{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T21:26:53Z","timestamp":1781299613190,"version":"3.54.1"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Duchenne muscular dystrophy (DMD) is associated with impaired airway clearance and chest wall restriction, treated with lung volume recruitment (LVR) therapy. This study evaluated adherence patterns to LVR over 2 years in a cohort of boys with DMD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants were included from the intervention arm of STEADFAST, a multi\u2010centre randomized controlled trial of twice\u2010daily LVR over 2 years in boys with DMD, 6\u221216 years with baseline forced vital capacity percent predicted (FVC%)\u2009\u2265\u200930% (Clinicaltrials. gov # NCT01999075). Adherence data were downloaded from a data logger on the LVR equipment and defined as LVR use at least daily on &gt;50% of days. Logistic regression models evaluated associations between adherence and change in FVC%, rate of symptoms and change in quality of life (QOL) over 24 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fourteen of 33 boys (42.4%) were adherent to LVR. Among those non\u2010adherent in the first 3 months, only one became adherent to LVR. Adherent participants tended to have lower baseline FVC % predicted than non\u2010adherent individuals (median 77.2 (IQR (17.8) vs 89.7 (18.8) %;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08). The odds ratio for adherence was 1.02 (95% CI 0.97\u22121.08,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.4) per unit increase in FVC%, and 0.08 (95% CI 0.001\u221211.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.307) for each additional symptom\/month over 24 months, adjusting for baseline age and ambulatory status. Adherence was not associated with QOL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Long\u2010term LVR adherence was associated with early LVR usage pattern, but not change in lung function, symptoms or QOL. These findings underscore the importance of early support and education to promote long\u2010term LVR adherence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71357","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T13:55:13Z","timestamp":1761659713000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Patterns of Adherence to Lung Volume Recruitment Therapy Amongst Individuals With Duchenne Muscular Dystrophy: A Secondary Analysis of the STEADFAST Randomized Controlled Trial"],"prefix":"10.1002","volume":"60","author":[{"given":"Naomi","family":"Dussah","sequence":"first","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute Ontario Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas A.","family":"McKim","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ottawa Ontario Ottawa Canada"},{"name":"The Ottawa Hospital Research Institute Ontario Ottawa Canada"},{"name":"CANVent Respiratory Rehabilitation Services The Ottawa Hospital Rehabilitation Centre Ontario Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5795-9955","authenticated-orcid":false,"given":"Jean K.","family":"Mah","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology Alberta Children\u2032s Hospital Calgary Alberta Canada"},{"name":"Department of Pediatrics and Clinical Neurosciences, Cumming School of Medicine University of Calgary Calgary Alberta Canada"},{"name":"Alberta Children's Hospital Research Institute Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8927-2018","authenticated-orcid":false,"given":"Hugh J.","family":"McMillan","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute Ontario Ottawa Canada"},{"name":"Faculty of Medicine University of Ottawa Ontario Ottawa Canada"},{"name":"Department of Pediatrics Children\u2032s Hospital of Eastern Ontario Ontario Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Campbell","sequence":"additional","affiliation":[{"name":"Pediatrics, Epidemiology and Clinical Neurological Sciences University of Western Ontario Ontario London Canada"},{"name":"Department of Paediatrics Children\u2032s Hospital London Health Sciences Centre Ontario London Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vid","family":"Bijeli\u0107","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute Ontario Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Barrowman","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute Ontario Ottawa Canada"},{"name":"Faculty of Medicine University of Ottawa Ontario Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Momoli","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ottawa Ontario Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrietta","family":"Blinder","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute Ontario Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn","family":"Aaron","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ottawa Ontario Ottawa Canada"},{"name":"The Ottawa Hospital Research Institute Ontario Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura C.","family":"McAdam","sequence":"additional","affiliation":[{"name":"Holland Bloorview Kids Rehabilitation Hospital Ontario Toronto Canada"},{"name":"Department of Pediatrics University of Toronto; Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"The Thanh Diem","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Centre Hospitalier Universitaire Sainte\u2010Justine Quebec Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Tarnopolsky","sequence":"additional","affiliation":[{"name":"Division of Neuromuscular and Neruometabolic Disease McMaster University Children's Hospital Ontario Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Wensley","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine, Department of Paediatrics University of British Columbia Vancouver British Columbia Canada"},{"name":"BC Children's Hospital Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Zielinski","sequence":"additional","affiliation":[{"name":"Montreal Children's Hospital Quebec Montreal Canada"},{"name":"Research Institute of McGill University Health Centre McGill University Quebec Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Wolfe","sequence":"additional","affiliation":[{"name":"Medicine and Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"},{"name":"Respiratory Care\u2014The Shirley Ryan Ability Lab Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1879-1990","authenticated-orcid":false,"given":"Sherri L","family":"Katz","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute Ontario Ottawa Canada"},{"name":"Faculty of Medicine University of Ottawa Ontario Ottawa Canada"},{"name":"Department of Pediatrics Children\u2032s Hospital of Eastern Ontario Ontario Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.118.5.1390"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0b013e31817fb26f"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2006.47.2.184"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-0333H"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2018.01.012"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2012.02.024"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201507-475BC"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2021-218196"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2021-000918"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202404-360OC"},{"key":"e_1_2_10_12_1","unstructured":"J. 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