{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T23:18:10Z","timestamp":1782775090569,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"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":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2026,1]]},"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) is frequently associated with reduced peripheral arterial function, commonly referred to as peripheral arterial disease. To address this issue, therapies such as inspiratory muscle training (IMT) and aerobic exercise have been employed to improve both pulmonary and vascular function. This study investigated the combined effects of IMT and aerobic exercise on lung health, vascular function, and overall physical capability in COPD patients with arterial insufficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixty COPD patients with intermittent claudication were randomly assigned to two groups: the experimental group received both IMT and aerobic exercise, while the control group performed aerobic exercise only, three times per week for 4\u00a0weeks. IMT was administered using the eBreather device, which provides targeted resistance training for inspiratory muscles. Pulmonary function (forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1\/FVC ratio, peak expiratory flow (PEF)), vascular function (ankle brachial index (ABI), ankle peak systolic velocity (ASPV)), and functional capacity (treadmill test, 5\u2010repetition sit\u2010to\u2010stand test) were assessed before and after the intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to the control group, the experimental group showed significantly greater improvements. FEV1 increased by 88.19% compared to 1.95%, FVC by 31.02% compared to 0.41%, FEV1\/FVC ratio by 36.53% compared to 1.33%, and PEF by 64.82% compared to 0.66%. ABI increased by 24.64% compared to 4.41%, APSV by 46.31% compared to 16.90%, claudication distance improved by approximately 93% compared to 7%, and sit\u2010to\u2010stand time decreased by 36.51% compared to 3.06% (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Combining IMT with aerobic exercise may significantly enhance pulmonary, vascular, and functional outcomes in COPD patients. Future rehabilitation programs should integrate device\u2010based IMT to optimize recovery and long\u2010term health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.clinical\">https:\/\/www.clinical<\/jats:ext-link>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/trials.gov\">trials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT06529185\n                    <\/jats:p>\n                  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