Developing Protocol for Strengthening the Inspiratory Muscles of Cancer Patients After a Procedure to Prevent Fluid Re-Accumulating in the Chest

A 6-week individualised respiratory muscle training (RMT) program to be completed at the participant's home. This involves participants completing 30 rapid inspired deep breaths through an assigned breathing device, repeated twice daily. The device is a Power Breathe Plus RMT device, which is an inspiratory muscle breathing trainer designed to strengthen inspiratory muscles and improve breathing stamina. Participants will attend the study site to meet a physiotherapist on 3 occasions, allowing 60 minutes per visit. Visit 1 will be 2 weeks after the participant’s procedure and will include a test of inspiratory muscle strength, completion of questionnaires and a demonstration of how to use the device. This visit will also involve the initial breathing training session to allow this to be supervised by the physiotherapist. Training load will commence at 40% of inspiratory muscle strength (adjusted by physiotherapist for tolerance during initial supervised training). Threshold load of Power Breathe Plus will be increased by 2.5 cms H2O up to three times per week if all of the following are met: • Able to complete 30 rapid, deep breaths within approximately 7 minutes. •Rating Perceived Exertion (RPE) score recorded by participant in study diary is less than 13 out of 20 (“somewhat hard”) at end of 30 breaths. •No moderate/severe chest muscle discomfort caused by training. Each training session will take less than 7 minutes and include 1 minute rest periods after each set of 10 breaths (3 sets in total). Participants to then complete breathing training to suit their schedule with at least 6 hours between sessions. Participants will record details about each training session in a diary. A physiotherapist or research nurse will also phone participants during the 6-week training period for monitoring purposes and to discuss comfort of completing the breathing exercises. These phone calls will be as per below: - Twice per week during the first 2 weeks. - Once per week during the final 4 weeks. Visit 2 will be 2 weeks after Visit 1 and will again include a test of inspiratory muscle strength and completion of questionnaires. Another supervised breathing training session will also occur during this Visit. Visit 3 will be 6 weeks after Visit 1 and will again include a test of inspiratory muscle strength and completion of questionnaires. The final supervised breathing training session will also occur during this Visit.