information Leaflet
Breathing Exercises and Advice
Following a Video Fluoroscopic
Swallowing Exam
(VFSE)
Acute Therapy Services
01625 661484
Contact: 01625 241000 www.eastcheshire.nhs.uk
Leaflet Ref: 15013
Published: 11/15
t @eastcheshirenhs
t @echonhscharity
Review: 11/18
Page 1
Patient Information Leaflet
Why would I need to carry out breathing exercises following my Video
Fluoroscopic Swallow Exam (VFSE)?
Swallowing is the process that makes something pass from your mouth, to your
pharynx (throat) & into your oesophagus (food pipe) while shutting the epiglottis (the
flap at the base of the tongue that keeps food from going into your trachea, which is
your windpipe). If this process fails, then the substance goes through your trachea
and into your lungs.
If this swallowing process failed during your VFSE, then some of the liquid barium
(this is the white substance you were asked to swallow during your VFSE) will have
gone into your lungs. The liquid barium will normally be removed from your lungs
with a strong cough over the next 24-48 hours following the VFSE. You can assist
this process with some simple breathing exercises – the Active Cycle of Breathing
Technique, which is explained in this leaflet.
ACTIVE CYCLE OF BREATHING TECHNIQUE
(ACBT)
What is ACBT?
The ACBT are breathing exercises aim to improve ventilation, and to clear
substances from your lungs (such as phlegm). In this particular case, the substance
to be cleared is the liquid barium. It is a cycle of different types of breath which help
to move the liquid barium from the bottom of your lungs towards your main airways.
How often should I do them?
You should start the exercises immediately after your VFSE. For the following 24-48
hours you should aim to complete the cycle on 3 to 4 separate occasions throughout
the day (at times that are convenient for you). The exercises can be performed in
any position you find comfortable.
When should I stop?
You should stop once two cycles have been completed without clearing any of the
liquid barium, or when you are too tired to continue. You can stop performing the
ACBT 24-48hrs following the VFSE, or once you no longer notice any further liquid
barium on coughing.
Contact: 01625 241000 www.eastcheshire.nhs.uk
Leaflet Ref: 15013
Published: 11/15
t @eastcheshirenhs
t @echonhscharity
Review: 11/18
Page 2
Patient Information Leaflet
THE ACBT CYCLE
The ACBT cycle comprises of four main parts:
1. Breathing Control:
 Rest one hand over your stomach so that you can feel it rise and fall as you
breathe. Breathe in gently through your nose, and out through your mouth
(don’t force the air out).
 Do this for 20-30 seconds.
 Keep your shoulders relaxed.
 This helps to relax your airways.
2. Deep Breaths:
 Take a slow, deep breath in.
 Hold the breath for about 3 seconds.
 Breathe out gently until your lungs are empty (don’t force the air out).
 Repeat this 3-4 times.
 Try to keep your neck and shoulders relaxed.
Once you’ve done the deep breaths, go back to breathing control again to make sure
your airways are relaxed (please refer to the above diagram for guidance).
.
Contact: 01625 241000 www.eastcheshire.nhs.uk
Leaflet Ref: 15013
Published: 11/15
t @eastcheshirenhs
t @echonhscharity
Review: 11/18
Page 3
Patient Information Leaflet
3. Huffing:
 Take a medium sized breath in.
 Perform a short, sharp breath out through an open mouth (imagine you are
steaming up a mirror).
 This moves the liquid barium up your respiratory tract to the back of your
throat, where it can then be removed by coughing.
4. Cough if needed:
 A good, strong cough will enable the liquid barium to be cleared.
 Make sure you spit it out into a tissue or a pot.
You may find it beneficial to go back to the deep breathing exercises a second time
before huffing. Try it out and see what works for you.
If you have any concerns or questions regarding the Active Cycle of Breathing
Technique, then please do not hesitate to contact us on
01625 661484
Monday to Friday, 08:00 to 16:00
Ask to speak to one of the respiratory physiotherapists.
Contact: 01625 241000 www.eastcheshire.nhs.uk
Leaflet Ref: 15013
Published: 11/15
t @eastcheshirenhs
t @echonhscharity
Review: 11/18
Page 4
Patient Information Leaflet
For further information on the references and sources used for this leaflet, please contact
01625 661184.
Comments, compliments or complaints
We welcome any suggestions you have about the quality of our
care and our services. Contact us: Freephone: 0800 1613997
Phone:
01625 661449
Textphone: 01625 663723 Customer Care, Reception,
Macclesfield District General Hospital, Victoria Road,
SK10 3BL
For large print, audio, Braille version or translation, contact
Communications and Engagement on 0800 195 4194.
East Cheshire NHS Trust operates a smoke-free policy
(including e-cigarettes)
For advice on stopping smoking please contact our Stop Smoking
Service on 0800 085 8818.
East Cheshire NHS Trust
does not tolerate any form of
discrimination, harassment,
bullying or abuse and is
committed to ensuring that
patients, staff and the public
are treated fairly, with dignity
and respect.
Contact: 01625 241000 www.eastcheshire.nhs.uk
Leaflet Ref: 15013
Published: 11/15
t @eastcheshirenhs
t @echonhscharity
Review: 11/18
Page 5