Before and after an @-wk intervention , measurements were taken for dynamic inspiratory muscle function and inspiratory muscle endurance using a weighted plunger pressure-threshold loading device ; diaphragm thickness by using B-mode ultrasonography ; plasma cytokine concentrations by using immunoassays ; DNA damage levels in peripheral blood mononuclear cells by using comet assays ; spirometry , maximal mouth pressures , and exercise performance by using a @-min walk test ; PAL by using a questionnaire and accelerometry ; and QoL using a questionnaire .