{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:46:49Z","timestamp":1788785209431,"version":"build-2803163510"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Natural Science Foundation of Science and Technology Joint Fund project of Hunan Province","award":["2021JJ70097"],"award-info":[{"award-number":["2021JJ70097"]}]},{"name":"Technology Innovation Guiding Plan clinical medical technology innovation guiding project of Hunan Province","award":["2017sk50522"],"award-info":[{"award-number":["2017sk50522"]}]},{"name":"Key project of Health Commission of Hunan Provincial","award":["20201498"],"award-info":[{"award-number":["20201498"]}]},{"name":"Scientific research project of health care Special fund of Hunan Province","award":["B2020-01"],"award-info":[{"award-number":["B2020-01"]}]},{"name":"COVID-19 Emergency Thematic Science and Technology Plan project of Changsha","award":["kq2001018"],"award-info":[{"award-number":["kq2001018"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Exercise intolerance is one of the major symptoms of chronic obstructive pulmonary disease (COPD). Exercise training can benefit COPD patients, but the underlying mechanism remains unclear. The modified Total Body Recumbent Stepper (TBRS, Nustep-T4) can benefit patients with stroke, spinal cord injury and amyotrophic lateral sclerosis. Nevertheless, the effect of TBRS training alone on pulmonary rehabilitation (PR) in COPD patients remains largely unknown. We aimed to explore the effect of TBRS training on exercise capacity and the thioredoxin system (TRXS) in COPD patients to provide a novel rehabilitation modality and new theoretical basis for PR of COPD patients. Ninety stable COPD patients were randomly divided into a control group (NC group) and a TBRS training group (TBRS group), with 45 cases in each group. Subjects in the TBRS training group were scheduled to undergo TBRS endurance training triweekly for 12\u00a0weeks under the guidance of a rehabilitation therapist. We assessed the primary outcome: exercise capacity (6-min walking distance, 6MWD); and secondary outcomes: perception of dyspnoea (mMRC, Borg), the COPD assessment test (CAT), the BODE index, pulmonary function, the number of acute exacerbations of COPD and oxidative stress (TRXS) at one-year follow-up. Compared with before the intervention and the control group, after the intervention, the TBRS training group, exhibited an increase in the 6MWD (from 366.92\u2009\u00b1\u200985.81 to 484.10\u2009\u00b1\u200971.90, 484.10\u2009\u00b1\u200971.90 vs 370.63\u2009\u00b1\u200979.87,<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01), while the scores on the BORG, mMRC, BODE index, CAT, and the number of acute exacerbations of COPD were reduced, and the protein and mRNA expression levels of TRXS was significantly increased (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). However, no differences were found in PF parameters in the comparison with before the intervention or between groups. TBRS training can effectively increase exercise capacity, while there are indications that it can alleviate COPD-related dyspnoea and reduce the number of acute exacerbations of COPD. Interestingly, long-term regular TBRS training may reduce oxidative stress associated with COPD to increase exercise capacity.<\/jats:p>","DOI":"10.1038\/s41598-022-15466-2","type":"journal-article","created":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T10:13:20Z","timestamp":1656670400000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Effect of modified Total Body Recumbent Stepper training on exercise capacity and thioredoxin in COPD: a randomized clinical trial"],"prefix":"10.1038","volume":"12","author":[{"given":"Wentao","family":"Duan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"San","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinling","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liming","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xudong","family":"Xiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiguo","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,1]]},"reference":[{"key":"15466_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1164\/rccm.1991P1","volume":"199","author":"SC Lareau","year":"2019","unstructured":"Lareau, S. C., Fahy, B., Meek, P. & Wang, A. Chronic obstructive pulmonary disease (COPD). Am. J. Respir. Crit. Care Med. 199, 1\u20132. https:\/\/doi.org\/10.1164\/rccm.1991P1 (2019).","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"15466_CR2","doi-asserted-by":"publisher","first-page":"e13","DOI":"10.1164\/rccm.201309-1634ST","volume":"188","author":"MA Spruit","year":"2013","unstructured":"Spruit, M. A. et al. An official American Thoracic Society\/European Respiratory Society statement: Key concepts and advances in pulmonary rehabilitation. Am. J. Resp. Crit. Care Med. 188, e13-64. https:\/\/doi.org\/10.1164\/rccm.201309-1634ST (2013).","journal-title":"Am. J. Resp. Crit. Care Med."},{"key":"15466_CR3","doi-asserted-by":"crossref","first-page":"414","DOI":"10.70252\/FZZN2389","volume":"8","author":"J McCulloch","year":"2018","unstructured":"McCulloch, J. et al. Prediction of maximal oxygen consumption from rating of perceived exertion (RPE) using a modified total-body recumbent stepper. Int. J. Exer. Sci. 8, 414\u2013424 (2018).","journal-title":"Int. J. Exer. Sci."},{"key":"15466_CR4","doi-asserted-by":"publisher","first-page":"183","DOI":"10.2466\/06.15.27.PMS.112.1.183-192","volume":"112","author":"LC Dalleck","year":"2011","unstructured":"Dalleck, L. C. et al. Development of a metabolic equation for the NuStep recumbent stepper in older adults. Percept. Mot. Skills 112, 183\u2013192. https:\/\/doi.org\/10.2466\/06.15.27.PMS.112.1.183-192 (2011).","journal-title":"Percept. Mot. Skills"},{"key":"15466_CR5","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1097\/NPT.0b013e318274d082","volume":"36","author":"SA Billinger","year":"2012","unstructured":"Billinger, S. A. et al. Aerobic exercise in subacute stroke improves cardiovascular health and physical performance. J. Neurol. Phys. Ther. 36, 159\u2013165. https:\/\/doi.org\/10.1097\/NPT.0b013e318274d082 (2012).","journal-title":"J. Neurol. Phys. Ther."},{"key":"15466_CR6","doi-asserted-by":"publisher","first-page":"101544","DOI":"10.1016\/j.redox.2020.101544","volume":"33","author":"PJ Barnes","year":"2020","unstructured":"Barnes, P. J. Oxidative stress-based therapeutics in COPD. Redox Biol. 33, 101544. https:\/\/doi.org\/10.1016\/j.redox.2020.101544 (2020).","journal-title":"Redox Biol."},{"key":"15466_CR7","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1378\/chest.08-2767","volume":"136","author":"EM Mercken","year":"2009","unstructured":"Mercken, E. M. et al. Systemic and pulmonary oxidative stress after single-leg exercise in COPD. Chest 136, 1291\u20131300. https:\/\/doi.org\/10.1378\/chest.08-2767 (2009).","journal-title":"Chest"},{"key":"15466_CR8","doi-asserted-by":"publisher","first-page":"2339","DOI":"10.1111\/sms.13227","volume":"28","author":"CK Ryrs\u00f8","year":"2018","unstructured":"Ryrs\u00f8, C. K. et al. Effect of endurance versus resistance training on local muscle and systemic inflammation and oxidative stress in COPD. Scand. J. Med. Sci. Sports 28, 2339\u20132348. https:\/\/doi.org\/10.1111\/sms.13227 (2018).","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"15466_CR9","doi-asserted-by":"publisher","first-page":"1830","DOI":"10.1016\/j.rmed.2007.02.004","volume":"101","author":"RA Pinho","year":"2007","unstructured":"Pinho, R. A. et al. Oxidative stress in chronic obstructive pulmonary disease patients submitted to a rehabilitation program. Respir. Med. 101, 1830\u20131835. https:\/\/doi.org\/10.1016\/j.rmed.2007.02.004 (2007).","journal-title":"Respir. Med."},{"key":"15466_CR10","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1378\/chest.10-2788","volume":"140","author":"F Garc\u00eda-Rio","year":"2011","unstructured":"Garc\u00eda-Rio, F. et al. Dynamic hyperinflation, arterial blood oxygen, and airway oxidative stress in stable patients with COPD. Chest 140, 961\u2013969. https:\/\/doi.org\/10.1378\/chest.10-2788 (2011).","journal-title":"Chest"},{"key":"15466_CR11","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.1016\/S0954-6111(11)70008-7","volume":"105","author":"I Stanojkovic","year":"2011","unstructured":"Stanojkovic, I. et al. Pulmonary function, oxidative stress and inflammatory markers in moderate and severe COPD exacerbation. Respir. Med. 105, S31\u2013S37. https:\/\/doi.org\/10.1016\/S0954-6111(11)70008-7 (2011).","journal-title":"Respir. Med."},{"key":"15466_CR12","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/j.cytogfr.2013.01.001","volume":"24","author":"Y Matsuo","year":"2013","unstructured":"Matsuo, Y. & Yodoi, J. Extracellular thioredoxin: A therapeutic tool to combat inflammation. Cytokine Growth Factor Rev. 24, 345\u2013353. https:\/\/doi.org\/10.1016\/j.cytogfr.2013.01.001 (2013).","journal-title":"Cytokine Growth Factor Rev."},{"key":"15466_CR13","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.1016\/j.freeradbiomed.2005.02.026","volume":"38","author":"SG Rhee","year":"2005","unstructured":"Rhee, S. G. et al. Peroxiredoxins: A historical overview and speculative preview of novel mechanisms and emerging concepts in cell signaling. Free Radic. Biol. Med. 38, 1543\u20131552. https:\/\/doi.org\/10.1016\/j.freeradbiomed.2005.02.026 (2005).","journal-title":"Free Radic. Biol. Med."},{"key":"15466_CR14","doi-asserted-by":"publisher","first-page":"339","DOI":"10.2165\/00007256-200535040-00004","volume":"35","author":"WJ Kraemer","year":"2005","unstructured":"Kraemer, W. J. & Ratamess, N. A. Hormonal responses and adaptations to resistance exercise and training. Sports Med. 35, 339\u2013361. https:\/\/doi.org\/10.2165\/00007256-200535040-00004 (2005).","journal-title":"Sports Med."},{"key":"15466_CR15","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.ijsu.2011.10.001","volume":"10","author":"D Moher","year":"2012","unstructured":"Moher, D. et al. CONSORT 2010 explanation and elaboration: Updated guidelines for reporting parallel group randomised trials. Int. J. Surg. 10, 28\u201355. https:\/\/doi.org\/10.1016\/j.ijsu.2011.10.001 (2012).","journal-title":"Int. J. Surg."},{"key":"15466_CR16","unstructured":"Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease revised 2016 [OL]. http:\/\/www.Gold--copd.org\/guidelines-global-strategy-for-diagnosis-management.Html (2016)."},{"key":"15466_CR17","doi-asserted-by":"publisher","first-page":"3688","DOI":"10.1158\/0008-5472.CAN-05-4564","volume":"66","author":"F Dayan","year":"2006","unstructured":"Dayan, F. et al. The oxygen sensor factor-inhibiting hypoxia-inducible factor-1 controls expression of distinct genes through the bifunctional transcriptional character of hypoxia-inducible factor-1alpha. Cancer Res. 66, 3688\u20133698. https:\/\/doi.org\/10.1158\/0008-5472.CAN-05-4564 (2006).","journal-title":"Cancer Res."},{"key":"15466_CR18","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.tox.2008.12.013","volume":"257","author":"CR Myers","year":"2009","unstructured":"Myers, C. R. & Myers, J. M. The effects of acrolein on peroxiredoxins, thioredoxins, and thioredoxin reductase in human bronchial epithelial cells. Toxicology 257, 95\u2013104. https:\/\/doi.org\/10.1016\/j.tox.2008.12.013 (2009).","journal-title":"Toxicology"},{"key":"15466_CR19","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1016\/j.rmed.2015.01.008","volume":"109","author":"A Kawagoshi","year":"2015","unstructured":"Kawagoshi, A. et al. Effects of low-intensity exercise and home-based pulmonary rehabilitation with pedometer feedback on physical activity in elderly patients with chronic obstructive pulmonary disease. Respir. Med. 109, 364\u2013371. https:\/\/doi.org\/10.1016\/j.rmed.2015.01.008 (2015).","journal-title":"Respir. Med."},{"key":"15466_CR20","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1249\/JSR.0b013e31829a68cf","volume":"12","author":"PD Thompson","year":"2013","unstructured":"Thompson, P. D. et al. ACSM\u2019s new preparticipation health screening recommendations from ACSM\u2019s guidelines for exercise testing and prescription, ninth edition. Curr. Sports Med. Rep. 12, 215\u2013217. https:\/\/doi.org\/10.1249\/JSR.0b013e31829a68cf (2013).","journal-title":"Curr. Sports Med. Rep."},{"key":"15466_CR21","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1164\/ajrccm.166.1.at1102","volume":"166","author":"ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories","year":"2002","unstructured":"ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: Guidelines for the six-minute walk test. Am. J. Respir. Crit. Care Med. 166, 111\u2013117. https:\/\/doi.org\/10.1164\/ajrccm.166.1.at1102 (2002).","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"15466_CR22","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/S0272-5231(21)00710-3","volume":"11","author":"L Sweer","year":"1990","unstructured":"Sweer, L. & Zwillich, C. W. Dyspnea in the patient with chronic obstructive pulmonary disease. Etiology and management. Clin. Chest Med. 11, 417\u2013445 (1990).","journal-title":"Clin. Chest Med."},{"key":"15466_CR23","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","volume":"14","author":"GA Borg","year":"1982","unstructured":"Borg, G. A. Psychophysical bases of perceived exertion. Med. Sci. Sports Exerc. 14, 377\u2013381 (1982).","journal-title":"Med. Sci. Sports Exerc."},{"key":"15466_CR24","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1183\/09031936.00102509","volume":"34","author":"PW Jones","year":"2009","unstructured":"Jones, P. W. et al. Development and first validation of the COPD Assessment Test. Eur. Respir. J. 34, 648\u2013654. https:\/\/doi.org\/10.1183\/09031936.00102509 (2009).","journal-title":"Eur. Respir. J."},{"key":"15466_CR25","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1056\/NEJMoa021322","volume":"350","author":"BR Celli","year":"2004","unstructured":"Celli, B. R. et al. The body-mass index, airflow obstruction, dyspnoea, and exercise capacity index in chronic obstructive pulmonary disease. N. Engl. J. Med. 350, 1005\u20131012. https:\/\/doi.org\/10.1056\/NEJMoa021322 (2004).","journal-title":"N. Engl. J. Med."},{"key":"15466_CR26","unstructured":"Global Initiative for Chronic Lung Disease. GOLD Spirometry Guide\u20142010 Update (accessed November 2, 2011). http:\/\/www.goldcopd.org\/other-resources-gold-spirometry-guide.html."},{"key":"15466_CR27","doi-asserted-by":"publisher","first-page":"155","DOI":"10.2147\/copd.s2126","volume":"3","author":"S Barakat","year":"2008","unstructured":"Barakat, S., Michele, G., George, P., Nicole, V. & Guy, A. Outpatient pulmonary rehabilitation in patients with chronic obstructive pulmonary disease. Int. J. Chron. Obstruct. Pulmon. Dis. 3, 155\u2013162. https:\/\/doi.org\/10.2147\/copd.s2126 (2008).","journal-title":"Int. J. Chron. Obstruct. Pulmon. Dis."},{"key":"15466_CR28","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1590\/s1413-35552012005000011","volume":"16","author":"MA Spruit","year":"2012","unstructured":"Spruit, M. A. et al. Age-graded reductions in quadriceps muscle strength and peak aerobic capacity in COPD. Revista brasileira de fisioterapia (Sao Carlos (Sao Paulo, Brazil) 16, 148\u2013156. https:\/\/doi.org\/10.1590\/s1413-35552012005000011 (2012).","journal-title":"Revista brasileira de fisioterapia (Sao Carlos (Sao Paulo, Brazil)"},{"key":"15466_CR29","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1152\/japplphysiol.90336","volume":"105","author":"A Aliverti","year":"2008","unstructured":"Aliverti, A. & Macklem, P. T. The major limitation to exercise performance in COPD is inadequate energy supply to the respiratory and locomotor muscles. J. Appl. Physiol. 105, 749\u2013751. https:\/\/doi.org\/10.1152\/japplphysiol.90336 (2008).","journal-title":"J. Appl. Physiol."},{"key":"15466_CR30","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1152\/japplphysiol.90336.2008a","volume":"105","author":"R Debigar\u00e9","year":"2008","unstructured":"Debigar\u00e9, R. & Maltais, F. The major limitation to exercise performance in COPD is lower limb muscle dysfunction. J. Appl. Physiol. 105, 751\u2013753. https:\/\/doi.org\/10.1152\/japplphysiol.90336.2008a (2008).","journal-title":"J. Appl. Physiol."},{"key":"15466_CR31","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1177\/039463200702000411","volume":"20","author":"MP Foschino Barbaro","year":"2007","unstructured":"Foschino Barbaro, M. P. et al. Inflammation, oxidative stress and systemic effects in mild chronic obstructive pulmonary disease. Int. J. Immunopathol. Pharmacol. 20, 753\u2013763. https:\/\/doi.org\/10.1177\/039463200702000411 (2007).","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"15466_CR32","doi-asserted-by":"publisher","first-page":"37","DOI":"10.2147\/COPD.S143101","volume":"13","author":"L Houchen-Wolloff","year":"2017","unstructured":"Houchen-Wolloff, L. et al. Survival following pulmonary rehabilitation in patients with COPD: the effect of program completion and change in incremental shuttle walking test distance. Int. J. Chron. Obstruct. Pulmon. Dis. 13, 37\u201344. https:\/\/doi.org\/10.2147\/COPD.S143101 (2017).","journal-title":"Int. J. Chron. Obstruct. Pulmon. Dis."},{"key":"15466_CR33","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1016\/j.rmed.2014.06.001","volume":"108","author":"MK Covey","year":"2014","unstructured":"Covey, M. K. et al. Resistance training as a preconditioning strategy for enhancing aerobic exercise training outcomes in COPD. Respir. Med. 108, 1141\u20131152. https:\/\/doi.org\/10.1016\/j.rmed.2014.06.001 (2014).","journal-title":"Respir. Med."},{"key":"15466_CR34","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1055\/s-0030-1254066","volume":"31","author":"WD Cornwell","year":"2010","unstructured":"Cornwell, W. D. et al. Pathogenesis of inflammation and repair in advanced COPD. Semin. Respir. Crit. Care Med. 31, 257\u2013266. https:\/\/doi.org\/10.1055\/s-0030-1254066 (2010).","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"15466_CR35","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1164\/ajrccm.164.7.2103065","volume":"164","author":"RA Rabinovich","year":"2001","unstructured":"Rabinovich, R. A. et al. Reduced muscle redox capacity after endurance training in patients with chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 164, 1114\u20131118. https:\/\/doi.org\/10.1164\/ajrccm.164.7.2103065 (2001).","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"15466_CR36","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1164\/rccm.200411-1580OC","volume":"172","author":"EM Mercken","year":"2005","unstructured":"Mercken, E. M. et al. Rehabilitation decreases exercise-induced oxidative stress in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 172, 994\u20131001. https:\/\/doi.org\/10.1164\/rccm.200411-1580OC (2005).","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"15466_CR37","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1164\/ajrccm.156.5.96-11035","volume":"56","author":"S Oh-ishi","year":"1997","unstructured":"Oh-ishi, S. et al. Endurance training improves the resistance of rat diaphragm to exercise-induced oxidative stress. Am. J. Respir. Crit. Care Med. 56, 1579\u20131585. https:\/\/doi.org\/10.1164\/ajrccm.156.5.96-11035 (1997).","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"15466_CR38","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1046\/j.1365-201X.2002.01008.x","volume":"176","author":"MB Svensson","year":"2002","unstructured":"Svensson, M. B. et al. Adaptive stress response of glutathione and uric acid metabolism in man following controlled exercise and diet. Acta Physiol. Scand. 176, 43\u201356. https:\/\/doi.org\/10.1046\/j.1365-201X.2002.01008.x (2002).","journal-title":"Acta Physiol. Scand."},{"key":"15466_CR39","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.freeradbiomed.2011.09.022","volume":"52","author":"DA Rodriguez","year":"2012","unstructured":"Rodriguez, D. A. et al. Muscle and blood redox status after exercise training in severe COPD patients. Free Radic. Biol. Med. 52, 88\u201394. https:\/\/doi.org\/10.1016\/j.freeradbiomed.2011.09.022 (2012).","journal-title":"Free Radic. Biol. Med."},{"key":"15466_CR40","first-page":"34","volume":"70","author":"K Nemoto","year":"2012","unstructured":"Nemoto, K. et al. Effect of exercise therapy on reactive oxygen species and reactive nitrogen species in COPD patients. J. Tokyo Med. Univ. 70, 34\u201341 (2012).","journal-title":"J. Tokyo Med. Univ."},{"key":"15466_CR41","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1183\/09031936.00138507","volume":"32","author":"CG Cote","year":"2008","unstructured":"Cote, C. G. et al. The modified BODE index: validation with mortality in COPD. Eur. Respir. J. 32, 1269\u20131274. https:\/\/doi.org\/10.1183\/09031936.00138507 (2008).","journal-title":"Eur. Respir. J."},{"key":"15466_CR42","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1183\/09031936.05.00045505","volume":"26","author":"CG Cote","year":"2005","unstructured":"Cote, C. G. & Celli, B. R. Pulmonary rehabilitation and the BODE index in COPD. Eur. Respir. J. 26, 630\u2013636. https:\/\/doi.org\/10.1183\/09031936.05.00045505 (2005).","journal-title":"Eur. Respir. J."},{"key":"15466_CR43","doi-asserted-by":"publisher","first-page":"116","DOI":"10.5578\/tt.68468","volume":"67","author":"\u0130 Candemir","year":"2019","unstructured":"Candemir, \u0130 et al. Use of i-BODE index to determine efficacy of pulmonary rehabilitation in COPD patients. Tuberkuloz ve toraks. 67, 116\u2013123. https:\/\/doi.org\/10.5578\/tt.68468 (2019).","journal-title":"Tuberkuloz ve toraks."},{"key":"15466_CR44","doi-asserted-by":"publisher","first-page":"2021","DOI":"10.1378\/chest.125.6.2021","volume":"125","author":"FM Franssen","year":"2004","unstructured":"Franssen, F. M. et al. Effects of whole-body exercise training on body composition and functional capacity in normal-weight patients with COPD. Chest 125, 2021\u20132028. https:\/\/doi.org\/10.1378\/chest.125.6.2021 (2004).","journal-title":"Chest"},{"key":"15466_CR45","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1183\/09031936.02.00287102","volume":"19","author":"MA Spruit","year":"2002","unstructured":"Spruit, M. A. et al. Resistance versus endurance training in patients with COPD and peripheral muscle weakness. Eur. Respir. J. 19, 1072\u20131078. https:\/\/doi.org\/10.1183\/09031936.02.00287102 (2002).","journal-title":"Eur. Respir. J."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-15466-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-15466-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-15466-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T07:54:40Z","timestamp":1727510080000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-15466-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,1]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["15466"],"URL":"https:\/\/doi.org\/10.1038\/s41598-022-15466-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,1]]},"assertion":[{"value":"25 December 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 June 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"11139"}}