Physiotherapy - Unassisted Breath Stacking Exercises

What is breath stacking?

Breath stacking is a technique you can use regularly for keeping your lungs clear of secretions and improving the size of your breath that you take in. It is used for people with weakness of the muscles used for breathing and can help to improve the strength of your cough and improve your voice quality.

Benefits of breath stacking

• Helps keep lungs clear of secretions
• Helps prevent chest infections
• Helps keep lungs and chest wall flexible
• Can make it easier to cough effectively
• Can improve voice strength.

When is breath stacking used?

Your physio will advise you about how and when to use this technique, but it is recommended you do breath stacking exercises every day.

It is recommended to do them between 1-4 times per day, but you may choose to complete this more frequently if it's beneficial. If clearing mucus becomes more difficult throughout the day, then you may be advised to use this technique more often.

When should I not use it?

• Ideally leave more than 1 hour after having either food or drink
• If you have a PEG/RIG, stop the feed 1 hour before doing the exercises
• Stop completing exercises if you notice any blood in your phlegm or feel any acute chest pain.

How to complete breath stacking

This is best to be completed in an upright position (seated or standing) and doesn’t require any equipment.

The following steps are a basic example of how to complete breath stacking exercises, but your physiotherapist may make specific recommendations for you which they will go through with you.

1. Sit up straight with your back and head supported or stand tall and balanced
2. Breathe OUT fully
3. Take small breath IN through your nose and try to hold for short moment
4. Then immediately take another breath IN on top of the previous one
5. Repeat this process of stacking breaths until you can no longer fit any additional breaths IN: this may take between 2-5 breaths IN
6. Try an hold your breath for 3-5 seconds then gently breathe OUT of your mouth.

• Rest between each breath stacking attempt for at least 30 seconds
• Repeat steps 1 to 6 up to five times in any one session
• If you have any secretions or mucus, try to produce a strong cough at any point
• Rest between cycles as you may feel tired or slightly light headed.

Individual modifications:

Contact numbers:

If you have any queries or require advice about this technique then please contact the Physiotherapy Team on 0161 206 2154.
Email Address: anu.therapy@nca.nhs.uk
Email address: respiratoryphysio@nca.nhs.uk

Useful Contacts

Association of Chartered Physiotherapists in Respiratory Care
www.acprc.org.uk

British Thoracic Society
www.brit-thoracic.org.uk

British Lung Foundation
www.lunguk.org

Chartered Society of Physiotherapy
www.csp.org.uk

Motor Neurone Disease Association
www.mndassociation.org/

Muscular Dystrophy Campaign
www.muscular-dystrophy.org/ Post Polio Support Group www.ppsg.ie

NHS free smoking helpline 0800 0224332
www.smokefree.nhs.uk