The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this information for consumers
Trial registered on ANZCTR


Registration number
ACTRN12625000917437
Ethics application status
Approved
Date submitted
13/06/2025
Date registered
22/08/2025
Date last updated
22/08/2025
Date data sharing statement initially provided
22/08/2025
Type of registration
Prospectively registered

Titles & IDs
Public title
Developing Protocol for Strengthening the Inspiratory Muscles of Cancer Patients After a Procedure to Prevent Fluid Re-Accumulating in the Chest
Scientific title
Acceptability and Feasibility of an Individualised Inspiratory Muscle Threshold Load Training Protocol after Intervention to control Malignant Pleural Effusion (RMT-MPE)
Secondary ID [1] 313913 0
None
Universal Trial Number (UTN)
Trial acronym
RMT-MPE
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Malignant pleural effusion 336605 0
Condition category
Condition code
Respiratory 333110 333110 0 0
Other respiratory disorders / diseases
Cancer 333111 333111 0 0
Any cancer

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
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.
Intervention code [1] 330504 0
Treatment: Other
Intervention code [2] 330505 0
Lifestyle
Comparator / control treatment
Usual care. Noting that no specific exercises are done as part of usual care. Patients who have symptomatic recurrence of pleural effusion may have further drainage procedures and/or talc pleurodesis.
Control group
Active

Outcomes
Primary outcome [1] 340649 0
Feasibility of respiratory muscle training (RMT)
Timepoint [1] 340649 0
Across 6 week period of completing RMT at home.
Primary outcome [2] 340650 0
Acceptability and tolerability of respiratory muscle training (RMT)
Timepoint [2] 340650 0
At 2 week and 6 weeks post-commencement of intervention.
Primary outcome [3] 340651 0
Safety respiratory muscle training (RMT)
Timepoint [3] 340651 0
From baseline to 26 weeks post-commencement of intervention.
Secondary outcome [1] 444700 0
Change in maximum inspiratory pressure in the respiratory muscle training (RMT) cohort.
Timepoint [1] 444700 0
At baseline (commencement of intervention), 2 weeks post-commencement of intervention and 6 weeks post-commencement of intervention.
Secondary outcome [2] 444701 0
Dyspnea experienced in daily life over 26 weeks in RMT participants and control participants.
Timepoint [2] 444701 0
For RMT participants measures at commencement of intervention, 2 weeks, 6 weeks, 8 weeks, 12 weeks, 18 weeks, 26 weeks post-commencement of intervention. For control participants measures at baseline (study entry), 2 weeks, 6 weeks, 8 weeks, 12 weeks, 18 weeks, 26 weeks.
Secondary outcome [3] 444702 0
Dyspnea experienced in daily life over 26 weeks in RMT participants and control participants.
Timepoint [3] 444702 0
For RMT participants measures at commencement of intervention, 2 weeks, 6 weeks, 8 weeks, 12 weeks, 18 weeks, 26 weeks post-commencement of intervention. For control participants measures at baseline (study entry), 2 weeks, 6 weeks, 8 weeks, 12 weeks, 18 weeks, 26 weeks.
Secondary outcome [4] 450888 0
Quality of life over 26 weeks in RMT participants and control participants.
Timepoint [4] 450888 0
For RMT participants measures at commencement of intervention, 2 weeks, 6 weeks, 8 weeks, 12 weeks, 18 weeks and 26 weeks post-commencement of intervention. For control participants measures at baseline (study entry), 2 weeks, 6 weeks, 8 weeks, 12 weeks, 18 weeks and 26 weeks.
Secondary outcome [5] 450889 0
Number of drainages of pleural fluid over 26 weeks in RMT participants and control participants.
Timepoint [5] 450889 0
For RMT participants measures from commencement of intervention to 26 weeks post-commencement of intervention. For control participants measures from at baseline (study entry) to 26 weeks post study entry.
Secondary outcome [6] 451330 0
Volume of drainages of pleural fluid over 26 weeks in RMT participants and control participants.
Timepoint [6] 451330 0
For RMT participants measures from commencement of intervention to 26 weeks post-commencement of intervention. For control participants measures from at baseline (study entry) to 26 weeks post study entry.

Eligibility
Key inclusion criteria
•MPE (pleural biopsy or pleural fluid diagnostic of pleural malignancy, or recurrent exudative pleural effusions with no alternative cause in the setting of histocytologically proven extra-pleural cancer).
•Have received TP or IPC aiming to control symptomatic pleural effusion
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
• Expected survival < 6 months.
• WHO performance status 3 or 4.
• Age <18 years
• Pregnant.
•Significant chest pain expected to interfere with breathing training.
•Risk of spontaneous rib fractures (e.g. rib metastasis).
•Eustachian tube insufficiency or perforated ear drum.
•Communication difficulty or neurologic disease preventing co-operation with testing.
•Visual impairment.

Study design
Purpose of the study
Treatment
Allocation to intervention
Non-randomised trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Other design features
Phase
Not Applicable
Type of endpoint/s
Safety/efficacy
Statistical methods / analysis

Recruitment
Recruitment status
Not yet recruiting
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
QLD
Recruitment hospital [1] 27574 0
The Wesley Hospital - Auchenflower
Recruitment hospital [2] 27575 0
St Andrew's War Memorial Hospital - Brisbane
Recruitment postcode(s) [1] 43688 0
4066 - Auchenflower
Recruitment postcode(s) [2] 43689 0
4000 - Brisbane

Funding & Sponsors
Funding source category [1] 318386 0
Other
Name [1] 318386 0
Wesley Research Institute
Country [1] 318386 0
Australia
Primary sponsor type
Other
Name
Wesley Research Institute
Address
Country
Australia
Secondary sponsor category [1] 320788 0
None
Name [1] 320788 0
Address [1] 320788 0
Country [1] 320788 0

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 317019 0
UnitingCare Health Human Research Ethics Committee
Ethics committee address [1] 317019 0
Ethics committee country [1] 317019 0
Australia
Date submitted for ethics approval [1] 317019 0
02/12/2024
Approval date [1] 317019 0
20/05/2025
Ethics approval number [1] 317019 0

Summary
Brief summary
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 139754 0
Dr Luke Garske
Address 139754 0
The Wesley Hospital, 451 Coronation Drive, Auchenflower Queensland 4066
Country 139754 0
Australia
Phone 139754 0
+61 7 3193 3389
Fax 139754 0
Email 139754 0
Contact person for public queries
Name 139755 0
Joshua Sear
Address 139755 0
Level 8, East Wing, The Wesley Hospital, 451 Coronation Drive, Auchenflower Queensland 4066
Country 139755 0
Australia
Phone 139755 0
+61 7 3721 1500
Fax 139755 0
Email 139755 0
Contact person for scientific queries
Name 139756 0
Luke Garske
Address 139756 0
The Wesley Hospital, 451 Coronation Drive, Auchenflower Queensland 4066
Country 139756 0
Australia
Phone 139756 0
+61 7 3193 3389
Fax 139756 0
Email 139756 0

Data sharing statement
Will the study consider sharing individual participant data?
No


What supporting documents are/will be available?

No Supporting Document Provided


Results publications and other study-related documents

Documents added manually
No documents have been uploaded by study researchers.

Documents added automatically
No additional documents have been identified.