Skeletal muscle dysfunction in chronic obstructive pulmonary disease

Skeletal muscle dysfunction in chronic obstructive pulmonary disease. Med. Sci. Sports Exerc., Vol. 33. No. 7, Suppl., pp. S662-S670. 2001. Chronic ob structive pulmonary disease (COPD) is a major health care problem. Formerly mainly a disease of men, women are increasingly frequently afflicted. In m any of these patients, exercise intolerance is the chief complaint. Few eff ective therapies are available. In recent years, dysfunction of the muscles of ambulation has been identified as a source of a portion of the exercise intolerance these patients experience, and this dysfunction has been shown to be, at least in part, remediable. Mechanisms inducing muscle dysfunctio n include disuse atrophy, malnutrition, low levels of anabolic steroids, an d myopathy from corticosteroid use. Endurance exercise training has been co nclusively demonstrated to improve exercise tolerance in COPD. Recent studi es suggest that strength training is beneficial as well. A new frontier of therapy for muscle dysfunction in COPD is the use of anabolic hormones. Tes tosterone supplementation has been shown to increase muscle mass and streng th in both hypogonadal and eugonodal healthy men. Low-dose testosterone sup plementation is being considered for use in postmenopausal women. Though sh ort-term administration of testosterone in moderate doses seems to be well tolerated in both men and women, further studies are required before safety and effectiveness can be established for routine use in COPD patients.