Active Cycle Breathing Technique (ACBT) on Respiratory Parameters, Dyspnea Related Kinesiophobia and Pain ((ACBT))

The Effect of Active Cycle Breathing Technique on Respiratory Parameters, Dyspnea Related Kinesiophobia and Pain in Early Post Cardiac Surgery Patients

This study aims to improve pulmonary function impairment is associated with a reduction in chest expansion, lung volume, pain perception and an impairment of the Post cardiac surgery patient's ability to cough effectively. The technique of active cycle breathing consisted of three parts to the ACBT, which are:

• breathing control
• deep breaths
• huff or cough

Study Overview

• Status: Completed
• Conditions: Cardiac Disease; Respiratory Complication
• Intervention / Treatment: Procedure: Routine care; Procedure: Active cycle breathing technique

Detailed Description

This study aims to explore the effect of Active Cycle Breathing Technique on Respiratory Parameters and Pain in Early Post Cardiac Surgery Patients

Research hypothesis:

-Post cardiac surgery patients who practice active breathing techniques exhibit an improvement in clinical outcomes compared to those who do not practice.

Research design:

A randomized control trial research design will be utilized to conduct this study.

Study Setting:

This study was carried out at the cardiac ICUs. A sample of 120 cardiac patients will be assigned in the current study from the previously mentioned settings.

The patients will be allocated into two equal groups, each with 60 patients. The control group will be composed of 60 patients who were managed by routine cardiac care The study group will consist of 60 patients who were exposed to an active cycle of breathing techniques

Inclusion criteria:

• Adult patients of both genders.
• After extubating for at least 6 hours
• Hemodynamic stable patients
• Able to communicate. Exclusion criteria: Patient with complication postoperative surgery Patient's demographic characteristics as patient's code, age, gender, marital status, education, and occupation.

Study group: managed by the use of active cycle breathing techniques combined with routine physiotherapy.

• Each session of the active cycle breathing technique lasted for 10 to 20 minutes.
• The active cycle breathing technique was carried out for three days post extubating four sessions done daily.

Implementation of active cycle breathing technique

• Explain the steps of ACBT to the patient.

• The patient was placed in a semi-sitting position with her or his back straight, and instructions were given to the patient to do the following steps:

  1 . Breathing control phase

• Hold the spirometer straight.
• Exhale, then seal your lips around the mouthpiece and inhale slowly and deeply into your mouth.
• The piston in the incentive spirometer's transparent chamber will rise when you inhale deeply.
• Hold your breath for 3 to 5 seconds after taking a deep breath.
• Remove the mouthpiece and slowly exhale. For a few seconds, until the piston descends to the bottom of the chamber, relax and breathe normally.

• To regain control of their breathing, the patient was told to do lengthy, slow expirations between 5 and 7 times.

  2 . Thoracic expansion exercises The patient was instructed to relax your upper chest.

• The patient was instructed to breathe slowly and deeply through the nose without using the accessory muscle.
• The patient was instructed to hold their breath initially for 3 to 4 seconds and gradually increase it to the maximum time.

Don't force the breath out; instead, softly exhale through pursed lips until your lungs are empty.

• Repeat the previous steps from 3to4 times. 3- Forced expiration technique (huffing)
• Patient was instructed to support the incision site by using a chest binder or keeping your hands over your incision.
• Cough twice as many times as they huffed two to three times.
• This step was repeated a minimum of two times and a maximum of three times in one session.

• Study Type: Interventional
• Enrollment (Actual): 120
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Damanhūr, Egypt
    • Faculty of nursing Damanhour university

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Adult patients of both genders.
• After extubating for at least 6 hours post operation.
• Hemodynamic stable patients
• Able to communicate.

Exclusion Criteria:

• Instability of patient's medical condition or hemodynamic instability

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Active cycle breathing technique; Breathing control phase Thoracic expansion exercises Forced expiration technique (huffing)	Procedure: Active cycle breathing technique; The ACBT was included if it was described as containing three essential components: 1) breathing control, 2) forced expiration technique and 3) thoracic expansion exercises. The technique may also include postural drainage (PD) or percussion/shaking.
Placebo Comparator: Control group; Patient who receives the routine care	Procedure: Routine care; Routine care delivers after extubating such as percussion or chest physiotherapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain perception	Using visual analogue scale score 0 mean no pain while score 10 means sever pain	Three observation days
Dyspnea-related kinesiophobia	comprises 11 items include five items dyspnea and six items for fear of activity dimension and each item is rated from "strongly disagree" (score = 1) to "strongly agree" (score = 5) for a total score between 11 and 55.	preoperative, three observation days, and day of discharge
Respiratory parameters	change in respiratory rate	Three observation days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Deterioration in clinical parameters such as vital signs	hypoxic event	Three observation days
ICU and hospital stay	ICU and hospital stay	three observation days

Collaborators and Investigators

• Sponsor: Damanhour University

Publications and helpful links

General Publications

• Lewis LK, Williams MT, Olds TS. The active cycle of breathing technique: a systematic review and meta-analysis. Respir Med. 2012 Feb;106(2):155-72. doi: 10.1016/j.rmed.2011.10.014. Epub 2011 Nov 18.
• Mckoy NA, Wilson LM, Saldanha IJ, Odelola OA, Robinson KA. Active cycle of breathing technique for cystic fibrosis. Cochrane Database Syst Rev. 2016 Jul 5;7(7):CD007862. doi: 10.1002/14651858.CD007862.pub4.

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2024
• Primary Completion (Actual): July 1, 2025
• Study Completion (Actual): October 31, 2025

Study Registration Dates

• First Submitted: July 19, 2024
• First Submitted That Met QC Criteria: July 24, 2024
• First Posted (Actual): July 25, 2024

Study Record Updates

• Last Update Posted (Actual): December 26, 2025
• Last Update Submitted That Met QC Criteria: December 19, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Cardiac surgery; Respiratory function
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Pathologic Processes; Respiratory Tract Diseases; Respiration Disorders; Pathological Conditions, Signs and Symptoms; Heart Diseases; Respiratory Aspiration
• Other Study ID Numbers: Active cycle breath technique

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No