{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:25:10Z","timestamp":1785432310375,"version":"3.56.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T00:00:00Z","timestamp":1610668800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T00:00:00Z","timestamp":1610668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP17ek0210045 and JP20ek0210112"],"award-info":[{"award-number":["JP17ek0210045 and JP20ek0210112"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Respir Res"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Physical inactivity due to cachexia and muscle wasting is well recognized as a sign of poor prognosis in chronic obstructive pulmonary disease (COPD). However, there have been no reports on the relationship between trunk muscle measurements and energy expenditure parameters, such as the total energy expenditure (TEE) and physical activity level (PAL), in COPD. In this study, we investigated the associations of computed tomography (CT)-derived muscle area and density measurements with clinical parameters, including TEE and PAL, in patients with or at risk for COPD, and examined whether these muscle measurements serve as an indicator of TEE and PAL.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The study population consisted of 36 male patients with (n\u2009=\u200928, stage 1\u20134) and at risk for (n\u2009=\u20098) COPD aged over 50\u00a0years. TEE was measured by the doubly labeled water method, and PAL was calculated as the TEE\/basal metabolic rate estimated by the indirect method. The cross-sectional areas and densities of the pectoralis muscles, rectus abdominis muscles, and erector spinae muscles were measured. We evaluated the relationship between these muscle measurements and clinical outcomes, including body composition, lung function, muscle strength, TEE, and PAL.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>All the muscle areas were significantly associated with TEE, severity of emphysema, and body composition indices such as body mass index, fat-free mass, and trunk muscle mass. All trunk muscle densities were correlated with PAL. The product of the rectus abdominis muscle area and density showed the highest association with TEE (r\u2009=\u20090.732) and PAL (r\u2009=\u20090.578). Several trunk muscle measurements showed significant correlations with maximal inspiratory and expiratory pressures, indicating their roles in respiration.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>CT-derived measurements for trunk muscles are helpful in evaluating physical status and function in patients with or at risk for COPD. Particularly, trunk muscle evaluation may be a useful marker reflecting TEE and PAL.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12931-021-01621-2","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T19:02:36Z","timestamp":1610737356000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The product of trunk muscle area and density on the CT image is a good indicator of energy expenditure in patients with or at risk for COPD"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8975-6618","authenticated-orcid":false,"given":"Toru","family":"Shirahata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanehiro","family":"Yogi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaiji","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamoru","family":"Niitsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoe","family":"Akagami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Machika","family":"Soma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiko","family":"Mio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Nagata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Nakae","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Nishida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeho","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuminori","family":"Katsukawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetoshi","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,15]]},"reference":[{"issue":"9823","key":"1621_CR1","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1016\/S0140-6736(11)60968-9","volume":"379","author":"M Decramer","year":"2012","unstructured":"Decramer M, Janssens W, Miravitlles M. Chronic obstructive pulmonary disease. Lancet (London, England). 2012;379(9823):1341\u201351.","journal-title":"Lancet (London, England)"},{"issue":"9524","key":"1621_CR2","doi-asserted-by":"publisher","first-page":"1747","DOI":"10.1016\/S0140-6736(06)68770-9","volume":"367","author":"AD Lopez","year":"2006","unstructured":"Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet (London, England). 2006;367(9524):1747\u201357.","journal-title":"Lancet (London, England)"},{"issue":"3","key":"1621_CR3","doi-asserted-by":"publisher","first-page":"226","DOI":"10.4046\/trd.2017.80.3.226","volume":"80","author":"YI Hwang","year":"2017","unstructured":"Hwang YI, Park YB, Yoo KH. Recent trends in the prevalence of chronic obstructive pulmonary disease in Korea. Tuberc Respir Dis (Seoul). 2017;80(3):226\u20139.","journal-title":"Tuberc Respir Dis (Seoul)"},{"issue":"2","key":"1621_CR4","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1164\/ajrccm.155.2.9032193","volume":"155","author":"EM Baarends","year":"1997","unstructured":"Baarends EM, Schols AM, Pannemans DL, Westerterp KR, Wouters EF. Total free living energy expenditure in patients with severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1997;155(2):549\u201354.","journal-title":"Am J Respir Crit Care Med"},{"issue":"6","key":"1621_CR5","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.1164\/ajrccm\/143.6.1248","volume":"143","author":"AM Schols","year":"1991","unstructured":"Schols AM, Soeters PB, Mostert R, Saris WH, Wouters EF. Energy balance in chronic obstructive pulmonary disease. Am Rev Respir Dis. 1991;143(6):1248\u201352.","journal-title":"Am Rev Respir Dis"},{"issue":"4","key":"1621_CR6","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1513\/pats.200707-092ET","volume":"5","author":"DA King","year":"2008","unstructured":"King DA, Cordova F, Scharf SM. Nutritional aspects of chronic obstructive pulmonary disease. Proc Am Thor Soc. 2008;5(4):519\u201323.","journal-title":"Proc Am Thor Soc"},{"issue":"6","key":"1621_CR7","doi-asserted-by":"publisher","first-page":"1504","DOI":"10.1183\/09031936.00070914","volume":"44","author":"AM Schols","year":"2014","unstructured":"Schols AM, Ferreira IM, Franssen FM, Gosker HR, Janssens W, Muscaritoli M, et al. Nutritional assessment and therapy in COPD: a European Respiratory Society statement. Eur Respir J. 2014;44(6):1504\u201320.","journal-title":"Eur Respir J"},{"issue":"8","key":"1621_CR8","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1016\/j.rmed.2004.09.024","volume":"99","author":"F Slinde","year":"2005","unstructured":"Slinde F, Gronberg A, Engstrom CP, Rossander-Hulthen L, Larsson S. Body composition by bioelectrical impedance predicts mortality in chronic obstructive pulmonary disease patients. Respir Med. 2005;99(8):1004\u20139.","journal-title":"Respir Med"},{"issue":"3","key":"1621_CR9","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1016\/j.rmed.2005.05.020","volume":"100","author":"R Hallin","year":"2006","unstructured":"Hallin R, Koivisto-Hursti UK, Lindberg E, Janson C. Nutritional status, dietary energy intake and the risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Respir Med. 2006;100(3):561\u20137.","journal-title":"Respir Med"},{"issue":"2","key":"1621_CR10","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1378\/chest.10-2521","volume":"140","author":"B Waschki","year":"2011","unstructured":"Waschki B, Kirsten A, Holz O, Muller KC, Meyer T, Watz H, et al. Physical activity is the strongest predictor of all-cause mortality in patients with COPD: a prospective cohort study. Chest. 2011;140(2):331\u201342.","journal-title":"Chest"},{"issue":"2","key":"1621_CR11","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1054\/clnu.2002.0618","volume":"22","author":"F Slinde","year":"2003","unstructured":"Slinde F, Ellegard L, Gronberg AM, Larsson S, Rossander-Hulthen L. Total energy expenditure in underweight patients with severe chronic obstructive pulmonary disease living at home. Clin Nutr. 2003;22(2):159\u201365.","journal-title":"Clin Nutr"},{"issue":"6","key":"1621_CR12","doi-asserted-by":"publisher","first-page":"e00150","DOI":"10.1002\/phy2.150","volume":"1","author":"N Farooqi","year":"2013","unstructured":"Farooqi N, Slinde F, Haglin L, Sandstrom T. Validation of SenseWear Armband and ActiHeart monitors for assessments of daily energy expenditure in free-living women with chronic obstructive pulmonary disease. Physiol Rep. 2013;1(6):e00150.","journal-title":"Physiol Rep"},{"key":"1621_CR13","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.2147\/COPD.S80616","volume":"10","author":"N Farooqi","year":"2015","unstructured":"Farooqi N, Slinde F, Carlsson M, Haglin L, Sandstrom T. Predicting energy requirement with pedometer-determined physical-activity level in women with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2015;10:1129\u201337.","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"issue":"6","key":"1621_CR14","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1016\/j.rmed.2011.01.004","volume":"105","author":"V Cavalheri","year":"2011","unstructured":"Cavalheri V, Donaria L, Ferreira T, Finatti M, Camillo CA, Cipulo Ramos EM, et al. Energy expenditure during daily activities as measured by two motion sensors in patients with COPD. Respir Med. 2011;105(6):922\u20139.","journal-title":"Respir Med"},{"issue":"5","key":"1621_CR15","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1183\/09031936.00134312","volume":"42","author":"RA Rabinovich","year":"2013","unstructured":"Rabinovich RA, Louvaris Z, Raste Y, Langer D, Van Remoortel H, Giavedoni S, et al. Validity of physical activity monitors during daily life in patients with COPD. Eur Respir J. 2013;42(5):1205\u201315.","journal-title":"Eur Respir J"},{"issue":"4","key":"1621_CR16","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1093\/ajcn\/83.4.735","volume":"83","author":"JE Morley","year":"2006","unstructured":"Morley JE, Thomas DR, Wilson MM. Cachexia: pathophysiology and clinical relevance. Am J Clin Nutr. 2006;83(4):735\u201343.","journal-title":"Am J Clin Nutr"},{"issue":"5","key":"1621_CR17","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1016\/S1470-2045(10)70218-7","volume":"12","author":"K Fearon","year":"2011","unstructured":"Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12(5):489\u201395.","journal-title":"Lancet Oncol"},{"issue":"7","key":"1621_CR18","doi-asserted-by":"publisher","first-page":"e0180928","DOI":"10.1371\/journal.pone.0180928","volume":"12","author":"LW Lee","year":"2017","unstructured":"Lee LW, Lin CM, Li HC, Hsiao PL, Chung AC, Hsieh CJ, et al. Body composition changes in male patients with chronic obstructive pulmonary disease: Aging or disease process? PLoS ONE. 2017;12(7):e0180928.","journal-title":"PLoS ONE"},{"issue":"3","key":"1621_CR19","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1513\/AnnalsATS.201307-229OC","volume":"11","author":"ML McDonald","year":"2014","unstructured":"McDonald ML, Diaz AA, Ross JC, Estepar R, Zhou L, Regan EA, et al. Quantitative computed tomography measures of pectoralis muscle area and disease severity in chronic obstructive pulmonary disease: a cross-sectional study. Ann Am Thorac Soc. 2014;11(3):326\u201334.","journal-title":"Ann Am Thorac Soc."},{"issue":"2","key":"1621_CR20","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1164\/ajrccm.158.2.9711023","volume":"158","author":"S Bernard","year":"1998","unstructured":"Bernard S, LeBlanc P, Whittom F, Carrier G, Jobin J, Belleau R, et al. Peripheral muscle weakness in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998;158(2):629\u201334.","journal-title":"Am J Respir Crit Care Med"},{"issue":"3","key":"1621_CR21","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1016\/j.rmed.2009.10.015","volume":"104","author":"R Guerri","year":"2010","unstructured":"Guerri R, Gayete A, Balcells E, Ramirez-Sarmiento A, Vollmer I, Garcia-Aymerich J, et al. Mass of intercostal muscles associates with risk of multiple exacerbations in COPD. Respir Med. 2010;104(3):378\u201388.","journal-title":"Respir Med"},{"issue":"3","key":"1621_CR22","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1513\/AnnalsATS.201507-446OC","volume":"13","author":"K Tanimura","year":"2016","unstructured":"Tanimura K, Sato S, Fuseya Y, Hasegawa K, Uemasu K, Sato A, et al. Quantitative Assessment of erector spinae muscles in patients with chronic obstructive pulmonary disease. Novel Chest Computed Tomography-derived Index for Prognosis. Ann Am Thorac Soc. 2016;13(3):334\u201341.","journal-title":"Ann Am Thorac Soc."},{"issue":"1","key":"1621_CR23","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1186\/s12931-019-1191-y","volume":"20","author":"SH Bak","year":"2019","unstructured":"Bak SH, Kwon SO, Han SS, Kim WJ. Computed tomography-derived area and density of pectoralis muscle associated disease severity and longitudinal changes in chronic obstructive pulmonary disease: a case control study. Respir Res. 2019;20(1):226.","journal-title":"Respir Res"},{"issue":"6","key":"1621_CR24","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1164\/rccm.2107031","volume":"166","author":"K Marquis","year":"2002","unstructured":"Marquis K, Debigare R, Lacasse Y, LeBlanc P, Jobin J, Carrier G, et al. Midthigh muscle cross-sectional area is a better predictor of mortality than body mass index in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2002;166(6):809\u201313.","journal-title":"Am J Respir Crit Care Med"},{"issue":"2","key":"1621_CR25","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.atherosclerosis.2007.12.038","volume":"200","author":"MY Tsai","year":"2008","unstructured":"Tsai MY, Johnson C, Kao WH, Sharrett AR, Arends VL, Kronmal R, et al. Cholesteryl ester transfer protein genetic polymorphisms, HDL cholesterol, and subclinical cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis. 2008;200(2):359\u201367.","journal-title":"Atherosclerosis"},{"issue":"7","key":"1621_CR26","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1002\/acr.22557","volume":"67","author":"LC Cleary","year":"2015","unstructured":"Cleary LC, Crofford LJ, Long D, Charnigo R, Clasey J, Beaman F, et al. Does computed tomography-based muscle density predict muscle function and health-related quality of life in patients with idiopathic inflammatory myopathies? Arthritis Care Res (Hoboken). 2015;67(7):1031\u201340.","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"1621_CR27","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1111\/j.1749-6632.2000.tb06416.x","volume":"904","author":"BH Goodpaster","year":"2000","unstructured":"Goodpaster BH, Thaete FL, Kelley DE. Composition of skeletal muscle evaluated with computed tomography. Ann N Y Acad Sci. 2000;904:18\u201324.","journal-title":"Ann N Y Acad Sci"},{"issue":"13","key":"1621_CR28","doi-asserted-by":"publisher","first-page":"R203","DOI":"10.1088\/0031-9155\/51\/13\/R13","volume":"51","author":"S Mattsson","year":"2006","unstructured":"Mattsson S, Thomas BJ. Development of methods for body composition studies. Phys Med Biol. 2006;51(13):R203\u201328.","journal-title":"Phys Med Biol"},{"issue":"6","key":"1621_CR29","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1111\/j.1475-097X.1992.tb00366.x","volume":"12","author":"TJ Overend","year":"1992","unstructured":"Overend TJ, Cunningham DA, Paterson DH, Lefcoe MS. Thigh composition in young and elderly men determined by computed tomography. Clin Physiol. 1992;12(6):629\u201340.","journal-title":"Clin Physiol"},{"issue":"2","key":"1621_CR30","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1159\/000182084","volume":"55","author":"DR Taaffe","year":"2009","unstructured":"Taaffe DR, Henwood TR, Nalls MA, Walker DG, Lang TF, Harris TB. Alterations in muscle attenuation following detraining and retraining in resistance-trained older adults. Gerontology. 2009;55(2):217\u201323.","journal-title":"Gerontology"},{"key":"1621_CR31","unstructured":"The Global Initiative for Chronic Obstructive Lung Disease. 2020 REPORT. https:\/\/goldcopd.org\/wp-content\/uploads\/2019\/11\/GOLD-2020-REPORT-ver1.0wms.pdf."},{"issue":"4","key":"1621_CR32","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1016\/j.resinv.2014.03.003","volume":"52","author":"M Kubota","year":"2014","unstructured":"Kubota M, Kobayashi H, Quanjer PH, Omori H, Tatsumi K, Kanazawa M. Reference values for spirometry, including vital capacity, in Japanese adults calculated with the LMS method and compared with previous values. Respir Invest. 2014;52(4):242\u201350.","journal-title":"Respir Invest"},{"issue":"1\u20132","key":"1621_CR33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1113\/jphysiol.1949.sp004363","volume":"109","author":"JB Weir","year":"1949","unstructured":"Weir JB. New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol. 1949;109(1\u20132):1\u20139.","journal-title":"J Physiol"},{"issue":"1","key":"1621_CR34","first-page":"e000648","volume":"7","author":"K Morino","year":"2019","unstructured":"Morino K, Kondo K, Tanaka S, Nishida Y, Nakae S, Yamada Y, et al. Total energy expenditure is comparable between patients with and without diabetes mellitus: Clinical Evaluation of Energy Requirements in Patients with Diabetes Mellitus (CLEVER-DM) Study. BMJ Open Diabetes Res Care. 2019;7(1):e000648.","journal-title":"BMJ Open Diabetes Res Care"},{"issue":"4","key":"1621_CR35","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1079\/BJN19950059","volume":"73","author":"DL Pannemans","year":"1995","unstructured":"Pannemans DL, Westerterp KR. Energy expenditure, physical activity and basal metabolic rate of elderly subjects. Br J Nutr. 1995;73(4):571\u201381.","journal-title":"Br J Nutr"},{"issue":"1","key":"1621_CR36","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1186\/s12931-018-0771-6","volume":"19","author":"AA Diaz","year":"2018","unstructured":"Diaz AA, Martinez CH, Harmouche R, Young TP, McDonald ML, Ross JC, et al. Pectoralis muscle area and mortality in smokers without airflow obstruction. Respir Res. 2018;19(1):62.","journal-title":"Respir Res"},{"issue":"7","key":"1621_CR37","doi-asserted-by":"publisher","first-page":"1576","DOI":"10.1183\/09031936.97.10071576","volume":"10","author":"R Shoup","year":"1997","unstructured":"Shoup R, Dalsky G, Warner S, Davies M, Connors M, Khan M, et al. Body composition and health-related quality of life in patients with obstructive airways disease. Eur Respir J. 1997;10(7):1576\u201380.","journal-title":"Eur Respir J"},{"issue":"9","key":"1621_CR38","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1053\/rmed.2000.0829","volume":"94","author":"R Mostert","year":"2000","unstructured":"Mostert R, Goris A, Weling-Scheepers C, Wouters EF, Schols AM. Tissue depletion and health related quality of life in patients with chronic obstructive pulmonary disease. Respir Med. 2000;94(9):859\u201367.","journal-title":"Respir Med"},{"issue":"5","key":"1621_CR39","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1097\/00002060-199909000-00009","volume":"78","author":"T Fujiwara","year":"1999","unstructured":"Fujiwara T, Hara Y, Chino N. Expiratory function in complete tetraplegics: study of spirometry, maximal expiratory pressure, and muscle activity of pectoralis major and latissimus dorsi muscles. Am J Phys Med Rehabil. 1999;78(5):464\u20139.","journal-title":"Am J Phys Med Rehabil"},{"key":"1621_CR40","first-page":"263","volume-title":"Physiologic basis of respiratory disease","author":"A Troyer","year":"2005","unstructured":"Troyer A. Actions of the respiratory muscles. In: Hamid Q, Shannon J, Martin J, editors. Physiologic basis of respiratory disease. Hamilton: BC Decker; 2005. p. 263\u201375."}],"container-title":["Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12931-021-01621-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12931-021-01621-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12931-021-01621-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T19:03:40Z","timestamp":1610737420000},"score":1,"resource":{"primary":{"URL":"https:\/\/respiratory-research.biomedcentral.com\/articles\/10.1186\/s12931-021-01621-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,15]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1621"],"URL":"https:\/\/doi.org\/10.1186\/s12931-021-01621-2","relation":{},"ISSN":["1465-993X"],"issn-type":[{"value":"1465-993X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,15]]},"assertion":[{"value":"9 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the Ethics Committees of Saitama Medical University Hospital, Keio University and National Institutes of Biomedical Innovation, Health and Nutrition, and informed consent was obtained from each subject.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"18"}}