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Gürbüz AK, Demirel A. The effect of single-limb exercises on functional exercise capacity, pulmonary function and dyspnea in patients with COPD. Heart Lung 2024; 68:98-106. [PMID: 38941773 DOI: 10.1016/j.hrtlng.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 05/14/2024] [Accepted: 06/10/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND Aeorobic exercise is an essential component of the pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease (COPD). Single-limb exercises are a type of aeorobic exercise that aims to increase patient tolerance by reducing the workload of the respiratory system. OBJEKTIVES The aim of our systematic review was to determine the effects of single-limb exercises on pulmonary function, dyspnea, fatigue, and muscle dysfunction in patients with COPD. METHODS Searches were performed using PubMed, Pedro, Google Scholar, MEDLINE, EMBASE, Scopus, Cochrane Library, Web of Science databases. Publications from the beginning to 2023 searched. Studies were selected by two authors by scanning the title, Mesh terms abstract in Rayyan QCRI software. Selected studies were subjected to full-text screening by applying selection criteria. Randomized controlled, case-control, cohort studies were included. RESULTS In the first screening according to mesh terms, 1011 articles were identified. After the screening criteria and duplicate articles were evaluated, 10 articles were included. This systematic review includes seven case-control, one randomized control trial (RCT), one cross-sectional, and one non-randomized study. A total of 157 patients with COPD received treatment in these studies. According to the Bakker scale, single-limb exercises have been shown to improve pulmonary function with strong evidence. There is strong evidence that single-limb exercises have no effect on dyspnea and fatigue in COPD patients. There is limited evidence that single-limb exercises have an effect on functional exercise capacity. CONCLUSION Single-limb exercise can advised in terms of improving pulmonary function in patients with COPD. Current systematic review has found single limb exercise has no effect on dyspnea and fatigue perception. No side effects were reported in the studies and these exercises can be considered safe.
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Affiliation(s)
- Alper Kemal Gürbüz
- Kırıkkale University, Health Science Faculty, Physical Therapy and Rehabilitation Departmant, Turkey.
| | - Aynur Demirel
- Hacettepe University, Faculty Physical Therapy and Rehabilitation, 06100, Samanpazari, Ankara, Turkey.
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2
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Kim M, Kuruma H, Thawisuk C. The use of elastic band exercise as a physical therapy intervention for improving shoulder function in older adults: a scoping review. J Exerc Rehabil 2021; 17:313-318. [PMID: 34805019 PMCID: PMC8566100 DOI: 10.12965/jer.2142574.287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 09/30/2021] [Indexed: 11/22/2022] Open
Abstract
Many older adults experience a decline in shoulder function due to aging. This decline leads to limitations in daily activities and a lower quality of life. The incorporation of physical therapy interventions through elastic band exercises has demonstrated improved overall physical faculties among older adults. However, there is limited literature regarding the effect of these interventions on shoulder function in older adults. This scoping review summarized the current literature regarding elastic band exercises targeting shoulder function in older adults. A systematic literature search was performed using the Scopus and PubMed databases. An additional manual search was conducted using the PEDro (Physiotherapy Evidence Database). Articles were included if they were published in a peer-reviewed journal in 2017-2021. After assessing eligibility, five randomized controlled trials articles were included in the analysis. We discovered that two types of elastic interventions were applied to older adults: namely, the TheraBand and tube bands. We observed heterogeneity in participant characteristics among the studies (healthy older adults, older adults with chronic obstructive pulmonary disease, and older adults with sarcopenic obesity). The duration of the exercise intervention ranged from 3 to 36 sessions. Only one study measured shoulder function as the primary outcome. Our findings suggest that elastic band exercises have been applied to older adults in various conditions and tended to be effective; however, evidence on this topic is insufficient.
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Affiliation(s)
- Minjoon Kim
- Department of Rehabilitation, Tokyo General Hospital, Tokyo, Japan
| | - Hironobu Kuruma
- Department of Physical Therapy, Tokyo Metropolitan University, Tokyo, Japan
| | - Chirathip Thawisuk
- Department of Occupational Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Tokyo, Japan
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3
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Nyberg A, Martin M, Saey D, Milad N, Patoine D, Morissette MC, Auger D, Stål P, Maltais F. Effects of Low-Load/High-Repetition Resistance Training on Exercise Capacity, Health Status, and Limb Muscle Adaptation in Patients With Severe COPD: A Randomized Controlled Trial. Chest 2020; 159:1821-1832. [PMID: 33316237 DOI: 10.1016/j.chest.2020.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/14/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Training volume is paramount in the magnitude of physiological adaptations following resistance training. However, patients with severe COPD are limited by dyspnea during traditional two-limb low-load/high-repetition resistance training (LLHR-RT), resulting in suboptimal training volumes. During a single exercise session, single-limb LLHR-RT decreases the ventilatory load and enables higher localized training volumes compared with two-limb LLHR-RT. RESEARCH QUESTION Does single-limb LLHR-RT lead to more profound effects compared with two-limb LLHR-RT on exercise capacity (6-min walk distance [6MWD]), health status, muscle function, and limb adaptations in patients with severe COPD? STUDY DESIGN AND METHODS Thirty-three patients (mean age 66 ± 7 years; FEV1 39 ± 10% predicted) were randomized to 8 weeks of single- or two-limb LLHR-RT. Exercise capacity (6MWD), health status, and muscle function were compared between groups. Quadriceps muscle biopsy specimens were collected to examine physiological responses. RESULTS Single-limb LLHR-RT did not further enhance 6MWD compared with two-limb LLHR-RT (difference, 14 [-12 to 39 m]. However, 73% in the single-limb group exceeded the known minimal clinically important difference of 30 m compared with 25% in the two-limb group (P = .02). Health status and muscle function improved to a similar extent in both groups. During training, single-limb LLHR-RT resulted in a clinically relevant reduction in dyspnea during training compared with two-limb LLHR-RT (-1.75; P = .01), but training volume was not significantly increased (23%; P = .179). Quadriceps muscle citrate synthase activity (19%; P = .03), hydroxyacyl-coenzyme A dehydrogenase protein levels (32%; P < .01), and capillary-to-fiber ratio (41%; P < .01) were increased compared with baseline after pooling muscle biopsy data from all participants. INTERPRETATION Single-limb LLHR-RT did not further increase mean 6MWD compared with two-limb LLHR-RT, but it reduced exertional dyspnea and enabled more people to reach clinically relevant improvements in 6MWD. Independent of execution strategy, LLHR-RT improved exercise capacity, health status, muscle endurance, and enabled several physiological muscle adaptations, reducing the negative consequences of limb muscle dysfunction in COPD. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov; No.: NCT02283580; URL: www.clinicaltrials.gov.
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Affiliation(s)
- Andre Nyberg
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden; Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada.
| | - Mickael Martin
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Didier Saey
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Nadia Milad
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Dany Patoine
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Mathieu C Morissette
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Dominique Auger
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Per Stål
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - Francois Maltais
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
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4
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Fiorentino G, Esquinas AM, Annunziata A. Exercise and Chronic Obstructive Pulmonary Disease (COPD). ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1228:355-368. [PMID: 32342470 DOI: 10.1007/978-981-15-1792-1_24] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Systemic effects of COPD lead to cardiovascular co-morbidities, muscle wasting and osteoporosis that, in turn, lead to inactivity and physical deconditioning. This evolution has a direct influence on the health-related quality of life (HRQoL) of patients suffering from this respiratory disease. Pharmacological therapy leads to improvement in shortness of breath, but it has a limited effect on the physical deconditioning. Pulmonary rehabilitation relieves dyspnoea and fatigue, improves emotional function and enhances the sense of control that individuals have over their condition. These improvements are moderately substantial and clinically significant. Rehabilitation serves as an essential component of the management of COPD and is beneficial in improving health-related quality of life and exercise capacity.
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Affiliation(s)
- Giuseppe Fiorentino
- Division of Respiratory Physiopathology and Rehabilitation, A.O.R.N. "Dei Colli" - Monaldi Hospital, Naples, Italy
- , Salerno, Italy
| | - Antonio M Esquinas
- Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain
- Non Invasive Ventilatory Unit, Hospital Morales Meseguer, Murcia, Spain
| | - Anna Annunziata
- Division of Respiratory Physiopathology and Rehabilitation, A.O.R.N. "Dei Colli" - Monaldi Hospital, Naples, Italy
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Mølmen KS, Evensen Thy J, Thallaug Dalane S, Ellefsen S, Falch GS. Muscular performance decreases with increasing complexity of resistance exercises in subjects with chronic obstructive pulmonary disease. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Knut Sindre Mølmen
- Section for Health and Exercise Physiology Inland Norway University of Applied Sciences Lillehammer Norway
| | - Jonas Evensen Thy
- Section for Health and Exercise Physiology Inland Norway University of Applied Sciences Lillehammer Norway
- Faculty of Teacher Education, Arts and Sports Western Norway University of Applied Sciences Sogndal Norway
| | | | - Stian Ellefsen
- Section for Health and Exercise Physiology Inland Norway University of Applied Sciences Lillehammer Norway
- Innlandet Hospital Trust Brumunddal Norway
| | - Gunnar S. Falch
- Section for Health and Exercise Physiology Inland Norway University of Applied Sciences Lillehammer Norway
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Frykholm E, Lima VP, Selander HV, Nyberg A, Janaudis-Ferreira T. Physiological and Symptomatic Responses to Arm versus Leg Activities in People with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. COPD 2019; 16:390-405. [PMID: 31631711 DOI: 10.1080/15412555.2019.1674269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
While the mechanisms underlying exercise limitations and symptoms during leg activities have been investigated in detail, knowledge of potential differences between leg and arm activities are not well understood and results from individual studies are contradictory. Thus, the aim of the present study was to synthesize physiological and symptomatic responses during activities involving the arms relative to activities involving the legs in people with Chronic Obstructive Pulmonary Disease (COPD). Any study with a cross-sectional comparison of acute physiological (cardiorespiratory, metabolic) and symptomatic responses to activities performed with the arms versus the legs were included. Studies were sub-grouped based on the type of activity performed (cycle ergometer, resistance exercises, or functional test/activities). Eighteen studies with 423 individuals with COPD were included. Leg cycle ergometer resulted in greater tidal volume (137 mL), minute ventilation (4.8 L/min), and oxygen consumption (164 mL/min) than arm cycle ergometer, while symptomatic responses were similar. Resistance exercises resulted in similar physiological and symptomatic responses irrespective of whether the legs or the arms were involved while studies on functional activities report different results depending on the type and intensity of the activity performed. With the exception of cycle ergometer activities, physiological and symptomatic responses do not seem to depend on whether the arms or the legs are used, but rather seem to be task and intensity dependent. These novel findings suggest, for example, that strategies used to increase exercise tolerance should not be dependent on whether the arms or the legs are used, but rather the intensity of specific activity performed.
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Affiliation(s)
- Erik Frykholm
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Vanessa Pereira Lima
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Hanna-Vega Selander
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Andre Nyberg
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Tania Janaudis-Ferreira
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,Translational Research in Respiratory Diseases Program, Research Institute of the McGill University Health Centre, Montreal, Canada
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7
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Marklund S, Bui KL, Nyberg A. Measuring and monitoring skeletal muscle function in COPD: current perspectives. Int J Chron Obstruct Pulmon Dis 2019; 14:1825-1838. [PMID: 31695351 PMCID: PMC6707440 DOI: 10.2147/copd.s178948] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/25/2019] [Indexed: 11/23/2022] Open
Abstract
Skeletal muscle dysfunction is an important systemic consequence of chronic obstructive pulmonary disease (COPD) that worsens the natural cause of the disease. Up to a third of all people with COPD express some form of impairment which encompasses reductions in strength and endurance, as well as an increased fatigability. Considering this complexity, no single test could be used to measure and monitor all aspects of the impaired skeletal muscle function within the COPD population, resulting in a wide range of available tests and measurement techniques. The aim of the current review is to highlight current and new perspectives relevant to skeletal muscle function measurements within the COPD population in order to provide guidance for researchers as well as for clinicians. First of all, standardized and clinically feasible measurement protocols, as well as normative values and predictive equations across the spectrum of impaired function in COPD, are needed before assessment of skeletal muscle function can become a reality in clinical praxis. This should minimally target the quadriceps muscle; however, depending on the objective of measurements, eg, to determine upper limb muscle function or walking capacity, other muscles could also be tested. Furthermore, even though muscle strength measurements are important, current evidence suggests that other aspects, such as the endurance and power capacity of the muscle, should also be considered. Moreover, although static (isometric) measurements have been favored, dynamic measurements of skeletal muscle function should not be neglected as they, in a larger extent than static measurements, are related to tasks of daily living. Lastly, the often modest relationships between functional tests and skeletal muscle function measurements indicate that they evaluate different constructs and thus cannot replace one another. Therefore, for accurate measurements of skeletal muscle function in people with COPD, specific and formal measurements should still be prioritized.
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Affiliation(s)
- Sarah Marklund
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Kim-Ly Bui
- Rehabilitation Department, Faculty of Medicine Laval University and Centre de recherche, Laval University Quebec Heart and Lung Institute (CRIUCPQ), Québec, QC, Canada
| | - Andre Nyberg
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
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8
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The Relevance of Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease. Clin Chest Med 2019; 40:367-383. [DOI: 10.1016/j.ccm.2019.02.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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9
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Nyberg A, Saey D, Martin M, Maltais F. Cardiorespiratory and muscle oxygenation responses to low-load/high-repetition resistance exercises in COPD and healthy controls. J Appl Physiol (1985) 2018; 124:877-887. [DOI: 10.1152/japplphysiol.00447.2017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Single-limb exercises have been used as a strategy to improve aerobic exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) by alleviating the cardiopulmonary demand. We asked whether this strategy would also apply to cardiorespiratory demand and amount of work performed during single-limb and two-limb low-load/high-repetition resistance exercises in 20 patients with COPD [forced expiratory volume in 1 s (FEV1) = 1.0 liters, 38% of predicted] and 15 age-, sex-, and activity-matched healthy controls. Peak ventilation, peak oxygen consumption (V̇o2), and peak heart rate (HR) were assessed to document cardiorespiratory demand during shoulder flexion and knee extension exercises while exercise tolerance was assessed by the total amount of work achieved. In addition, changes in myoglobin-deoxyhemoglobin level (Δdeoxy-[Hb/Mb]) were measured during single-limb knee extension. In COPD, single-limb shoulder flexion and knee extension elicited higher localized workloads than two-limb exercises (21 and 24% higher workloads for the former exercise) while cardiopulmonary demand was 8–16% higher during two-limb exercises. When expressed as a percentage of peak values achieved during incremental cycle ergometry, peak V̇O2 and HR were similarly high during single-limb shoulder flexion and knee extension exercises, representing 90% of peak HR and 60% of peak V̇O2. Apart from single-limb knee extension, cardiorespiratory demand per kilogram work during low-load/high-repetition knee extension and shoulder flexion exercises was higher in patients with COPD than in healthy controls (range 27–122%, P < 0.0125). Δdeoxy-[Hb/Mb] of the quadriceps during knee extension was similar between the two groups, while Δdeoxy-[Hb/Mb] per kilogram work was higher in patients with COPD. We conclude that 1) in patients with COPD, single-limb exercises resulted in lower peak cardiorespiratory demand as well as higher localized workloads compared with two-limb exercises; 2) compared with healthy controls, the cardiorespiratory demand, either expressed per unit of work or relative to peak capacity, was higher in patients with COPD than in controls during low-load/high-repetition resistance exercises, irrespective of the involvement of one or two limbs or of the upper or lower extremity; 3) quadriceps muscle deoxygenation per unit of work during low-load/high-repetition knee extension was increased in COPD compared with controls; and 4) single- and two-limb low-load/high-repetition knee extension and shoulder flexion resistance exercises imposed a similar burden on the cardiorespiratory system, resulting in a higher cardiorespiratory demand per kilogram work performed during shoulder flexion compared with knee extension, in both COPD and healthy controls. NEW & NOTEWORTHY In chronic obstructive pulmonary disease (COPD), single-limb knee extension and shoulder flexion resulted in a lower peak cardiorespiratory response as well as larger localized exercise workloads compared with two-limb exercises. Cardiorespiratory and quadriceps deoxygenation cost per kilogram work was greater in COPD compared with healthy controls, despite similar acute responses. Compared with knee extension, shoulder flexion imposed a similar burden on the cardiorespiratory system in patients with COPD and healthy controls.
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Affiliation(s)
- André Nyberg
- Institut Universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec, Canada
| | - Didier Saey
- Institut Universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec, Canada
- Faculté de Médicine, Université Laval, Quebec, Canada
| | - Mickaël Martin
- Institut Universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec, Canada
| | - François Maltais
- Institut Universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec, Canada
- Faculté de Médicine, Université Laval, Quebec, Canada
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Chen Y, Niu M, Zhang X, Qian H, Xie A, Wang X. Effects of home-based lower limb resistance training on muscle strength and functional status in stable Chronic obstructive pulmonary disease patients. J Clin Nurs 2018; 27:e1022-e1037. [PMID: 29076609 DOI: 10.1111/jocn.14131] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Yi Chen
- Department of Emergency and Critical Care Medicine; The First Affiliated Hospital of Soochow University; Suzhou Jiangsu China
| | - Mei'e Niu
- Department of Nursing; The First Affiliated Hospital of Soochow University; Suzhou Jiangsu China
| | - Xiuqin Zhang
- Respiratory Department; The First Affiliated Hospital of Soochow University; Suzhou Jiangsu China
| | - Hongying Qian
- Respiratory Department; The First Affiliated Hospital of Soochow University; Suzhou Jiangsu China
| | - Anwei Xie
- Department of Infectious Diseases; The Children's Affiliated Hospital of Soochow University; Suzhou Industrial Park Jiangsu China
| | - Xiya Wang
- Gastrointestinal Endoscopy Center; The First Affiliated Hospital of Soochow University; Suzhou Jiangsu China
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11
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Vaes AW. Partitioning strength exercises as an alternative training modality for patients with COPD. Respirology 2017; 22:1243-1244. [DOI: 10.1111/resp.13087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 05/03/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Anouk W. Vaes
- Department of Research and Education; Ciro; Horn Netherlands
- Environmental Risk and Health Unit; Flemish Institute for Technological Research (VITO); Mol Belgium
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12
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Bisca GW, Camillo CA, Cavalheri V, Pitta F, Osadnik CR. Peripheral muscle training in patients with chronic obstructive pulmonary disease: novel approaches and recent advances. Expert Rev Respir Med 2017; 11:413-423. [DOI: 10.1080/17476348.2017.1317598] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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