{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T16:55:29Z","timestamp":1788454529403,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":36,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":["Canadian Respiratory Journal"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of respiratory muscle training (RMT) on respiratory symptom severity and symptom duration in adults with chronic obstructive pulmonary disease (COPD) and to appraise the certainty of the evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We searched seven databases and included parallel\u2010group randomized controlled trials (RCTs) comparing RMT plus guideline\u2010based care versus control. Meta\u2010analyses were conducted in RevMan using fixed\u2010 or random\u2010effects models as appropriate. Risk of bias was assessed using RoB 2. Certainty of evidence was assessed using the GRADE approach. Because multiple outcomes were analysed, we controlled the false discovery rate using the Benjamini\u2013Hochberg (BH) procedure across prespecified meta\u2010analysed outcomes and report both unadjusted and BH\u2010adjusted\n                      <jats:italic>p<\/jats:italic>\n                      values.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven RCTs (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091171) were included. No trial reported symptom duration in a way that matched our prespecified definition. Compared with control, RMT reduced dyspnoea (mMRC; unadjusted\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003; BH\u2010adjusted\n                      <jats:italic>p<\/jats:italic>\n                      = 0.007; moderate certainty) and improved health\u2010related quality of life (SGRQ; unadjusted\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.00001; BH\u2010adjusted\n                      <jats:italic>p<\/jats:italic>\n                      = 3.5e \u2212 05; moderate certainty). Lung function effects were mixed: FVC improved (MD\u2009=\u20090.37\u2009L, 95% CI 0.33 to 0.40; unadjusted\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.00001; BH\u2010adjusted\n                      <jats:italic>p<\/jats:italic>\n                      = 3.5e \u2212 05; low certainty) and FEV1\/FVC improved (MD\u2009=\u20091.84%, 95% CI 0.29 to 3.39; unadjusted\n                      <jats:italic>p<\/jats:italic>\n                      = 0.02; BH\u2010adjusted\n                      <jats:italic>p<\/jats:italic>\n                      = 0.035; low certainty), while FEV1 did not differ significantly (MD\u2009=\u20090.18\u2009L, 95% CI \u22120.04 to 0.40; unadjusted\n                      <jats:italic>p<\/jats:italic>\n                      = 0.11; BH\u2010adjusted\n                      <jats:italic>p<\/jats:italic>\n                      = 0.11; low certainty). Evidence for overall symptom burden and exercise capacity was uncertain: CAT (unadjusted\n                      <jats:italic>p<\/jats:italic>\n                      = 0.06; BH\u2010adjusted\n                      <jats:italic>p<\/jats:italic>\n                      = 0.07; very low certainty) and 6MWD (unadjusted\n                      <jats:italic>p<\/jats:italic>\n                      = 0.05; BH\u2010adjusted\n                      <jats:italic>p<\/jats:italic>\n                      = 0.07; very low certainty).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In adults with COPD, adding RMT to guideline\u2010based care probably reduces dyspnoea and improves health\u2010related quality of life (moderate certainty). Evidence for benefits on overall symptom burden, lung function, and exercise capacity is low to very low, and the effect on symptom duration remains unknown due to the lack of reporting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/carj\/6434649","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T12:12:42Z","timestamp":1770379962000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Effectiveness of Respiratory Muscle Training on the Duration and Severity of Respiratory Symptoms in Patients With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5856-532X","authenticated-orcid":false,"given":"Zhenghao","family":"Yu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4558-7453","authenticated-orcid":false,"given":"Hui","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8659-3698","authenticated-orcid":false,"given":"Si","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0296-2041","authenticated-orcid":false,"given":"Li","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(21)00511-7"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-069679"},{"key":"e_1_2_11_3_2","unstructured":"Chronic Obstructive Pulmonary Disease (COPD) Fact Sheet 2017 https:\/\/www.who.int\/en\/news-room\/fact-sheets\/detail\/chronic-obstructive-pulmonary-disease-copd."},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.46598"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00239-2023"},{"key":"e_1_2_11_6_2","first-page":"1937","article-title":"Interpretation of Global Strategy for the Diagnosis, Treatment, Management and Prevention of Chronic Obstructive Pulmonary Disease 2024 Report","volume":"28","author":"Chen D.","year":"2025","journal-title":"Chinese General Practice"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.02.00237402"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2005.03.006"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2008.07.005"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/crj.12905"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07098"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19095564"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e28733"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/life14111470"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i5440"},{"key":"e_1_2_11_16_2","article-title":"Evidence-Based Research Series-Paper 3: Using an Evidence-Based Research Approach to Place Your Results Into Context After the Study Is Performed to Ensure Usefulness of the Conclusion","volume":"129","author":"Lund H. C. B. N.","year":"2021","journal-title":"Journal of Clinical Epidemiology"},{"key":"e_1_2_11_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2020.07.020"},{"key":"e_1_2_11_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2020.07.019"},{"key":"e_1_2_11_19_2","first-page":"162","article-title":"Application of Early Pulmonary Rehabilitation Training in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease","volume":"42","author":"Jiang Z.","year":"2023","journal-title":"Chinese and Foreign Medical Journal"},{"key":"e_1_2_11_20_2","unstructured":"WuJ. Observation on the Efficacy of Step-by-Step Respiratory Muscle Training in Patients With Stable Chronic Obstructive Pulmonary Disease."},{"key":"e_1_2_11_21_2","first-page":"122","article-title":"Effect of Respiratory Muscle Function Training Combined With Deep Breathing Exercises in the Nursing of COPD Patients","volume":"21","author":"Cheng L.","year":"2023","journal-title":"Chinese and Foreign Medical Research"},{"key":"e_1_2_11_22_2","first-page":"285","article-title":"Effect of Standardized Breathing Training on the Quality of Life of COPD Patients","volume":"2","author":"Xiang M.","year":"2025","journal-title":"Chinese Journal of Standardization"},{"key":"e_1_2_11_23_2","article-title":"Application of Respiratory Muscle Function Training in Patients With Stable Chronic Obstructive Pulmonary Disease","volume":"34","author":"Wang X.","year":"2020","journal-title":"Journal of Clinical Rational Drug Use"},{"key":"e_1_2_11_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/1479972315594625"},{"key":"e_1_2_11_25_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02000-2017"},{"key":"e_1_2_11_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013778.pub2"},{"key":"e_1_2_11_27_2","article-title":"Research Progress on Rehabilitation Exercises for Respiratory Muscle Fatigue in Chronic Obstructive Pulmonary Disease","volume":"35","author":"Wang S.","year":"2021","journal-title":"Nursing Research"},{"key":"e_1_2_11_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2021.106679"},{"key":"e_1_2_11_29_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S460649"},{"key":"e_1_2_11_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/crj.13486"},{"key":"e_1_2_11_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-022-06603-3"}],"container-title":["Canadian Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/carj\/6434649","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/carj\/6434649","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/carj\/6434649","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T12:12:44Z","timestamp":1770379964000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/carj\/6434649"}},"subtitle":[],"editor":[{"given":"Xi-Qian","family":"Xing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/carj\/6434649"],"URL":"https:\/\/doi.org\/10.1155\/carj\/6434649","archive":["Portico"],"relation":{},"ISSN":["1198-2241","1916-7245"],"issn-type":[{"value":"1198-2241","type":"print"},{"value":"1916-7245","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-08-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"6434649"}}