{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T10:54:16Z","timestamp":1783335256035,"version":"3.54.6"},"reference-count":45,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Sichuan Science and Technology Program","award":["2023YFS0237"],"award-info":[{"award-number":["2023YFS0237"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Respir Dis"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pulmonary rehabilitation (PR) is a cornerstone of chronic obstructive pulmonary disease (COPD) management, but exercise intolerance often limits its effectiveness. Non-invasive positive pressure ventilation (NPPV) during PR may enhance training tolerance and outcomes, yet the overall evidence remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate the effects of adding NPPV to PR on exercise capacity, dyspnea, and respiratory muscle strength in 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 of randomized controlled trials (RCTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources and methods:<\/jats:title>\n                    <jats:p>We searched PubMed, Web of Science, Embase, the Cochrane Library, and CINAHL from inception to December 2024 for RCTs evaluating NPPV combined with PR in patients with COPD. Two reviewers independently assessed risk of bias using the Cochrane Risk of Bias Assessment Tool for Randomized Trials (RoB 2), extracted data, and performed analyses using RevMan 5.3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 17 RCTs (489 participants; predominantly GOLD stage III\u2013IV) were included. NPPV + PR significantly improved 6-minute walk distance (MD\u2009=\u200929.1\u2009m, 95% CI: 3.6\u201354.6), incremental shuttle walk test distance (MD\u2009=\u200921.8\u2009m, 95% CI: 5.0\u201338.7), peak oxygen uptake (SMD\u2009=\u20090.53, 95% CI: 0.23\u20130.83), maximal inspiratory pressure (Pimax; MD\u2009=\u20095.8\u2009cmH\n                      <jats:sub>2<\/jats:sub>\n                      O, 95% CI: 1.0\u201310.7), and maximal expiratory pressure (Pemax; MD\u2009=\u200914.9\u2009cmH\n                      <jats:sub>2<\/jats:sub>\n                      O, 95% CI:4.1\u201325.7). Significant reductions were observed in blood lactate levels (MD\u2009=\u2009\u22120.49\u2009mmol\/L, 95% CI:\u22120.79 to \u22120.19), BORG dyspnea score (MD\u2009=\u2009\u22121.1, 95% CI: \u22121.7 to \u22120.6), and mMRC scale (MD\u2009=\u2009\u20130.3, 95% CI: \u22120.5 to \u22120.1). No significant effect was found on quality of life.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Adding NPPV to exercise-based PR provides clinically meaningful improvements in exercise capacity, dyspnea, and respiratory muscle strength in patients with COPD who have significant exercise limitation. NPPV may be a valuable adjunct to optimize PR outcomes in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>This review was prospectively registered in PROSPERO (CRD42023486598).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666261424364","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T10:36:01Z","timestamp":1771497361000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The effectiveness of non-invasive positive pressure ventilation combined with rehabilitation training in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2531-4244","authenticated-orcid":false,"given":"Shuqin","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China"},{"name":"Breast Center, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9254-5785","authenticated-orcid":false,"given":"Ying","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China"},{"name":"Department of Nursing, Sanya People\u2019s Hospital\/West China (Sanya) Hospital, Sichuan University, Sanya, Hainan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.46598"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00217-6"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0222-2022"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.850964"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1479972317709642"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S114351"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.5603\/ARM.a2021.0015"},{"issue":"8","key":"e_1_3_4_9_2","first-page":"117","article-title":"Pulmonary Rehabilitation and Exercise Training in Chronic Obstructive Pulmonary Disease","volume":"115","author":"Gloeckl R","year":"2018","unstructured":"Gloeckl R, Schneeberger T, Jaroschi I, et al. Pulmonary Rehabilitation and Exercise Training in Chronic Obstructive Pulmonary Disease. Dtsch Arztebl Int. 2018;115(8):117-123.","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0000000000000359"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692163221079697"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-006-0216-4"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.164.5.2012122"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201402-0373ST"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/j.2040-4603.2012.tb00444.x"},{"issue":"5","key":"e_1_3_4_16_2","first-page":"262","article-title":"Adding non-invasive positive pressure ventilation to supplemental oxygen during exercise training in severe chronic obstructive pulmonary disease: a randomized controlled study","volume":"24","author":"Deniz S","unstructured":"Deniz S, Tuncel S, Gurgun A, et al. Adding non-invasive positive pressure ventilation to supplemental oxygen during exercise training in severe chronic obstructive pulmonary disease: a randomized controlled study. Thorac Res Pract2023; 24(5): 262\u2013269.","journal-title":"Thorac Res Pract"},{"key":"e_1_3_4_17_2","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page MJ","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372: n71.","journal-title":"BMJ"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1590\/S1807-59322007000200004"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2023-001913"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.29390\/cjrt-2022-051"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2014.10.005"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05763"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcdt.2014.12.007"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.1055023"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/1465-9921-12-112"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.10550885"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.099044"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00036505"},{"issue":"3","key":"e_1_3_4_29_2","first-page":"151","article-title":"Ventilatory support during training improves training benefit in severe chronic airway obstruction","volume":"7","author":"Reuveny R","year":"2005","unstructured":"Reuveny R, Ben-dov I, Gaides M, et al. Ventilatory support during training improves training benefit in severe chronic airway obstruction. Isr Med Assoc J 2005; 7(3): 151\u2013155.","journal-title":"Isr Med Assoc J"},{"issue":"1","key":"e_1_3_4_30_2","article-title":"Inspiratory muscle training, with or without concomitant pulmonary rehabilitation, for chronic obstructive pulmonary disease (COPD)","volume":"1","author":"Ammous O","year":"2023","unstructured":"Ammous O, Feki W, Lotfi T, et al. Inspiratory muscle training, with or without concomitant pulmonary rehabilitation, for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev 2023; 1(1): CD013778.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(14)70001-3"},{"key":"e_1_3_4_32_2","first-page":"173","article-title":"A systematic review on the concept of quality of life","volume":"3","author":"Moridi H","year":"2015","unstructured":"Moridi H, Nikrang M. A systematic review on the concept of quality of life. J Soc Issues Hum 2015; 3: 173\u2013178.","journal-title":"J Soc Issues Hum"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202306-1066ST"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.10.014"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2021.101582"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0198-2024"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2020.105938"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1177\/17534666231162250"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00791-2016"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1111\/resp.13399"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1111\/resp.13181"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.122.2.464"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1053\/rmed.2001.1287"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.57.10.853"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.162.4.9912029"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-024-03605-7"}],"container-title":["Therapeutic Advances in Respiratory Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17534666261424364","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17534666261424364","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17534666261424364","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T15:54:37Z","timestamp":1773244477000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17534666261424364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,19]]},"references-count":45,"alternative-id":["10.1177\/17534666261424364"],"URL":"https:\/\/doi.org\/10.1177\/17534666261424364","relation":{"has-review":[{"id-type":"doi","id":"10.1177\/17534666261424364\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261424364\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261424364\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261424364\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261424364\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261424364\/v3\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261424364\/v3\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261424364\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261424364\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261424364\/v3\/response1","asserted-by":"object"}]},"ISSN":["1753-4666","1753-4666"],"issn-type":[{"value":"1753-4666","type":"print"},{"value":"1753-4666","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,19]]},"article-number":"17534666261424364"}}