Targeting Limb Muscle Dysfunction in COPD

Abstract

Chronic obstructive pulmonary disease (COPD), is today one of the world’s most common chronic diseases, estimated by the World Health Organization to be the third leading cause of death worldwide by the year 2030. An often neglected aspect of COPD is that the course of the disease is linked to extrapulmonary manifestations that are currently not dealt with optimally, but that has a direct and substantial impact on the condition. Limb muscle dysfunction, at the functional level defined as the reduction of either strength or endurance (or both) properties of the muscle, is highly prevalent in COPD, closely linked to critical clinical and prognostic out- comes including functional status, quality of life, and even mortality. If the goal is to improve limb muscle function among people with COPD is exercise training recommended before other treatment modalities, highly prioritized in international guidelines. In this chapter, why and how to assess and manage limb muscle dysfunction among people with COPD will be targeted, highlighting the vital role of physical therapy and the physiotherapist. encompasses several manifestations including, muscle atrophy and and to which both structural and muscle adapta that in Exercise training, and resistance training in particular, is the most efficacious approach to ameliorate limb muscle dysfunction among people with COPD, with the latter resulting in the most substantial improvements in limb mus cle mass and function. However, COPD limb muscle is characterized by a large heterogeneity of muscle phenotypes and muscle dysfunction, stressing the importance of identifying those specific factors that should be considered in the development of individualized resistance training programs among people with COPD. Thus, no single intervention is sufficient to target all aspects of limb muscle dysfunction in the disease. To achieve intramuscular adaptations, exercise intensity seems to be an important factor, and high intensity interval training seems to be the most promising approach. Lastly, irrespective of exercise training modality, general exercise principles and acute program variables should always be incorporated when designing the exercise program. cross-sectional area is a better predictor of mortality than body mass index in patients