Skeletal muscle dysfunction in chronic obstructive pulmonary disease

Skeletal muscle dysfunction is considered to be one of the key systemic co-morbidities in chronic obstructive pulmonary disease (COPD) influencing exercise capacity and quality of life. The loss of skeletal muscle bulk and skeletal muscle strength are now recognised as important predictors of mortality in this patient group. The mechanisms involved in the development of muscle weakness are likely to be multifactorial, and systemic factors including inflammation and oxidative stress are thought to interact with local factors such as muscle inactivity. A greater understanding of the molecular pathways involved in muscle weakness may provide target areas for future treatments as an adjunct to pulmonary rehabilitation, which remains the mainstay of current therapy. Further research is required to increase and sustain the benefits of pulmonary rehabilitation and to develop novel interventions for this chronic, debilitating condition.