{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T13:55:22Z","timestamp":1777902922291,"version":"3.51.4"},"reference-count":34,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T00:00:00Z","timestamp":1733702400000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Shanghai Baoshan District Science and Technology Commission Medical and Health Project","award":["2023-E-51"],"award-info":[{"award-number":["2023-E-51"]}]},{"name":"Youth Programs of Shanghai Municipal Health Care Commission","award":["20214Y0321"],"award-info":[{"award-number":["20214Y0321"]}]},{"name":"the scientific research project of The Second Rehabilitation Hospital of Shanghai","award":["Y2024-05"],"award-info":[{"award-number":["Y2024-05"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,11,6]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Elderly stable chronic obstructive pulmonary disease (COPD) patients frequently experience walking dysfunction. Research indicates that balance training holds promise for enhancing walking stability in these individuals, whereas respiratory therapy (RT) can enhance walking endurance effectively. However, existing balance training regimens tailored for COPD are intricate and lack specificity, and the impact of combined RT on patients\u2019 walking function remains uncertain. This study aims to assess the influence of core training (CT) integrated with RT on walking function among elderly stable COPD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This randomised, assessment-blinded, routine rehabilitation-controlled trial will be carried out at the Department of Respiratory and Critical Care Rehabilitation, the Second Rehabilitation Hospital of Shanghai. A total of 42 elderly patients diagnosed with stable COPD will be randomly allocated to either the study group (SG) or the control group in a 1:1 ratio. Both groups will undergo 6 weeks of standard rehabilitation training. Additionally, patients in the SG will receive CT based on RT. The primary outcome of the study is the 6\u2009min walk test. Secondary outcomes encompass ultrasound indicators of the diaphragm and multifidus, pulmonary function tests, Berg balance scale test, trunk impairment scale test, COPD assessment test and St. George\u2019s Respiratory Questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval was obtained from the Ethics Committee of the Second Rehabilitation Hospital of Shanghai (2023-01-01, see online supplemental file 1). All patients will provide written informed consent before participation. The results of the trial are intended for publication in a peer-reviewed journal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR2400080276.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-086837","type":"journal-article","created":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T21:30:38Z","timestamp":1733779838000},"page":"e086837","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of core training based on respiratory therapy on elderly stable COPD patients in the rehabilitation hospital: a study protocol for a randomised controlled trial"],"prefix":"10.1136","volume":"14","author":[{"given":"Jianqing","family":"Su","sequence":"first","affiliation":[{"name":"Department of Pulmonary Rehabilitation, the Second Rehabilitation Hospital of Shanghai, Shanghai, China"},{"name":"school of rehabilitation science, Shanghai University of Traditional Chinese Medicine, Shanghai, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Rehabilitation, the Second Rehabilitation Hospital of Shanghai, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingjun","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Rehabilitation, the Second Rehabilitation Hospital of Shanghai, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanshan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Rehabilitation, the Second Rehabilitation Hospital of Shanghai, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingjing","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Rehabilitation, the Second Rehabilitation Hospital of Shanghai, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bingyang","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Rehabilitation, the Second Rehabilitation Hospital of Shanghai, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunlai","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Rehabilitation, the Second Rehabilitation Hospital of Shanghai, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2741-7882","authenticated-orcid":false,"given":"Zinan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Rehabilitation, the Second Rehabilitation Hospital of Shanghai, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Rehabilitation, the Second Rehabilitation Hospital of Shanghai, Shanghai, China"},{"name":"school of rehabilitation science, Shanghai University of Traditional Chinese Medicine, Shanghai, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,9]]},"reference":[{"key":"2025121409223142000_14.12.e086837.1","doi-asserted-by":"crossref","first-page":"2227","DOI":"10.1016\/S0140-6736(22)00470-6","article-title":"Chronic obstructive pulmonary disease","volume":"399","author":"Christenson","year":"2022","journal-title":"The Lancet"},{"key":"2025121409223142000_14.12.e086837.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00458-X"},{"key":"2025121409223142000_14.12.e086837.3","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1016\/S0140-6736(17)31222-9","article-title":"Chronic obstructive pulmonary disease","volume":"389","author":"Rabe","year":"2017","journal-title":"The Lancet"},{"key":"2025121409223142000_14.12.e086837.4","first-page":"384","article-title":"Guidelines for the Evaluation and Treatment of Muscle Dysfunction in Patients With Chronic Obstructive Pulmonary Disease","volume":"51","author":"Barreiro","year":"2015","journal-title":"Arch Bronconeumol (Eng Ed)"},{"key":"2025121409223142000_14.12.e086837.5","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201402-0373ST"},{"key":"2025121409223142000_14.12.e086837.6","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00000513"},{"key":"2025121409223142000_14.12.e086837.7","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-1093"},{"key":"2025121409223142000_14.12.e086837.8","doi-asserted-by":"crossref","DOI":"10.1177\/1479973118820311","article-title":"Balance assessment in people with COPD: An evidence-based guide","volume":"16","author":"Beauchamp","year":"2019","journal-title":"Chron Respir Dis"},{"key":"2025121409223142000_14.12.e086837.9","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1080\/15412555.2021.1904867","article-title":"The Investigation of Falls and Balance from the Perspective of Activities of Daily Living in Patients with COPD","volume":"18","author":"Birinci","year":"2021","journal-title":"COPD"},{"key":"2025121409223142000_14.12.e086837.10","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/HCR.0000000000000109","article-title":"Effect of 6 Months of Balance Training During Pulmonary Rehabilitation in Patients With COPD","volume":"35","author":"Mkacher","year":"2015","journal-title":"J Cardiopulm Rehabil Prev"},{"key":"2025121409223142000_14.12.e086837.11","doi-asserted-by":"crossref","first-page":"2178","DOI":"10.1111\/crj.12905","article-title":"Effects of inspiratory muscle training in COPD patients: A systematic review and meta-analysis","volume":"12","author":"Beaumont","year":"2018","journal-title":"Clin Respir J"},{"key":"2025121409223142000_14.12.e086837.12","first-page":"19","article-title":"Respiratory muscles training in COPD patients","volume":"2","author":"Crisafulli","year":"2007","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2025121409223142000_14.12.e086837.13","article-title":"A Cross-Sectional Study on Balance Deficits and Gait Deviations in COPD Patients","volume":"2021","author":"Jirange","year":"2021","journal-title":"Can Respir J"},{"key":"2025121409223142000_14.12.e086837.14","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1007\/s11845-021-02654-8","article-title":"Daily living activities, exercise capacity, cognition, and balance in COPD patients with and without frailty","volume":"191","author":"Kagiali","year":"2022","journal-title":"Ir J Med Sci"},{"key":"2025121409223142000_14.12.e086837.15","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2019-213608"},{"key":"2025121409223142000_14.12.e086837.16","article-title":"Inspiratory muscle training, with or without concomitant pulmonary rehabilitation, for chronic obstructive pulmonary disease (COPD)","volume":"1","author":"Ammous","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121409223142000_14.12.e086837.17","doi-asserted-by":"crossref","DOI":"10.1186\/s13063-022-06603-3","article-title":"The effects of breathing exercises and inhaler training in patients with COPD on the severity of dyspnea and life quality: a randomized controlled trial","volume":"23","author":"Ceyhan","year":"2022","journal-title":"Trials"},{"key":"2025121409223142000_14.12.e086837.18","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1152\/japplphysiol.01078.2017","article-title":"Inspiratory muscle training reduces diaphragm activation and dyspnea during exercise in COPD","volume":"125","author":"Langer","year":"2018","journal-title":"J Appl Physiol"},{"key":"2025121409223142000_14.12.e086837.19","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.osfp.2011.07.001","article-title":"The anatomical \u201ccore\u201d: a definition and functional classification","volume":"3","author":"Dougherty","year":"2011","journal-title":"Osteop Fam Physician"},{"key":"2025121409223142000_14.12.e086837.20","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1589\/jpts.30.1014","article-title":"Effects of core strength training on core stability","volume":"30","author":"Hsu","year":"2018","journal-title":"J Phys Ther Sci"},{"key":"2025121409223142000_14.12.e086837.21","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/S0004-9514(14)60514-6","article-title":"An initial evaluation of eight abdominal exercises for their ability to provide stabilisation for the lumbar spine","volume":"36","author":"Richardson","year":"1990","journal-title":"Aust J Physiother"},{"key":"2025121409223142000_14.12.e086837.22","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.rehab.2013.01.008","article-title":"The effects of respiratory muscle training on improvement of the internal and external thoraco-pulmonary respiratory mechanism in COPD patients","volume":"56","author":"Tout","year":"2013","journal-title":"Ann Phys Rehabil Med"},{"key":"2025121409223142000_14.12.e086837.23","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1620\/tjem.245.79","article-title":"Decreased Respiratory Muscle Function Is Associated with Impaired Trunk Balance among Chronic Stroke Patients: A Cross-sectional Study","volume":"245","author":"Lee","year":"2018","journal-title":"Tohoku J Exp Med"},{"key":"2025121409223142000_14.12.e086837.24","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1589\/jpts.29.1954","article-title":"The effect of the inspiratory muscle training on functional ability in stroke patients","volume":"29","author":"Jung","year":"2017","journal-title":"J Phys Ther Sci"},{"key":"2025121409223142000_14.12.e086837.25","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-016-3424-9"},{"key":"2025121409223142000_14.12.e086837.26","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1097\/HCR.0000000000000427","article-title":"The Mini-Balance Evaluation System Test Can Predict Falls in Clinically Stable Outpatients With COPD: A 12-MO PROSPECTIVE COHORT STUDY","volume":"39","author":"Pereira","year":"2019","journal-title":"J Cardiopulm Rehabil Prev"},{"key":"2025121409223142000_14.12.e086837.27","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.chest.2023.03.040","article-title":"Valaciclovir for Epstein-Barr Virus Suppression in Moderate-to-Severe COPD: A Randomized Double-Blind Placebo-Controlled Trial","volume":"164","author":"Linden","year":"2023","journal-title":"Chest"},{"key":"2025121409223142000_14.12.e086837.28","first-page":"1011","article-title":"An Official American Thoracic Society\/European Respiratory Society Statement","volume":"188","author":"Spruit","year":"2013","journal-title":"Key Concepts and Advances in Pulm Rehab"},{"key":"2025121409223142000_14.12.e086837.29","doi-asserted-by":"crossref","first-page":"478","DOI":"10.23736\/S1973-9087.22.07383-X","article-title":"The effectiveness of home-based balance and pulmonary rehabilitation program in individuals with chronic obstructive pulmonary disease: a randomized controlled trial","volume":"58","author":"Chuatrakoon","year":"2022","journal-title":"Eur J Phys Rehabil Med"},{"key":"2025121409223142000_14.12.e086837.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.10.014"},{"key":"2025121409223142000_14.12.e086837.31","doi-asserted-by":"crossref","first-page":"141","DOI":"10.2147\/COPD.S188994","article-title":"The relationship between steps of 6MWT and COPD severity: a cross-sectional study","volume":"14","author":"Zeng","year":"2019","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2025121409223142000_14.12.e086837.32","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12471"},{"key":"2025121409223142000_14.12.e086837.33","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1515\/jom-2021-0101","article-title":"Functional evaluation of the diaphragm with a noninvasive test","volume":"121","author":"Bordoni","year":"2021","journal-title":"J Osteopath Med"},{"key":"2025121409223142000_14.12.e086837.34","doi-asserted-by":"crossref","first-page":"102357","DOI":"10.1016\/j.jelekin.2019.102357","article-title":"Trunk muscle activity during trunk stabilizing exercise with isometric hip rotation using electromyography and ultrasound","volume":"49","author":"Nakai","year":"2019","journal-title":"J Electromyogr Kinesiol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-086837","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T17:22:42Z","timestamp":1765732962000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-086837"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":34,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,9]]},"published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1136\/bmjopen-2024-086837"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-086837","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}