Chronic obstructive pulmonary disease (COPD) is increasingly recognized as a multisystem disorder in which extrapulmonary manifestations substantially contribute to disease burden. Among these, skeletal muscle dysfunction (SMD) represents a major determinant of exercise intolerance, reduced physical activity, impaired quality of life, and mortality. Growing evidence suggests that physical inactivity is not merely a consequence of advanced COPD but may act as an early and potentially modifiable driver of skeletal muscle deterioration, being detectable even in patients with mild disease and potentially preceding clinically relevant airflow limitation.
