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Editorials |

Treating the Exercise Problem in COPDTreating the Exercise Problem in COPD

Michael C. Steiner, MBBS; Neil J. Greening, MBBS
Author and Funding Information

From the Leicester Respiratory Biomedical Research Unit (Prof Steiner and Dr Greening), University Hospitals of Leicester NHS Trust; and School of Sport, Exercise and Health Sciences (Prof Steiner), Loughborough University.

CORRESPONDENCE TO: Michael C. Steiner, MBBS, Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, LE3 9QP, England; e-mail: michael.steiner@uhl-tr.nhs.uk


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(4):878-880. doi:10.1378/chest.14-0654
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Extract

The inability to be physically active is one of the key complaints expressed by patients with COPD. This is best considered as an exercise problem because it is the quantitative restriction to physical capacity more than the sensation of breathlessness or fatigue during exercise (something we all experience) that is the abnormal symptom. There is now a convincing body of evidence indicating that skeletal muscle dysfunction is a frequent and clinically relevant feature of COPD that contributes significantly to reduced exercise performance and, indeed, mortality independently from the severity of lung function impairment.1 The cause of this dysfunction has been debated, but a long-term downward spiral of inactivity and deconditioning is the key feature of its natural history, although other disease-related factors (eg, hypoxia, drug therapy, systemic inflammation) may contribute in selected patients.

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