{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:31:46Z","timestamp":1787315506716,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","license":[{"start":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T00:00:00Z","timestamp":1599436800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009392","name":"Prince Sattam bin Abdulaziz University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009392","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disease Markers"],"published-print":{"date-parts":[[2020,9,7]]},"abstract":"<jats:p>\n                    <jats:italic>Objectives<\/jats:italic>\n                    . Congenital diaphragmatic hernia (CDH) is a birth defect affecting the respiratory functions, functional performance, and quality of life (QOL) in school-aged children. Rarely have studies been conducted to evaluate the impacts of respiratory muscle training on school-aged children with postoperative CDH. The current study was designed to evaluate the impacts of respiratory muscle training on respiratory function, maximal exercise capacity, functional performance, and QOL in these children.\n                    <jats:italic>Methods<\/jats:italic>\n                    . This study is a randomized control study. 40 children with CDH (age: 9-11 years) were assigned randomly into two groups. The first group conducted an incentive spirometer exercise combined with inspiratory muscle training (study group,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                      <mml:mi>n<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn>20<\/mml:mn>\n                    <\/mml:math>\n                    ), whereas the second group conducted only incentive spirometer exercise (control group,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                      <mml:mi>n<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn>20<\/mml:mn>\n                    <\/mml:math>\n                    ), thrice weekly for twelve consecutive weeks. Respiratory functions, maximal exercise capacity, functional performance, and pediatric quality of life inventory (PedsQL) were assessed before and after the treatment program\n                    <jats:italic>. Results<\/jats:italic>\n                    . Regarding the posttreatment analysis, the study group showed significant improvements in all outcome measures (FVC%,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>&lt;<\/mml:mo>\n                      <mml:mn>0.001<\/mml:mn>\n                    <\/mml:math>\n                    ; FEV1%,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn>0.002<\/mml:mn>\n                    <\/mml:math>\n                    ; VO\n                    <jats:sub>2<\/jats:sub>\n                    max,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn>0.008<\/mml:mn>\n                    <\/mml:math>\n                    ; VE\/VCO\n                    <jats:sub>2<\/jats:sub>\n                    slope,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn>0.002<\/mml:mn>\n                    <\/mml:math>\n                    ; 6-MWT,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>&lt;<\/mml:mo>\n                      <mml:mn>0.001<\/mml:mn>\n                    <\/mml:math>\n                    ; and PedsQL,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>&lt;<\/mml:mo>\n                      <mml:mn>0.001<\/mml:mn>\n                    <\/mml:math>\n                    ), whereas the control group did not show significant changes (\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>&gt;<\/mml:mo>\n                      <mml:mn>0.05<\/mml:mn>\n                    <\/mml:math>\n                    ).\n                    <jats:italic>Conclusion<\/jats:italic>\n                    . Respiratory muscle training may improve respiratory functions, maximal exercise capacities, functional performance, and QOL in children with postoperative CDH. Clinical commendations have to be considered to include respiratory muscle training in pulmonary rehabilitation programs in children with a history of CDH.\n                  <\/jats:p>","DOI":"10.1155\/2020\/8829373","type":"journal-article","created":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T19:32:48Z","timestamp":1599507168000},"page":"1-7","source":"Crossref","is-referenced-by-count":19,"title":["Impacts of Respiratory Muscle Training on Respiratory Functions, Maximal Exercise Capacity, Functional Performance, and Quality of Life in School-Aged Children with Postoperative Congenital Diaphragmatic Hernia"],"prefix":"10.1155","volume":"2020","author":[{"given":"Samah A.","family":"Moawd","sequence":"first","affiliation":[{"name":"Department of Physical Therapy for Cardiovascular\/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alshimaa R.","family":"Azab","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt"},{"name":"Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6309-3484","authenticated-orcid":true,"given":"Zizi M.","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt"},{"name":"Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anju","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4703-661X","authenticated-orcid":true,"given":"Walid Kamal","family":"Abdelbasset","sequence":"additional","affiliation":[{"name":"Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia"},{"name":"Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, 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