title: Guidelines for the evaluation and treatment of muscle dysfunction in patients with chronic obstructive pulmonary disease.
abstract: In patients with chronic obstructive pulmonary disease (COPD), skeletal muscle dysfunction is a major comorbidity that negatively impacts their exercise capacity and quality of life. In the current guidelines, the most recent literature on the various aspects of COPD muscle dysfunction has been included. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) scale has been used to make evidence-based recommendations on the different features. Compared to a control population, one third of COPD patients exhibited a 25% decline in quadriceps muscle strength, even at early stages of their disease. Although both respiratory and limb muscles are altered, the latter are usually more severely affected. Numerous factors and biological mechanisms are involved in the etiology of COPD muscle dysfunction. Several tests are proposed in order to diagnose and evaluate the degree of muscle dysfunction of both respiratory and limb muscles (peripheral), as well as to identify the patients' exercise capacity (six-minute walking test and cycloergometry). Currently available therapeutic strategies including the different training modalities and pharmacological and nutritional support are also described.
authors.affiliation: Servei de Pneumologia, Unitat de Recerca en Múscul i Aparell Respiratori (URMAR), IMIM-Hospital del Mar, CEXS, Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona (PRBB), Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España. Electronic address: ebarreiro@imim.es.
authors.forename: Esther
authors.initials: E
authors.lastname: Barreiro
authors.affiliation: Hospital Universitario Basurto, Osakidetza, Departamento de Medicina, Universidad del País Vasco, Bilbao, España; Servicio de Neumología y Unidad de Investigación, Hospital de Cruces, Universidad del País Vasco , Barakaldo, España.
authors.forename: Víctor
authors.initials: V
authors.lastname: Bustamante
authors.affiliation: Servicio de Neumología y Unidad de Investigación, Hospital de Cruces, Universidad del País Vasco , Barakaldo, España.
authors.forename: Pilar
authors.initials: P
authors.lastname: Cejudo
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España; Hospital Universitario Basurto, Osakidetza, Departamento de Medicina, Universidad del País Vasco, Bilbao, España.
authors.forename: Juan B
authors.initials: JB
authors.lastname: Gáldiz
authors.affiliation: Servei de Pneumologia, Unitat de Recerca en Múscul i Aparell Respiratori (URMAR), IMIM-Hospital del Mar, CEXS, Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona (PRBB), Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gea
authors.affiliation: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: Pilar
authors.initials: P
authors.lastname: de Lucas
authors.affiliation: Servei de Pneumologia, Unitat de Recerca en Múscul i Aparell Respiratori (URMAR), IMIM-Hospital del Mar, CEXS, Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona (PRBB), Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España.
authors.forename: Juana
authors.initials: J
authors.lastname: Martínez-Llorens
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España; Servicio de Neumología y Unidad de Investigación, Hospital de Cruces, Universidad del País Vasco , Barakaldo, España.
authors.forename: Francisco
authors.initials: F
authors.lastname: Ortega
authors.affiliation: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: Luis
authors.initials: L
authors.lastname: Puente-Maestu
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España; Servicio de Neumología, Hospital General Gregorio Marañón, Universidad Complutense de Madrid, Madrid, España; Servei de Pneumologia, Hospital Clínic de Barcelona, Barcelona, España.
authors.forename: Josep
authors.initials: J
authors.lastname: Roca
authors.affiliation: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Rodríguez-González Moro
mesh_terms: D001945:Breathing Exercises; D017097:Electric Impedance; D004568:Electrodiagnosis; D019317:Evidence-Based Medicine; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D054439:Ghrelin / Q000627:therapeutic use; D018737:Hand Strength; D006371:Helium / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000628:therapy; D018908:Muscle Weakness / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy*; D018529:Nutritional Support; D010100:Oxygen / Q000627:therapeutic use; D010807:Physical Endurance; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D011788:Quality of Life; D012132:Respiratory Muscles / Q000503:physiopathology; D013147:Spirometry; D013256:Steroids / Q000627:therapeutic use
chemical_list: D054439:Ghrelin; D013256:Steroids; D019382:Human Growth Hormone; D006371:Helium; C038949:heliox; D010100:Oxygen
keywords: Chronic obstructive pulmonary disease; Disfunción muscular; Enfermedad pulmonar obstructiva crónica; Guía española; Muscle dysfunction; Spanish guidelines