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This study aimed to elucidate the utility of DE\n                      <jats:sub>max<\/jats:sub>\n                      to predict the improvement in exercise tolerance after pulmonary rehabilitation (PR) in patients with COPD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a prospective cohort study. Of the 62 patients with stable COPD who participated in the outpatient PR programme from April 2018 to February 2021, 50 completed the programme. Six-minute walk distance (6MWD) was performed to evaluate exercise tolerance, and ultrasonography was performed to measure DE\n                      <jats:sub>max<\/jats:sub>\n                      . Responders to PR in exercise capacity were defined as patients who demonstrated an increase of\u2009&gt;\u200930\u00a0m in 6MWD. The receiver operating characteristic (ROC) curve was used to determine the cut-off point of DE\n                      <jats:sub>max<\/jats:sub>\n                      to predict responses to PR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline levels of forced expiratory volume in 1\u00a0s, 6MWD, maximum inspiratory pressure, DE\n                      <jats:sub>max<\/jats:sub>\n                      and quadriceps muscle strength were significantly higher, and peak dyspnoea of modified Borg (mBorg) scale score was lower in responders (n\u2009=\u200930) than in non-responders (n\u2009=\u200920) to PR (p\u2009&lt;\u20090.01). In multivariate analysis, DE\n                      <jats:sub>max<\/jats:sub>\n                      was significantly correlated with an increase of\u2009&gt;\u200930\u00a0m in 6MWD. The area under the ROC curve of DE\n                      <jats:sub>max<\/jats:sub>\n                      to predict responders was 0.915, with a sensitivity and specificity of 83% and 95%, respectively, at a cut-off value of 44.9\u00a0mm of DE\n                      <jats:sub>max<\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      DE\n                      <jats:sub>max<\/jats:sub>\n                      could adequately predict the improvement in exercise tolerance after PR in patients with COPD.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12931-021-01870-1","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T07:03:42Z","timestamp":1634886222000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Diaphragmatic excursion is correlated with the improvement in exercise tolerance after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5410-1331","authenticated-orcid":false,"given":"Masashi","family":"Shiraishi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Higashimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuji","family":"Sugiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Mizusawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Takeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhei","family":"Fujita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Nishiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintarou","family":"Kudo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamotsu","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutaka","family":"Chiba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanji","family":"Fukuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Tohda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisako","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,22]]},"reference":[{"key":"1870_CR1","unstructured":"Global initiative for chronic obstructive lung disease (gold). 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