1. www.derby.ac.uk Can inspiratory muscle training relieve symptoms of dyspnoea and improve quality of life for advanced cancer patients? A pilot study. Breathlessness ? Dr Heidi Sowter Dr Manjusha Keni Jo Ruck Mandy Moore Mark Faghy Mres students and URSS interns

2. www.derby.ac.uk Cut-Away Illustration of the POWERbreathe® Pressure Threshold inspiratory muscle training (IMT) Device

3. www.derby.ac.uk Participants have a “coping with breathlessness” and goal setting workshop with respiratory physiotherapists They use the IMT device for 30 breaths twice a day for 8 weeks Functional improvement measurements: 6MWT and maximal inspiratory pressure (MIP) QoL measurements: Weekly diary and St. George’s respiratory questionnaire (SGRQ) Focus group to gauge patient experience Study Design

4. www.derby.ac.uk 3 participants (2 male, 1 female) All completed the intervention No-one engaged with goal setting, SGRQ scores didn’t change Results MIP increased by up to 50% for 2 participants

5. www.derby.ac.uk Total distance walked wasn’t significantly different Perceived exertion and dyspnoea significantly reduced for each participant

6. www.derby.ac.uk Conclusions ‘I didn’t stop as much as I would normally … the biggest difference I’ve noticed is on a slight gradient, even those it’s only a matter of forty yard but I’m getting to the top without being breathless’ ‘I’d say obviously the apparatuses is working, otherwise I wouldn’t be as good as I am’ ‘I have definitely felt and improvement.’ IMT improved the functional capability of all participants The STRQ and diary didn’t effectively capture any changes in quality of life Participants felt that this therapy was effective and easy to manage