{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T14:38:43Z","timestamp":1784126323558,"version":"3.55.0"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Shanghai Super Postdoctoral Incentive Program","award":["2022510"],"award-info":[{"award-number":["2022510"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81902307"],"award-info":[{"award-number":["81902307"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82072551"],"award-info":[{"award-number":["82072551"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82172551"],"award-info":[{"award-number":["82172551"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Health Discipline Leader Project of Shanghai Municipal Health Commission","award":["2022XD044"],"award-info":[{"award-number":["2022XD044"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Respir Dis"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Numerous randomized controlled trials (RCTs) have reported the benefits of external diaphragm pacing combined with conventional rehabilitation therapies (EDP-CRTs) on pulmonary function and exercise capacity in patients with chronic obstructive pulmonary disease (COPD). However, evidence-based regarding its effects remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis aimed to evaluate the effects of EDP-CRTs versus CRTs on patients with COPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources and methods:<\/jats:title>\n                    <jats:p>\n                      We performed a systematic review and meta-analysis, searching PubMed, Embase, Cochrane Central Register of Controlled Trials, Scopus, China Biology Medicine Disc, Chinese National Knowledge Infrastructure, Wan-Fang Database, and Chinese Scientific Journal Database from inception to 10 September 2023. RCTs investigating the effects of EDP-CRTs versus CRTs on COPD patients were included. The primary outcome was pulmonary function, including forced expiratory volume in 1\u2009s (FEV1), the percentage of predicted values of FEV1 (FEV1%pred), and FEV1\/forced vital capacity (FVC)%. Secondary outcomes included arterial blood gas analysis [the partial pressure of arterial oxygen (PaO\n                      <jats:sub>2<\/jats:sub>\n                      ) and the partial pressure of arterial carbon dioxide (PaCO\n                      <jats:sub>2<\/jats:sub>\n                      )]; dyspnea [modified Medical Research Council Dyspnea Scale (mMRC)]; exercise capacity [6-min walking distance (6MWD)]; and quality of life [COPD assessment test (CAT)]. RevMan 5.3 software was used for meta-analysis. The quality of the included studies was assessed using the revised Cochrane Risk of Bias tool for randomized trials (RoB 2.0). The certainty of the evidence was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation system.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In total, 13 studies\/981 participants were included. The pooled results revealed significant benefits of EDP-CRTs versus CRTs on the FEV1 [standardized mean difference (SMD)\u2009=\u20091.07, 95% confidence interval (CI)\u2009=\u20090.58\u20131.56], FEV1%pred [weighted mean difference (WMD)\u2009=\u20096.67, 95% CI\u2009=\u20095.69\u20137.64], the FEV1\/FVC% (SMD\u2009=\u20091.24, 95% CI\u2009=\u20090.48\u20132.00), PaO\n                      <jats:sub>2<\/jats:sub>\n                      (SMD\u2009=\u20091.29, 95% CI\u2009=\u20090.74\u20131.84), PaCO\n                      <jats:sub>2<\/jats:sub>\n                      (SMD\u2009=\u2009\u22121.88, 95% CI\u2009=\u2009\u22122.71 to \u22121.04), mMRC (WMD\u2009=\u2009\u22120.55, 95% CI\u2009=\u2009\u22120.65 to \u22120.45), 6MWD (SMD\u2009=\u20091.63, 95% CI\u2009=\u20090.85\u20132.42), and CAT (WMD\u2009=\u2009\u22121.75, 95% CI\u2009=\u2009\u22123.16 to \u22120.35), respectively. Planned subgroup analysis suggested that EDP-CRTs had a better effect on FEV1, FEV1\/FVC%, 6MWD, and CAT in the duration of 2\u20134\u2009weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      EDP-CRTs have better effects on pulmonary function, PaCO\n                      <jats:sub>2<\/jats:sub>\n                      , dyspnea, exercise capacity, and quality of life in COPD patients than CRTs, and the duration to achieve the most effective treatment is 2\u20134\u2009weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis protocol was prospectively registered with PROSPERO (No. CRD42022355964).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666231218086","type":"journal-article","created":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T05:35:37Z","timestamp":1703309737000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Effects of external diaphragm pacing combined with conventional rehabilitation therapies in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1061-1123","authenticated-orcid":false,"given":"Linhong","family":"Jiang","sequence":"first","affiliation":[{"name":"School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingping","family":"Sun","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peijun","family":"Li","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weibing","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Exercise and Health, Shanghai University of Sport, Shanghai, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenwei","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai University of Traditional Chinese Medicine Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, No. 110 Ganhe Road, Hongkou District, Shanghai 200437, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodan","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, No. 1200 Cailun Road, Pudong New District, Shanghai 201203, People\u2019s Republic of China"},{"name":"Engineering Research Center of Traditional Chinese Medicine, Intelligent Rehabilitation, Ministry of Education, Shanghai, People\u2019s Republic of China"},{"name":"Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,12,23]]},"reference":[{"key":"bibr1-17534666231218086","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01273-9"},{"key":"bibr2-17534666231218086","unstructured":"Global Initiative for Chronic Obstructive Lung Disease. 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