{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:16:49Z","timestamp":1787242609680,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T00:00:00Z","timestamp":1749168000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Chronic obstructive pulmonary disease (COPD) adversely affects respiratory function and quality of life (QoL). Optimizing respiratory muscle performance through novel interventions may enhance patient outcomes. Our objective is to compare the efficacy of the PowerBreathe device and transcutaneous electrical diaphragmatic stimulation (TEDS) on COPD severity and functional capacity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Sixty male patients (45\u201365\u00a0years; BMI 25\u201329.9\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) with stage II or III COPD under full medical management were allocated at random to Group A who received inspiratory muscle (IM) training (IMT) using the PowerBreathe device in addition to prescribed medications and Group B who received TEDS alongside standard therapy. Outcomes assessed included the COPD Assessment Test (CAT) score, dyspnea score, six\u2010minute walk test (6MWT), forced expiratory volume in one second (FEV\n                      <jats:sub>1<\/jats:sub>\n                      ), forced vital capacity (FVC), FEV\n                      <jats:sub>1<\/jats:sub>\n                      \/FVC ratio, and forced mid\u2010expiratory flow (FEF 25%\u201375%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Group A showed significantly reduced CAT scores and dyspnea severity post\u2010treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Post\u2010intervention comparisons demonstrated superior improvements in 6MWT, FEV\n                      <jats:sub>1<\/jats:sub>\n                      , FVC, FEV\n                      <jats:sub>1<\/jats:sub>\n                      \/FVC, and FEF 25%\u201375% for Group A unlike Group B (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05\u20130.001). TEDS produced a significant improvement only in diaphragmatic thickness (DT) without notable gains in pulmonary function or exercise capacity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>IMT with the PowerBreathe device is more effective than TEDS in enhancing pulmonary function, exercise tolerance, and QoL in moderate\u2010severe COPD patients. TEDS showed limited benefits, primarily improving DT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pri.70073","type":"journal-article","created":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T11:58:58Z","timestamp":1749211138000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effect of Power\u2010Breath Versus Transcutaneous Electrical Diaphragmatic Stimulation on the Severity of Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9792-6016","authenticated-orcid":false,"given":"Eman M.","family":"Abdelsalam","sequence":"first","affiliation":[{"name":"Cairo University Specialized Children's Hospitals  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra M.","family":"Serry","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Respiratory Disorder and Geriatrics Cairo University  Giza Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youssef M.","family":"Soliman","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donia M.","family":"Elmasry","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Respiratory Disorder and Geriatrics Cairo University  Giza Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa M.","family":"El Moatassem","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Respiratory Disorder and Geriatrics Cairo University  Giza Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/cpt.0000000000000092"},{"issue":"1","key":"e_1_2_12_3_1","first-page":"Cd013778","article-title":"Inspiratory Muscle Training, With or Without Concomitant Pulmonary Rehabilitation, for Chronic Obstructive Pulmonary Disease (COPD)","volume":"1","author":"Ammous O.","year":"2023","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"2","key":"e_1_2_12_4_1","first-page":"136","article-title":"Inspiratory Muscle Training for Chronic Obstructive Pulmonary Disease","volume":"108","author":"Anciro S. A.","year":"2023","journal-title":"American Family Physician"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.03947"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/crj.12905"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v8.i12.2408"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11162310"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41394\u2010021\u201000396\u20104"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.21608\/ijma.2021.84944.1339"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18136703"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2021.101582"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07098"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/resp.70003"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000017241"},{"issue":"6","key":"e_1_2_12_16_1","first-page":"1743","article-title":"Outcome Measures of Acute Transcutaneous Electrical DiaphragmaticStimulation in Mechanically Ventilated Patients","volume":"90","author":"Hashish S. M.","year":"2022","journal-title":"Medical Journal of Cairo University"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.29390\/cjrt\u20102018\u2010017"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00150314"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.4103\/atm.atm_158_21"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2023.e20079"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.942076"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1201\/9781003560579-19"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.43694"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0319899"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/17476348.2021.1854737"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/resp.14041"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2213\u20102600(15)00503\u20102"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010023\u201004597\u20101"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_1397_23"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pulmoe.2021.06.001"},{"issue":"10","key":"e_1_2_12_31_1","first-page":"1","article-title":"Calculated Decisions: mMRC (Modified Medical Research Council) Dyspnea Scale","volume":"19","author":"Richards J. B.","year":"2017","journal-title":"Emergency Medicine Practice"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctcp.2021.101418"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.79433"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.5455\/jhspe.20231222042304"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(22)01273\u20109"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.14218\/fim.2023.00026"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19095564"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(24)00413-2"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14020397"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1590\/fm.2021.34124"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2024.107747"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbmt.2025.01.010"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1080\/01616412.2024.2347133"}],"container-title":["Physiotherapy Research International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pri.70073","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T13:36:51Z","timestamp":1754660211000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pri.70073"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,6]]},"references-count":42,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/pri.70073"],"URL":"https:\/\/doi.org\/10.1002\/pri.70073","archive":["Portico"],"relation":{},"ISSN":["1358-2267","1471-2865"],"issn-type":[{"value":"1358-2267","type":"print"},{"value":"1471-2865","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,6]]},"assertion":[{"value":"2025-02-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70073"}}