Here is the design of a clinical trial:

Official Title: Effects of Inspiratory Muscle Training and Neuromuscular Electrical Stimulation in Patients With Chronic Obstructive Pulmonary Disease

Included conditions:
- Chronic Obstructive Pulmonary Disease

Study Armgroups:
- {'label': 'Multimodal training', 'type': 'EXPERIMENTAL', 'description': 'IMT + NMES + Pulmonary Rehabilitation\n\nIMT will be performed using a device with linear load pressure (POWERbreathe Medic Plus ®, SP, BR).\n\nNMES will be applied using an calibrated electrical stimulator (Neurodyn High Volt, IBRAMED, São Paulo/São Paulo, Brazil).\n\nPulmonary Rehabilitation: The physical training part of pulmonary rehabilitation will consist of aerobic and resistance exercise.', 'interventionNames': ['Device: Multimodal training']}
- {'label': 'IMT + Pulmonary Rehabilitation', 'type': 'EXPERIMENTAL', 'description': 'IMT will be performed using a device with linear load pressure (POWERbreathe Medic Plus ®, SP, BR).\n\nPulmonary Rehabilitation: The physical training part of pulmonary rehabilitation will consist of aerobic and resistance exercise.', 'interventionNames': ['Device: IMT + Pulmonary Rehabilitation']}
- {'label': 'NMES + Pulmonary Rehabilitation', 'type': 'EXPERIMENTAL', 'description': 'NMES will be applied using an calibrated electrical stimulator (Neurodyn High Volt, IBRAMED, São Paulo/São Paulo, Brazil).\n\nPulmonary Rehabilitation: The physical training part of pulmonary rehabilitation will consist of aerobic and resistance exercise.', 'interventionNames': ['Device: NMES + Pulmonary Rehabilitation']}
- {'label': 'Pulmonary Rehabilitation', 'type': 'PLACEBO_COMPARATOR', 'description': 'Pulmonary Rehabilitation: The physical training part of pulmonary rehabilitation will consist of aerobic and resistance exercise.', 'interventionNames': ['Device: Pulmonary Rehabilitation']}

Interventions:
- {'type': 'DEVICE', 'name': 'Multimodal training', 'description': 'IMT will be performed using the POWERbreathe® Medic Plus inspiratory training device for five sets of 10 repetitions each, with a one-minute interval between each set. The initial load set will be 30% of maximal inspiratory pressure (MIP), during the first two weeks to allow for an adjustment period. The IMT wil be performed two times per week for 8 weeks.\n\nNMES will be applied using an calibrated electrical stimulator (Neurodyn High Volt, IBRAMED, São Paulo/São Paulo, Brazil). The following parameters will be used: 50 Hz frequency, pulse duration of 400 µs, work cycle of 5 seconds ON and 15 seconds OFF (first month) adjusted for 10 seconds ON and 30 seconds OFF (second month) and maximum intensity tolerated during 2 times per week for 8 weeks.\n\nPulmonary Rehabilitation The pulmonary rehabilitation will consist of aerobic and resistance exercise during 8 weeks.', 'armGroupLabels': ['Multimodal training']}
- {'type': 'DEVICE', 'name': 'IMT + Pulmonary Rehabilitation', 'description': 'IMT will be performed using the POWERbreathe® Medic Plus (POWERbreathe Medic Plus ®, SP, BR) inspiratory training device for five sets of 10 repetitions each, with a one-minute interval between each set. The initial load set will be 30% of maximal inspiratory pressure (MIP), during the first two weeks to allow for an adjustment period. After that, load increases occurred as follows: 35% of MIP in week 3, 40% of MIP in week 4, 45% of MIP in week 5, 50% of MIP at week 6, 55% of MIP in week 7, and 60% of MIP in weeks 8.\n\nPulmonary Rehabilitation The pulmonary rehabilitation will consist of aerobic and resistance exercise during 8 weeks.', 'armGroupLabels': ['IMT + Pulmonary Rehabilitation']}
- {'type': 'DEVICE', 'name': 'NMES + Pulmonary Rehabilitation', 'description': 'NMES will be applied using an calibrated electrical stimulator (Neurodyn High Volt, IBRAMED, São Paulo/São Paulo, Brazil). The following parameters will be used: 50 Hz frequency, pulse duration of 400 µs, work cycle of 5 seconds ON and 15 seconds OFF (first month) adjusted for 10 seconds ON and 30 seconds OFF (second month) and maximum intensity tolerated during 2 times per week for 8 weeks.\n\nPulmonary Rehabilitation The pulmonary rehabilitation will consist of aerobic and resistance exercise during 8 weeks.', 'armGroupLabels': ['NMES + Pulmonary Rehabilitation']}
- {'type': 'DEVICE', 'name': 'Pulmonary Rehabilitation', 'description': 'Pulmonary Rehabilitation The pulmonary rehabilitation will consist of aerobic and resistance exercise during 8 weeks.', 'armGroupLabels': ['Pulmonary Rehabilitation']}

Primary Outcomes:
- {'measure': 'Static postural balance', 'description': 'Static postural balance will be assessed on a portable force platform (AccuSway Plus, AMTI®, MA, USA) using the center of pressure displacement amplitude in the anteroposterior direction (COP) (cm).', 'timeFrame': 'Post-intervention (change after 8 weeks of training)'}
- {'measure': 'Static postural balance', 'description': 'Static postural balance will be assessed on a portable force platform (AccuSway Plus, AMTI®, MA, USA) using the area of ellipse (AE) (cm2).', 'timeFrame': 'Post-intervention (change after 8 weeks of training)'}
- {'measure': 'Static postural balance', 'description': 'Static postural balance will be assessed on a portable force platform (AccuSway Plus, AMTI®, MA, USA) using the velocity of displacement of center of pressure (COPvel) (cm/s).', 'timeFrame': 'Post-intervention (change after 8 weeks of training)'}
- {'measure': 'Static postural balance', 'description': 'Static postural balance will be assessed on a portable force platform (AccuSway Plus, AMTI®, MA, USA) using the center of area of pressure and area of ellipse (AE) (cm2).', 'timeFrame': 'Post-intervention (change after 8 weeks of training)'}

Please estimate the sample size based on the assumption: 
p value <0.05, power of 80%, and loss of 20%
Sample size {14}
        Based on the data from a previous study, performed by Mekki et al. [13] (n=45 participants, conducted in Tunisia), it will be necessary in a minimum sample size of 10 individuals per group and a total of 40 patients, considering the variable of mean lateral displacement of the pressure center mid-lateral displacement amplitude (COPml) in the follow-up of the intervention group, which performed NMES associated with PR program (Â±12.1 mm) and the control group that only performed standard PR (Â±7.2 mm). We also considered p value <0.05, power of 80% and loss of 20%.