Abstract

Chronic obstructive pulmonary disease (COPD) is a systemic condition that not only affects the lungs but also results in significant extrapulmonary manifestations, including skeletal muscle dysfunction, malnutrition, and reduced exercise tolerance. These systemic effects are particularly pronounced in patients with moderate-to-severe disease, often leading to physical deconditioning, fatigue, and diminished quality of life. Pulmonary rehabilitation (PR), consisting primarily of structured exercise and education, is well-established in improving exercise capacity and symptom control.