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Assessing the effects\u00a0of inspiratory muscle training\u00a0in a\u00a0patient with unilateral diaphragm\u00a0dysfunction. Breathe (Sheff). 2019, 15:e90-6. 10.1183\/20734735.0129-2019","journal-title":"Breathe (Sheff)"},{"key":"ref95","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd11110351","article-title":"Effects of respiratory muscle training pre- and post-cardiac surgery in adults: a scoping review","volume":"11","author":"Starko G","year":"2024","unstructured":"Starko G, M\u00fcller D, Lipka A, Feiereisen P, Corbellini C, Abreu RM. Effects of respiratory muscle training pre- and post-cardiac surgery in adults: a scoping review. J Cardiovasc Dev Dis. 2024, 11:351. 10.3390\/jcdd11110351","journal-title":"J Cardiovasc Dev Dis"},{"key":"ref96","article-title":"Incentive spirometer and inspiratory muscle training","author":"Franklin E","year":"2026","unstructured":"Franklin E, Anjum F. Incentive spirometer and inspiratory muscle training. StatPearls [Internet]. 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