Comparing an app-based breathing exercise program with standard breathing exercises in preparing breast cancer patients for breath-hold radiation therapy

What is the intervention? The intervention is a structured breathwork exercise program delivered through the Physitrack mobile application. The program uses exercises selected from the existing Physitrack exercise library to improve diaphragmatic breathing, respiratory control, and breath-hold performance in preparation for Deep Inspiration Breath Hold (DIBH) radiation therapy. Examples of these exercises include: diaphragmatic breathing, bilateral shoulder flexion with breathing, thoracic expansion, abdominal breathing and box breathing. The comparison group will receive the breath-hold exercises routinely provided as part of standard departmental education. Who delivers it and their relevant expertise? The exercise program will be prescribed by a Senior Exercise Physiologist with expertise in respiratory exercise prescription. The program will then be set up for the participant, who received the Physitrack arm, in the Physitrack application by the healthcare professional from the research team. The healthcare professional will either be the radiation therapist or radiation oncology nurse who obtained consent from the participant. This team member will also provide the participant with instructions on accessing and using the application. How is it delivered? The intervention is delivered individually through the Physitrack application. Participants receive video demonstrations, written instructions, exercise reminders, and adherence monitoring through the application. Participants allocated to the control arm receive standard departmental education and written instructions describing the breath-hold exercises. How often and for how long? Participants will complete the prescribed exercises twice daily for approximately two weeks before their CT simulation/planning appointment. Each session takes less than 10 minutes to complete and consists of four progressively challenging diaphragmatic breathing and breath-hold exercises designed to prepare patients for DIBH radiation therapy. Where is it delivered? Participants will be introduced to the intervention following their initial consultation with their radiation oncologist at the North Coast Cancer Institute, Lismore Base Hospital. The exercise program is then completed independently in the participant's home using the Physitrack application (intervention arm) or written exercise instructions (control arm). Adherence Participants allocated to the Physitrack arm will receive automated exercise reminders through the application, and adherence will be monitored using app-recorded exercise completion data. Both arm participants will record their exercise completion in a paper diary, which will be collected at their CT simulation appointment.