Introduction: Chronic obstructive pulmonary disease (COPD) is third cause of chronic morbidity and mortality in the world until 2020. Patients with COPD often complain of dyspnea and fatigue in exercise intolerance, also significantly impede quality of life in them. Patients with respiratory chronic airway disease present systemic consequences that alter muscle function and mass, which are attributed to factors such as systemic inflammation, hypoxia, atrophy of type I and IIa muscle fibers, reduced fiber capillarization and oxidative enzyme capacity. In a study mentioned that muscle weakness special in muscle major femoral and leg is multi and importance factorial, disuse is likely to be the major reversible factor with loss of strength most pronounced in the muscles of locomotion and performance that COPD patients used of that for more daily activities.
Extra pulmonary effects: COPD is a multicomponent disease characterized by pulmonary and systemic inflammation. The origin of the latter is unclear and probably multifactorial. It is likely to be a major contributor to the pathobiology of many (if not all) of the extra pulmonary effects in COPD, including skeletal muscle atrophy and dysfunction and cardiovascular disease. Available evidence suggests that systemic inflammation in COPD can be reduced by steroid therapy (both oral and inhaled). The potential effects of this observation on clinically relevant outcomes in these patients (e.g., mortality, health status) remain to be demonstrated, but open a new avenue to improve the therapy and care of patients with this devastating disease.
Pulmonary rehabilitation: Pulmonary rehabilitation has clearly been demonstrated to reduce dyspnea and hospital length of stay, increase exercise capacity and improve quality of life in these patients, and is indicated for persons who remain symptomatic despite optimal pharmacological therapy. Exercise training, nutritional support, education and behavior change and techniques to improve self-management and physiological support are therapies frequently included in pulmonary rehabilitation programs. That is based on an assessment of the integrated health status of the individual patient, and addresses and treats systemic effects and comorbidities of the disease.
Conclusion: The clinical relevance of these systemic effects has been recently recognized; however, many important questions about its pathophysiology remain unanswered. We will review what is known about it and, more importantly, highlights what is not (but should be) known in order to stimulate research in this area, in the hope that a better understanding of this field may lead to better treatment options for patients with COPD.