Article information
Resumen
La función muscular se halla frecuentamente afectada en los pacientes con enfermedad pulmonar obstructiva crónica (EPOC), lo cual condiciona su semiología y pronóstico. La distribución y la gravedad de esta disfunción son heterogéneas, por lo que sus causas predominantes parecen en parte específicas del grupo muscular examinado. Es el caso de la sobreactividad y una geometría desfavorable características de los músculos respiratorios, frente a la relativa inactividad de los músculos de las extremidades. También hay factores que serían comunes a todos los músculos del organismo. Entre ellos destacarían la inflamación sistémica, las alteraciones nutricionales, el uso de determinados fármacos, la hipoxia y la presencia de comorbilidad y/o edad avanzada. Sin embargo, mientras que los músculos respiratorios muestran un fenotipo adaptado a su situación desfavorable, y llegan a compensarla parcialmente, los músculos de las extremidades muestran cambios de tipo involutivo, que contribuirían a la disfunción. Por tanto, aunque la pérdida funcional puede aparecer en diferentes territorios musculares, sus causas, y por tanto sus enfoques terapéuticos, serán diversos, incluidos el soporte nutricional, el entrenamiento y/o el reposo, según los casos.
Palabras clave:
EPOC
Disfunción muscular
Músculos ventilatorios
Músculos de las extremidades
Rehabilitación
Abstract
Muscle function is frequently affected in patients with chronic obstructive pulmonary disease (COPD), influencing the symptoms and prognosis of this disease. The distribution and severity of this dysfunction are heterogeneous and therefore the main causes seem, in part, to be specific to the muscular group examined, which is the case of the overactivity and unfavorable geometry characteristic of respiratory muscles, compared with the relative inactivity of the muscles of the limbs.
There are also factors that are common to all the muscles in the body. Notable among these factors are systemic inflammation, nutritional alterations, the use of certain drugs, hypoxia and the presence of comorbidity and/or advanced age. However, while the respiratory muscles show a phenotype adapted to their unfavorable situation and manage to partially compensate for this situation, the muscles of the limbs show involutive changes, which contribute to dysfunction. Therefore, although functional loss can develop in distinct muscular territories, the causes – and consequently the therapeutic approaches – differ, including nutritional support, muscle training and/or rest, depending on the muscle.
Key words:
COPD
Muscular dysfunction
Ventilatory muscles
Muscles of the extremities
Rehabilitation
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