Obstructive Airways DiseaseSkeletal Muscle Dysfunction and Pulmonary Rehabilitation in COPDKon, Samantha S. C., BSc, MBBS, MRCP; Man, William D-C., MBBS, MRCP, PhDAuthor Information NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust and Imperial College London, London, UK S.S.K. is funded by the Medical Research Council (MRC), UK. W.D.C.M. is funded by a National Institute for Health Research Clinician Scientist award and a MRC New Investigator Research Grant. The views expressed in this review are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, the Department of Health, or the MRC. The authors declare that they have nothing to disclose. Address Correspondence to: Samantha S. C. Kon, BSc, MBBS, MRCP, Department of Respiratory Medicine Harefield Hospital, Hill End Road, Harefield UB9 6JH, UK. E-mail: firstname.lastname@example.org. Clinical Pulmonary Medicine: July 2012 - Volume 19 - Issue 4 - p 153-158 doi: 10.1097/CPM.0b013e31825d59fe Buy Metrics Abstract Chronic obstructive pulmonary disease (COPD) is now well recognized as a systemic disorder. Apart from the lungs, the musculoskeletal system is one of the most frequently affected organs. Skeletal muscle dysfunction contributes independently to symptoms, impaired health status, increased health care resource usage, and reduced survival. Pulmonary impairment is largely irreversible and therefore the skeletal muscles represent a potential site to improve functioning and symptoms in patients with COPD. The etiology of skeletal muscle dysfunction in COPD is probably multifactorial with varying contributions from physical inactivity, systemic inflammation, hormone imbalance, tissue hypoxia, nutritional abnormalities, oxidative stress, genetic susceptibility, and chronic corticosteroid use. Exercise training is effective at reversing skeletal muscle dysfunction, and pulmonary rehabilitation, a largely exercise-based intervention, has become a cornerstone in the management of COPD. This article summarizes the structural and functional characteristics of skeletal muscle dysfunction in COPD, reviews the possible contributing factors, and describes the effect of pulmonary rehabilitation on skeletal muscle structure and function. © 2012 Lippincott Williams & Wilkins, Inc.