1. © 2013 POWERbreathe International Ltd Availability – Spring 2014

2. © 2013 POWERbreathe International Ltd Emma Hamilton Specialised Respiratory Physiotherapist Cumbria - National Health Service, UK

3. © 2013 POWERbreathe International Ltd Respiratory Muscle Training Suitable for a wide range of conditions Chronic respiratory conditions- COPD, bronchiectasis, cystic fibrosis, asthma Neuromuscular conditions – multiple sclerosis

4. © 2013 POWERbreathe International Ltd Heart Failure Ventilator weaning Post surgical

5. © 2013 POWERbreathe International Ltd Patient Selection Criteria Breathlessness on activity Motivated to make changes Stand alone treatment or incorporated into rehabilitation programme

6. © 2013 POWERbreathe International Ltd POWERbreathe Medic Plus - benefits Lower starting resistance Suited for patients with very weak respiratory muscle strength Post surgical

7. © 2013 POWERbreathe International Ltd Weaning from ventilators Advanced neuromuscular conditions Severe COPD especially where hyperinflation creates large mechanical disadvantage

8. © 2013 POWERbreathe International Ltd How used? Abdominal breathing 30 breaths twice a day initially, then maintenance Start with low resistance and gradually increase as able

9. © 2013 POWERbreathe International Ltd Pacing breathing to avoid dizziness May need to teach chest clearance-deep breathing can loosen mucus Full increment not required as it is spring operated

10. © 2013 POWERbreathe International Ltd Precautions Recent pneumothorax Unexplained recent haemoptysis Recent perforated eardrum