Peripheral muscle dysfunction in chronic obstructive pulmonary disease

As their life expectancy has been prolonged with improved medical care, pat ients with chronic obstructive pulmonary disease (COPD) frequently develop systemic complications of their disease. These complications include osteop orosis, depression, and peripheral muscle dysfunction(2) characterized by a trophy, weakness, and low oxidative capacity. These muscle changes have bee n associated with exercise intolerance,(44) poor quality of life(115) and r educed survival,(108) (127) which occur independently of the impairment in lung function. Physicians dealing with patients with advanced COPD face the challenge of finding innovative ways to improve their patients' level of f unction despite the irreversible impairment of the primarily diseased organ . In this article, the evidence for peripheral muscle dysfunction in patien ts with COPD and the possible clinical implications of this problem are dis cussed. The available therapeutic options for improving peripheral muscle f unction are also considered.