{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T15:42:53Z","timestamp":1784907773646,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,8,1]],"date-time":"2014-08-01T00:00:00Z","timestamp":1406851200000},"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":["Internal Medicine Journal"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Expiratory flow limitation (<jats:styled-content style=\"fixed-case\">EFL<\/jats:styled-content>) is the primary pathophysiological hallmark of chronic obstructive pulmonary disease (<jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content>). However, the effect of lower\u2010extremity endurance training alone on EFL in patients with COPD remains largely unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aims to determine the effects of endurance training on <jats:styled-content style=\"fixed-case\">EFL<\/jats:styled-content> and dynamic hyperinflation in patients with stable <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective, single\u2010blinded, non\u2010randomised controlled 12\u2010week study recruiting <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>hinese patients with stable <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> in an endurance training group (<jats:italic>n<\/jats:italic> = 15) or a control group (<jats:italic>n<\/jats:italic> = 13). Before and at the end of the study, we measured the <jats:styled-content style=\"fixed-case\">EFL<\/jats:styled-content>, pulmonary function, peak inspiratory flow (<jats:styled-content style=\"fixed-case\">PIF<\/jats:styled-content>) and maximum inspiratory pressure (<jats:styled-content style=\"fixed-case\">MIP<\/jats:styled-content>); moreover, the patients underwent a constant work rate exercise test in which Borg dyspnoea scale, tidal breathing flow volume curves and inspiratory capacity (<jats:styled-content style=\"fixed-case\">IC<\/jats:styled-content>) were determined every other minute.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Exercise training significantly improved the exercise endurance time (7.00 \u00b1 3.05 vs 18.13 \u00b1 6.44\u2009min, <jats:italic>P<\/jats:italic> &lt; 0.001), <jats:styled-content style=\"fixed-case\">MIP<\/jats:styled-content> (69.49 \u00b1 16.03 vs 80.18 \u00b1 15.97 cm<jats:styled-content style=\"fixed-case\"><jats:roman>H<jats:sub>2<\/jats:sub>O<\/jats:roman><\/jats:styled-content>, <jats:italic>P<\/jats:italic> &lt; 0.001) and <jats:styled-content style=\"fixed-case\">PIF<\/jats:styled-content> (3.96 \u00b1 1.01 vs 4.51 \u00b1 1.13\u2009L\/s, <jats:italic>P<\/jats:italic> = 0.014), but not <jats:styled-content style=\"fixed-case\">EFL<\/jats:styled-content> (3.33 \u00b1 0.49 vs 3.40 \u00b1 0.51, <jats:italic>P<\/jats:italic> = 0.334). Subjects on training had decreased breathing frequency (26.26 \u00b1 7.13 vs 23.15 \u00b1 5.34 breaths\/min, <jats:italic>P<\/jats:italic> = 0.002), minute ventilation (30.28 \u00b1 7.52 vs 26.85 \u00b1 4.17\u2009L, <jats:italic>P<\/jats:italic> = 0.013), tidal peak expiratory flow (1.53 \u00b1 0.22 vs 1.32 \u00b1 0.20 L\/s, <jats:italic>P<\/jats:italic> = 0.006), mean expiratory flow (0.87 \u00b1 0.19 vs 0.68 \u00b1 0.15 L\/s, <jats:italic>P<\/jats:italic> = 0.011) and Borg dyspnoea score (7.20 \u00b1 1.15 vs 3.93 \u00b1 1.39, <jats:italic>P<\/jats:italic> &lt; 0.001), as well as increased <jats:styled-content style=\"fixed-case\">IC<\/jats:styled-content> (1.50 \u00b1 0.34 vs 1.67 \u00b1 0.45\u2009L, <jats:italic>P<\/jats:italic> = 0.002), expiratory time (1.47 \u00b1 0.62 vs 1.72 \u00b1 0.62\u2009s, <jats:italic>P<\/jats:italic> = 0.004) and inspiratory flow reserve (2.05 \u00b1 1.10 vs 2.95 \u00b1 1.19\u2009L\/s, <jats:italic>P<\/jats:italic> = 0.002) at isotime. These changes were not observed in the control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Endurance training may benefit stable <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> patients in improving exercise endurance, inspiratory muscle strength, ventilatory requirements, exercise\u2010induced hyperinflation and exertional dyspnoea.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.12483","type":"journal-article","created":{"date-parts":[[2014,5,27]],"date-time":"2014-05-27T07:55:40Z","timestamp":1401177340000},"page":"791-800","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Effect of endurance training on expiratory flow limitation and dynamic hyperinflation in patients with stable chronic obstructive pulmonary disease"],"prefix":"10.1111","volume":"44","author":[{"given":"R.","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Respiratory 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